Can Breathing Exercises Help Manage Acid Reflux?

Your lower esophageal sphincter (LES) is a muscular ring that connects your esophagus with your stomach. It relaxes to let food pass through but otherwise stays closed to prevent stomach acid from coming back up your throat, according to the Cleveland Clinic.

If you want to try easing the discomfort of heartburn and other symptoms of acid reflux naturally, strengthening your LES might bring you some relief. Read on to learn more about how LES breathing exercises might help with symptoms of gastrointestinal reflux disease (GERD), such as heartburn.

About the LES and GERD

“The goal of the lower esophageal sphincter is to open up when you swallow, let the food go down through the esophagus and into the stomach, and then close to serve as a blocker against reflux,” explains Michael S. Smith, MD, associate system chief of gastroenterology for the Mount Sinai Health System in New York City. “Other than when you’re going through a swallow, the sphincter is supposed to stay shut.”

GERD typically occurs when the LES doesn’t properly stay closed and stomach acids come back up into your esophagus from your stomach, according to Mount Sinai. The LES may become overly relaxed due to several factors, according to Harvard Health, including:

• Trigger foods such as peppermint, caffeinated beverages, whole milk, fatty foods, and chocolate
• Smoking
• Alcoholic beverages
• Certain medications
• Abdominal pressure from obesity or pregnancy
• Hiatal hernia (when the stomach protrudes into the diaphragm)

This may lead to typical GERD symptoms, such as burning in the chest (aka heartburn) and regurgitation of food or liquid in the throat, as well as to possible trouble swallowing or a lump in your throat, according to the Mayo Clinic.

About 20 percent of Americans experience GERD, per the National Institute of Diabetes and Digestive and Kidney Diseases.

Breathing Exercises for GERD

Though many people may turn to medication like proton pump inhibitors to help relieve their heartburn symptoms, breathing exercises to strengthen your LES may help as well.

The exercises typically focus on teaching you to breathe from your diaphragm, according to a recent research review. Your diaphragm is a dome-shaped organ that supports deep breathing, according to the Center for Digestive Diseases. It also plays an important role in what’s known as your anti-reflux barrier, according to the research review.

Over time, your posture and body mechanics can affect your diaphragm. But it’s possible to reeducate the body so that the diaphragm and, in turn, the LES work better, says Nefarati Ellis-Marin, DPT, a physical therapist with Brooklyn Health Physical Therapy in Brooklyn, New York.

Research seems to support the benefit of diaphragm-focused breathing exercises, too.

According to the recent research review, strengthening your diaphragm may improve the function of your anti-reflux barrier as a whole. A meta-analysis of randomized controlled trials and prospective studies also found that breathing exercises can improve the pressure created by the LES and, to some extent, relieve GERD symptoms.

In a recent small clinical trial, participants with GERD performed a five-minute breathing exercise five times per day for four weeks, while participants in a control group performed an exercise that had no effect on the LES. At the end of the study, the people who did the breathing exercise reported using their proton pump inhibitor less often and said they had an improvement in quality of life.

An older review of studies also suggests that breathing exercises involving the diaphragm could help with chronic acid reflux.

However, more large-scale research needs to be done to further test and confirm these findings as well as determine which types of exercises work best for different types of GERD.

Exercises to Try

Now that you understand how and why these exercises may work, you’re likely wondering whether you can try them at home.

The short answer is yes. The longer answer is that you likely want to first check in with your doctor for a full workup and diagnosis or with a physical therapist who can give you advice suitable for your specific situation.

A physical therapist can look at the position of your diaphragm and your ribs to see how everything is aligned and then suggest exercises, such as deep breathing (also called belly breathing), done either lying down or standing, and show you how to engage the stomach muscles, Dr. Ellis-Marin says.

The physical therapist can also help you perform some exercises, such as by manually adjusting your chest to help it remain in the correct position and allow you to focus on the diaphragm instead, according to the research review mentioned earlier.

“Because there isn’t a lot of research, it can be trial and error with each patient,” Ellis-Marin says. Working with a trained physical therapist will help you learn the correct techniques for your situation, she says.

If you don’t have access to a physical therapist or just want to get started at home, here are a few exercises you can try on your own, according to the Center for Digestive Diseases:

• Breathing With Proper Posture Stand straight and relax your shoulders, placing your hands on your abdomen, one on top of the other. Take a deep breath, feeling your stomach and rib cage expand, and then breathe out while consciously tightening your stomach muscles. This can help you learn to breathe deeply from your diaphragm rather than shallowly from your chest.
• Deep Breathing While Lying Down Lie flat on your back and place a book or other light object on your stomach. Focus on allowing your stomach to rise when you breathe in and fall when you breathe out, keeping the object steady.
• Belt Breathing Exercise Fasten a belt around your lower ribs so that it’s harder to breathe from your chest. Breathe in deeply through your diaphragm instead. Keep your breathing slow and relaxed, and if you ever find it too difficult to breathe, remove the belt immediately.

Try to practice these exercises every day, perhaps even several times per day, if you can. The recent research review suggests that, in order to help improve the reflux barrier, breathing exercises need to be performed consistently over time.

“In general, you need to be very diligent,” Ellis-Marin says.

Along with these exercises, consider trying other at-home GERD treatments, too. According to Harvard Health Publishing, these remedies might include:

• Avoid trigger foods and carbonated beverages.
• Eat slowly and aim to eat several smaller meals daily rather than one large meal.
• Wait at least three hours after eating before lying down and consider sleeping on an incline by using bed risers or a foam wedge (not a bunch of pillows stacked on top of each other, as this can be uneven and unsupportive).
• Make lifestyle changes like losing weight if needed, quitting smoking, and cutting back on alcohol.
• Check with a doctor or pharmacist to see whether any of your medications could be contributing to acid reflux symptoms.