Have you ever been in the middle of a run and suddenly been crippled by pain in your chest? It happens to more runners than you may realize!
It’s natural for your first thought to be “Heart attack!” In most cases, though, it’s much more likely to be heartburn. The symptoms can be similar, and we’ll discuss how to know the difference further down.
But heartburn when running is fairly common! If you’ve ever had this happen to you, here are some of the reasons why, plus some tips to prevent it.
What is Heartburn?
Heartburn is the common name for the pain or discomfort in the chest, caused by the irritation of the esophagus as stomach acid moves upwards into the chest and throat.
It may start as a burning sensation in the upper abdomen, which moves up into the chest and throat. It can cause pain in the chest, just below your breastbone.
While it may feel as though you’re having a heart attack, heartburn actually doesn’t have anything to do with the heart!
Because it has to do with the stomach, you’re likely to experience heartburn after eating a meal, especially if you’re bending over or lying down. If you go to bed within two hours of eating, it’s possible that heartburn will disrupt your sleep.
If you’re experiencing heartburn, you may notice that you also have a sour or bitter taste in the back of your throat. This is caused by the acid reflux rising up in the back of your throat. Some people may even have difficulty swallowing.
Heartburn can last for a few minutes or for a few hours. It’s typically not dangerous, but can be annoying and disruptive. You can find relief by taking an over-the-counter antacid.
What Causes Exercise Heartburn?
Many things can cause exercise-induced heartburn. For example, if you’re exercising after work, it could be triggered by foods or drinks that you’ve consumed during the day.
Some foods, like pizza, french fries, and burgers, can take longer to digest, which leads to increased abdominal pressure. This extra pressure in the stomach can cause the stomach acid to leak into the esophagus.
Tomato-based dishes or snacking on foods that are high in fiber and fat can cause the lower esophageal sphincter (LES) to relax, which also leads to reflux.
Exercise can also cause the LES to relax. The stomach acid is then able to flow in reverse, leading to acid reflux.
The type of exercise you’re doing can also cause intra-abdominal pressure; for example, if you’re doing a hard set of ab exercises. This can cause heartburn either during or after your workout.
Why Does Running Cause Heartburn?
Heartburn can be triggered when the pressure on the abdomen increases, and the repeated up-and-down motion of the body irritates the lower esophageal sphincter.
The repeated running motion (bouncing) can reduce the amount of pressure on the lower esophageal sphincter, causing the muscle to loosen or not close completely. This can cause the acid reflux to flow upwards to your chest.
Sometimes, running on an empty stomach can lead to acid reflux as the empty stomach becomes aggravated. If this happens to you, it would be best to find a pre-and mid-run fueling strategy.
The Most Common Triggers for Heartburn
Weakness in the Muscle
The muscle between the esophagus and the stomach is called the lower esophageal sphincter (LES). As food passes into the stomach, this band of muscle closes.
But if there’s a weakness in the muscle, it may not close completely, leaving a small opening through which stomach acid is leaked into the esophagus.
The stomach acid irritates the lining of the esophagus, causing a burning sensation or pain in the chest area.
Eating the Wrong Foods
Eating a large meal will stretch the stomach, putting pressure on the lower esophageal sphincter. Not only will you feel “stuffed”, but the LES can’t close properly and the stomach contents start moving in the wrong direction.
But there are also a number of specific foods that trigger heartburn. Spicy or fatty meals, citrus drinks like orange juice, and even chocolate (sorry!) are some of the most common.
Caffeinated drinks, especially if the acidity levels are high, can also lead to heartburn. So can overly processed foods, as well as alcohol, carbonated drinks (sodas), peppermint, and foods that are high in fiber.
Tips to Avoid Discomfort from Heartburn
1. Fix Your Diet
One of the best ways to problem-solve your diet is to keep a journal. This will help you to keep track of the foods you’ve eaten that could be triggering your acid reflux.
You’ll be able to see how often you have heartburn, either during or after your run, if there’s a pattern, and if it’s frequent enough for it to be a concern.
You can also keep track of how long it takes for you to eat your meals. This might sound odd, but eating too quickly can also be a culprit when it comes to heartburn.
If you’re mindful about the time it takes you to eat, you can slow down and make sure that you’re chewing your food thoroughly, reducing the risk of developing acid reflux.
Your food journal will let you experiment with foods and you’ll eventually develop a very good idea of what foods bring on heartburn. If you’re fueling on the run, experiment with different types, brands, and consistencies (like liquid gels) to see if you can find something that doesn’t trigger it.
Keep notes of how you feel before, during, and after your workout, and you’ll start to see a pattern of what works best for you.
2. Avoid the Four C’s
Avoid carbonated drinks, citrus, chocolate, and coffee for at least a few hours before you go for a run.
Carbonated drinks will cause your stomach to expand, putting pressure on the LES, which then may not close properly. Avoid citrus fruits (orange, lemon, tangerine, grapefruit, etc) and fruit juices, as they will increase the production of acid in your stomach.
Both coffee and chocolate contain caffeine. Depending on the amount, the caffeine could actually cause the LES to relax. This could cause a backflow of stomach acid into the esophagus, setting the stage for heartburn.
Also avoid eating nuts as they’re high in fat, which can slow the process of emptying your stomach. Fatty foods and overly processed foods will also place pressure on the LES and trigger heartburn.
3. Eat Something Soothing Before Exercise
It’s possible that running on an empty stomach can trigger heartburn. Unless you prefer running in a fasted state, it’s best to eat something that will soothe your stomach.
This will depend somewhat on the time of day that you’re running, but try eating dry foods like toast or crackers, as they’ll help to “soak up” the stomach acids.
If you’re going to run in the morning, you can have a small bowl of whole-grain cereal or oatmeal. It’s low in fiber, easy to digest, and keeps your gastrointestinal tract moving.
Yogurt contains microorganisms that aid the digestive process, or you could have a banana, which is rich in minerals.
If you’re going to be running in the afternoon or evening, then choose a lunch with white rice, feta cheese, low-fat cottage cheese, or couscous, as they’re easy to digest.
Avoid foods that are high in protein, as they can exacerbate heartburn and they take too long to digest.
4. Eat Two to Three Hours Before Working Out
Try to plan when you eat your meals so that you have at least 2 to 3 hours before you go for a run. This can be tricky if you prefer to run early in the morning. While you can get up earlier and have a slice of toast, it’s not always feasible.
You want to give your body the time it needs to digest the food, which will help your body to use the energy more efficiently. This means that you may have to experiment with different foods and snacks.
You can try a light snack about an hour before your run. But if you have a carb-heavy meal, then you’ll need about 2 to 3 hours for the food to be processed. You could try both to find out what works best for you.
5. Reassess Your Workout
Keeping track of how you feel during and after your workouts will help you to identify what type of workout could be triggering heartburn.
If you’re doing speed work and you find that vigorous running is triggering it, then decrease your pace. This will most likely decrease the amount of pressure that’s being placed on your abdomen and lower the risk of heartburn.
You may have to experiment to see what workouts trigger your heartburn and what doesn’t. A journal can be helpful here too!
6. Try Baking Soda
There’s a variety of natural remedies that can provide temporary relief from heartburn, such as aloe juice. But not everyone has aloe juice in their kitchen cupboards!
One of the best remedies is baking soda (sodium bicarbonate). It’s a natural antacid and you’ll probably find it in your kitchen.
Dissolve a teaspoon of baking soda in approximately 8 ounces of water and drink it. This will provide relief from heartburn, as it’s able to neutralize the stomach acid.
Don’t use this constantly, though, as it may add high levels of salt to your diet and can contribute to high blood pressure.
7. Try Over-the-Counter Relief
Over-the-counter antacids are fast-acting and provide effective relief. Try to choose an antacid that also contains calcium, as this will neutralize stomach acid.
You can take one as a preventative measure before you go for a run, if heartburn happens regularly.
8. Drink Plenty of Water
Drinking water will help with the digestion process, which will in turn help with acid reflux. If you’ve had an acidic meal (tomato-based or very spicy), then drinking water can help raise the pH levels in the stomach. It will clear out your esophagus and help to dilute the acid.
If you use sports drinks or gels on your runs, then try and avoid the citrus varieties or experiment with different brands. If you’re going for a short run, then it’s best to just drink water and keep the gels and sports drinks for intense or long runs.
Keep track of how much water you’re drinking throughout the day. Drinking too much water can cause a mineral imbalance in your body, which could actually increase your risk of acid reflux and heartburn.
9. Wear Loose-Fitting Clothes
Check your running gear and make sure that your clothing isn’t too tight. Tight clothing can increase abdominal pressure, leading to stomach acid flowing upwards to your chest and throat.
Your clothing should fit closely and can feel like a second skin. But if it’s leaving indentations on your skin, then it could be too tight. While it should feel comfortable, you should be able to get a finger between the clothing item and your skin quite easily.
Call Your Doctor or Pharmacist If
You should see your doctor if:
- The symptoms of your heartburn have become frequent and more severe
- You’re having difficulty or pain when swallowing
- You’ve been using antacid medications for at least two weeks (no longer than the recommended period on the label) and still have heartburn symptoms
- You’ve been suffering from nausea and vomiting
But don’t ignore or just dismiss chest pain as heartburn. Assess it carefully to figure out if it could be something worse, especially if you have pain and other symptoms, symptoms including:
- Pain in the jaw, neck, arms or legs
- Profuse or unexplained sweating
- Irregular pulse
- Shortness of breath
You should also seek immediate medical attention if you’re experiencing extreme stomach pain.