Improving Your Posture to Reduce GERD, Reflux and Heartburn Symptoms
In adults, a slouched posture can be an important factor contributing to GERD. With a slouched posture there is no straight path between the stomach and esophagus; muscles around the esophagus go into a spasm. Gas and acidity get blocked in the spasm, causing coughing and other asthma-like symptoms.
Maintaining a proper, upright posture is important to avoiding GERD symptoms. It allows gas to pass up through the esophagus and release pressure on the stomach. Conversely, stomach pressure and an incorrect angle of the esophagus can lead to reflux. While standing, sitting and sleeping, it is important to have a body position that minimizes stomach pressure and places the esophagus in the correct angle, so as to allow easy passage of food on the way into the stomach and easy passage of gas on the way out. In addition, a “straight” position allows gravity to more easily push any refluxed acid back down the esophagus and into the stomach.
The image on the left shows improper posture while standing. The esophagus is more likely to have a twist or “kink”, much like a garden hose. This prevents digestive gas build-up from releasing through the mouth. This will increase the intra-abdominal pressure leading to reflux.
The image on the right depicts proper standing posture in which the esophagus tube will be directly perpendicular to the ground and allow for maximum passage of gas from the stomach to the mouth.
To maintain proper standing posture follow the guidelines:
- Stand with weight mostly on the balls of the feet.
- Slightly bend your knees
- Keep feet at shoulder-width.
- Let arms hang naturally down the sides of the body.
- Be sure your head directly above your spine, not pushed out forward or pulled backed behind
- Maintain slightly arched lower back
- Avoid high heels
- Distribute any carrying weight evenly across shoulders
The image to the left shows incorrect sitting posture. The weight of the chest, shoulders and head increases intra-abdominal pressure. In this position, stomach contents will be forced up through the LES and into the esophagus. In addition, the esophagus is not in a straight position to allow for the easy release of gas.
The image on the right shows correct sitting posture. This minimizes intra-abdominal pressure and keeps the esophagus perpendicular to the ground.
To maintain proper sitting posture follow the guidelines:
- Sit in an ergonomically-made chair.
- Align your spine parallel with the back of the chair. Avoid slouching or leaning forward
- Keep your shoulders straight.
- Flex your arms at a 75- to 90-degree angle at the elbows. You may have to adjust the chair.
- Make sure your neck, back, and heels are all aligned.
- Keep both feet flat on the floor. If there's a problem with feet reaching the floor comfortably, a footrest should be used.
While lying down, it is essential to allow gravity to work in your favor. Sleeping on an incline uses gravity to keep stomach acids from coming back into the esophagus and prevents the tongue and throat from blocking the airway. Sleep in the supine position (on back) with the head raised at least 6 in. above the waist. Bed wedges are a simple, cost effective solution to a major problem.
Sleep on a mattress that is firm and will provide your back with good support. Either sleep on your back and keep your legs straight or place a pillow under your knees, or if you sleep on your side, keep your legs slightly bent and make sure the top leg is straighter than the bottom leg. Do not sleep on your stomach.
Postural Improvement Exercises
As previously discussed, slumping can trigger reflux symptoms. When this position is maintained for extended periods of time, the muscles across the middle back and between the shoulder blades become atrophied, weak and loose. This leads to more slumping and more reflux symptoms. The cycle continues. To break this cycle, reflux sufferers can engage in physical exercises to strengthen the muscles that support posture.
Trying to correct posture by willpower alone is impossible because as soon as the conscious mind takes its attention away from posture the body lapses back into its usual incorrect posture. Postural exercises are the only reliable natural and non-invasive method to correct standing and sitting posture.
Here are several exercises that can reduce reflux symptoms.
- Choose 3 or 4 exercises that work best for you and practice them at least once per day for three weeks.
- At the end of each week subtract the one exercise you find the easiest and add a harder one. That way your postural muscles will benefit from a broader range of exercises.
- After three weeks you can gradually reduce the frequency of exercises until you are able to consistently maintain correct posture.
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