Acidity and reflux: settling it

Step by step

1. 1

   Step 1: Eat smaller, and earlier

   Two changes do most of the work here. Smaller meals put less pressure on the valve at the top of the stomach, so three modest meals sit better than one large one. And leave three to four hours between your last meal and lying down, which usually means moving dinner earlier rather than eating less at it. Some people also find starting the meal with protein, then vegetables, and leaving the rice or roti until later sits more comfortably. Carrying less weight around the middle takes real pressure off too.

   Learn more: Nutrition basics
2. 2

   Step 2: Stay upright after eating

   Gravity is doing useful work while you are upright. Avoid lying down or reclining for a couple of hours after a meal, and skip the after-dinner nap. A gentle walk instead helps digestion, though save anything vigorous for later. Stay well hydrated across the day, but if large drinks with meals make things worse, take most of your fluid between meals instead. If you smoke, stopping helps reflux as much as it helps everything else.

   Learn more: Movement & blood sugar
3. 3

   Step 3: Find your own triggers

   Triggers differ from person to person, so a general list is less useful than your own. Common ones are deep-fried and very oily food, heavy chilli, tomato, citrus, chocolate, mint, coffee, fizzy drinks and alcohol. Keep a simple food and symptom diary for a fortnight and the pattern usually shows itself. Do not cut out more than you need to. One thing worth saying plainly: a food allergy panel is not the way to find reflux triggers. Most triggers are sensitivities rather than allergies, those panels are not recommended for this, and they tend to produce a long list of foods to avoid for no good reason. A diary costs nothing and tells you more.

   Learn more: Anti-inflammatory swaps for an Indian kitchen
4. 4

   Step 4: Raise the head of the bed

   For reflux that troubles you at night, raising the head end of the bed by six inches, with blocks under the legs rather than extra pillows, works better than most things. Extra pillows bend you at the waist, which can make it worse. Lying on your left side helps some people too.

   Learn more: Sleep & recovery
5. 5

   Step 5: Know what is not ordinary heartburn

   Most reflux is a nuisance rather than a danger, but some things should be seen rather than managed. Difficulty or pain on swallowing, food sticking, vomiting blood, black stools, unexplained weight loss, or symptoms that are new and persistent after 50 all warrant a doctor. So does needing antacids most days. Chest pain with breathlessness or sweating is an emergency, not reflux until proven otherwise.

   Learn more: Stress: what it is, and why not all of it is bad

All topics in this guide

• Nutrition basics
• Movement & blood sugar
• Anti-inflammatory swaps for an Indian kitchen
• Sleep & recovery
• Stress: what it is, and why not all of it is bad

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