Running and Heartburn

Heartburn when running is a fairly common complaint. You might get a bad taste in your mouth, burning or discomfort behind your breast bone or simply keep burping as you run along. Let’s explore what causes heartburn during running and what you can do to stop it happening.

What is heartburn?

When you eat something, food goes down your oesophagus (gullet) and into your stomach. The stomach is a muscular bag where food gets mixed with acid and enzymes to start breaking it down. At the bottom of the oesophagus and top of the stomach there’s a muscular ring called the oesophageal sphincter. This opens to let food in and closes to prevent stomach contents going back up the oesophagus.

Sometimes the acidic contents do travel back up your oesophagus. This can happen if your sphincter is weak or it transiently opens. You can experience a range of symptoms including the characteristic ‘acid reflux’ ones of a burning feeling in your chest or a bad, often metallic, taste in your mouth. You can also get a sore throat, upper abdominal pain or a persistent cough. It can sometimes be hard to differentiate between indigestion and a stitch. Occasionally there aren’t any symptoms. Acid can irritate the delicate lining of the oesophagus and cause damage over time including ulcers and in rare cases over long periods of time, cancer.

What causes heartburn when running?

Now you know the reason heartburn happens, it’s easy to see why the up and down motion ad repetitive jolting of running could cause the contents of your stomach to go back up your oesophagus.

This will be more likely if:

• You’ve eaten a lot
• You’ve eaten too close to running
• You’ve consumed food or drink known to trigger heartburn in some people e.g. caffeine, alcohol, tomatoes, spicy food, fruit juices
• You’ve used an anti-inflammatory such as ibuprofen for a running niggle or injury, particularly if you’ve taken it on an empty stomach
• You’re taking iron supplements or other medications that can cause heartburn
• You also have these symptoms when you aren’t running.

What is GORD?

Most people get a bit of heart burn and indigestion from time to time after a big meal or when they’ve run too close to eating. You can usually manage this pretty easily (read on). However, if you’re getting heartburn and acid reflux when you aren’t running and it’s happening frequently or is severe, then you may have GORD (Gastro Oesophageal Reflux Disease). GORD is often linked to lifestyle. It’s more common if you have high stress levels, smoke or drink more than the recommended amounts of alcohol. It’s also more likely if you’re overweight and if you have a history of GORD in your family. There are sometimes underlying causes of GORD such as a hiatus hernia where your stomach is pushed up into your chest cavity.

How do I stop heartburn when I run?

It’s always best to focus on simple things first:

• Avoid heavy meals before running.
• Take time when you eat and chew food well, this helps digestion.
• Leave plenty of time between eating and running; this may be as long as three hours for some people.
• Avoid trigger foods – keep a diary of what you eat to spot these.
• Take care with your running fuel. Some gels or drinks may trigger symptoms. On the other hand, real food on the run can be the culprit. Trial and error is invaluable.
• Speak to your pharmacist about antacid medications. These will give you relief by neutralising the acid but they don’t solve the underlying issue.

If you get symptoms at other times, when you aren’t running and lifestyle changes aren’t helping, speak to your pharmacist or GP. Your GP will decide if you need any investigations and be able to prescribe medications to give you short or long term relief.

What are the warning signs?

Yes, heartburn is common but there are certain situations where you shouldn’t spend time writing food diaries and trying to spot trigger foods. These are called red flags. Having a red flag doesn’t mean there is definitely something serious going on but you do need to see your doctor as soon as possible:

• Difficulty or pain on swallowing.
• Food or drink feels like it’s getting stuck.
• You’re losing weight with no good explanation.
• You’ve vomited up any blood.
• You’re over 55 and you’ve suddenly started with these symptoms.
• You have chest pain on exertion – heart pain can be confused with heartburn.

You can read more about these topics in my best-selling book Run Well: Essential health questions and answers for runners published by Bloomsbury and available from all good book sellers.

Featured image: Photo by Pixabay