* Avoid lying down for two to three hours after eating. When you lie down, it's physically easier for stomach contents to splash up toward the LES. By sitting up or standing, gravity helps stomach contents stay where they belong -- at the bottom of the stomach.
* Avoid items that weaken the LES muscle (like chocolate, peppermint, caffeine, alcohol, fatty foods) and foods and beverages that may irritate a damaged esophagus lining (citrus and citrus juice, tomatoes and tomato juice, and chili peppers and black pepper).
* Avoid eating large meals because the more volume in the stomach, the more likely the stomach contents will splash toward the LES. Try eating four to five small meals instead of two or three large ones. By portaion out your food, it will tax your stomach too much
* Avoid high-fat meals because they tend to stay in the stomach longer; greasy or fried foods can also weaken the LES muscle. This can help you to maintain your weight loss also.
* Avoid smoking and avoid alcohol before, during, or after meals that seem to result in heartburn (like dinner). Both can weaken the LES muscle.
* Try waiting at least two hours after a meal before exercising if you find your heartburn seems to get worse after exercise.
* Chew gum (a nonpeppermint flavor) after meals to stimulate saliva production (the bicarbonate in saliva neutralizes acid) and increase peristalsis (which helps move the stomach contents into the small intestine more quickly).
* Plan your meals to encourage slow but sure weight loss if you are overweight. Extra weight around the midsection, especially, can press against the stomach and increase the pressure going up toward the LES.
* Drink a small glass of water at the end of meals to help dilute and wash down any stomach acid that might be splashing up into the esophagus, suggests Shekhar Challa, MD, president of Kansas Medical Clinic and author of Spurn The Burn: Treat The Heat.
* Plan on heartburn-friendly beverages like water, mineral water, decaffeinated tea, noncitrus juices, or nonfat or low-fat milk. Beverages to avoid include:
- Sodas: These can bloat the abdomen, increasing the pressure in the stomach and encouraging stomach acid to splash up into the esophagus.
- Juices: Tomato and citrus juices can irritate a damaged esophagus.
- Alcoholic beverages, coffee (even decaf) and caffeinated tea and cola can increase the acid content in the stomach as well as relax the LES.
* Eat a high fiber diet! A recent study found that people who followed a high-fiber meal plan were 20% less likely to have acid reflux symptoms, regardless of their body weight. You'll find fiber in whole grains, fruits, vegetables, beans, nuts and seeds (basically unprocessed plant foods).
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