MS, RD The Reflux Dietitian

Me, patiently waiting for everyone with acid reflux, GERD, and LPR to find this page so they can strengthen their anti-reflux barrier and lean on their meds a little less. So let’s start here. The barrier that keeps acid out of your esophagus is actually two muscles working together. Your lower esophageal sphincter (LES) and the crural diaphragm that wraps around it, forming your esophagogastric junction (Zdrhova et al., 2023, Dysphagia, PMID 35842548). Here’s the part that gives me hope for you. Your diaphragm is a skeletal muscle, so you can actually train it. For free. Here is what I teach my clients. I call it the LES Lock: 1 to 5 minutes of diaphragmatic breathing immediately after meals, breathing into a full 360 ribcage expansion (not just your belly), up to 5 times a day. In a randomized trial, this kind of breathing raised LES pressure on every inhale (42.2 vs 23.1 mm Hg) and lowered post-meal reflux events (0.36 vs 2.60 per meal) by widening the pressure gap between your LES and your stomach (Halland et al., 2021, Am J Gastroenterol, PMID 33009052). Two more ways to take pressure off that barrier: keep meals on the smaller side so your stomach isn’t pushing up against it, and give yourself a 3-hour buffer between your last meal and bed. Does any of this replace your care team? No. But in a 4-week trial, the people who kept up breathing training reduced their acid exposure time and were using fewer PPIs 9 months later (Eherer et al., 2012, Am J Gastroenterol, PMID 22146488). Always sort out any medication changes with your doctor. Consistency is the secret sauce. Save this for after your next meal, and follow for more. #AcidReflux #GERD #LPR #SilentReflux #RefluxRelief