Post by @mollypelletier.rd

I spent a decade blaming my acid reflux on acid. If you have done the same and you are still not better, this is the reframe I wish someone had handed me sooner. Here is what finally made it click. Your LES (lower esophageal sphincter) is a barrier. It is a valve, plus the crural diaphragm wrapped around it, and its whole job is to keep stomach contents down. When that barrier loses pressure and coordination, contents slip up and irritate tissue that was never built to handle them. The amount of acid matters less than whether that barrier holds. And a big part of what coordinates the barrier is your gut-brain signaling, the autonomic nervous system that helps run your LES tone, your motility, and your rest-and-digest state. In reflux, that signaling looks dysregulated. The research is still mapping the exact direction. A 2024 pilot found high parasympathetic tone with clear autonomic dysregulation of LES tone (Triki et al., PMID 39244825), while a 2025 review reported reduced vagal tone (Sobrino-Cossio et al., PMID 40199278). They agree on the headline: the autonomic balance is off, and supporting it helps. The encouraging part is that the barrier and your nervous system are both trainable. Here is what I teach my clients. • The 5+1 Method. Before meals, 5 slow breaths plus 1 gratitude, to settle into rest-and-digest before you eat. • The LES Lock. 1 to 5 minutes of diaphragmatic breathing immediately after meals, up to 5x daily, to train the crural diaphragm. Halland et al. (2021, PMID 33009052) saw LES pressure rise and post-meal reflux events fall from 2.60 to 0.36. • Gentle nervous system practices, like slow exhales and humming, to nudge you toward a calmer, parasympathetic state. • Left-side, elevated sleep and a loose waistline, to keep physical pressure off the barrier. • A 3-hour buffer before bed so your stomach can empty. When you support the barrier and your nervous system, you are finally working on the real root contributors. This is the work, and small hinges swing big doors. Follow for more. #AcidReflux #GERD #VagusNerve #LESsupport #RefluxRelief RegisteredDietitian