Breathing exercises for GERD (acid reflux)

Can breathing exercises help acid reflux?

They seem to, for some people. Reflux happens when stomach contents slip back up into your food pipe. Two things normally stop that: a ring of muscle at the bottom of the food pipe, and the diaphragm wrapped around it like a second belt. Together they form your anti-reflux barrier (Zdrhova et al. 2023).

The diaphragm is a muscle you can train. Slow, deep belly breathing, also called diaphragmatic breathing, makes it work through its full range, and a handful of small trials have found less reflux and fewer symptoms in people who practise.

How does diaphragmatic breathing help GERD?

By tightening that second belt, at least while you do it. In a Mayo Clinic study of 23 people with reflux, pressure at the valve almost doubled during the in-breath of diaphragmatic breathing. Belly breathing straight after a meal also cut the number of reflux episodes compared with simply sitting (Halland et al. 2021).

There’s a calming side too. Slow breathing shifts your body towards rest and digest, which is when your gut does its best work. More on that in how to activate your parasympathetic nervous system and how to calm your nervous system.

How to do breathing exercises for GERD

The key is breathing low, so your belly moves and your chest stays fairly still.

Finding it hard to keep your chest still? Try it lying on your back with your knees bent first, then bring it back to a chair. Chest breathing vs belly breathing explains the difference.

When should I do breathing exercises for reflux?

After meals, when reflux is most likely. In the study above, belly breathing in the two hours after a test meal more than halved the share of time patients’ food pipes were acidic, compared with the day before (Halland et al. 2021). It’s also worth a few minutes whenever you notice heartburn or belching starting.

Routine · 10 minutes

The 10-minute after-meal routine

1. Sit back upright within half an hour of finishing your meal.
2. 2 minutes of 6-6 belly breathing, hands on belly and chest, to find the movement.
3. 8 minutes of 5-5 breathing, hands resting, belly still doing the work.
4. Stay upright for a while afterwards. No need to rush back to the sofa.

Can breathing help belching and bloating?

Belching, yes, according to one study. In 36 people whose reflux hadn’t settled on medicine and who belched a lot, a structured belly-breathing programme halved belching scores for 9 of 15 people, and for none of those still on the waiting list. Their reflux symptoms and quality of life improved too, and the benefit lasted 4 months (Ong et al. 2018). It wasn’t a randomised trial, so treat it as encouraging.

Bloating hasn’t been studied in the same way. Slow belly breathing is gentle to try, and some people find it eases the tight, full feeling. If your stomach feels queasy rather than full, breathing exercises for nausea has a steadier rhythm for that.

How long before breathing exercises help reflux?

Expect weeks, not days. As with any slow breathing habit, what was tested is regular practice. In a small randomised study, 4 weeks of breathing training cut the time the food pipe spent acidic from about 9% to under 5%, and people rated their quality of life better. People who kept training for 9 months used much less acid-reducing medicine (Eherer et al. 2012). Weeks of after-meal practice are easier to keep up when you can see them: Breathform’s History marks each day you practised. Stepping down from acid tablets? Coming off medication covers the rebound heartburn that can follow.

What does the research say?

The trials are small but point the same way. In 19 people with reflux, 4 weeks of breathing training reduced acid exposure and improved quality of life, with no change in the control group (Eherer et al. 2012). A 2023 systematic review concluded that diaphragmatic breathing training could ease symptoms in selected people with GERD (Zdrhova et al. 2023).

There are limits. In the Mayo Clinic trial, total acid exposure over a day wasn’t better with belly breathing than with a sham exercise (Halland et al. 2021).

So: belly breathing after meals is a gentle, promising addition for reflux, backed by a few small trials. Larger ones are still needed.

How well each breath is studied

• Slow breathing (6-6)Some evidence
• Coherent breathingWell studied

Every study on this page (4)

• Zdrhova et al., 2023: Systematic review: the crural diaphragm is a main part of the anti-reflux barrier, and diaphragmatic breathing training has the potential to ease symptoms in selected people with GERD.
• Halland et al., 2021: In 23 patients with upright GERD and 10 controls, pressure at the lower oesophageal sphincter rose during the in-breath of diaphragmatic breathing (42.2 vs 23.1 mmHg) and post-meal diaphragmatic breathing reduced post-meal reflux events; compared with sham, total acid exposure on day 2 did not differ.
• Ong et al., 2018: In a prospective study of 36 people with PPI-refractory GERD and excessive belching, 9 of 15 treated with a diaphragmatic breathing protocol (60%) and none of 21 waitlisted controls halved their belching score; reflux symptoms and quality of life also improved, sustained at 4 months.
• Eherer et al., 2012: In a randomised controlled study of 19 people with non-erosive GERD or healed oesophagitis, 4 weeks of abdominal breathing training reduced the time the oesophagus spent acidic (pH below 4: 9.1% to 4.7%) and improved quality of life, with no change in controls; at 9 months, those who kept training had better quality of life and used less PPI (98 to 25 mg a week).

Questions people ask

Should I do breathing exercises right after eating?

Yes, that’s when reflux is most likely, and it’s when one trial tested it. Sit upright rather than lying flat, and start within the first half hour or so after a meal. Five to ten minutes is enough. If a big meal makes belly breathing uncomfortable, breathe a little more gently and let your belly move less.

Can breathing exercises replace reflux medicine?

Not on their own, but they may help some people need less. In one small trial, people who kept up breathing training for 9 months used much less of their acid-reducing medicine. Talk to your doctor before you change any dose, and think of breathing as something you add to your routine rather than swap in.

Is it better to sit or lie down for belly breathing with reflux?

After a meal, sit upright or recline with your head and shoulders well raised, so gravity is on your side. Lying flat soon after eating makes reflux more likely for many people. At other times of day, lying on your back with your knees bent is a good way to learn the movement, because you can feel your belly rise and fall.

What’s the difference between belly breathing and diaphragmatic breathing?

They’re the same thing under two names. When your diaphragm contracts, it moves down and pushes your belly out, so belly breathing is simply what diaphragmatic breathing looks like from the outside. There’s a full how-to, with more on the muscle itself, in our guide to diaphragmatic breathing.