Sports Drinks and Acid Reflux

by Melinda Burris

This subject is of particular interest to athletes as they tend to consume sports drinks and because the scientific evidence explored in the article below reveals athletes suffer disproportionately from a variety of gastrointestinal disorders, including acid reflux.

Athletes Are at an Increased Risk of Acid Reflux

The American College of Sports Medicine points to research demonstrating that for a variety of reasons, “Athletes are already at a heightened risk for gut problems like acid reflux.”¹ This assertion is born out by findings that approximately 30%-50% of athletes that compete in endurance sports suffer from gastrointestinal symptoms. For the most part, these symptoms are mild and pose no serious threat to athletes’ long-term health. However, this susceptibility to physical distress may impact sports performance.¹

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The scientific evidence suggests that “Reduced blood flow to the intestines during intense exercise is . . . one of the main contributors to GI symptoms, and this can be exacerbated by being dehydrated.”² The importance of consistent hydration is a recurring theme in the pages of this magazine because the body must be able to perform at maximum capacity and more importantly, it is a key factor that must be considered to protect and preserve the health of competitors. As is discussed later in this article, how you choose to hydrate is equally important, as the wrong choice of beverage may actually dehydrate you and introduce ingredients known to exacerbate gastrointestinal irritation, especially acid reflux.

What is Acid Reflux?

Acid reflux is a frequent health complaint, with approximately 20% of Americans suffering from the condition. Acid reflux occurs when the lower esophageal sphincter (LES), “a muscular ring located in the digestive tract where the esophagus meets the stomach” fails to work properly.³ The function of the LES is to provide an opening for drink and food to enter the stomach after swallowing. When the LES works properly, this opening closes afterward so that gastric acids and the nutrients you have just taken in do not come back up and re-enter the esophagus. Acid reflux occurs when the LES fails to close properly as a result of damage.³ Acid reflux can cause discomfort, pain, and if it is severe and ongoing for a significant amount of time, can lead to other health problems, some of which are quite serious. Therefore, it is not an ailment that should be ignored and left untreated.

Symptoms of Acid Reflux

Acid reflux is characterized by a range of symptoms. The following is a list of the most common:

1. Heartburn is the most widely reported symptom of the condition and is the first most people notice.³
2. A sour/acidic taste that rises to the top of your throat or the back of the mouth. Since this material is so acidic, you may feel a burning sensation when this occurs.³
3. Regurgitation: Although the terms vomit (or throw up) and regurgitation are often used interchangeably, regurgitation refers to the sensation that something you’ve eaten or drank, or simply gastric acid is coming up your throat. This is also a very common symptom. Rarely, people with this condition will vomit.³
4. Dyspepsia occurs when you feel a burning sensation in the upper abdomen. Digestion is the common term for this symptom. This burning sensation can also occur in the chest; this is known as heartburn. Other common complaints associated with dyspepsia are nausea, upset stomach, excessive burping, and feeling overfull or bloated. Symptoms associated with dyspepsia require consultation with a healthcare provider as these same symptoms can be attributed to peptic ulcer disease.³
5. Trouble swallowing.³
6. Throat irritation including soreness, hoarseness, or the feeling that there is a lump in the throat.¹

People are more likely to experience acid reflux symptoms while lying down, after consuming a large amount of food or following the consumption of especially spicy or fatty foods. Symptoms of acid reflux can happen throughout the day but are most common at night. This is because the reclining position allows the acidic material to more easily move up to the upper abdomen, throat, and/or mouth.¹

As stated previously, medical attention should be sought if the symptoms of acid reflux are frequent and ongoing, and if you feel it impacts your ability to go about your daily routine. This is important because acid reflux that occurs regularly can be an indicator of gastroesophageal reflux disease (GERD), which is a “severe form of acid reflux that can lead to serious health complications if it goes untreated.”¹

Ingredients in Sports Drinks That Cause Acid Reflux to Worsen

Sports drinks are known to aggravate acid reflux due to ingredients commonly used in these beverages:

1.     Citric acid is a flavoring agent frequently used in sports drinks. As the name “citric acid” implies, this is an acidic component that not only exacerbates acid reflux, it has also been shown to cause tooth enamel to break down, heightening the risk of decay and the introduction of bacteria.²

2.     Caffeine is a key ingredient in many popular sports drinks. While still inconclusive, scientific research studies suggest caffeine “may relax your lower LES” causing acid reflux to flare up.²

Alternatives: Drink Water Rather Than Sports Drinks

Again, the importance of maintaining proper hydration is emphasized because consuming plenty of fluids is instrumental in allowing the digestive system to properly function. Jo Scott-Dalgleish from the U.K.’s Endurance Sports Nutritionist website cites a study printed in the International Journal of Sports Medicine that concluded athletes who consumed plain water maintained adequate hydration levels and experienced less acid reflux symptoms.²

Scott-Dalgleish recommends consuming 20 oz. of water about 3 hours prior to working out. If you feel your sodium level is down, add a bit of salt to the water. 30 minutes before you begin training, consume 8 additional ounces of water. It is also important to consume an additional “7-10 ounces of water every 20 minutes while exercising.”² Lastly, remember to continue to hydrate after your workout is complete to replenish fluids lost during exercise.

Beverages That May Relieve Acid Reflux Symptoms

Herbal teas have been shown to assist in digestion and can help relieve a variety of gastrointestinal symptoms. Stick to caffeine-free herbal teas. It is recommended that teas that contain mint, including spearmint and peppermint, be avoided as mint is known to provoke acid reflux in some individuals.³

Plant-based milk, particularly almond milk, has been shown to alleviate acid reflux symptoms. It is believed these products are effective because their alkaline composition “neutralize[s] stomach acidity.”³

References

1. Sepalika.com. (17 July 2017). Don’t Drink Sports Drinks if You Have Acid Reflux.
2. Scott-Dalgleish, J. (30 May 2019). Gastro-Intestinal Problems and Endurance Sport.
3. Healthline.com. (2005-2020). Symptoms of Acid Reflux.
4. Gotter, A. (14 June 2019). What to Drink for Acid Reflux.

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