Strengthening the LES to cure acid reflux

The following is quoted from the fourteenth chapter of How I Learned to Manage GERD and Live Without Acid Reflux. The first chapter can be found at Before trying these strategies, or any other method or technique, for managing GERD or any other disease you should consult with a qualified physician. See the Terms of Use + warnings, cautions and sound advice before proceeding.


Strengthening the LES to cure acid reflux

By Jim Notto

lower esophageal sphincterThe lower esophageal sphincter (LES) is one of over fifty sphincters (somewhat circular muscles) in the human body. It is located at the top of the stomach and bottom of the esophagus. Under normal conditions this muscle acts as a valve, allowing food to enter the stomach while preventing gastric juices from entering the esophagus from the stomach.

In a person with GERD, the LES becomes soft, sloppy or ineffective. It was and is necessary for me to believe that this muscle could be strengthened. Whether or not the actions I’m about to outline really strengthen the LES are irrelevant, because I discovered they are crucial to my management of GERD and the accompanying acid reflux. It would require controlled scientific observation to determine if there is any real strengthening happening, but it only takes individual observation of the affects to know that this was a crucial step for me.

weak lower esophageal sphincterIt all began when my physician told me about the “weakened sphincter” and how in it’s weak state the LES allowed stomach acid to flow the wrong way. Having had a back injury years earlier and desiring to avoid surgery I went through a rehabilitation process that was unique at the time, but has since become very popular. In that program I learned about isolating muscles you normally are not even aware of, and then working those muscles into a condition of strength.

I decided I could try to do the same kind of thing with the LES. In the rehabilitation program I mentioned we used special weight and resistance machines to isolate the muscles we wanted to work. As it was explained to me, when we were not able to directly isolate a muscle we wanted to strengthen we would simply focus on the muscles we knew worked with that muscle.

Using that approach I learned all I could about the LES and the muscles surrounding it. I decided the best thing I could do was to practice regular breathing exercises to get all he muscles in that area moving. This has proven to be one of my greatest tools in the prevention of acid reflux. I have no scientific data to back it up; I’m just saying it works for me, and for the people I have shared this with who given it a try.huge difference

How I do this is very easy. I breathe. I focus on making sure I am inhaling fully, and exhaling completely. Not every breath I take, but several deep, full breathes in a row several times each day. It only takes seconds, but it has given me hours of acid-free living.

I even go so far as to imagine that each breath in is bringing cool, clean, healthy energy into my body. I imagine that cool energy giving life and strength to my LES and my esophagus. Several times a day for a few seconds. Not a huge lifestyle change, but what a huge change to my health!

When I have overdone it a little, stacked a couple more triggers than I could handle or have messed up some other way and I can feel I’m at risk of getting acid reflux, simply relaxing and breathing in this way is almost always enough to set my body right. It is the one discovery in my quest for a solution to GERD for which I am most grateful.

27 thoughts on “Strengthening the LES to cure acid reflux”

  1. Thank you for sharing. Do you feel that you continue to improve and possibly strengthen the LES more? Did you need to take PPIs to help reduce the stomach acid? Have you by chance had another UGI to see if there has been any improvement in the LES? I am hoping I can help heal my LES or at least improve it and be medication free.

    • Thanks for reading Melissa. I have not had any UGI series to tell how my LES is doing. (Would a UGI reveal that?)

      I rely entirely on the results I experience daily, namely: no acid reflux. The effects on the LES that I mention are completely speculative as far as I know. It’s just an explanation that works for me in improving the quality of my life.

      I would enjoy having some serious studies performed by a competent medical research team, but I do not have any way to make this happen. Perhaps one day a major university will take up a study. Until then, I can only hope that what has worked for me can help others, too.

      I wish you all the best as you pursue better health and better living.

  2. Thank you for sharing this with us. I have been trying many techniques to strengthen my LES and nothing worked. I will try your technique and see if it works.

    How long does it take to start seeing some results?


  3. Thanks for sharing, I shall give this a try as well as many other theories I have and shall let you know what works for me. Do you still use PPIs as I feel they are affecting my health and I want to stop them. IF you did how did you stop using them because i feel doctors don’t tackle the problem but just pump you with so many drugs that hinder normal bodily function.

  4. Hi There, I am diagnosed with reflux and desperate to find a solution as I cannot take PPI’s.. they make me feel very sick! Last week I went for an MRI scan of my abdomen as after taking PPI’s I seem to have acquired some bad digestive problems.. Well with this scan I had to take deep breaths all the way in and hold for quite a while and then relax.. I must have done this at leasy 30 times.. At the time I was worried as I was lying flat and thought it may make me feel bad.. To my surprise when I got up I felt very good.. when I went home that evening I said to my husband it is odd but I feel much better since I went for the scan.. It was only after that I made the connection with the breathing exercises.. Now I have read your article, I am convinced.. this is maybe possible.. I used to teach keep-fit but over the past 10 years I have worked sitting at a computer all day.. little exercise and my stomach muscles are in poor shape.. I like you once healed an ailment which I was told needed surgery.. I am now going to work hard with this one.. Any other info you can offer would be much appreciated.. Thank you!

  5. Thanks for sharing. The strange thing is that before reading your information I had been getting this nagging feeling or thought that I needed to start doing this very exercise, but couldn’t for the life of me figure out why! I guess it was my body telling my mind what it needed lol. So I am starting this today. Thanks again!

  6. question? – did you have any real test done to show you had GERD? If so, what test and how bad what your GERD? What other lifestyle changes did you make when you found out?

    You sound like you have tried the relaxation technique I have heard about. I will be trying this along with simply changing in eating habits and diet. I have been accustomed to eating fast. Started in basic training in the military. 5 minutes to eat a lot of food or nothing for hours 🙁 First time I did this I barfed! Then I got out and ate the same way and now I have 2 kids and they keep me running. I have very little time to relax to eat and when I do I overeat. I didn’t used to be this way. I ate like a French person for most of my life. Picked like a bird when I ate.. so now I am having to relearn and figure out how to take a big step back. Thus Far, my body is responding to being HUNGRY all the time. so I am trying to eat a little portion of snack after a small meal.. Hope this helps.. Any ideas on what people say about getting rid of SOY out of your diet.. I really hope I don’t have to do this as I will be left with just about nothing to eat.. 🙁

    Any advice would be helpful.

  7. Thanks

    Occasional discomfort at age 82 occurs when foods are improperly heated, badly mixed, and feel dry and “grainy to the upper sphincter.

    Indeed, stopping, centering and asking what is going on–an inner conversation–reminds me to breathe in ways you recommend.

    That helps, immensely.

    Three options occur:
    1). I lay aside completion of that food in a congregate setting, or
    2). Either vinegar or olive oil provides needed lubrication for ease of muscle receptivity and/or
    3). I sip sweet tea for a bit and resume pleasurable moments of eating, mastication and digestion.

    Thanks again for post.

    • I wish you the best, sinni. I outlined my approach in the “In A Nutshell” post. Basically I manage my physical response to stress and anxiety, practice good breathing, and avoid stacking triggers (that is, I avoid having too many foods or behaviors that trigger reflux during any given time).

  8. You may have been practicing mindfulness meditation without even knowing and there are studies which link this to many improved conditions. Mine suddenly became out of control after a month on valtrex and am searching for a way to reverse it.

  9. Reconditioning the LES does make a lot of sense to me.

    In high school, I sat in front of a computer, let myself get out of shape (40-60lbs over)and let my stomach muscles rest up for a long, long time. Then came the acid reflux.

    Went to visit the DR and was prescribed omeprazole, and signed up for the weightlifting classes (not because I wanted to get muscle, not fix my acid reflux). Later on (can’t remember how quickly or slowly it went away), my acid reflux disappeared. It went away for a really long time (5 years) and I hadn’t worked out since. I got lazy, back to my old ways, and I am back to hurting again.

    Time to workout, stop over eating, and strengthen up my body once more.

    PS. The omeprazole didn’t seem to help much, probably just a bandaid while I worked on getting myself physically fit. I am on protonix now 2 times daily and am starting to workout despite how I feel in order to see if this helps. I am having little to no relief and hoping I can redo what I did many years ago.

  10. Thank you for sharing this.I have been wanting know of exercises that can tighten the LES muscles. this helps. if any one sees any sites for exercises to strengthen LES pl respond to this. I started with my breathing exercises from today. am planning on going to nutritionist too. aparently we should learn to eat the right food and avoid the food triggering it. I am not happy to take meds but have to.

  11. Thanks so much for this site. I too discovered the power of breathing exercise for LPR or silent reflux. I discovered it by accident in my quest to reduce stomach bloating. I came across several utube videos for yoga breathing and digestion. Lo and behold, I noticed my LPR improve significantly. So let’s spread the word on this because meds. especially for women and bones are not an option.

  12. I have GERD, Esophageal Hypersensitivity and my LES is slow to open causing my food to pool in my chest, which then causes esophageal spasms. I also have Burning Mouth Syndrome, which I feel has some type of connection to my chest pain. If my esophagus pain is bad, my mouth pain us bad. There is no cure or a cause and very little to do to help the pain. I have stopped my PPI because it did not help and everything I have read about long term use of this drug concerned me. Over the last six years, I gave tried every PPI on the market. And none of them worked for me. I have had two balloon dilations on my LES valve. It has helped some with my pain, but I do still have episodes of pain. All this us very hard to live a normal and quality life. I am going to try the breathing techniques. Thank you for this information.

  13. I read a great article by a MD that said to do breathing exercises, but to make the LES muscle work you have to push your stomach out and relax those muscles, then inhale. When exhaling, pull stomach in and exhale. Its the opposite of what you would naturally do. He said your diaphragm surrounds the LES, and doing these exercises will work both. It makes the diaphragm do the breathing. Doing this while inverted is even better, because the LES has to work to hold in acid at same time your exercising it. Probiotic yogurt and, Melatonin the sleep aid is also good for digestive health. Hope this helps.

  14. I have had LPR for over 18 months now – won’t bore you with all the details of endoscopy, x-rays, PPI’s (yuk) etc etc. But like you, the breathing exercises, which I only started about ten days ago have been magical. I realised I had been breathing with the chest, not the diaphragm and changing to the diaphragm, or belly breathing as some people call it, made incredible differences just after a few days. The globus has virtually disappeared, the bloating which was often horrendous, also almost gone. And no burning mouth or sore throat. Coincidence? Was it going to go anyway? Who knows, but I came upon these exercises and I’m so much better. I still keep away from too much wheat and grains and don’t tempt fate with tomatoes and spices and onions – but it’s a small price to pay!

    • Thanks for sharing your success Fran! I’m happy you’re getting good results from practicing good breathing technique. I wish you the best and continual improvement.

  15. Hallow please help im taking PPI for the year now and nothing helped, please what should I do to strengthen my LES, any help please

    • I use breathing exercises, Rajabu. There are many videos on YouTube that show different breathing techniques. Qigong exercises are good. Lesley mentioned pushups in the comment following yours. Sounds like it couldn’t hurt. The important part is to breath deeply and fully. this is why mental and emotional stress is so harmful; it causes us to breath in a shallow manner, when deep, full breathing is what we need to support our health.

  16. Read a book today about a man who completely recovered from Gerd,no pills worked for him so he decided to start jogging and doing push ups,anyway it worked by strengthening the diaphragm and the LES.I started push ups today and will ride the exercise bike too,knees to weak for jogging.

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