How to deal with acid reflux, heart burn, IBS and more.
woman with upset stomach in bed
Credit: Christopher Baker

The phrase "healthy gut" may sound like an oxymoron. But your gut isn't a few pesky abdominal pounds you want to lose; it's a biological powerhouse you want to cultivate, because it's critical to your digestion-and your overall well-being. The system that breaks down food to energize and nourish you also hosts trillions of bacteria, and when they thrive, so do you. They help you shed extra weight, control your cholesterol, and boost your immunity. In fact, nearly 70 percent of your immune system lives in your gut.

What's going on down there also can affect how happy and relaxed you feel. That's why experts often call the gut the "second brain," referring to the complex network of neurons, hormones, and chemicals that link your gray matter and your belly-and why digestive woes can have such a profound effect on your mental health, and vice versa.

When your gut is out of balance, you know it. A grumble here, a bout of gas there, burning that makes your chest feel like it's on fire-these are all signs that something's out of whack. Veering from your routine can cause problems, as can stress; too little sleep and exercise; and grabbing whatever's easiest, yet not always healthiest, to eat (aka living a normal, packed human life).

For healthy digestion, food needs to move through at just the right speed, neither too quickly nor too slowly, says Susan Blum, M.D., founder of the Blum Center for Health, in Rye Brook, New York. Pick up a few good habits and treat your discomfort smartly, and you'll be back on pace in no time.

Acid Reflux

You had a second helping of spaghetti with marinara at dinner; now the acid is working its way back up. Australian research shows that women are more likely to report having heartburn-and that their symptoms (fiery chest, coughing, and sore throat) tend to be worse than men's.


Tomatoes are prime examples, as are chocolate, citrus, and spicy foods. "But everyone's triggers are different," says Sumona Saha, an associate professor and gastroenterologist at the University of Wisconsin School of Medicine and Public Health, in Madison. Keep track of yours, and try to avoid them.


Sit down to smaller, more frequent meals that contain fewer fats, and wrap up dinner at least three hours before bed to give your body time to digest.


"Antacids can do the trick if reflux isn't severe or frequent," says Saha. But if your symptoms occur more than three times a week, you may need an over-the-counter H2 blocker like Zantac or Pepcid, medications that cut the amount of stomach acid you produce by targeting histamines. The key to relief is following the instructions carefully.


Women contend with this discomfort more often than men, too, because our colons are about 10 centimeters longer, which can make our digestion more sluggish. Not getting enough fiber (plentiful in foods like oatmeal and avocado; aim for 25 grams a day) or water (the Institute of Medicine, which is associated with the National Academies of Science, recommends 2.7 liters) slows things down further; so can travel and pregnancy. If the issue lingers, tell your doc; she may screen you for other potential causes, like a low thyroid, says Jennifer Katz, a gastroenterologist at Montefiore Health System and an assistant professor at Albert Einstein College of Medicine, in New York City.


These supplements encourage the growth of healthy bacteria, says Blum. Look for formulas with at least five different strains and 15 to 30 billion bacteria. Yogurt and kefir are great food sources.


"I tell my patients to hop on a treadmill for 30 minutes when they wake up as their morning laxative," says Saha.


It's not a cure, but an a.m. cup of coffee can help get your gut going, says Patricia Raymond, an assistant professor of clinical internal medicine at Eastern Virginia Medical School, in Norfolk.


This stomach inflammation is brought on by bile reflux, alcohol, or potentially harsh medications such as NSAIDs (like ibuprofen and naproxen)-meds many women rely on for migraines and period cramps. You know it's gastritis if eating buffers the pain, or if you take Tums like it's your job and they don't help, says Raymond.


Rather than leaning on ibuprofen and its ilk, consider what sets off your headaches and play defense. For instance, if it's stress or staring at a computer screen, build a lunchtime walk into your day.


"Some people can go through ibuprofen like candy and be okay, while others may have one at that time of the month and get a painful sensation," says Raymond. Reach for NSAIDs only after a full meal.


A bacteria called Helicobacter pylori that lurks in dirty food and water can cause gastritis and gastric and duodenal ulcers if left untreated for years (though half of us carry it and are symptomless). It can be really nasty: "Women with H. pylori are 16 times more likely to be diagnosed with gastric cancer," says Raymond. Searing pain is a clue that it's there and acting up. A breath, stool, scope, or blood test, followed by antibiotics and a high-dose proton-pumpinhibitor antacid, will usually wipe it out.

Irritable Bowel Syndrome

A hypersensitive gut-marked by abdominal pain, excess gas, and bouts of (sometimes alternating) diarrhea and constipation-is 1.5 times more common among women, says Katz. Your symptoms are more than a fluke when you have them at least one day a week over three months.


Research shows that eliminating foods containing various hard-to-digest sugars (like garlic, dairy, and many breads) from your diet can bring relief. It's tricky, because you need to systematically monitor the foods you restrict and how each change affects you, so talk to a doctor or dietitian first. The Monash University FODMAP app is also a helpful resource (


Fill up on fiber and water to help prevent constipation. Then keep helpful meds on hand: Your doctor can prescribe laxatives or antidiarrheal drugs to use as needed.


"Stress, anxiety, and depression can affect digestive function. And when your GI tract is out of sorts, you may feel more anxious," says Saha. To help break this mind-gut feedback loop, your M.D. may refer you to a psychologist.

Feeling Puffy?

"Outside of your period, bloating isn't normal," says Blum. "Some women tell me, ‘I look nine months pregnant after I eat.' That's not supposed to happen." Abdominal swelling and tightness can stem from stress, food sensitivities, and chronic constipation, among other things. If your belly feels like a balloon, try these tactics to deflate it.


Once you hit 40, your body produces less of the fluids that help you break down what you eat. Add a plant-based digestive enzyme to your mealtime routine to help your body metabolize food better.


Downing sparkling water all day, chewing gum, and drinking through a straw all fill your belly with air, says Raymond. Sip still water from a glass instead.


A brisk lap around the block can help move gas through.


"Some people stop eating gluten and dairy and say that solves their constipation issues," says Blum. Before you take this route, consider working with a nutritionist to make sure you're getting all the nutrients you need, and ask if you should be tested for conditions like celiac disease.

LEARN: Why You Should Take A Probiotic


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