Reflux and the path to relief:
do you need medication for life?

When severe heartburn, a night cough or unpleasant pressure under the breastbone appears, the first and most important step is a visit to the doctor. A clear diagnosis from a gastroenterologist is the absolute foundation. Self-treatment and trying over-the-counter medicines on your own often has little effect, because it doesn't address the real cause.

When I went through this period myself, my doctor prescribed the medication I needed and explained clearly that its purpose was to calm the lining and give the oesophagus room to heal. Medication is certainly not an evil to be feared — in the acute phase it is an excellent, safe umbrella that brings the body relief.

At the same time, I knew that pills alone wouldn't be enough.

Food as medicine and a safe foundation

The basis of success is knowing what suits your stomach and what irritates it. In the acute phase and during treatment it's key to cut out the main triggers (acidic food, too much fat, coffee on an empty stomach) and focus on foods that work like a balm for the stomach — soft porridge, steamed vegetables or pumpkin.

If you work or are on the move all day, without preparing food in advance it's easy to fall into the trap of long hunger followed by overeating. The power of meal prep is having exactly what your stomach needs to hand, divided into smaller portions that don't burden your digestion. A detailed food guide is in Food as medicine and trigger.

Medication as a safe springboard: what PPIs are

Treatment led by a professional and medication from your doctor have real meaning. They help you through the worst period, when the lining is irritated. But once your condition stabilises on medication, there's room for the real work on your own body.

This medication is usually based on proton pump inhibitors (PPIs). They work by suppressing, directly in the stomach wall, the enzymes responsible for producing hydrochloric acid. This makes stomach juices less aggressive and lets the irritated oesophageal lining recover in peace.

Medication shouldn't automatically be a solution for the rest of your life, but rather a safe springboard in the acute phase. It's good to be motivated to gradually reduce and possibly stop medication — always after a thorough discussion with your doctor or gastroenterologist.

In the pharmacy you'll find a range of over-the-counter products — from antacids (such as Rennie) that neutralise acid instantly, to alginates (such as Gaviscon) that form a protective mechanical raft on top of the stomach contents, to milder PPIs for short-term self-treatment. Long-term use of strong prescription medicines does have its downsides, such as poorer absorption of some nutrients (vitamin B12, calcium, iron) or weaker stomach defences.

That's why stopping medication quickly, overnight, is risky. The body can react to sudden withdrawal with a so-called rebound effect, releasing a large amount of acid and giving you the false impression that the reflux has come back even worse.

When your doctor recommends more than a prescription

Along with medication, my doctor back then also recommended rehabilitation for my thoracic spine and practising proper diaphragmatic breathing. This is where things really start to change. Reflux often has deeper mechanical and movement-related connections that no pill will fix.

When you go deeper, you'll find how much targeted movement and breath can do:

• Posture and physiotherapy. Posture has a big influence on reflux. A physiotherapist can advise exercises to improve your posture and release your thoracic spine. Yoga is also great for getting the whole body moving.
• Diaphragmatic breathing. Good breathing brings a lot of relief. People often have poor breathing patterns because of stress or desk jobs, leading to shallow breathing that doesn't use the diaphragm at all.
• The hypopressive method and vacuum. Hypopressive exercise and the vacuum are a great tool. They gently stretch the diaphragm — the muscle that supports the oesophageal valve from outside —, lower upward intra-abdominal pressure and get digestion moving.
• Calming the mind and nervous system. Stress and tension in the nervous system keep the diaphragm in spasm. Once you learn to relax your mind, the whole digestive tract relaxes too. More in When stress is behind your reflux.

What the path to lasting relief looks like

The aim is not to reject medication or be afraid of it. On the contrary — with respect for it and under the supervision of a gastroenterologist, you can safely get through the healing phase. But once you've honestly introduced routine changes, adjusted your diet, started meal prep, exercise regularly, look after your thoracic spine and have mastered diaphragmatic breathing, the right time comes. When these new habits are firmly in your body, you and your doctor can agree on gradually and slowly reducing or stopping medication, or taking it only as needed.

By gradually building this all-round care, you'll get to a point where your body starts working on its own, in harmony. Trust your body, listen to the experts, and discover a path to relief that makes sense.