Gastroesophageal reflux is prevented by the action of the lower oesophageal sphincter, which creates a non-return valve allowing food and fluid down but not back up again when abdominal pressures rise (such as exercise) or you lie flat (to sleep, swim or crouch down as in a rugby scrum).
There may be problems if intense physical exertion occurs when an individual is lying flat (such as a swimmer) or crouching and pushing hard such as in a game of rugby. A mouth full of vomit can not only be unpleasant, but a significant impairment to sporting performance.
Like any muscle, the lower oesophageal sphincter (which is several muscles working together) can be strained and take time to recover. A correct diagnosis will involve a careful history and examination and may involve an examination under anaesthesia (via a flexible endoscopy). At the time of an endoscopy a wireless Bravo ph probe is clipped to the lower oesophagus and records episodes of acid reflux for 48 hours (it then self detaches and passes out in the stools).
Treatment involves anti-reflux therapies, possibly some dietary modifications but also an exercise programme overseen by a sports physiotherapist with experience in this type of problem.
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