Acupressure for Heartburn and Acid Reflux

Heartburn is a burning feeling in the chest or throat. It happens when stomach acid flows back up into the esophagus, the tube that carries food from the mouth to the stomach. A ring of muscle at the bottom of the esophagus normally keeps it out; when that ring does not close fully, stomach contents leak upward. This is called reflux.

MedlinePlus notes a few things that shape how to think about it:

• it is often worse after eating, when bending over or lying down, and at night;
• pregnancy, certain foods, alcohol, smoking, being overweight and some medicines can bring it on;
• heartburn more than twice a week may be GERD (gastroesophageal reflux disease). Over time, reflux can damage the esophagus, so frequent heartburn needs a provider, not only self-care.

Acupressure is self-care for the occasional episode. The Heartburn page is the reference; this post explains the routine and the evidence behind it.

Burning in the chest is usually the stomach, but not always. MedlinePlus warns that other symptoms, such as crushing chest pain, could be a heart attack. If the pain is crushing, call your local emergency number right away. Do not stop to try acupressure first. The warning signs are on the when not to self-treat page.

We found no Cochrane review of acupressure or acupuncture for heartburn or reflux itself. The nearest one is a 2014 Cochrane review of acupuncture for functional dyspepsia, which is ongoing indigestion with no cause found on testing. That is not the same as reflux, so read it as a neighbour, not as evidence for heartburn.

It pooled 7 randomised trials with 542 adults, and looked at needle acupuncture and electroacupuncture, not acupressure.

• Against medicines, in four trials, there was no clear difference in symptoms.
• Against sham (fake) acupuncture, three trials reported better symptom scores with real acupuncture.
• Side effects were minor, but several outcomes were not reported at all.

The authors rated all of the evidence as low or very low quality and concluded that it cannot yet support a robust conclusion about whether acupuncture works or is safe for functional dyspepsia.

So for heartburn, little high-quality research exists, and the points below are tradition, labelled as such. What MedlinePlus advises for reflux (below) comes first, and the routine is built around it.

Traditional use: in TCM, these points are traditionally used for heartburn and an upset stomach. Each point's page shows where to find it and when to skip it.

• Main points: CV-12 Middle Duct (Zhōng wǎn) on the upper belly, PC-6 Inner Pass (Nèi guān) on the inner forearm, and ST-36 Leg Three Miles (Zú sān lǐ) on the lower leg.
• Optional: SP-4 Grandfather Grandson (Gōng sūn) on the inner foot.
• When stress sets it off: LR-3 Great Rushing (Tài chōng) on the top of the foot.
• Another point the page lists: BL-21 Stomach Shu (Wèi shū) on the back. It is hard to reach on yourself; skip it rather than strain.

The Heartburn routine has the order and timings. The idea behind it is simple: reflux gets worse when you lie down or bend over, so do the routine sitting upright, not lying on a bed or the floor.

1. Sit up straight in a chair with your feet on the floor. Breathe slowly for a minute.
2. Start with CV-12. Because it sits on the belly, keep this one light: small, gentle circles rather than pressing in.
3. For the other points, press with your thumb or fingertip, straight into the skin. The pressure should be firm, steady and noticeable, but never painful. Start lighter until you know how much feels right.
4. Hold each point for 15 to 30 seconds to begin with, and work up to 1 to 2 minutes. Do both sides for points that come in pairs. Cross one foot over the other knee to reach SP-4 and LR-3 without bending forward.

Don't press on broken, irritated or blistered skin, bruises or new scars, or on an area that has not healed after surgery. If you have a bleeding or clotting disorder or low platelets, press more lightly and for less time, or ask your doctor first.

Pregnancy can bring on heartburn. If you are pregnant, leave out CV-12: the guide marks it as traditionally avoided in pregnancy (see its page).

MedlinePlus lists these changes for reflux:

• Avoid tobacco, alcohol and the foods that set off your symptoms.
• Eat dinner 2 to 3 hours before bed, and don't eat after it. Lying down within 3 hours of a meal makes reflux more likely.
• If symptoms are worse at night, raise the head of your bed.
• If you are overweight, losing weight often helps.

Some medicines can bring on heartburn. Talk to your provider before changing or stopping any medicine, and ask them about medicines for heartburn.

Call your local emergency number for crushing chest pain or other signs of a heart attack (above).

Contact your provider if you have heartburn more than twice a week, if it does not get better with these changes, or if you have any of these:

• bleeding
• choking, such as coughing or shortness of breath
• feeling full quickly when eating
• vomiting often
• hoarseness
• loss of appetite
• trouble swallowing or pain when swallowing
• weight loss
• a feeling that food or pills are stuck behind the breastbone

See also when not to self-treat.