Thank you for your thoughtful response. I am doing the low-acid, whole food diet and lifestyle changes, including smaller more frequent meals and elevated upper body for sleeping. It definitely helps. The PPI helped too but that gave me side effects so I ditched those.

I have had cardiac workups with stress tests and others. Supposedly my CV system is fine.

The GI doc talks to me only when I am coming out of sedation after a scope. He did email me once enigmatically saying he could do laproscopic surgery on me. He didn't specify what it was for. I was left to guess a fundoplication surgery. In short, neither he nor my PCP know anything about diet/exercising to address GERD issues. Drugs and surgery are their tools. They are not good communicators either. I would have to travel to find a better doctor option, which I did do for my osteoporosis (6.5 hours round trip). I just don't know of anyone else worth the travel to do the GI consult.

I have signed up with various exercise coaches explicitly stating my GERD condition and how it affects my exercise comfort. They all assure me they have dealt with GERD patients before and know how to approach abdominal exercises. Then guess what? Same old same old.

I read about the Iqoro device, which isn't available in the US. Based on someone else's comments, I bought a mouthguard with strap to replicate the Iqoro and do the associated breathing exercises to mitigate the hiatal hernia. I think there was limited success with that approach.

So ..... I have done the plain vanilla recommendations and have found success for the most part. The exercise question is the last big remaining puzzle piece.

I asked the question because if the pain is just esophageal spasms, I wouldn't care that much. I could ignore it, and hope it lessens over time. However, if it's the stomach poking through the hernia, that could mean bigger problems down the line. Ditto if it was also acid/pepsin shooting up that I couldn't feel or taste, but would still do damage.

I will continue to search for abdominal exercises that don't cause chest pains. I need a strong core for balance and bone health. GERD surgery is a last resort for me.

Thanks again for caring!