I’ve been dealing with it for a couple years and still have the occasional flare up. Had a doozy about three weeks ago and the doc tried getting rid of H. Pylori (which can cause peptic ulcers) by BIG doses of two antibiotics. That seemed to work but then at the end of treatment I somehow got strep throat and was put on a third antibiotic which caused another huge flareup, which I’m still getting under control using aciphex (used Protonix in the past but that stopped working)
My big question after doing some digging online is that there seems to be a split in the medical field about what is really triggering reflux: too much or too little acid. Common sense says “too much” but the arguments on the other side are convincing too. I’m thinking about trying out a digestive enzyme suppliment especially after taking that many antibiotics (I’ll spare you the literal bathroom humor )
So, anybody else have any success with non-standard or standard treatments. Any tiips I may not have picked up over the years?
Any response is welcome. I will be offline until Tuesday SEpt. 2 but don’t let that stop you.
I’m one of the success stories. I was on aciphex, then prilosec. Neither of those worked. My wife had been telling me to drink peppermint tea because it helps with an upset stomach. My doctor laughed when I told him that. Apparently it helps by relaxing the sphincter muscle at the top of the stomach … great for regular indigestion, but horrible for someone w/our particular malady.
I eventually went on Nexium, the new pill by the Prilosec folks. It is amazing. Within three months, my reflux was gone. I’ve done some things to help, though. I try to not eat a meal past 7:30 p.m. – especially a high fat one. If I eat a high fat meal later than 7:30 p.m., I know I’m in for a hard ride and a night sleeping propped up on the couch. Also, I’ve eliminated – okay, well, cut back drastically – sweets after 7:30 p.m. Sweets, for me anyway, is as much a trigger as high fat foods. 'Course, I’m also diabetic, so that may have something to do with it.
Anyway, I hope that helps. It IS something you can overcome. Feel free to PM me if you have any other questions …
Thankfully, I don’t have it. A couple of thoughts here. If you had h. pylori, you may have been developing an ulcer. If you got rid of the bacteria, you may still not have healed the ulcer and it could still be aggravated to pain by foods and stomach acid. Prilosec or Protonix are given to reduce stomach acid to allow the stomach time to heal at the same time one gets the h. pylori treatment. Seems common-sensical.
Having a relaxed or weak sphincter between the esophagus and the stomach has been believed to be a cause of pain as acidic stomach contents work their way up to the esophagus, which isn’t built to take the acid, so, I’d be dubious about relaxing the sphincter on purpose. You’ve probably reviewed the list of foods that relax the sphincter, which, sadly, include chocolate.
Email me if you want a more detailed description of the condition, though, it sounds like you’ve already investigated it.
Tony
Heartburn or GERD is caused by stomach acids backing up into the esophagus. Therefore, you want to avoid any foods that relax the esophageal sphincter. These include foods such as mint, chocolate, coffee, fatty foods, alcohol and tobacco. Also, pressure on the area can exacerbate the problem. Too tight clothing, or obesity can be factors. Avoid eating late at night. Also, some docs recommend raising the head end of your bed. Bricks work well for this. Certain foods, such as acidic foods or spicy foods may or may not make GERD worse, you just have to discover what are your own trigger foods. It’s interesting, because no matter how acidic a food you eat, it will never approach the acidity of your own stomach acid.
Yeah, I wouldn’t buy the line that GERD is from having too little acid. That’s crazy. If you reflux high-pH (non-acidic) stuff, it doesn’t damage the esophagus. If you reflux low-pH (acidic) stuff, it does. All there is to it.
As for the antacids . . . just keep trying them until you find one that works for you. Protonix, Nexium, etc. are PPIs (proton pump inhibitors) and might work better than the Zantac/Pepcid variety (antihistamines). I’d NEVER take Tagamet unless it was the only thing that worked for me: Tagamet interferes with lots of drugs. The others are, by and large, relatively free of interactions.
The other thing you can think about is taking other antacids as a supplement when times are rough. Bicitra is a good non-particulate antacid that tastes like a Sprite without the carbonated water, meaning like soda syrup. It raises the pH really fast, though.
Just out of curiosity, if you’ve read stuff that suggests that GERD comes from too little acid, what on earth do they suggest doing to improve the acid environment of the stomach? Drink hydrochloric acid?
Mine has been very controlled with Aciphex. My doctor told me diet and exercise are also important. It weems weight control and eating sensible are very helpful. I find I have to stay away from drinking too much coffee and anything that causes too much burping to avoid bringing up stomach acids. But for me the Aciphex has eliminated it. The only time I have a problem anymore is when I forget to get the prescription refilled.
I had this problem for quite some time, but only at night. Doc put me on Aciphex, which worked well for a couple of months, then started having severe gall bladder type pains, but nothing wrong with my gall bladder. This medicine “turns off” the acid pumps in your stomach, and I believe I did not have enough stomach acid to properly digest my food. After doing quite a bit of research on natural methods of dealing with this, I started taking high-quality/potency digestive enzymes and probiotics. Haven’t had any problems in a year, although I find if I eat a high-fat meal at dinner, I need to double up on the enzymes!
I hope you find something that works well for you. It is a terrible problem to deal with.
I’ve read about the theory that GERD may be the result of too little, rather than too much, stomach acid. Here’s a quote from an article about it:
“Stomach acid is a paradoxical substance: too little can actually make you think you have too much. Many people think they have acid reflux or GERD, and they take Prilosec or other antacids to reduce the amount of stomach acid. In actuality, they may not have enough acid in their stomach to trigger the opening of a valve at its base. When food begins to fill the stomach, acid is released to assist with digestion. When enough acid is detected, the valve opens, releasing the food into the small intestine. If there isn’t enough acid, the valve doesn’t open. The food, mixed with what little acid is present, is forced back up the esophagus, creating a burning sensation. Paradoxically, the answer to the burning sensation is more acid, not less. Antacids can create a vicious cycle in these cases.”
The article is primarily about Chronic Fatigue Syndrome, which often has a component of hypochlorhydria that needs to be addressed. Here’s a link to the whole text: http://www.cfsresearch.org/cfs/cheney/32nf.htm
The question of whether there’s too much or too little stomach acid can be addressed in individual patients by using some simple lab tests. One source for such testing is Great Smokies Diagnostic Laboratory, www.gsdl.com. They have a comprehensive digestive stool analysis that may be of help. I believe there’s also a test that’s done in a doctor’s office (probably a gastroenterologist), called a “Heidleberg capsule” test, where the patient swallows a small device on a sort of tether, that samples the stomach juices so it can be determined how much acid is present.
I would encourage anyone who’s contemplating taking prescription medicine for GERD to research these ideas as thoroughly as possible. Hopefully, you’ll be able to find a cooperative doctor who will be willing to prescribe some tests and treat according to the actual lab findings, rather than just try a few different drugs until one brings symptomatic relief, perhaps without at all addressing the actual underlying source of the trouble.
Aha. Chocolate usually does a number on me, especially if it’s the cheapo pedestrian junk (won’t name brands; don’t want any litigious chocolatiers on my case). I always wondered about that. What used to otherwise be a cast-iron stomach is in fact showing signs of rust. I’ll want to keep an eye on that.
Thanks for the information, Jerry! However, those ideas are amazingly radical. The product of most of the research I’ve ever seen is that a low pH (or lots of acid) SLOWS gastric emptying. A quick perusal of available online physiology texts . . . this one from Colorado State:
However, if the (stomach)fluid is hypertonic or acidic or rich in nutrients such as fat or certain amino acids, the rate of gastric emptying will be considerably slower and non-exponential. Indeed, the rate of gastric emptying of any meal can be predicted rather accurately by knowing its nutrient density.
pH is a very minor determinant of gastric emptying, much less so than fat content or total volume, but its small contribution is that acid slows empyting (acid keeps that pyloric sphincter closed).
Interesting, though. Much of the chronic fatigue popular wisdom is contrary to “accepted” allopathic medical principles, and this might just be another of them.
GERD can lead to Barrett’s Esophagus (which results from acid damage), which can progress to malignancy. I don’t think keeping the pH down is the right answer for GERD.
I should have mentioned stuff that’s more important than pH for completeness. And, I’ve done more looking, and have seen some things say either way for pH. Gastric emptying is multifactorial, so changing one thing isn’t a cure-all.
One thing I will say is that it’s my opinion that gastric emptying isn’t usually the reason for the reflux. Rather, it’s a loose lower esophageal sphincter. Changing the pH of the stomach contents has the benefit of making the reflux less damaging to the throat.
The chief determinant of emptying time is, I think, fat content. The fattier the meal, the longer it will stay in the stomach. That’s why the fasting guidelines have changed in recent years to reflect better understanding. Now, most places have adopted a 2-4-6 rule. 2 hours for clear liquids, 4 hours for breastmilk, and 6 hours for any other milk or any solids. Human breastmilk is a special case.
What I’m interested in doing is checking with a couple of resources I’m in contact with.
One is the lead pharmacist at one of the compounding pharmacies used by integrative and complementary physicians. He’s a good resource because he knows what hundreds of physicians are doing routinely.
The other is Great Smokies Diagnostic Laboratory, who specialize in functional tests that can help get to the root of various problems that are usually only treated symptomatically by most mainstream practitioners. They employ a gastro-enterologist, who has been a useful source of information in the past.
The problem with the drug based approach is that it tends to eclipse any other potentially beneficial interventions. Typically, the other modalities that may be helpful for a given problem, aren’t patentable and don’t offer profit potential that would justify organized clinical trials and an information campaign to educate doctors in their use.
I don’t know if there’s a body of clinical experience that has developed in non-drug based treatment of GERD, but I’m interested in finding out.
I mentioned breastmilk because . . . I’ll come clean . . . I’m a pediatric anesthesiologist. Truth is out.
I have no problem with non-drug therapies, as long as the motivation is finding the best therapy. I have trouble with so-called holistic treatments that start with the premise that medications are evil.
Here’s a bit from the wife.
I’ve experience it, been clinically diagnosed and all the gamut. I’m into natural, but went the “quick” route via Nexium. Worked for two weeks, but then I stopped being able to digest my food. Imagine still feeling breakfast in your stomach when it is dinner time. I went off the Nexium. We do need acid in our stomach to digest and that medication stopped the production of acid. There are natural supplements that will aid in the rebuilding of the esophagus: marshmallow root, l-glutamine powder, and DGL - deglycyrrhizinated licorice (must be chewable). I no longer experience the problem - except if I have a glass of wine too close to bedtime. The DGL really did the trick. Check with the Health food store or a Licensed Naturopathic doctor. The brand I like is from Ayurveda Science of life - 508-753-0006. Hope this helps. Terri
Also a quick reminder - A good couple weeks of Acidophilus is in order after any course of antibiotics. The best type to get is one that is refridgerated. Terri
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I’ll want to keep an eye on that.