Papaya Good for GERD? The Jury's Still Out

There's tons of articles, blogs, and websites out there that talk about the benefits of Papaya fruit and GERD:

Papaya is a powerhouse fruit that is not used nearly enough in our society. Papaya is an excellent natural remedy for acid reflux disease.  It is not only a low acidic food, but contains an enzyme called papain that is designed specifically to help with digestion.  It also consists of potassium which is helpful in providing  an healthy bacterial setting for your intestines.  This eases the digestive process and helps your stomach not work as hard.  This is the underlying source of health to fix the disease process. 

Papaya also has more than the recommended daily allowance of vitamin C.  vitamin C also helps with digestion.  You don't necessarily have to eat papaya to get it's benefits.  You can also buy a papaya enzyme supplement.  My family uses this to get our papain and it comes with a mint taste. 

and

Papaya : If you have access to fresh papaya, eat half of one for breakfast every morning with half a cup of yogurt and you will see a huge improvement in the amount of acid your body is producing. Papayas contains papain which will aide in the digestive process along with the live cultures in the yogurt. Squirt a slice of lemon over the flesh of the papaya for added flavor and Vitamins before eating, or sprinkle with a Tablespoon of wheat germ for a nutty flavor. If papaya is not available in your area, pick up some papaya tablets at the health food store. Read the label to be sure they do not contain any salt, sugar or sorbitol (sugar substitute).

However, after more digging, it seems there's still no real evidence, or consensus on Papaya: 

Papaya Enzyme 
One of the alternative treatments for GERD that you may have heard about is papain, or papaya enzyme.Papaya enzymes occur naturally in the fruit of the papaya plant, and they have well established proteolytic properties, meaning that they help digest proteins. For this reason, one of the historical uses of papaya has been as a meat tenderizer -- marinading tough cuts of meat in papaya for several hours can soften the muscle fibers, making the meat easier to chew.

Enzyme FunctionThere simply isn't any scientific evidence that papaya enzyme can help reduce symptoms of GERD. In part, this is because enzymes are very reaction-specific, as explained by Drs. Mary Campbell and Shawn Farrell in their book "Biochemistry." Enzymes with roles in metabolism don't play a part in digestion. Enzymes that digest fats can't affect carbohydrates. In the specific case of papaya enzyme, because it digests protein, it has by definition no effect whatsoever upon acid production or reflux.

Other Considerations

A further reason that papaya enzyme can't affect or reduce your GERD is that enzymes operate within a very narrow range of temperatures and acidity levels. Very few enzymes can survive the highly acidic interior of the stomach, and papaya enzymes aren't among them. As such, when you consume papaya enzyme, your stomach acid renders it inactive. You simply digest the enzyme, which is itself a protein, as you would any other dietary protein.

For now, I've added papaya to my list of items to buy at the super market.  We'll see how it goes.

Garlic Helps with GERD

You may have read in many places how garlic should be avoided if you have GERD.  However, I've read tons of blogs where people have said the opposite.  I found this article that may help to explain why garlic may or may not help:

Eat Garlic & Parsley: This is one of the biggest myths you will see on line, not to eat garlic. Garlic is one of the great plant healers. The garlic must be crushed or chopped up to release the components. Don't buy garlic that is shipped in from over seas. All garlic that comes into America from over seas has to be irradiated before entering the country. This kills the healing properties. Only buy local grown garlic. Parsley is another great healer. It is not only for garnish. Get fresh parsley, mince it up with the garlic and add it all fish, chicken or meat dishes. Add parsley minced (stems too) to all types of salads, soups and stews. Add a handful into the juicer when juicing other vegetables to pack a healthy punch.

 So, I ran to the store and bought myself some locally grown garlic.  I can't say it's cured me, but it definitely has not hurt.


Also, take a look at more information:

How Garlic Works

• Garlic contains the enzyme allinase and alliin, an amino acid. When a garlic clove is attacked by bacteria or crushed, the enzyme reacts with the amino acid to produce allicin. The new compound is known to fight off bacterial infections, such as those which cause acid reflux symptoms.

Using Garlic

• In order for allicin to be produced, a garlic clove must be damaged, either through biting, chewing or crushing. To relieve acid reflux, you should chew garlic thoroughly before swallowing, or blend a clove with fruits or vegetables in a juicer and consume immediately.

Prevention/Solution

• Whether garlic will be good or bad for acid reflux relief depends on how it is consumed. Despite the known health benefits, in some instances, garlic remains listed as a food to avoid to prevent acid reflux, as are other foods used to create spicy, highly seasoned dishes. These types of foods aggravate the condition rather than help it.

I think the reason why garlic is still listed is because we're all so use to just buying garlic from the super market.  According to articles, this garlic has lost all its original healing properties because import regulations require that the garlic be irradiated (exposed to radiation).

GERD Remedy: Apple Cider Vinegar

I think if you do a search of the internet you'll find that Bragg's Apple Cider Vinegar (ACV) is considered almost a universal cure.  I tried it myself and it did provide some relief, but just not enough.  Nevertheless, there's plenty of people that swear by ACV and how it both helps and removes their symptoms.  Just note, that, currently, there's no studies to support if ACV does or doesn't help with acid reflux.  

Some people say that ACV helps to tighten the Lower Esophageal Sphincter (LES).  The LES is the valve separating the stomach and the esophagus that when weak is said to be the reason why stomach acids flow back up towards your throat.  Some people say ACV encourages the production of acid in your stomach, and so helps if you have low stomach acid.  Others still say that ACV helps in the digestion of fats.

What Kind of ACV

People recommend Bragg's raw unpasteurized apple cider vinegar because it retains the natural enzymes that are lost during pasteurization. You can try finding other brands, but Bragg's seems to be the most popular.  Just make sure it's organic and raw unpasteurized.

How to Drink It

1. Try two tablespoons with a glass of water.  If you hate the taste then mix in a tiny bit of honey.

2. Another GERD remedy I found:
Heaping teaspoon of bee pollen granules. (Let them soak in 8 to 10oz of Purified or Alkaline Water for 15minutes
1/4 teaspoon pure cinnamon (I use Saigon)
1 tablespoon Bragg's Organic Apple Cider Vinegar with the Mother
Mix them together after the bee pollen granules have soaked, and drink it down. Don't sip, gulp.  

Possible Side Effects

1. Teeth Enamel Damage - Make sure to dilute the vinegar.
2.  Apple cider vinegar is suspected to negatively interact with:

• Diuretics
• Laxatives
• Heart disease medication
• Diabetes drugs

3. DO NOT TAKE IF YOU SUSPECT AN ULCER.  ACV can seriously aggravate your ulcer.  Check with your doctor before taking ACV to make sure you're not making your condition worse.

What are H2 Blockers and GERD

Many of us run to the pharmacy as soon as we feel any kind of heartburn. When we get to the pharmacy, we're bombarded by different remedies.  One type of remedy we can take are called H2 Blockers.

I thought maybe you'd like some more information on these drugs:

Examples of H2 Blockers

Generic Name	Brand Name
cimetidine	Tagamet
famotidine	Pepcid
nizatidine	Axid
ranitidine	Zantac

H2 blockers (also sometimes referred to as acid reducers or H2 receptor antagonists) are available in nonprescription and prescription forms. Prescription forms are stronger than the nonprescription forms.
H2 blockers are usually taken by mouth, although some can also be given as an injection. Two doses (morning and evening) are generally recommended to control both daytime and nighttime symptoms. Doctors sometimes recommend a single dose, taken at bedtime, for people who have difficulty remembering to take their medicines.

How It Works

H2 blockers reduce the production of stomach acid. This makes the stomach juices less acidic so that any stomach juice that gets into the esophagus is less irritating. This relieves symptoms and allows the esophagus to heal.

Why It Is Used

H2 blockers are used to treat the symptoms of gastroesophageal reflux disease (GERD). They may be prescribed for your symptoms without any diagnostic testing if your symptoms point to GERD.

• H2 blockers may be used together with antacids.
• Nonprescription H2 blockers may be used for up to 2 weeks for short-term symptom relief. But if you have been using nonprescription medicines to treat your symptoms for longer than 2 weeks, talk to your doctor. If you have GERD, the stomach acid could be causing damage to your esophagus. Your doctor can help you find the right treatment.
• H2 blockers may be used on a long-term basis to relieve persistent GERD symptoms.

How Well It Works

All of the H2 blockers in this class are about equally effective.
H2 blockers heal the damage done to the esophagus by GERD (esophagitis) in about 5 out of 10 people.

H2 blockers also work to help symptoms of GERD. But the number of people who take H2 blockers and who have no GERD symptoms is usually less than 5 out of 10 people. That means that of the people taking H2 blockers, more than 5 out of 10 still have some GERD symptoms.

Side Effects

H2 blockers have been in use since the late 1960s. H2 blockers are well studied and are considered very safe.
Minimal side effects occur with use of H2 blockers. Side effects may include:

• Headache.
• Dizziness.
• Diarrhea.
• Constipation.
• Nausea.
• Vomiting.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Real GERD Cause

High Stomach Acid GERD

HSA

This is what is treated with the proton pump inhibitors.  This also explains why PPIs may not work with everyone, because


Low Stomach Acid GERD

LSA

HCL supplements



I recommend asking your doctor to test your stomach acid levels before accepting any type of medical treatment.

GERD Remedy: Raw Potato Juice - My Current Treatment

So after my HCL supplementation did not work, I was at a loss.  I needed something that would work.  Since I reacted so badly to the HCL supplements, I decided that it cannot be low stomach acid but perhaps the opposite.

I heard from a family friend a while ago that the juice from raw potato can help.  I had tried it a while ago but we messed up the recipe and I got worse so I put that away.  However, he recently reminded me of this remedy so I went researching on the internet again.  I found several articles about potato juice being used as a natural home remedy for GERD and ulcers.  The starchy part of the potato is no good, but the juice itself - fresh juice - is very good for GERD because it acts like an alkaline.

I was already supplementing with DGL Licorice - to help rebuild the mucous lining of my stomach.  I'm also taking Similase to help replenish the enzymes in my stomach.  But this was not enough, so I thought I'd try the potato juice:

Raw potato juice

This is another natural remedy that can help on you acid reflux.
Get two medium sized potatoes, wash clean and leave the skin intact. Remove the buds and cut into pieces. Make sure that you remove all those sprouting and greenish parts, as these are poisonous if consumed. Then use a juicer to extract about 200cc of juices. Set it one side and allow to stand for three minutes, filter the residue and only take the liquid on top.
If you do not like the taste of raw potato juice, add in an apple will make it taste better. 

Do not consume the white sediments at the bottom as the starch will only worsen your condition. You can consume this for twice a day and remember that it must be consume with an empty stomach, for example, you can take it in between your meals. 

Since the sedimentation of starch is still edible, you can keep it and use it to thicken food.

I generally just drink the juice, making sure to keep away from the starch part.  I've consumed the starch part and I almost ended up in the hospital.

Progress:

I'm at the end of day 3 and so far my GERD symptoms have almost disappeared completely.  I'm still not at 100% but I'm definitely better.  I've stopped losing weight and overall feel like maybe this will be it.  I'm hoping.

I'll keep you updated on my potato juice progress.

GERD Causing Foods to Avoid

Tangy Citrus Fruits

Oranges, grapefruits and orange juice are classic heartburn foods

Tomatoes

They're highly acidic and are likely to trigger your GERD.

Garlic

Onions

Spicy foods

Peppermint

Cheese

Nuts

Avocados

Greasy redmeat (rib eye)

Alcohol

Caffeine

Chocolate

Carbonated Beverages

Fried/Fatty foods

Vinegar 

Excluding apple cider vinegar which has been known to help some GERD sufferers

High sugar foods (including fruits) 

Almonds Keep the GERD Away

So I realized today that I can eat almonds without ever getting any GERD.  I was surprised today that I was able to just eat a handful of almonds (never too much, because we know over eating is no good). I thought "I'm cured," because I didn't feel any GERD.  So, of course, I went looking for the reason.

Eat Raw Almonds: There is a lot of powerful good things packed into these little tear-shaped nuts that are very beneficial to people that suffer from acid reflux. They are packed full of protein and amino acids. Grind them up into almond milk for another healthy food to replace junk food in the acid reflux diet. Almonds will help your heartburn and acid reflux.

However, some say that almonds is actually a trigger for GERD.  It's definitely not the case for me, but you try it and see:

PropertiesThe USDA reports that almonds have more than 200 calories and nearly 18 g fat per 1/4 cup. Nutritionally, almonds can still serve as part of a healthy diet because most of their fat content is unsaturated and they contain none of the cholesterol that meat- and dairy-based fats have. However, in terms of GERD, the source of fat does not matter; almonds still run the risk of causing the LES muscle to relax or weaken. Prevention and AlternativesIf you have GERD, you may already know that almonds are a trigger food for you, or you may never have experienced symptoms related to almonds. Just because almonds have properties that can encourage reflux does not mean they're a trigger for everyone, so it's not necessary to eliminate them from your diet entirely until you judge your own reaction to them. However, the University of Pittsburgh Medical Center does suggest avoiding all nuts if you have chronic GERD and instead, choosing fats such as vegetable-based oils and plain cream cheese. You may also find that traditional GERD remedies, such as wearing loose clothing and maintaining a healthy weight, can offer relief.

Because it seems this topic is still up in the air, I suggest you try eating a bit of almonds and see how you feel.  Like anything, don't eat too much and try to have a varied diet.

Foods to Eat to Prevent GERD

I personally eat these foods, they generally do not aggravate my GERD.

Oatmeal
Drop that doughnut, unless you want heartburn for breakfast. If you have GERD, high-fat food is usually a recipe for pain. Instead choose oatmeal. It's a low-fat, high-fiber meal that can soothe your stomach. Top it off with sliced bananas, which are thought to fight stomach acid naturally.

Ginger
Fresh ginger acts as an anti-inflammatory and is an age-old remedy for stomach problems of all kinds. You can get your daily dose—2 to 4 grams (more than that can actually cause heartburn)—by steeping ginger in hot water to make tea, chewing a piece of ginger, or using ginger generously when you cook.

Pasta (hold the red sauce)
Tomatoes and heavy sauces are a no-no for people with GERD—which rules out a lot of classic Italian dishes (unfortunately). For those with a craving for pasta, the National Heartburn Alliance recommends thin, broth-like sauces. And using a whole-wheat pasta will boost your fiber intake.

I personally like to make a garlic sauce.  Make sure you use locally grown garlic to make sure the import process has not killed off the health benefits of your garlic.

Beans
Certain fatty meats, such as ground beef, are thought to trigger heartburn. Beans are an excellent source of protein and fiber and a great alternative to meat. If you have GERD, they should be a regular feature in your diet.

Almonds
Raw almonds are wonderful if you're looking for a mid-day snack.  It's loaded with protein and vitamins, and you can be quite satisfied by just eating a handful.

I found a chart that's pretty handy, to which I both added and put some notes for you.  I definitely don't subscribe to eating all these foods, particularly the cookies.  But take a look:

Safe Foods for the Acid Reflux Diet

Food Group	Foods With Little Potential to Cause Heartburn
Fruit	• Apple, fresh • Apple, dried • Apple juice • Banana • Melons • Strawberries Try to limit high calorie fruits.
Vegetables	• Baked potato • Broccoli • Cabbage • Carrots • Green beans • Peas • Romaine or iceberg lettuce • Eggplant • Celery • Sweet bell peppers • Lentils • Watercress Some websites warn against eating vegetables rich in starch, such as potato, sweet potato, carrots, brussel sprouts, tomatos and turnips.
Meat	• Ground beef, extra-lean • Steak, London Broil • Chicken breast, skinless • Turkey meat • Egg whites • Egg substitute • Fish, no added fat • Shrimp, crab meat I've read that pork may not be good for GERD.
Dairy	• Cheese, feta or goat • Cream cheese, fat-free • Sour cream, fat-free • Soy cheese, low-fat Just make sure you're not lactose intolerant or that lactose in some way may be the cause of your GERD.  Cut all lactose out then introduce it again to see if this may be the cause.
Grains	• Bread, mult-grain or white • Cereal, bran or oatmeal • Corn bread • Graham crakers • Pretzels • Rice, brown or white • Rice cakes Just keep in mind that your GERD may be cause because of some Gluten intolerance, so try to cut glutens out then introduce them to see how you feel.
Beverages	• Mineral water • Alkaline water I've read some articles on the benefits of alkaline water, so this may be worth a try.
Fats / Oils	• Salad dressing, low-fat • Olive oil • Coconut oil Try to limit the use of oils as much as possible because, as you probably know, grease can aggravate GERD.
Sweets / Desserts	• Cookie, fat-free • Jelly beans • Red licorice • Potato chips, baked I've been staying far away from all kinds of deserts period, but you can give these a try and note how you feel.

My GERD Cause: Water Addiction

Believe it or not, I think my virtual addiction to water may have contributed to me having GERD.

Let me go back, so about 6 years ago I gave up soda and fruit juices.  Like most of you, I read and heard on the radio and TV about how soda is so bad for you, along with every type of drink that has tons of sugar.  So, me, being a pseudo health conscious person, gave up soda.  Yeap, just like that.  Cold turkey.

I went from a about a liter of soda a day to about a gallon of water a day.  I think I got addicted to the drinking motion.  The best thing is that water is quite accessible, and free!

I think my problem started with my obsession with drinking at least a glass of water at night.  I'd just chug down a whole glass then get to bed.  It's only now, with all my GERD research, that I realize that putting water in your stomach is the same as putting food in your stomach.  Water, like the rest of your food, has to be digested.  Also, like I've written in other posts, water dilutes stomach acids.  This means that I was filling up my stomach with liquid that needed to be digested, while at the same time diluting the stomach acid that was meant to digest it.

By filling my belly with water I was forcing my stomach to digest at night (when digestion slows), while my body was lying down (no gravity to help), and diluting the stomach acid that was meant to do the digestion.

My GERD Cause: Eating Too Little, Eating Too Much

My hate of food goes back to when I was young, being told I wasn't skinny enough.  So I started starving myself.  Unfortunately, my love of food would call me back and I would eat and eat a lot.  I'm not sure if I was a binge eater per se, particularly during my college years.  I was quite thin and eating was just something you did between all the other stuff going on.  This all changed when I came back home and started to work.

Once you're working, going out to eat becomes a big part of socializing.  You eat, you drink, and sometimes you eat some more to sober up before you pass out.  However, as I got older and exercised less, while still going out then I started to put in more pounds.  This is when I discovered lemonade cleanses (which most people I knew used as a diet really).  At some point I lost 20lbs doing that cleanse, just to be told by my doctor that I was much too weak because I had lost so much muscle mass.  I also suspect that doing those lemonade cleanse (ie. starvation diets) led to other health complications, which I wont go into right now.

At some point I just couldn't do the lemonade cleanses, so I started doing crazy calorie diets, trying to stop myself at 1,000 a day; though 1200 was the very minimum they recommended for me.  This is when my binging really started.  I would devoutly keep my diet but once I was off the diet then I just lost all control and would buy like $20 worth of candy, ice cream, and cookies.  I wasn't a big chip person, all sugar for me.  You'd laugh now but I was quite good at eating right during the day, organic, local, all that bs that at night I completely forgot.  Also, I'd control myself all day, whether by choice or because I was busy, then just eat as much as I wanted at night, which was always too much.  Then I'd crash.  I think going to bed with my stomach twice the size of what it should be was an every day thing.  I blamed it on my scheduled: work was at fault for me working late hours so of course I have to eat late then go to bed full.

Prevent Night Time GERD

There's tons of suggestions out there on how to prevent night time GERD.  Just know, I find that by preventing night time GERD, you can wake up to a GERD free morning too.

So here are some of the suggestions I've found out there:

1. Eat your big meal at lunch instead of at dinnertime.

This is very important to make sure you digest your food before sleep.  Going to bed with a full belly is a guaranteed way of not getting a good night sleep.

2. Eat at least two to three hours before lying down.

This will give you time to digest and go to bed with an empty stomach.

3. Avoid foods that are known to lead to heartburn.  Some foods to avoid: chocolate, mint, citrus, tomatoes, pepper, vinegar, catsup, and mustard.

Consider a high protein and low carbohydrate diet.  I'm now on a paleo diet.

4. Eliminate late-night snacking.

This has been extremely hard for me.  I use to do most of my eating as night time snacking.  Just take a look at how I got here. The thing is, that every little bit of food and liquid (including water) needs to be digested and in order to have a good night sleep most of your digestion has to be done before hand.

5. Sleep with your head and shoulder on an incline.

I raised the head of my bed by 4 inches.  I have read in many places that this helps by relieving pressure from your esophagus.  Gravity is a great thing for us GERD sufferers.

6. Sleep on your left side.

I prefer to sleep on my back, but I have found that sleeping on my right side doesn't feel as comfortable.

7. Make sure your bed clothes are loose-fitting.

This really applies to everything.  Forget the tight clothes, they restrict everything in your body. Loose clothing helps your body's circulation.

8. Stop smoking.

Considering all the other problems that smoking causes, this is just not a surprise.

9. Avoid alcohol, caffeine, and carbonated drinks.

This is quite painful.  It means no going out to bars, unless it's to drink water, and no morning coffee.

10. Eat your food slowly.

I find this is very helpful.  I use a small teaspoon, cut my food into tiny pieces, and make sure I pay attention to what I'm eating and how I'm eating.  For this, you may need to turn the TV off while eating.  Just pay attention, slow it down, and chew a lot.

11. Eat smaller portions.  

I think I've cut my food portions by more than half.  Sometimes it's because I really can't eat any more.  Smaller portions will help you not over eat, which very important in controlling your GERD.

12. Avoid fatty/greasy foods. Try lean meats.

I mostly only eat poultry and fish now.  I'm not looking forward to this summer though, because I've always enjoyed a big burger. I've just found that everything to control grease.  I find that eating greasy food will give me what I call my "GERD attack," which is sudden shortness of breath and painful bloating and burping.

Mornings without GERD

I love mornings.

It is only in the mornings when I feel 100% normal, almost every day since my GERD struggle begun. I generally feel light, like perhaps I'm ok.  Better yet, perhaps today will be a symptom free day.  I feel so good!

So why are my mornings better?

I've looked online and can only guess that it's because of my behavior at night.

1. I stop eating 3-4 hours (preferably 4+ hours) before I go to sleep.  I don't get into bed unless I feel my stomach is already empty.

2.  No more snacking after dinner.  At most, I drink water. I know this is hard but every time I put something in my mouth, I wonder how it will affect my GERD.

3. I have changed my diet, I'm now on a paleo diet.

4. I stop drinking glass fulls of water before going to sleep.

5. I try to sleep on my back, this helps to eliminate pressure on your esophagus.

6. I raised the head of my bed 5 inches from the ground.  This makes my bed look quite funny but it does help; it's also better than buying tons of pillows.

Take a look at other recommendations people have for minimizing night GERD.

How to Control GERD

I found this wonderful list on some of the things to do to avoid GERD.  These may not solve your GERD, but they will help to minimize symptoms.

12 Food and Drink Tips for Nighttime Heartburn Relief

1. Prevent heartburn by limiting acidic foods, such as grapefruit, oranges, tomatoes, or vinegar.
2. Spicy foods giving you heartburn? Cut back on pepper or chilies.
3. Don't lie down for two to three hours after you eat. When you are sitting up, gravity helps drain food and stomach acid into your stomach.
4. Enjoy lean meats and nonfatty foods. Greasy foods (like French fries and cheeseburgers) can trigger heartburn.
5. Want to avoid GERD symptom triggers? You may want to cut back on chocolate, mint, citrus, tomatoes, pepper, vinegar, catsup, and mustard.
6. Avoid drinks that can trigger reflux, such as alcohol, drinks with caffeine, and carbonated drinks.
7. Size matters: Eat smaller meals and you may avoid triggering GERD symptoms.
8. Enjoy an after-work drink? You may want to turn to teetotaling: Alcohol can relax the esophageal sphincter, worsening GERD.
9. Crazy about colas? It may be time to cut back. Colas can be related to reflux and to GERD symptoms.
10. Keep heartburn at bay: Don't eat too quickly! Try putting your fork down between bites.
11. Avoid snacking at bedtime. Eating close to bedtime can trigger heartburn symptoms.
12. Reduce your nighttime heartburn risk: Eat meals two to three hours before sleep.

16 Lifestyle Tips for Nighttime Heartburn Relief

1. Steer clear of tight clothes. Tight belts, waistbands, and pantyhose can press on your stomach, triggering heartburn.
2. Strive for a less stressful life. Stress may increase stomach acids, boosting heartburn symptoms.
3. Heavy? Try losing weight. The pressure of excess weight increases the chance stomach acid will backup into the esophagus.
4. Popping antacids more than once a week? You may have GERD, not heartburn, and need more aggressive treatment.
5. Try chewing gum at night. This can boost the production of saliva, which neutralizes stomach acid.
6. Not all "trigger" foods cause GERD symptoms in everyone. Keep track of your symptoms to find your personal triggers.
7. Pregnant? You may experience heartburn or GERD. Talk to your doctor about finding relief.
8. Heartburn worse after exercise? Drink plenty of water. It helps with hydration and digestion.
9. Untreated GERD can radically increase your risk of esophageal cancer. But reflux can be managed. Talk with your doctor.
10. Try keeping a diary or heartburn log to keep track of activities that might trigger incidents.
11. A full tummy can mean a night full of heartburn pain. Wait at least 2-3 hours after you eat before going to bed.
12. Wait for your workout. Don't want to trigger heartburn? Wait at least two hours after a meal before exercising.
13. Nicotine can cause your esophageal sphincter to relax. If you smoke, kick the habit.
14. Some medicines can worsen reflux. Talk with your doctor about alternatives.
15. Use blocks or bricks under the bedpost to raise the head of your bed 6 inches so you can sleep with head and chest elevated. You can also try a wedge pillow.
16. Bend with your knees. Bending over at the waist tends to increase reflux symptoms.

My GERD Plan of Attack

So, I'm a pretty methodical person.  Also, despite feeling depressed over my GERD, I do deep down have hope that I can beat this and will get most of my life back, if not all of it.  But these are the steps I feel I have had to follow:

1.  Hope for my life back, but not despair.

Alright, so I do hope to get my life back but I realize that this may not be possible.  In fact, it wont be possible at all because the reason I'm in this situation is because I led a life that my body could not sustain.  My body couldn't handle the way I drank, nor the way I handled pain killers.

2. Life style / food change.

Yes, my life has to change forever!  Only through changing my behavior for good can I make sure that  a) I can cure GERD, or b) I can cope with GERD.  This is quite hard for most of us because it's so easy to fall on our past behaviors.  I have to walk past an ice cream shop every day, and I sometimes feel like crying at the idea that I wont ever taste ice cream or any of my favorite foods again.  I now try not to think about it.

Instead, I've changed my diet and feel quite strong.

3.  Pay attention to what I put in my body.

So, generally I'd go around eating and drinking whatever I wanted, whenever I wanted.  That just can't be so.

I have been keeping a journal.  At first I was simply writing what I was eating, then I started writing down how I was feeling and how I was reacting to my food and natural supplements.  Guess what?  It's helped a lot.  I now can look back and see what has caused me pain, how bad, how much burping, everything.  I have an app on my tablet, but any phone app should work too.  I write the time, then what I ate, or how I was feeling.  (This has included many burping notations.)

4. Educate myself.

I'd like to thank the internet community for this part.  I have read countless articles, both scientific and amateur, countless blogs and their comments.  The comments have been so wonderful because they've helped me see I'm not alone and what I thought was an odd symptom is really not.

From my readings, I believe that GERD may be caused because of either too much or too little acid in the stomach.  I now many would say is really one and never the other, but I disagree.  You can have GERD with both, and they both have the same symptoms.  I'll delve into the difference in subsequent posts, including the different treatments.

5.  Try and try again.

I have tried so many things now that I feel my kitchen has become a mini "natural foods store."  The thing is, that so many different things work for different people that you really have to just keep trying stuff.  Something that worked for someone out there is bound to work for you.  I'm definitely determined to try every little thing people have done out there.  If they say it works, then why not give it a go?

6. Don't let depression win, shake yourself out of the house.

So, because I was so weak, I just became quite depressed.  I read that making your stomach muscles can help, so I started doing yoga at home.  Well, it seems I was way too weak for that and then not only did my stomach hurt, but also the muscles.  All this made me even more depressed.  Finally, I just told myself, get the hell out of the house!  I went walking.  Just walking has lifted my spirits.

So what's the plan you say?

a. Change diet.
b. Keep a food/symptom journal
c. Educate myself on GERD
d. Try each different remedy
e. Exercise

Water and GERD - How Water Makes GERD Worse

After a few days of suffering from all my GERD symptoms, I started to see a pattern between my water drinking and GERD.  So I did some research on the internet and found out that water makes GERD worse:

You need an acidic stomach environment in order to digest food. When you drink water with meals, stomach acid is usually diluted, which leads to incomplete digestion of food. Undigested food may stay longer in your stomach, which can increase acid reflux symptoms. Drinking water with meals also over fills your stomach, which can cause the LES muscle to open and allow stomach contents to leak into the esophagus.

There are those that would argue to the contrary, explaining that since GERD is mainly due to having too little acid in your stomach, actually raising the PH via antacids or, better yet, by drinking water, then water is a good way of fighting GERD.  Although I see the merits in this argument, this was absolutely not the case for me.

I paid close attention to my reaction to food, and I found a direct correlation between my water drinking and the amount of acid that I felt crawling up my esophagus.  I do mean, that I can't have water about 30 minutes or more before a meal, definitely not during the meal, and at least 1 hour after the meal.  So, I fall more on the camp that says that water, either because it dilutes the acid in your stomach or because  it feels you up is no good for my GERD.

GERD Hell / Symptoms / Suffering

So my Nexium medication ran out, except for 1 pill I had in my bag, a few weeks ago.  I took my last capsule on a Thuraday.  I went out with friends that night.  I tried to be good but we ate quite late.

The next day I felt ok.  Saturday was not too bad, but I started to feel like I couldn't eat as much.  By Sunday, I was already feeling stomach distress.  That Thursday I had to take off work.  I was trying hard to keep things under control.  I ate tiny meals, every two hours.  But at some point it wasn't enough.  I was quite weak.  I weighed myself and I had lost almost 4 pounds in what was about 7 days.  That's virtually impossible for me.  I rushed to get Pedyalite.  I recommend Pedialyte for anyone that thinks they might be dehydrated.  It works fast, and to me, it doesn't taste horrible, bad yes, but not horrible.

It was probably Friday, so 1 week after I quit Nexium that the pain started.  It's hard to describe pain that never goes away.  I had the following symtoms:

Stomach pain
Stomach burning
Lightheadedness
Head pressure (from the back of my head to my skull)
Shortness of breath
Nausea
Constantly clearing my throat
Taste of acid in the back of my throat or slowly rising from my stomach
Painful bloating for hours
Extreme weakness
Sore Throat
Constant burping (particularly after eating or drinking)

I rarely felt hungry because I was in almost constant pain.  It was agonizing that when I did feel hunger, I was too scared to eat.  I knew I had to, so I forced myself to eat, but always with the same consequences.  Worse, even water made me sick!!

I realized after the first few days of being at home that whenever I drank water with my meal: before, during, or immediately after, I felt the acid in my stomach rising up my esophagus.  This is torture because I love water.  I only drink water or alcohol.  So, I did some researched and found out that  water is actually not good to have during meals if you have GERD.

As soon as I read this, I stopped drinking water, which did cut down on my feeling all the acid flowing up my esophagus.  However, I needed to do more, and so I set out to look on the internet for natural ways of curing/treating my GERD.

My GERD Cause: My Ibuprofen Addiction Gave me GERD

So during my stints at the hospital, the doctors thought had an ulcer and so they kept asking me about my use of pain killers and the like.  I thought about it and just nodded, this made sense.  I use ibuprofen a lot.

I was diagnosed with plantar fasciitis.  Plantar fasciitis (PF) is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. The doctor had me change shoes and other things, but also told me to just take pain killers, such as Ibuprofen.  I went to the store and bought the biggest bottle of Ibuprofen and started popping a couple several times a day.  Anything to get rid of my PF.  At the same time, I ignored the warning on the bottle that said that such medications can cause ulcer.  Why ignore it? Because of course that wouldn't happen to me.

Unfortunately, my Ibuprofen habit went further.  I discovered that I could take Midol for my PMS.  Just so you know, Midol and the like have 500mg of Ibuprofen and the like.  This was great, I'd take two. and felt great for all 5 days.

Finally, I decided to get laser to remove the hair on my legs for good.  They recommend people take one or 2 pain killers before the treatment, about an hour.  Well, since I knew Ibuprofen was so good, I was popping 5.  I was obviously out of control and never stopped to think about how these drugs were affecting my stomach.

This pain killer reliance, since I don't think it was exactly an addiction, went on for about 2 years, until my GERD came on.

After my GERD episodes started, I realized how much pain killers harm your stomach:

Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn pain, and others can increase the severity of gastroesophageal reflux disease (GERD).
 Medications and dietary supplements that can irritate your esophagus and cause heartburn pain include:

• Antibiotics such as tetracycline

• Bisphosphonates, such as alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel)

• Iron supplements

• Pain relievers such as ibuprofen (Advil, Motrin, others) and aspirin

• Potassium supplements

Medications and dietary supplements that can increase acid reflux and worsen GERD include:

• Anticholinergics such as oxybutynin (Ditropan) prescribed for overactive bladder and irritable bowel syndrome

• Calcium channel blockers and nitrates used for high blood pressure and heart disease

• Narcotics (opioids) such as codeine and those containing hydrocodone and acetaminophen (Lortab, Norco, Vicodin)

• Progesterone

• Quinidine

• Sedatives or tranquilizers, including benzodiazepines such as diazepam (Valium) and temazepam (Restoril)

• Theophylline (Elixophyllin, Theochron)

I'm now convinced that pain killers contributed greatly to me getting GERD, along with my diet, and my way of eating.

Enjoying Nexium

I have read a lot of blogs the last few weeks and currently feel quite fortunate that Nexium did work for me.  It seems there's many out there that take PPIs twice a day, in addition to other medicines but nothing works.  I was lucky in that 1 Nexium in the morning was enough to keep me, mostly, symptom free all day.

Alright, so what is Nexium and what are PPIs?

Nexium:

Nexium (esomeprazole) belongs to a group of drugs called proton pump inhibitors. Nexium decreases the amount of acid produced in the stomach.
Nexium is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome. Nexium is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).
Nexium may also be given to prevent gastric ulcer caused by infection with helicobacter pylori (H. pylori), or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Nexium is not for immediate relief of heartburn symptoms.
Nexium may also be used for other purposes not listed in this medication guide.

Nexium Side Effects:

Get emergency medical help if you have any of these signs of an allergic reaction to Nexium: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using Nexium and call your doctor at once if you have any of these symptoms of low magnesium such as:

• dizziness, confusion;
  
• fast or uneven heart rate;
  
• jerking muscle movements;
  
• feeling jittery;
  
• diarrhea that is watery or bloody;
  
• muscle cramps, muscle weakness or limp feeling;
  
• cough or choking feeling; or
  
• seizure (convulsions).
  

Less serious Nexium side effects may include:

• headache, drowsiness;
  
• mild diarrhea;
  
• nausea, stomach pain, gas, constipation; or
  
• dry mouth.
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach.

• Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD), a condition where food or liquid travels backwards from the stomach to the esophagus (the tube from the mouth to the stomach)

• Treat a peptic or stomach ulcer

• Treat damage to the lower esophagus caused by acid reflux

Types of PPIs

There are many different names and brands of PPIs. Most work as well as another. Side effects may be different for different ones.

• Omeprazole (Prilosec), also available over the counter without a prescription (Prilosec OTC)
• Esomeprazole (Nexium),
• Lansoprazole (Prevacid),
• Rabeprazole (AcipHex)
• Pantoprazole (Protonix)
• Dexlansoprazole (Kapidex)

Although I was scared, I started taking the Nexium every morning as soon as I got up.  At first, I felt just as sick, like the side effects were worse than the disease; within a week most side effects were gone.  It became a habit, something I just didn't think about.  I just knew I had to take my medication and couldn't drink too much.  Mainly limited my drinking to 1-2 drinks.  That definitely slowed my social life.  I wasn't 100% but I was close enough where I just didn't think I was sick anymore.

After 1 month on Nexium I tried to stop it.  I felt fine the first day, so I went on my usual super drinking and eating.  The following day I was so sick I ran to get another refill.  As the end of my 3rd month approached, I realized I had to some how find a cure for whatever was wrong with me.  At least that's how I was thinking: I just need to cure myself naturally.  No more drugs.  No more risk of 101 side effects.

GERD Doctors - The Gastroenterologist

After ending up in the hospital twice during the same week of New Years Eve (quite the beginning for the year), I went to 2 gastroenterologists.

A gastroenterologist is a physician who specializes in disorders and conditions of the gastrointestinal tract. Most gastroenterologists are board-certified in this subspecialty. After completing the same training as all other physicians, they first complete at least two years of additional training in order to attain board certification in internal medicine, then gastroenterologists study for an additional 2-3 years to train specifically in conditions of the gastrointestinal tract.

The first one of these that I went to said he thought it was an ulcer, so to schedule an appointment.  Due to health insurance issues (surprise surprise), I had to switch to another doctor so I scheduled another appointment.  This time I was prepared, though swearing this had to be an ulcer, and had a list of questions:

1. What's the most likely cause of my symptoms?
2. Are there other possible causes for my symptoms?
3. What kinds of tests do I need, and how do I need to prepare for them?
4. Is my condition likely temporary or chronic?
5. What treatment do you recommend?
6. How quickly will I start to feel better?
7. What if my symptoms don't improve?
8. What are the alternatives to the primary approach that you're suggesting?
9. Are there any dietary restrictions that I need to follow?
10. Is there a generic or over-the-counter alternative to the medicine you're prescribing me?
11. Are there any brochures or other printed material that I can take with me? What websites do you recommend?
12. What caused me to develop this ulcer?

I think I got this list from a website.

The second doctor right away said she thought I had IBS ("Irritable Bowel Symdrome") and gave me materials.  I read the materials and they pretty much said this of IBS:

Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS doesn't cause permanent damage to your colon.  

Now, I that point I had a long list of symptoms I carried with me for my doctor's information.  However, I absolutely knew I did not have IBS.  The only time I had ever been constipated was during my first "GERD Episode."  Otherwise, I have always been very regular, have had normal movements, and my symtoms were more like an ulcer if anything.

However, she said I needed to change my diet.  I read but dismissed her diagnosis, though I did make the appointment for the endoscopy, after much haggling with my insurance.  She also gave me a 3 month prescription for Nexium.  I read about PPIs, about how they have a million side effects.

During that time, I was eating every two hours and more like a bird.  I resented this change in eating.  I complained to everyone I could.  I did not want to fill the prescription because I hated drugs.

Finally, I went in for the endoscopy and all they found was inflammation around my lower esophageal sphincter. The doctor told me that was it, no ulcer, so I started to take the Nexium.

My GERD Beginnings

After living with GERD, I have taken a long look back at my life and my relationship with food.  I now realize that I've had a bit of a love/hate relationship with eating.

I love food.  I love eating food.  I've never been much for cooking, but I'm the first one knocking on my friends' door to see what they have on the stove.  I always say yes to dinner outings, and I rarely turned down a pizza after a night of drinking.  Please note that I'm from New York City.  One thing we have is restaurants and cuisine from every corner of the world, so over eating super wonderful food is quite easy.

This was exactly what happened when I had my first "GERD attack."  I call it this because before that, though I may have had GERD symptoms, I never truly thought there was something wrong:

I drove my family to the mall and ran some other errands.  I think I had maybe breakfast.  I got to my mother's house and she said she would make food.  This was around 9 pm.  I said no, I wanted to go home.  I drove myself home, but before that I stopped at Popeyes.  I'm a big Popeyes fan, never cared for KFC.  I bought a couple of chicken pieces, two servings of large cajun fries, a rootbeer (though I'm really not a soda drinker), and a couple of M&Ms almonds from the 711 next door because I love those and rarely saw them.  I went home, ate it all, and about an hour later I found myself bloated like I had never been.  I thought it would go away so didn't pay it any mind.  2 Hours later: my belly had grown more and I was shocked at how much it hurt.  4 hours later, my belly had not come down.  I read something online about walking to relieve bloating.  I walked for like 30 minutes.  I came back and I was still bloated.  I was a little scared, particularly because I couldn't lay down at all.  My breathing was shallow. I considered paramedics but knew this had to get better.  I sat on my couch and stayed there, barely sleeping.  The next day I was better but constipated, which is quite unusual for me.  I spent the next 4 days eating tons of fiber, but nothing helped me go.  I finally took a couple of different laxatives and that helped.  I could barely eat though, and felt weak.  On the 7th day (New Year's Eve by the way), I went to my family's for dinner and after a few bites of food was dizzy, had hot flashes, and my stomach got so big that my family rushed me to the hospital.  

What is GERD?

So, out of nowhere I have had to ask myself the above question.

This is the answer, according to the Mayo Clicnic's website:

Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.

See also Wikipedia, the National Library of Medicine, and many more out there.

They then list GERD symptoms as follows:

Acid Reflux
Heartburn

When these symptoms occur more than once a week, this is GERD.

Additional symptoms include:

• A burning sensation in your chest (heartburn), sometimes spreading to the throat, along with a sour taste in your mouth
• Chest pain
• Difficulty swallowing (dysphagia)
• Dry cough
• Hoarseness or sore throat
• Regurgitation of food or sour liquid (acid reflux)
• Sensation of a lump in the throat

However, I assure you, I have suffered much more than just Acid Reflux and Heartburn.  Worse yet, it's a day to day struggle.  I very much feel I have lost my life to GERD.  Every day, my first thought is how bad will my GERD be today, and at the end of the day "how bad will my GERD be tomorrow?"

I'm writing this blog to document my experience with GERD.   I hope this helps someone.  Good luck!