Yoga to Cure GERD

So in my search for a GERD cure, I read some stuff about how Yoga can help with GERD.  There's a number of yoga postures that people recommend to help with digestion.  So I went to Youtube and grabbed some videos.  It's really a simple search for Yoga and GERD.  I did some of the postures, and it was alright but didn't really stick with it.

After that, I was talking to a friend of mine who goes regularly to Bikram Yoga, and she finally convinced me to go:

Bikram Yoga is a series of twenty-six Hatha Yoga postures and two Pranayama breathing techniques designed to provide a challenging, invigorating, rejuvenating and effective yoga experience. During this 90-minute class, you will work every muscle, tendon, ligament, joint and internal organ in the entire body, giving you an incredible sense of well being.

There's Bikram or Hot Yoga studios around the world, so you can definitely find them, hopefully not too far from you.

I've been doing Bikram Yoga for the last 40 days or so, and I can tell you, I feel amazing:  I've lost weight, posture is better, stomach feels stronger, and have increased my overall flexibility.

It's to the point that I really don't feel like I have GERD anymore, at at least the symptoms have virtually disappeared.  About 3 weeks after I started doing Bikram, I started to: drink alcohol again, eat spicy food, eat closer to bed time, and eat bigger meals.  I do try to keep my portions smaller than before, but overall I'm to what to me is normal.

Kicking the Omeprazole / Nexium / PPI Habit

So, lately I've been wondering if it would have been better to not stop my nexium/omeprazole (started on Nexium) medication.  I went on a hunt to see what other people found to work best.  In reading, I found that simply stopping the PPI or H2 blockers because this may cause a sudden and nasty rebound effect.  It seems that gradually stopping may work best.  Take a look at the following schedule that was suggested for stopping Omeprazole:

1.

Week 1: Alternate 20mg of Prilosec (Omeprazole) with 100mg Prilosec
Week 2: 10mg Prilosec
Week 3: Alternate 10mg of Prilosec with 80mg Pepsid (Famotidine)
Week 4: 80mg Pepcid
Week 5: Alternate 80mg Pepsid with 40Mg Pepsid
Week 6: 40mg Pepcid

2.

Week 1 : alternate 10 mg Prilosec with 20 mg Pepcid
Week 2 : alternate 20 mg Pepcid with 10 mg Pepcid
Week 3 : same as week 3
Week 4 : 10 mg Pepcid
Week 5:  Use Apple Cider vinegar, DGL Licorice & ginger.

3.

Week 1: 40mg Omeprazole
Week 2: 20mg Omeprazole
Week 2: Alternate 20mg of Prilosec (Omeprazole) with 10mg Prilosec
Week 3: Alternate 10mg Prilosec, 40mg Pepsid
Week 4: Alternate 40mg Pepcid (Famotidine), 20mg Pepcid
Week 5: 20mg Pepsid, 10mg Pepcid
Week 6: 20mg Pepsid, 10mg Pepcid
Week 7: 10mg Pepsid
Week 8: 10mg Peps, Off (take DGL Licorice, apple cider vinegar at night, ginger)

4.

Take your Omeprazole/Nexium/Etc. capsule and begin to remove 1, then  2, then 3,  then 4, etc., of the capsule's content every day, until you're down to none.  This takes some effort, but has been known to work.

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.

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.

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

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.