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 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.

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.

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.

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.