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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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September 07, 2011

GERD: Symptoms, Causes and Remedies

By Mark Sisson
353 Comments

The symptoms can be abject misery: searing abdominal pain, debilitating stomach cramps, an excruciating, rising burn, acid-filled hiccups, tightened throat, constant sleep disturbance, and even the rare but terrifying bouts of choking from nighttime acid inhalation. I’m talking of course about acid reflux or GERD as it’s commonly called these days. I personally suffered from occasional bouts of GERD and experienced all the symptoms above for years during and even after my endurance days. (It wasn’t until I gave up grains that my GERD completely disappeared.) Maybe you’ve had it. Maybe you know someone who’s had it. GERD, by the way, isn’t your run-of-the-mill occasional heartburn (which isn’t much fun either) but a chronic pattern of heartburn in which you experience symptoms at least a few times a week. I get emails about it all the time, and it’s little wonder. Statistics suggest that 25-30% of American adults experience GERD related heartburn multiple times a week (PDF). Of all the pharmaceutical categories, proton pump inhibitors (a predominant prescription for GERD) have ranked consistently in the top twenty for years. And that doesn’t even take into account the old-fashioned antacids like Tums and Rolaids that people pop like candy. What, for the love, is going on here? It used to be heartburn was generally confined to women in their last months of pregnancy or to the annual Thanksgiving overindulgence. It certainly wasn’t a chronic condition plaguing a large percentage of the population. I sense a familiar pattern here, no?

What is GERD anyway? What causes – or at least contributes to it? How do everyday lifestyle choices influence the condition, and what measures – beyond the CW pharmaceutical schtick (e.g. the happy, ubiquitous “purple pill”) – can we employ in treating, let alone curing the condition. (While the establishment might be content with taming the reflux beast, most folks I know who have GERD would rather beat it to death with a stick.)

First off: the what. The standard explanation for GERD goes like this. When someone suffers from a bout of heartburn, acid in the stomach essentially rises into the esophagus following a spontaneous lapse of the lower esophageal sphincter. Although the stomach lining can inherently withstand the caustic digestive acid, the esophagus has no such protection. The result of the chemical invasion is the characteristic pain and cramping those with reflux experience. Over time, the esophagus can build up scar tissue. In more serious cases, the scarring can narrow the passageway, so to speak, and make swallowing more difficult and painful. Worse than that, prolonged exposure to digestive acid can induce changes in the cells of the esophagus themselves, which can – in relatively rare but increasing instances – result in esophageal cancer, one of the deadliest forms of cancer.

As for the why, the medical community doesn’t point to a specific cause, but the conventional pharmaceutical treatments address “excessive” production of stomach acid. (Yes, do the double take.) The most common drugs used for GERD are H2 blockers and the aforementioned proton pump inhibitors, which block the stomach’s production of acid (just at differing points of the signaling-production-release process). The old style antacids neutralize stomach acid that’s already there. The irony of treating people with GERD by raising the pH of their gastric juices (making it less acidic) is that food doesn’t digest as well, which can be a contributing factor to GERD. Decreasing the acidity of your stomach acid may provide short term relief, but it’s not a long term solution.

Prescription medication usually accompanies practical suggestions like eating small meals, limiting alcohol and avoiding nicotine (which relax the lower esophageal sphincter) and raising the head of your bed to discourage acid from rising too far up your esophagus at night and disrupting sleep. (On a personal note, some of my worst bouts with GERD occurred in the reclined position of an airline seat, so that final bit of advice never worked for me.) GERD sufferers are also advised to steer clear of common “trigger” foods like chocolate, alcohol, mint, citrus, tomatoes, onions, and spicy dishes, and (drum roll, please) fatty foods because they contribute to what’s known as slow stomach emptying, which can make GERD symptoms feel worse.

All this leaves GERD sufferers with few answers and no real solutions unless you count a lifelong pharmaceutical dependency as a solution. This doesn’t even take into account the countless people who take acid reflux medications who actually report a worsening of their symptoms with medication. The response? A higher dose prescription. Never mind that research connects long-term use of these drugs with a higher risk for serious infection and fractures. Keep in mind that the stomach acid’s job is to both digest for absorption of key nutrients and to kill off pathogens.

I know a number of people who’ve felt utterly wrecked by their long-term battles with GERD, many MDA readers included. I’ve heard stories from folks (on medication, yes) who said they would get a bad bout of GERD and be in agony for days unable to eat anything, unable to sleep or even find a comfortable position. When they were finally able to lick the condition, they felt they finally got their lives back.

So, if it’s not excess stomach acid, what the heck is it then? Let me put it this way. It’s not about excess stomach acid (unless there’s some other kind of underlying and unusual medical problem). The acid itself is a red herring. It’s ultimately the weakened esophageal sphincter itself. While some things like alcohol and nicotine genuinely relax the sphincter, most of the other maligned food categories are simply irritants to an already irritated stomach and esophagus.

Am I going to tell you going low carb is the answer? Partly, yes. There’s been scant research done in this area (as is generally the case with low carb eating). One small study highlights the effectiveness of eating low carb, but the connection has been noted for years in the low-carb community (check out some of the reader success stories) – but without clear rationale. Sure, obesity is a clear culprit, and a low-carb diet will undoubtedly address that condition. Yes, there’s the potent anti-inflammatory power of a low-carb diet. We’ve always known there’s more to the story, however.

Although the research will continue to hone in on the exact mechanism, one microbiologist expert presents a compelling explanation. Dr. Michael R. Eades has written in the past about researcher, Norm Robillard, and his book Heartburn Cured. Like Dr. Eades, I believe Robillard’s theory provides the most sound explanation for the growing incidence of GERD in Western society. If you have GERD, I’d encourage you to read the entire book, but the gist is this. When we eat a high carbohydrate diet, our digestive systems can become overloaded with their breakdown. (Remember, of course, that our systems aren’t evolutionarily designed to consistently handle the common 250-350 grams of carbs per day). The malabsorption of carbohydrates in the small intestine (the seat of many digestive ills) can result in a damaging overgrowth of bacteria. As anyone who’s suffered from digestive bloating knows, gas is created in the process and can be excessive when something is awry. According to Robillard’s theory, the gas “pressurizes the upper digestive system,” which sets in motion the reflux mechanism. Robillard, a long-term GERD sufferer himself, reports being fully cured by adopting a low glycemic diet.

But there’s more. Many people who are diagnosed (and pharmaceutically treated for GERD) can trace to a variety of medications that take a major toll on the stomach. NSAIDs constitute one. (Do you know those people – often chronic trainers – who down Costco size bottles of Advil in the course of a few weeks just to keep doing what they do? Add to this list oral antibiotics, which dermatologists often prescribe for long-term use in cases of acne. Others? Try nitrates, calcium channel blockers, theophylline, and one more of note….

You won’t hear this one from many people, but it’s important. Higher estrogen levels can relax the lower esophageal sphincter and can irritate the stomach and even cause the GERD or GERD-like symptoms (which – as in many cases in general – may be more simple stomach irritation than actual reflux). Most women who’ve been pregnant experienced heartburn in their later months. Sure, a growing fetus and all its supportive baggage (e.g. amniotic fluid and the like) pushing up on all of your organs can impact digestion, but rising estrogen has a hand in this as well.

Pregnant women usually have the baby and that’s that. The hormones shift again, and the reflux goes away. But there are millions of women who every day effectively supplement estrogen with the birth control pill or post-menopausal hormone therapy. For most, the uptick won’t be a major issue. For others, however, this medication may cause significant irritation and inflammation in the stomach as well as encourage GERD by its effect on the esophageal sphincter. In follow up research to the expansive Nurses Health Study, GERD symptoms were more common in those who were taking estrogen hormonal therapy. The larger the dose and longer the use strongly correlated with a rising severity of symptoms. Although the nature of the study didn’t isolate other risk factors, it does begin to illuminate a connection we’ve known for years and should expect now. On an anecdotal and wholly unscientific note, I knew a woman who took Nexium for three years before a nurse practitioner suggested the Pill might be related to her debilitating stomach pain. After going off the Pill (which she’d been on for 10 years), her symptoms finally subsided.

If you experience GERD even on a low-carb diet (and without medications known to negatively impact digestive function), a food allergy (often dairy or grains related) or chronic infection (including H. pylori) might be the culprit. Keep in mind also that for some people, an acid reflux problem can become imbricated (today’s fifty-cent word) with a whole host of other conditions (e.g. a systemic yeast overgrowth or other internal inflammation, etc.) A complete work over might be in order, and an intensive, very low carb period can help starve systemic yeast.

As Melissa from Hunt.Gather.Love. suggests (in relation to her own battle with GERD), it’s important to have patience with the healing process. Once you get rid of the underlying cause(s) of your GERD (and get off the pharmaceuticals), there’s a weak, out of order digestive system to bring back into balance. Commit yourself to a restorative mindset and regimen for a few months.

Here are a few things you can do to support healthy digestion:

  • Take an HCl or other digestive enzyme supplement for at least a few weeks if not months (if your reflux is bad). I believe Robb Wolf recommends NOW Super Enzymes.
  • Try old-fashioned bitters (remember those?) with or after each meal which can encourage better digestion.
  • Repopulate your system with healthy bacteria with hefty probiotics (e.g. Primal Flora) and frequent fermented foods.
  • Up your intake of anti-inflammatory omega-3s (e.g. Vital Omegas).
  • To contend with lingering symptoms while your system heals, try slippery elm, ginger, or DGL (deglycyrrihizinated form of licorice).
  • Some people – men and women – have luck with the various morning sickness teas, which contain a combination of stomach soothing and pro-digestive herbs.

Thanks for reading today, everyone. I’d love to hear from folks who have beaten GERD and those who are still working toward a full solution. Share your thoughts and perspectives, and have a great hump day!

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353 Comments on "GERD: Symptoms, Causes and Remedies"

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Peter
Peter
5 years 18 days ago

I had minor acid reflux that was getting steadily worse, but a few days after I started low carb, it went away entirely. It returns every so often, but usually is the result of eating too much or going off the reservation.

Alison Golden
5 years 18 days ago

The only time I ever experienced this was during pregnancy and it was absolute hell.

Whoever gets this on a regular basis has my huge sympathy on the one hand and a copy of The Primal Blueprint in the other.

Peggy The Primal Parent
5 years 18 days ago

I had acid reflux with just about every meal, every day for years. It totally cleared up after being Paleo for a while.

Eryn
5 years 17 days ago

I’m with you, Peggy. I tried everything for my acid reflux: PPI’s, antacids, sleeping with my bed tilted up, nothing helped. As soon as my diet changed it all went away!

Is there nothing that going Primal/Paleo can’t fix? 🙂

A side note: dairy was a particular issue for my GERD. Any Primal folks who still have issues, maybe consider staying away from dairy as well?

Jake
2 years 7 months ago

Hey I need advice I get server indigestion every time I eat and for the past few days I haven’t got much sleep for school

Karen
Karen
5 years 8 days ago

My pain was horrible for years… I didnt have the money to find out what it was b/c I have no insurance… giving up the grains and going paleo cured it! I have not had a priolosec since starting this way of life and I feel AWESOME every day!

kelly Valmore
kelly Valmore
10 months 21 hours ago

I have just gone grain free for reflux. Was gluten free for many years. since going grain free for only 10 days now my reflux is terrible…is this typical..will it pass?

Stevie
Stevie
7 months 3 days ago

I was wondering if you stayed on the grain free diet in spite of your reflux worsening. Did it finally subside or did you have to stop the diet? I’m having the same problem. Less grains equals more reflux for me 🙁

Nicky
Nicky
5 years 18 days ago

Paradoxically, a friend of mine who suffers from acid reflux has controlled the problem by taking hydrochloric acid capsules while she eats (about 4 spaced out through a meal). Apparently, there is a portion of the medical community that believes the problem is caused by NOT ENOUGH stomach acid. Adding extra acid during meals seems to be working for my friend, so it may be worth checking out.

PrimalGrandma
PrimalGrandma
5 years 18 days ago

Dr. Mercola has lots of info on that very thing — not enough acid as opposed to too much.

Here’s a link to just one of his articles;

articles.mercola.com/sites/articles/archive/2009/04/25/News-Flash-Acid-Reflux-Caused-by-Too-Little-Acid-Not-Too-Much.aspx

Tif
Tif
5 years 17 days ago

I will have to agree. I think it’s the lack of acid, especially after eating a bigger meal(with procesed carbs) when people have the problem.
My husband and I have great luck with
Apple Cider Vinegar. If you mix a tbls. with a couple of ounces of warm water, it’s really not bad. It will also help to balance your Ph levels amoung many other benefits:)

benji
benji
5 years 15 days ago

Just sprinkle some powdered stevia in the apple cider vinegar/water and presto- apple cider.
tastes great, no calories or sugar.

M Manny
M Manny
1 year 7 months ago

Please let me know when did you use ACV, while taking food or after having food.
Thanks for your all help
Manny

ruben
5 years 18 days ago

Nicky i agree with you 100%, i have used HCL in the past and it made a difference, also helping with the digestion of protein.
Most people dont realize that GERD is nothing but the body’s signal of saying “what the heck are you giving me to convert to fuel” also it says, “i will not digest it and in return you will get the message”, lol some people still dont get that and live on meds for that same reason. Just listen to what the body is saying!

Safi
Safi
1 year 5 months ago
If GERD is the body’s way of telling me I shouldn’t be eating something, then I guess I shouldn’t be eating meat. I was a gluten free vegetarian (practiced occasional intermittent fasting) until little under a week ago, I’d had GERD on and off (maybe 1-2 times per week, then off again) for 8 months now, but it has never been as bad as after I’ve eaten meat these past couple of days. My heartburn is horrible. Feels like something is on my chest, then the abdominal aches and pains, and the tight throat. It’s never been this bad. I… Read more »
Janice
4 years 23 days ago

Exactly. Ditto for me. Not sure if my post is here but I also said that my hair and nails have never been better!

Patrick
Patrick
5 years 18 days ago

Mark- one thing to be aware of when you do drop the PPIs- the sudden drop off of meds will cause your stomach to go into acid production overdrive, and will hurt like crazy. After going primal, I stopped taking Prilosec, and my heartburn lasted about three weeks with pure pain- almost to the point of giving in and taking them again. But, one morning I woke up and the pain was gone. Haven’t touched the meds in a year and a half. Like you said and Melissa and I have talked about, patience is key! Good luck!

Michelle
Michelle
5 years 18 days ago

Oh man, this is so good to hear. I’ve been on PPI’s for the better part of the past 6 years, and just quit taking Prevacid. It’s been two weeks and I was about to give up. I don’t have reflux, just a constant burning. I’m so glad to hear that it gets better!

Patrick
Patrick
5 years 18 days ago

Don’t give up! Keep eating Primal, and if you need something for temp relief, just pop some tums or a normal antacid. Also, you can try taking a probiotic in the morning to help. Promise it goes away!

Jill
5 years 18 days ago

I too took prilosec for years and then quit cold turkey. The pain was horrendous and I almost started taking them again, but I stuck it out. Now I am 100% heartburn free, unless I eat something with wheat in it, which is very rare.

Karen
Karen
5 years 8 days ago

WOW !! Im glad that did not happen to me; I was on them for around 5 years…. and I quit cold turkey and was FINE immediately! Totally pain free every since giving up grains and going Paleo!

PrimalGrandma
PrimalGrandma
5 years 18 days ago

From what I’ve read, there’s a terrible rebound effect if the PPI’s are stopped suddenly rather than a gradual weaning off of them. Glad you were able to stick it out until that was no longer the case for you.

Nothing like Big Pharma making sure we stay hooked once we start on a med —-

Ruth
Ruth
5 years 18 days ago
You could try the homeopathic remedy Carbo vegetabilis (30C potency) when decreasing your medication – it also can be used by anyone who is suffering from reflux (or from over-indulging) From Nature’s Materia Medica by Robin Murphy, ND, Carbo vegetabilis – section on stomach – “burning in stomach, epigastric region is very sensitive; digestion slow, food putrefies before it digests; distress comes on a half-hour after eating; belchings after eating and drinking, temporary relief from belching. HEARTBURN. pain worse lying down.” You can have one or more of these symptoms. You can take 2 or 3 pellets (let them melt… Read more »
Another Halocene Human
Another Halocene Human
5 years 16 days ago

Wow, I had a little pain still but the joy of not vomiting after every meal was totally worth it.

I stopped eating wheat and my reflux stopped in 3 days. With prilosec it takes about 2 weeks for the reflux to quit… and if you stop taking it after about 6 months you start needing it again.

After I got the wheat out of the way, the FODMAPS concept helped. Onions and garlic have fructans which turn into bacteria food and create enormous pressure which can lead to reflux.

Jessica
Jessica
4 years 8 months ago

I thought Prilosec was a once every 4 months medicine. Were you taking it all the time? I’m kind of stressed now because I just started taking it and don’t want WORSE heartburn after quitting.

Rachel
Rachel
5 years 18 days ago

Anyone have a perspective on infant GERD? Our little one was diagnosed with silent reflux (no major structural abnormalities) around 2 months and put on Zantac, which made a world of difference. 2 years later, he’s on a proton pump inhibitor, and I’m wondering if he’s ever going to go off meds!

Jen
Jen
5 years 18 days ago

Rachel, has he been tested for food allergies?

Rachel
Rachel
5 years 18 days ago

No, no allergy testing. When I was exclusively breastfeeding him, I did a month without dairy, a month without gluten, and both months without tomatoes, strawberries, peanuts or soy. Didn’t make any difference. Is that something to pursue, you think?

Jen
Jen
5 years 18 days ago
Rachel, I know infants can be prone to this. (Our daughter had it for the first year but never enough that we considered medication. I just cut down on allergenic foods and co-slept to help her if she woke up with problems.) Because reflux issues can take so long to resolve themselves even after a trigger is taken away, I’d go for it and make a plan to get your child off the meds very gradually over time regardless. At 2-years-old, his digestive system has matured, and the flap (sphincter) should be less relaxed. (That’s what our pediatrician told us… Read more »
Magda
Magda
5 years 18 days ago

A month without gluten or dairy is not enough to clean out your system. For dairy it’s at least 6 weeks, I think it’s 2 months for gluten. Have you thought of GAPS?? gapsdiet.com

Vanessa
Vanessa
5 years 17 days ago

I found that I get GERD with gluten, dairy, corn and rice. Aloe Vera juice and capsules, l-glutamine caps, Throat Coat tea, apple cider vinegar, acidophilus, and Antisid wafers (got at Whole Foods, they are kind of like a natural Tums) all helped heal the lining of my gut.

Another Halocene Human
Another Halocene Human
5 years 16 days ago
Vanessa, I tried probiotics and acidophilus for YEARS without the slightest result. The truth is that while the bacteria in these concoctions is harmless to us they don’t make it into our guts alive. Certainly did nothing for the horrible stomach pain that was being caused by eating things I was allergic to. I do think there is a lot of sense to taking betain HCl and papain, or even apple cider vinegar, if you have lowered your acid production after years of proton pump inhibitors. At the least you will send the helicobacter, which cause so much pain, into… Read more »
Brian
Brian
5 years 18 days ago

How you consulted with anyone regarding feeding therapy (an occupational therapist or a speech-language pathologist)?

I’m a speech-language pathologist, however I’m afraid my expertise is limited in the area of infant dysphagia (speech therapy is a VERY broad field). There are professionals who specialize in that area though.

Rachel
Rachel
5 years 18 days ago

Thanks for the input re allergies and OT. It would make sense to pursue that since the little guy has certain foods that he absolutely refuses to eat (most fruit).

eintob
eintob
5 years 18 days ago

Fructose malabsorption?

Cin
Cin
5 years 18 days ago

Oooh, that sounds like allergy-related GERD all right!

I would also explore EoE (google it.)

Marissa
5 years 18 days ago

Melissa, I would second GAPS Diet, most definitely. The doctor who wrote the diet recommends giving babies a pinch of HCL Betaine (brand is NuTriVene) to help stimulate stomach acid. You will notice a difference within one dose. Fruit is acidic, so that’s probably why he won’t eat it. Look into doing the muscle allergy tests – they are more accurate since he is still pretty young for other allergy tests to be accurate. But the GAPS Diet will heal the intolerances if that is the case… Good luck!

Marissa
5 years 18 days ago

There are some great articles about GERD on chriskresser.com. He will help you heal your boy.

Adrienne
Adrienne
5 years 18 days ago
I have a son who was diagnosed with Eosinophilic Esophagitis. This might be something to look into. The Pediatric Gastroenterologist put him on Omeprozole and we have been battling for 4 years to get him off. It is terrible to watch your child in pain. Get him off the pharmaceuticas as soon as you can. I feel like every day we are sliding deeper into trouble. We have gone thru all the allergy testing and gone grain, dairy, and legume free for a year we are definately Low carb and have dabbled with GAPS, but he won’t eat fermented foods… Read more »
Jill
Jill
5 years 17 days ago
My son has Esinophilic Esophagitis as well. And, I’ve been trying to force him to eat Primal because I know it will help. (My horrible reflux completely stopped on 7/27 when I started primal diet.) We did all the allergy testing and nothing came of that. He was on Budesnide (sp?) 1x a day and Nexium 1x a day as well. Then his next scope showed his EE went from 27 per inch to over 100. So, they doubled both meds to 2x per day and added Singular. His last scope showed he was cured. Although I’m afraid it will… Read more »
Bobby
Bobby
4 years 5 months ago
I know this is a little late but in case others stumble upon this, I am 24 and diagnosed with EE. I have been eating strict primal for about 5 months now and there honestly hasn’t been a difference. I understand that primal is the healthiest of livestyles, I have lost weight and gained muscles since beginning the lifestyle but it is not the solution for every EE sufferer. It has to do with allergies of specific foods not just grains or carbs. Sadly I feel mine is mostly meats (haven’t been officially tested because I wanted to try the… Read more »
todd
todd
5 years 18 days ago

…and bear in mind that PPIs (prilosec, prevacid, etc) are the perfect drug from a pharmaceutical profit perspective. studies have shown that severe rebound effects can occur when stopping these meds or missing doses (even in people without GERD that start them). this of course re-enforces the patients’ perspective that they are helpful. as a pharmacist, i see this quite frequently. the only solution is a slow taper off and making friends with potentially several weeks of increased symptoms.

FK
FK
5 years 18 days ago
I suffered from heartburn for years. I would take 24 hour “acid reducers” every day just to feel normal. My symptoms would be worse when I was hungry, so the CW of eating less and avoiding certain foods didn’t apply to me. I felt like I had a serious medical problem and even underwent a endoscopy (and biopsy) to check for scar tissue/cancer in my esophagus. (The results were negative.) It wasn’t until after I lost weight by low-carb dieting that I realized I didn’t get heartburn any more. I didn’t know if it was from losing weight, or cutting… Read more »
Another Halocene Human
Another Halocene Human
5 years 16 days ago

MARK, ARE YOU LISTENING?

Mark missed a big one in this article by not discussing the causes of a weak esophagal valve. Acid reflux can be a symptom of a hiatial hernia, which is–guess what–associated with sitting and with straining to defecate, especially from a high seated position, rather than (primally) squatting.

I’m shocked that he missed a chance to hammer the message home about primal movements and posture.

I think acid reflux is multifactoral but this piece of it should not be dismissed.

desperate
desperate
3 years 7 months ago
Thank you for mentioning a hiatal hernia!! I’ve recently been diagnosed with a hiatal hernia (it’s pretty large for my small frame). I had a severe bout of the stomach virus and shortly after, I could barely swallow. What is the solution if you have a hernia? I rarely, with the exception of this instance, see this mentioned? How are all the comments and diet advice going to help if your stomach protrudes into your esophagus? I eat very healthy and am underweight and unfortunately on meds since I could not eat or swallow anything. Is there any hope for… Read more »
Brian
Brian
5 years 18 days ago

I used to get absolutely terrible acid reflux. I haven’t had reflux since eliminating grains (12+months), limiting carbs and upping saturated fat (and I drink a heroic dose of coffee every day, and eat very spicy food).

Another Halocene Human
Another Halocene Human
5 years 16 days ago

My doc told me to avoid tomatoes and spicy foods. I knew hot peppers didn’t cause the reflux, although they could make it more painful, and I didn’t care to give up tomatoes. Well, one day the pain got so, so bad that I decided to get a (horrors) sauce-less pizza–and my reflux was worse than ever.

That was the day I started to suspect that the wheat might have something to do with it.

Love my tomatoes. (Suck it all you “nightshade” haterz.)

Another Halocene Human
Another Halocene Human
5 years 16 days ago

Heck, a few days after that revelation and the start of my crash elimination diet I actually deliberately overate fish and chips (fish was coated in cornmeal instead of flour)–and kept it all down!!! Overeating? HA! My esophagal valve is STRONG.

AD
AD
5 years 18 days ago
Heart burn is the reason I started researching my diet in the first place. That research ultimately led to me finding out about the paleo/primal diet and lifestyle. When I first developed the heartburn, I turned to my doctor for advice. He put me on some pills (PPI) which I threw away before taking. I don’t like to take medicine. Not even for a cold or fever. So I began researching ways to cure the heartburn. I came upon something called organic apple cider vinegar. If I took a tablespoon of it with every meal, I could eat whatever I… Read more »
kiss
kiss
5 years 18 days ago

I discovered ACV because I was looking for something to help with energy since I’m not keen on medicine/pills either. While researching it, I discovered it would help with heartburn which my husband suffered from terribly. Once he started with ACV it cleared up. There were times he was without it and took a packet of plain yellow mustard or some other vinegar and that worked as well.

Now that we’re Primal and low to moderate carb, there isn’t a need for the ACV, but I still like to use it in salad dressings and the like.

AD
AD
5 years 18 days ago

Yup, I still use it here and there, just not to the extent I did before I went primal. I’m not exactly sure how it worked so well though. I mean, while I was on ACV, I was eating everything that is bad for you, with no problem. I’m guessing it just denatures the proteins even more than your stomach acid does, and renders them harmless. That’s just based on conjecture though.

Andrés
5 years 18 days ago

I don’t know if vitamin D will be effective reducing GERD only in women due to the estrogen reduction effect or it will include men. I will continue to sunbath midday without sunscreen/<take D3 by mouth in either case ;-).

Best regards.

Another Halocene Human
Another Halocene Human
5 years 16 days ago

AD–me too. Found this site after looking for some help with gluten-free diet after I pegged to the fact that wheat was causing my horrible acid reflux.

Burn
5 years 18 days ago

fascinating article… never experienced GERD myself but I’m happy I now know more about it

jakey
jakey
5 years 18 days ago

oh, this is the worst. before taking control of my diet, back in the SAD years, i can remember horrible, sleepless, painful nights… thankfully, this is gone. primal diet seems to keep it gone too, but i will say, that in my low-fat mostly plan-based years, it was also in check. perhaps the real culprit is processed foods?

james
james
5 years 18 days ago

Does anyone have reflux when taking ALA as a supplement?

Suzanne
Suzanne
5 years 18 days ago

I had really bad GERD when I was pregnant with twins. Just one more reason I wish I knew more about primal living back then!

Dr Stephanie DVM
Dr Stephanie DVM
5 years 18 days ago

Currently 31 weeks pregnant with twins and when I “fall off the primal wagon” it is miserable!! If I watch my diet pretty closely I’m usually fine. Occasionally I’ll have a bout I can’t explain but I just blame it on one if the girls being in a position that puts more pressure on my stomach 🙂

Dustorama
Dustorama
5 years 18 days ago
I have had GERD for many years. So bad that it caused damage to the vagus nerve which resulted in gastroparesis (slow stomach emptying). I had great hopes that cutting out grains and eating low carb would help, but alas I still must take Zantac and Erythromycin just to make it through the day. At least I got off the PPIs which were causing terrible stomach pain. I have tried to go off the meds but it just does not work because of the physical damage done. I did go off them recently due to being pregnant and the symptoms… Read more »
Megan
Megan
5 years 18 days ago

Really? I am 21 and have severe gastroparesis since age 16 as well as GERD since age 4. I also have impairment of small intestine and SBBO. Are you able to follow a primal diet pretty well? I cannot digest meat and am allergic to eggs. And yes, I have tried every digestive enzyme on the market.

Dustorama
Dustorama
5 years 18 days ago
I come from a long line of folks with gastroparesis so it was pretty much a given that I would get it. I am also allergic to eggs, soy, and gluten. I can do the primal diet easily, meats are OK as long as I don’t eat too late at night or too much at one sitting (6 oz seems to be the meat limit for me). If I eat any more than that then I end up taking another Erythromycin to get things moving in the stomach and gut. Dairy doesn’t bother me so I do eat Greek (Fage… Read more »
Nion
Nion
5 years 18 days ago

I do find eating yogurt helps DRAMATICALLY. Also milk, but i’m fine with dairy, coming from Dutch farmer stock 😛

Arty
Arty
5 years 18 days ago

Wow, some people have it rough.
I have the stomach of a goat, never experienced GERD or anything similar in my life.

I did suffer from chronic hard stools my entire life though, which cleared up completely after going Primal.

chuck cotton
5 years 18 days ago

unless I missed it in the article, anyone have an idea where the name GERD comes from?

Rodney
Rodney
5 years 18 days ago

Chuck,

It stands for Gastro-Esophageal Reflux Disease, because it is the gastro-esophageal sphincter that is incompetent.

captain mike
captain mike
5 years 17 days ago
One of the great fallacies of this syndrome is that the esophageal sphincter is weak. In some cases that can be. But the most instances, it is that the duodenal sphincter (the other gate) that is stronger. It’s purpose is to restrict the stomach contents (chyme) until the pH has been lowered to a point where the more sensitive upper GI tract can do its job without being damaged (digested, as in duodenal ulcers) by your own gastric solutions. There are several reasons your stomach wont let go – but the bottom line is your system is electing to expel… Read more »
K.Gopal Rao
K.Gopal Rao
5 years 17 days ago

Not to worry, not gross, by any means. Nothing biological can be gross. However, if this theory is correct it means the system is actually choosing to expel acid from the other end, i.e. oesophagal sphincter, which doesn’t sound logical. I presume it makes nodiff whether the acid goes into the duodenum or the gullet, both are equally bad. Why, then, should the body choose to protect itself from harm at one end of the stomach by causing harm at the other end? Any research available into either theory that you’re aware of?

belinda
belinda
5 years 18 days ago

My reflux went away completely within 3 days of going Primal and cutting out grains.

Now, the only thing that upsets me is if I have too much dark chocolate. If I stick to 2 squares I’m ok.

Another Halocene Human
Another Halocene Human
5 years 16 days ago

cocoa, like mint, is, sadly, a stomach irritant.

but I can actually tolerate them now that my GERD is gone, so hooray.

kathy
kathy
4 years 3 months ago

I never (well, rarely) had indigestion or an stomach ache before starting the Primal diet. Now I have it all the time! I feel miserable! I have been on the diet now for 2 weeks! Am I doing something wrong? Is this a normal reaction?

RedYeti
4 years 3 months ago

You probably want to take this over to the Forum Kathy. There’ll likely be plenty of advise there.

It would be helpful if you mention some specifics about what you now eat and how it’s changed for you. Are you eating much more meat? More dairy? That kind of thing.

Generally the reverse effect is found. I’d take a wild guess that you may have less stomach acid than you need – which is easily correctable (Google HCL and Betaine) – and well worth doing to get the full value from your food 🙂

Robin
Robin
5 years 18 days ago

Thank you so much for covering this subject Mark! I’ve been meaning to email you about it since my Mother suffers from GERD and it has been a major obstacle in getting her to start Primal since she attributes her heartburn to eating meat. I really don’t think that is the case at all since it doesn’t happen every time she eats meat. I think her digestive system is in serious trouble based on a combination of symptoms.

Vanessa
Vanessa
5 years 17 days ago

Have her try drinking a glass of water with 2-3 tsp of apple cider vinegar (organic with the “mother” in it like Braggs brand). This will help with digestion.

Another Halocene Human
Another Halocene Human
5 years 16 days ago

Eh, distilled will probably work as well as acetic acid is probably the active ingredient.

Labhrain
Labhrain
5 years 18 days ago
I lived with daily, terribly painful GERD symptoms from my early 20s until recently. I popped Maalox, Tums, PPIs, baking soda and more multiple times every day. I even ended up in the ER one night as the GERD was so bad that I didn’t recognize it as GERD. I though I might be having a heart attack. The doctor gave me the usual advice that you noted in your article. Nothing helped. About 2 weeks after going low carb (9 months ago,) I noticed that I no longer needed the medications. I’ve been GERD free since then, and am… Read more »
Sandy
Sandy
5 years 18 days ago

I used to have the most horrible episodes of GERD. Some nights, in my sleep, acid would rise suddenly and explosively to the point where the acid would pour out of my nose and I would aspirate it into my lungs. The burning was horrendous and I would cough for hours trying to get it out of my lungs.

Within a couple of weeks of going Paleo and cutting out all the grains, I stopped taking the two Prilosecs a day and have never looked back. My doctor is intrigued to say the least!

captain mike
captain mike
5 years 18 days ago
Glad to hear you have improved. It’s really wretched, isn’t it? I Had the same experience long before I went primal, for about a year, even though I’m real healthy with no problems. I was determined to stay away from the witch doctors and their pills. Started some research. Drinking lots of water (Your Body’s Many Cries for Water) helped tremendously, but I still had frequent episodes. I even started having swallowing trouble at some meals, so this was not a good sign. Started taking notes. My worst episodes were starchy meals, especially with dairy. Pizza (one of my former… Read more »
Another Halocene Human
Another Halocene Human
5 years 16 days ago
Wow, water always made me vomit worse–much worse! And eating wheat makes me super, super thirsty so this was a frequent (and disgusting) occurrence. Now that I eat primal I only drink water when I’ve been sweating outside. I’ve switched from watered-down gas station coffee to espresso and get annoyed at all the liquid in tea (I have to pee again?!). Rare juice or alcohol, replaced milk with cream, butter, aged cheese, yogurt, sour cream. According to some doctor’s blog (that was linked in a primal blogroll), too much water at meals increases stomach pH and kinda sabotages good digestion.… Read more »
Pam
Pam
5 years 18 days ago

I recall the first time I experienced the reflux and the time that it awakened me in the middle of the night. It is so awful. I was just telling my son about the fact that I never have it any longer and described my primal diet to him.
He said I lost him when I talked about giving up grains. That was this weekend! And, today’s post was copied and sent to him. I surely hope he reads it.
Thanks for a great article and to PB.
Pam

Liv
Liv
5 years 18 days ago

What about a hiatial hernia?? A low carb diet drastically helps but I still have issues. My doctor critisized my stubborness of taking ppi’s & made it sound like my GERD may not be able to be treated naturally due to this hernia. . Do you think that is true? Everyday my esophogus is getting more irritated and as a result am engaging in this mental battle of whether or not to medicate.

Charlie Golf
Charlie Golf
5 years 18 days ago

I too have a small hiatial hernia. I am GERD symptom free since going strict Paleo. I only get occasional and very mild flareups if I cheat with my eating.

Anne
Anne
5 years 18 days ago

I was told all my GERD was related to my large hiatial hernia. I had to sleep with the head of my bed raised. Funny thing is that when I started a very strict gluten free diet, all my GERD disappeared. Can’t even have a crumb of gluten. That was 8 years ago. Went paleo about 2 yrs ago and still doing great.

Kitty
Kitty
5 years 17 days ago
If I understand right, a Hiatal Hernia is when the stomach is pushed up through the diaphragm and all or part of it is in the chest cavity, where the heart and lungs are supposed to be. If that information is correct, my sister’s chiropractor helped her by pushing downward on the area of pressure, til she moved the stomach back down through the diaphragm to where it belonged. When I felt pressure in my chest and around my lungs with heart burn symptoms I tried pushing down on it and could feel it gurgling and moving and then I… Read more »
Charlie Golf
Charlie Golf
5 years 18 days ago

I took PPI’s for over 15 years. Switched to Primal/Paleo. Drug and symptom-free now. I relish that I am able to eat foods I was told to avoid now that I know the true triggers to my GERD.

Interestingly, I also starting taking an HCl digestive enzyme at the same time I stopped the Prilosec.

Paint me a believer

Finnegans Wake
Finnegans Wake
5 years 18 days ago

NSAIDs can also cause GERD, and a lot of people take them regularly. I used to, and suffered horrible GERD that I mistook at the time for a heart attack. Weaning off excess use of NSAIDs helped me clear up esophogeal pain in days. If your stomach is already irritated, dietary irritants will only exacerbate the issue.

Another Halocene Human
Another Halocene Human
5 years 16 days ago

Hear, hear. Had some horrible episodes with NSAIDs (I think they’re also called COX II inhibitors?).

I had to stop taking them entirely for a while, no matter how bad the pain. Now that I’m primal my pain is less intense and less frequent. I think my inflammatory levels are way down. Don’t eat things you’re allergic to!

Maeve
Maeve
5 years 18 days ago

Home in on, not hone in on. Otherwise, great work, as always.

Josh Frey
5 years 18 days ago

Thanks for posting this. My mom has acid relflux – I’m going to email her the link to this.

Jenna
5 years 18 days ago

The 3rd day after shifting to Primal I went to be dand noticed I hadn’t taken a Tums since I’d started. I skipped the Prilosec the next day and haven’t had it or a Tums since. Such a relief!

Not sure it’s a processed foods thing. I’d been very whole food in the months prior to my Primal shift, and my GERD was raging, the pain and inflamation choking me at times.

katherine
katherine
5 years 18 days ago

I had terrible GERD for several years at the same time as many other symptoms, I was gulping acid back down my throat all day and night. Cutting gluten fixed it though I still get a little bit at night even though I am now totally grain free. But it doesn’t affect my quality of life like it used to. The only reason it didn’t seem a huge deal at the time was that gluten made me so sick in other ways too!

Jo
Jo
5 years 18 days ago
I suffered with reflux about 18 months ago, my doctor (although prescribing the usual meds) was actually quite clued up and mentioned a lot of what you’ve mentioned here, Mark. Long story short, she suggested playing around with my diet and eliminating anything that irritated my system. The easy culprit to identify was dairy – I had a lot of cow’s milk products in my diet back then, and my symptoms almost vanished when I cut it out. I like my dairy though, so I swapped to goat’s milk products and found the symptoms lessened further still. But going Primal… Read more »
RadiantLux
RadiantLux
5 years 18 days ago

I know someone who has goats. She said that goat milk is naturally homogenized. The cream won’t rise to the top. She thinks a cream separator would work but it’s not worth it to her.

Julia Thomson
Julia Thomson
5 years 18 days ago
I developed GERD this past January and did a lot of research. In addition to Norm Robillard’s fine book, I recommend that people read “Breaking The Vicious Cycle” by Elaine Gottschall, which discusses microbial dysbiosis in greater depth. While she recommends the diet for Crohn’s and Ulcerative Colitis, it works for the dysbiosis Robillard describes in his book. I was shocked (and pleased!) to discover, Mark, that your dietary recommendations are almost exactly the same as the dietary recommendations in The Specific Carbohydrate Diet (SCD), with only a couple of exceptions. The key isn’t so much to limit carbs, but… Read more »
Heather
Heather
5 years 18 days ago

That book is a gem! Totally saved my life.

Anne
5 years 18 days ago

I have had wicked awful heartburn while pregnant. I never understood before how heartburn could possibly be confused with a heart attack–but then I had heartburn that bad!

Being rigorous about my diet helped A LOT. (No grains, dairy or sugar. None.) It didn’t go away entirely, but it made it merely uncomfortable, instead of heart-attack intensity pain.

Katherine
Katherine
5 years 18 days ago

I was going to mention the info Julia wrote above, about avoid all but monosaccharides. An interesting book is http://www.lowstarchdiet.net/. I am following a strictly low starch paleo diet as I have mild AS, and it has helped my gut with some milder issues that stopping gluten didn’t completely get rid of. If you have any joint issues as well I would definately recommend trying a period of strict low starch and disaccharides.

Sandy
Sandy
5 years 18 days ago

Perfect timing! i just spent all day yesterday researching this very subject. I’ve been taking Prilosec for 1.5 years. Now that I’ve gone Primal(2 months now, I thought it’s time to get off the med’s. I’m taking HCI/Pepsin with every meal. So far seems to be working. This is a temporary thing as my body adjusts. It’s a slow process but that I think is worth it!!

Mimi Torchia Boothby Watercolors

After having GERD for his entire adulthood my husband was recently diagnosed with cancer of the esophagus. GERD CAUSES CANCER. It is too late for him to save his esophagus, but it is not too late for many of you. This is NOT something you want to mess around with. Those drugs made him virtually asymptomatic, but the damage continued. Hopefully he will survive the cure.

Johnny
Johnny
5 years 18 days ago

Giving up grains and eating lower carbs seemed to do the trick for me. I took Pepcid AC about 3-4 times per week over a year ago. I never take it now.

Turbo Kelly
Turbo Kelly
5 years 18 days ago

My GERD only rears its head if I am eating things off the paleo/primal grid, such as any grains, definitely baked goods of ANY kind (even though I only eat gluten-free, doesn’t matter), and a lot of sugar.

Tom
Tom
5 years 18 days ago
I’m a physician and have advised patients for years to do “lifestyle measures” like elevating the head of the bed, avoiding fatty/spicy food, alcohol, chocolate, mint, smoking (and then I usually ended up putting them on PPIs when those measures didn’t control their symptoms). But of all the foods that might cause or worsen GERD symptoms it never occurred to me — nor was I trained — that grains could be the problem or at least part of it. I suffered from GERD too and was on PPIs myself, but not anymore: my symptoms disappeared when I went primal and… Read more »
Lyne
Lyne
5 years 18 days ago
Hi I’ve been eating Paleo for the past 2 months and my stomach discomforts have been getting worse, although a bit different than usual(i.e. feeling more like light acid reflux rather than paralyzing heartburn). I’ve been diagnosed with gastroparesis (type 1 diabetic). What can I do and eat to stay paleo and try to manage my blood glucose levels and my general health? Enzymes? Food combining (fruits seem to make me bloat more than ever)? Reduce fats (these also seem to make it difficult for me) Taking ACV? Any suggestion is welcomed since I don’t know who to ask nor… Read more »
Another Halocene Human
Another Halocene Human
5 years 16 days ago
Tell them to try taro root. You can cook it in a minute in the microwave. Or potatoes. Everyone knows how to eat those. (Not french fries b/c most places they are “dropped” in the same fat with breaded items, meaning they are full of gluten. McD’s fries have their own, segregated Fry-O-Lator, so they’re okay, though certainly not primal with that nasty “vegetable” oil.) You can buy cassava/yuca in latin supermarkets frozen and boil it. Good with butter or garlic sauce or in meat stews. And sweet potatoes! Nature’s perfect food. Get them to nyam their yams, butter their… Read more »
Dilligaff
Dilligaff
5 years 9 days ago

@Another Halocene Human,

“…McD’s fries have their own, segregated Fry-O-Lator, so they’re okay…”

McDonald’s publishes that its french fries contain milk, wheat, and rancid oils (a possible cause internal inflammation). Yet, you say they’re ok in the context of this article. Hmmmm…not so much!

Your statement is inaccurate-they’re *not* OK. See for yourself:
http://tinyurl.com/3aplt8r

Dilligaff
Dilligaff
5 years 9 days ago

@Another Halocene Human,

“…McD’s fries have their own, segregated Fry-O-Lator, so they’re okay…”

McDonald’s publishes that its french fries contain milk, wheat, and rancid oils (a possible cause of internal inflammation). Yet, you say they’re ok in the context of this article. Hmmmm…not so much!

Your statement is inaccurate-they’re *not* OK. See for yourself:
http://tinyurl.com/3aplt8r

RedYetiDave
5 years 1 day ago

Tom it’s very refreshing to hear a doctor say that they have not only found that the Primal way of eating helped and that they also now advise their patients of the same.

It’s very easy for people to blame doctors for putting them on drugs rather than finding the cause but the information on this is just not commonly known (yet?). So often we hear of doctors casting aspersions on the idea that diet can change such things. Great to hear of a doctor that’s open minded enough to have worked this out properly and acted on it.

Jason
Jason
5 years 18 days ago

I recommend digestive enzymes for a few months along w/ a grain-free diet. For immediate, short-term relief, down a spoonful of organic apple cider vinegar. The taste isn’t great but the relief is amazing.

ShannonCC
ShannonCC
5 years 18 days ago
I’ve never been formally diagnosed with anything, but had problems with heartburn for decades (along with other issues with my stomach and digestion). It got so bad I was waking with panic attacks because I couldn’t breathe. I had been to regular doctors over the years and they never helped so this time I went to an allergist. He explained that was because my esophagus was swollen and prescribed me the little purple pill. It worked, and the heartburn, and the late night panic attacks, both stopped but at $50 a month I was not thrilled. Then I went primal… Read more »
Another Halocene Human
Another Halocene Human
5 years 16 days ago

THE ALLERGIST DIDN’T HELP YOU DIAGNOSE YOUR ALLERGY? WHAT MANNER OF ***KERY IS THIS?

Another Halocene Human
Another Halocene Human
5 years 16 days ago

Sorry for shouting. That is just some crazy $&@#, man.

JLM
JLM
5 years 18 days ago

Yep, I had acid reflux, took medication for it, etc.

Then I became primal and it stopped *that very week*. Haven’t had a single reflux event since then (July 2010).

It’s one of those secondary bonuses of Primal Life 🙂

Danae
Danae
5 years 18 days ago

I suffered from mild but persistent reflux for a couple of years when I was peri-menopausal. I had good success using HCl tablets with meals, so I assume that low stomach acid was at least part of the problem. Around that time I also became hypothyroid. When I finally got that condition corrected (with Armour thyroid), the reflux stopped. I read later that low stomach acid can be a result of hypothyroidism, so that may have been a factor.

Kim
Kim
5 years 18 days ago
Another miserable GERD sufferer for many years. I had an upper endoscopic done about 4 years ago which confirmed I had esophageal damage, a hiatal hernia and polyps in my stomach (proabably caused by the PPI’s) I was on the drugs for over 15 years. I shudder to think of all the damage that has been done. Several years ago I had severe anemia mostly likey the result of a combination of factors including the PPI’s which block the absorbtion of minerals like calcium and iron. Nearly, 2 years ago I went LC for health reasons: to avoid getting T2… Read more »
Janknitz
Janknitz
5 years 18 days ago
I had complete cessation of GERD on my first low carb experience–immediately before any significant weight loss. This time around it’s still a problem, but I had 10 years of additional damage :o( It is much, much better on low carb, though. People should not overlook another connection with GERD which is sleep apnea. Dr. Steven Park hypothesizes that when the airway is closed off during sleep, the struggle to breathe causes a negative pressure in the upper airway, and that pulls gastric juices up into the airway. People with GERD should be evaluated for sleep apnea and vice versa,… Read more »
Greg
Greg
5 years 18 days ago

I had gerd so bad it was making my ears hurt.. I would take HCL and antacids and I would still get heartburn. Went Primal about a month ago and no more heart burn.

Krista
5 years 18 days ago
That’s it, we’re changing our diet. My husband’s family has a history of reflux which usually clears up by the time they turn one. My nephew, however, is 11 and will vomit after eating too fast or drinking soda. My son had horrible reflux as a baby, but since he never acted like he was in pain my pediatrician didn’t think we needed to do anything about it. He has severe cavities from the reflux and getting his first teeth at 3.5 months, he looks like he has bottle rot (never had a bottle, though). Well, the last few weeks… Read more »
Joe Clark
Joe Clark
5 years 18 days ago

Thanks Mark! Started Paleo, lost twenty-five pounds and GERDS. No more medication or antacids. Have started a new life at 53!

Jeff
Jeff
5 years 18 days ago
Reflux is actually one of the main reasons I ended up here. I had a HORRIBLE case of GERD, and felt like I was dealing with absolute IDIOTS at the hospital. I was told to try an “easily digested foods” diet which meant rice, potatoes, sugar, and all that other garbage that is horrible for you. My symptoms of course got WORSE. I was very heavy…around 325 when this started. I lost about 40 lbs in little over 2 weeks, as I could not swallow. The hardest things to swallow were water and yogurt. I choked down broth and boost… Read more »
ryn
5 years 18 days ago
i’m glad to see you recommend bitters! herbalists differentiate the bitter herbs a little more. if you can find calamus, you’re in luck — it not only has the bitter principle that stimulates healthy digestive juices, it also has a tendency to normalize stomach acid levels, bringing them down if they’re too high, up if they’re too low. marshmallow root is another very helpful herb for heartburn, reflux, and GERD. just drop a tablespoon of the cut root in a quart of water, let it sit overnight in the fridge, and you’ll have a slightly thickened, mucilaginous drink in the… Read more »
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