Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
7 Sep

GERD: Symptoms, Causes and Remedies

heartburnThe 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!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. when i eliminate grains, my heartburn disappears.

    lynnie ley wrote on September 7th, 2011
  2. I suffered from GERD for about 30 years — I was diagnosed with a hiatal hernia at age 21 and had problems for years. Started on the first purple pill before it was called the purple pill. It helped with the GERD, but for years I lived under the mistaken impression that diarrhea was normal every morning. I did finally have the hernia repaired (along with my gall bladder removed, but that’s another story.) Stopped the purple pill and ended the heartburn.

    Unfortunately, a hernia is more severe than a simple relaxation of the lower esophageal sphincter muscle. Surgery is often ineffective, but can work. It was worth it for me.

    Meanwhile, a primal lifestyle and diet is a great adjunct to a GERD-free lifestyle. Even successful hernia repair surgery doesn’t eliminate heartburn if your diet is actively promoting it.

    Also — fascinating info about estrogen and GERD. I developed my first symptoms of GERD in college — and a couple of years after starting birth control pills (much higher in estrogen then than they are today.) Possibly a contributing factor to my hernia? Maybe.

    Still, today you will have to pry my bio-identical estrogen/testosterone/progesterone replacement creams out of my cold dead fingers. But my GERD doesn’t happen anymore, so I can feel good on so many levels!

    Diane wrote on September 7th, 2011
  3. I had a brief bout with horrendous GERD after increasing my intake of coconut oil to 6 TBS a day in order to see if I would benefit from a ketogenic diet.

    Paul Jaminet, of The Perfect Health Diet, helped me figure out that I had a systemic fungal infection and explained that while ketosis is helpful for many conditions, it feeds fungus if you have an existing infection.

    Went back to three meals a day, added a small amount of “safe” starch and limited coconut oil to <2 Tbs and the GERD stopped immediately.

    Ellen Ussery wrote on September 7th, 2011
    • Wow, good to know. This should be shared more prominently.

      Another Halocene Human wrote on September 10th, 2011
  4. I ended up having really bad acid reflux from other medical issues, and needing to take protonix and randiditine daily.

    It wasn’t until I cut out Gluten and Dairy and Sugar, that I don’t need to take the medicine daily anymore.

    I do at times have heavy whipping cream or cheese but not in large amounts.

    I do take the medicine as needed – which depends on the day, week, month I’m in.

    CindyK wrote on September 7th, 2011
  5. I used to suffer from GERD pretty badly. Used to take prescription drugs for it. Mark is right – this really is a crazy way to address the problem. I dropped 30-35 pounds and completely changed my eating style (amount not content) and the problem almost went away completely. I still eat a lot of carbs though I have cut back. My best advice is to get active (aerobically), lose weight, eat small meals and NEVER EVER eat after 6:30pm.

    Vince N. wrote on September 7th, 2011
  6. Growing up in an Italian family, Mamma would send me to school with homemade lasagna, pizza, calzones, etc. Most of my life I’ve had all of the symptoms you described.

    The worst was waking up choking, gagging on acid which was traumatic to say the least. My mother’s remedy was, “eat a piece of dry bread, and try to swallow it without chewing. It will soak up the grease.” This would make it worse.

    As soon as I started living low-carb the problem VANISHED. That fact is compelling evidence that this is the way we’re supposed to eat. Most people are astonished when I tell them how I eat. My typical breakfast is 4 eggs fried in bacon grease and butter, 3 strips of bacon, 1/4 cup refried beans, cheese, and salsa. Not a hint of upset stomach, acid reflux, or heart burn. I feel better than ever (and lost 48 pounds).

    Conventional wisdom says that foods high in fat are the very cause of heartburn, or at least exacerbate the condition. The only time I experience heart burn now is when I cheat myself. That’s just more motivation to stick with the plan. This was a great blog entry that confirms my experience is not atypical.

    Guido wrote on September 7th, 2011
  7. I have been a lifelong gastric reflux sufferer.

    For the last 10 years I have been on a daily PPI pill and got fat doing that. I can’t blame giving up smoking because I was still slim for 6 months before going on the PPIs. Once on, I gained weight.

    I didn’t know that a paleo diet would heal me, but it did – this happened by surprise and I noticed I’m missed pills. Having tried this before and ended up regularly vomiting, I was very surprised that I wasn’t while eating paleo. I went with it …

    I drank Cider Vinegar (one capful in a cup of water) about half an hour before eating and built up my gut with probiotic yoghurt, later finding a good and regular supply of proper sauerkraut.

    That, coupled with paleo eating healed me. That healed me inside two months! A lifelong condition gone by removing grains (I ate a VERY good diet beforehand, no processed food, no sugar, no any of those evil things …) and stimulating my gut!

    I feel amazing. I have won! This is as big a triumph as giving up smoking. I am a normal human being now and that is down to paleo. Okay, down to yoghurt, too … but many primals, functional paleos and archevores are happily endorsing dairy now :)

    Paul Halliday wrote on September 7th, 2011
  8. My almost 6 year old started having acid reflux issues just 6 months ago. i could smell the vomit on his breath and he told me sometimes he throws up in his mouth. Great. Explains the cavities. So far, it seems to flare up with grains, especially crackers, and spikes with sugar! So minimizing that stuff has helped a ton. I refuse to put him on medication. Also, we took him off flouride, now that we have learned more about flouride and that one of the side effects can be vomiting or stomach issues. So far so good. I’m thankful for all the posts on how I can stave off incidents when he does indulge, like at a child’s birthday party!

    Alicia wrote on September 7th, 2011
  9. Eating strictly primal never helped me, dairy-free never helped me, I’ve kept a food diary for the last 6 months and I can’t see any trigger foods at all. Going very-low carb for a month never helped me. Probiotics made it worse. HCl and herbal supplements did nothing. I’ve been tested for H.pylori and don’t have that. I’ve had a gastroscopy, no disease detected.

    BUT…PPIs did work. I really hope I don’t have to be on them forever, but seriously they’re the only thing that’s ever helped.

    Josh wrote on September 7th, 2011
    • See my comment on pg. 4 – You might have hyperparathyroidism.

      Leaf Eating Carnivore wrote on September 7th, 2011
  10. I’m a newbie, having been involved with this style of eating for only about 8 weeks. Before going primal, I had been quite bothered with GERD and finally resorted to taking omeprazole every morning, which did help a lot. However, after a couple of weeks of staying around 50 gm of carbs a day, I found I no longer needed the medication! SO, hurray for Primal Blueprint! I initiated this plan to help me lose some weight, never realizing it would also “cure” my GERD! Glad I found you guys!

    Connie Lard wrote on September 7th, 2011
  11. Even if I had never learned about paleo or gluten intolerance, I knew from personal experience of dealing with GERD since teenage years is that acid reflux occurs more frequently during non-active high-carb intake.

    jinushaun wrote on September 7th, 2011
  12. What I find interesting is the connection to excess estrogen. I’ve been researching a lot about excess estrogen lately and it appears to be quite the trouble maker on many fronts.

    Chelsea wrote on September 7th, 2011
  13. HELP!

    MARK:
    (and those of you with advice)

    I have had reflux for many, many years. I have a hiatal hernia. I am 35 years old, thin, very active. I have always had a pretty high carbohydrate diet. For about a year I’ve had GERD daily. I’ve changed my diet (in terms of limiting all citrus, tomatoes, alcohol, coffee, peppermint, onions, garlic, etc). I elevated my bed and sleep on a wedge. I don’t eat within 2 hours of sleeping at night. I’ve tried a myraid of PPIs, with no real success, including herbal remedies. I eliminated gluten in May, and have felt somewhat better, but still get heartburn every other day. I eliminated grains about a week ago, hoping to find true relief, but so far it’s not really helped. I now have 3 questions for you all.

    1) How long after eliminating grains did you find relief from the burn?

    2) I am still eating sweet potatoes, yams, and parsnips, as well as buckwheat (not a grain, but a seed). Also, I bake with chestnut flour and buckwheat flour. How to do feel about those foods?

    3) My diet is still very high in carbs, but it is almost all from fruit and vegetables (some from nut/seed flour). Do I need to limit fruit?

    Allison wrote on September 7th, 2011
    • Yes, eliminate fruit. You may also want to see a naturopath who can test you for candida or fungal growth in your stomach. Both conditions are fueled by sugar/mold bearing fruit/mushrooms/cheese, etc. Eating solely meat and vegetables for a while will probably help, but you may also need a supplement to attach the stomach fungus or yeast growth. Just one idea to consider.

      Joan wrote on September 7th, 2011
  14. I too have GERD, and took prevacid for over a year. I now eat paleo, primal, and about eight days ago I stopped taking prevacid. It was tough for a few days as I did have pretty strong rebound effects, but I am already better by about 95% with no drugs, I’ve also tried ACV and Now foods super enzymes and find that both of them help a lot. Good luck to all those who are about to stop PPI’s, it’s not as bad as you may think.

    DEAN wrote on September 7th, 2011
  15. All I did was get rid of the helicobacter pylori . 2 antibiotics per day for one week and the everything has been fine for several years .

    Witold wrote on September 7th, 2011
  16. Another thing I found awesome for sufferers of hiatal hernia, go to youtube and there are videos showing how to manually manipulate you’re stomach down from your diaphragm essentially curing the problem within a couple of weeks, definitely worth checking out. Good luck.

    DEAN wrote on September 7th, 2011
  17. It wasn’t until I cut out most carbs execpt from fruits and veggies my heart burn went away! I lived on antacids, what a great thing!

    Joel wrote on September 7th, 2011
  18. DR. Dahlman on youtube, keyword hiatal hernia,check it out.

    DEAN wrote on September 7th, 2011
  19. I found that using a quarter tsp. of L-glutamine dissolved in water eradicated flare ups completely. Also, for a lot of my friends and myself, getting off grains eradicated the problem. The estrogen link was interesting. I starting to have acid reflux for the first time in my life when my weight went up to 230 lbs from the normal 190 lbs. All that excess adipose tissue converts testosterone into estrogens. I lost most of the weight and the problem went away. I only have flare ups again when I cheat and eat grains. (Which is rarely).

    Luis wrote on September 7th, 2011
  20. I have suffered quite a bit of hearburn over the years, and got relief from Nexium. My doctor told me to avoid fatty foods.

    Once I switched to a Paleo diet, the heartburn went away. When I go off the wagon, like I did two weeks ago, and eat bread and pasta, the heartburn comes back. Instead of Nexium, I get relief from HCl tablets (100-200 mg). In contrast to what my doctor told me, I NEVER get heartburn from eating fatty foods, but often get it from eating grains.

    …. wait, i lied, i have gotten heartburn from eating ice cream also… but still, if I stick to Paleo, I simply don’t get heartburn

    macoda wrote on September 7th, 2011
  21. I just went through this last week. The Deglycerinized licorice definitely helps with the stomach burn. The cause/effect is almost instantaneous for me right now. Each grains or fruit = sleepless night with terrible stomach burn. But eat Paleo and I haven’t had any pain. Be careful about using the HCL for long periods of time as it can negatively affect your pancreas.

    Joan wrote on September 7th, 2011
  22. Great article, Mark! I had GERD a few years ago and kicked it in the butt by taking a tablespoon or two of apple cider vinegar whenever I experienced symptoms. Eventually it went away for good. Now that I’m primal, I don’t expect to ever have to deal with it again.:)

    Ashley North wrote on September 7th, 2011
  23. People need to be careful discontinuing meds prescribed for indigestion/GERD. There can be some serious effects of “cold turkey-ing” off them. If there is any underlying illness, it can flare, and symptoms can be extreme. Reducing the dosages over time is probably safer. Always check with your doctor or pharmacist about how to discontinue a medicine.

    While I agree that diet changes might help, too much histamine can be a culprit in digestive difficulties. Mast cells produce histamine which stimulates acid production. A low histamine diet might be helpful. This diet eliminates not only foods that contain histamine, but also foods that can cause direct histamine release from the mast cells. If the diet helps, then a mast cell disorder might exist that causes the symptoms.

    This site has an easy to read low histamine diet chart telling what foods to eliminate and which are acceptable:
    http://www.urticaria.thunderworksinc.com/pages/lowhistamine.htm

    J wrote on September 7th, 2011
  24. When it wakes me at night, I have done the Aajonus Vonderplanitz Primal raw guy’s remedy of apple cider vinegar and raw honey…..it has worked most every time in the past!

    Kieba wrote on September 7th, 2011
  25. I ate mostly whole grains, legumes and veggies for 40 years. A few years ago I developed GERD so severe that several times I found myself in an emergency rooms thinking that I was having a heart attack. I also developed severe arthritis in my neck and shoulders. I decided to go lowcarb and cut out all grains and legumes. The GERD WENT AWAY IN TWO DAYS. The arthritis in ten days

    Michael Cohen wrote on September 7th, 2011
  26. Thanks! I had no idea i wasnt alone with this! My pain was quite acute in my life but I almost had my gallbladder out cause the docs couldn’t pinpoint the problem. I took time out to do some self-testing and lowcarb/primal is the only cure for me. I kept my organs and my money and lost 20 lbs instead. Couldn’t be happier!

    Lisa wrote on September 7th, 2011
  27. Wow, this is a dilemma for me. The same day I started on Atkins induction I started Prempro–I’d suffered for EIGHT SOLID YEARS of hot flashes, day and night, and never got more than a two hours of continuous sleep at a time.

    Now I’m sleeping much better and don’t sweat through the days, but have “silent reflux”–which is affecting my ability to make a living as a singer.

    I’ve cut way back on dairy and coffee and chocolate and try to remain upright for a few hours after eating–all of which are difficult to maintain day after day.

    I’ve also started taking melatonin, which is supposed to help the lower esophageal sphincter. Only been on that for a few weeks, but it seems to help a little. I’d love to get off Prempro, but nothing, and I mean NOTHING, has made a difference (and I tried all the other remedies) but synthetic hormones.

    I take 80 mg Prilosec and 300 mg ranitidine, and have seen some reduction of symptoms, and would love to taper off those too. A real trade-off and none of them are good ones.

    JMarra wrote on September 7th, 2011
  28. I had terrible heartburn for over a decade. I was taking Aciphex every evening for over 10 years. Even with insurance it was costing me $40 per month. That’s $480 per year I was paying for that darn med! But compared to the pain, it was well worth the money.

    If I skipped just one day’s dose, I’d get terrible heartburn the next day. No matter what I ate or didn’t eat.

    Then I gave up wheat and the chronic heartburn went away. Now the only time I get heartburn is when I eat something bad, or if I’m under a lot of stress and/or lack of sleep.

    So now, heartburn is almost welcome, because it’s a painful incentive to get back on track and eat right, sleep more, and let go of the stress. :)

    Jon wrote on September 7th, 2011
  29. I suffered from GERD and embarrassingly excessive flatulence for years. I had little stashes of Zantac everywhere – my computer desks, my laptop bag, the glove compartment in my car. I went low-carb due to feeling like I was knocking on the door of type-II diabetes. After a month on low-carb it suddenly hit me one day I had not needed to reach for the Zantac for weeks. The gas problem had gone away too. You could have talked me into low-carb on the no-gas proposition years earlier. Interesting article – I hadn’t realized that the gas issue may have been a contributing factor to GERD – I had always considered them as separate issues.

    Rob N wrote on September 7th, 2011
  30. Have had heartburn only a couple times in my life, and considering what I ate to cause it, I deserved it!

    I’ve had PPI once for an entirely different issue. I had a stomach virus during my undergrad and the campus doctor gave me a two weeks supply to create conditions in my stomach to help defeat the virus and heal the damage. I was also put on a liquid diet for those two weeks. It did help my body; I wasn’t keeled over in agonising pain. I’m also glad that he chose to treat the virus first because my symptoms were similar to a certain bacterial infection (he didn’t specify which) which would have had to been treated with antibiotics.

    So PPIs aren’t entirely bad; it’s the context that makes them good or bad. I only took them for 2 weeks vs the long term use others have done.

    Erin wrote on September 7th, 2011
  31. I had never had significant reflux, even when eating the thrice-damned low-fat, high-carb, de minimus protein “Mediterranean (HAH!) Diet”, although I did have plenty of gas and bloating, and wound up fat and with a permanently damaged metabolism (Thanks, CW!).

    However, GERD DID rear it’s ugly head when I developed primary hyperparathyroidism, a disorder of calcium metabolism that is much more common than most Docs know.

    So for those of you who can’t seem to rid yourselves of this beast, check out http://WWW.PARATHYROID.COM, the definitive site on the subject, and get your calcium and PTH levels checked. This might well be your problem.

    Surgery is curative of the underlying disorder, and therefore, assuming no permanent structural damage, GERD goes away.

    Oh, what a relief it is…!

    Leaf Eating Carnivore wrote on September 7th, 2011
  32. Hi,

    I’ve never had heartburn in my life but after 4 weeks of low carb I started having it. It’s some kind of gastritis thing. I’m still doing exams. I feel it specially when I have an empty stomach and the symptoms aren’t very strong (unless I stop eating for a long time). I have no real reflux, just heartburn and a lot of gases. I notice I can make it better by concentrating, relaxing and breathing deeply, mostly with my belly. I’ve noticed that after a long period of fasting if I eat cheese alone It gets worse. I got very stressed since the first symptons appears and I couldn’t help but blame the diet. I still think it played some part. First because I wasn’t used at all to meat and vegetables living basically on bread and sugar my whole life (35). Second because I started cooking for myself and being single I might have stored too many vegetables for too much time which may have caused me to ingest a huge quantity of two week old bell pepper. We’ll see if examens show bacteria. The problem is, it’s been two months already and no matter what I do the symptons are always the same. I’m tired.

    Bernardo wrote on September 7th, 2011
    • Maybe you should go back to your old diet. Your body probably doesn’t create enough enzymes to break down the meat and is compensating by ramping up acid production (because acid activates the enzymes).

      Another choice would be a gradual diet change and take some of the supplements suggested here. Have you tried papain?

      Also–trust me–you are tired because you are a sugar burner. You are not doing yourself any favors depriving your body of food (glucose). Nobody goes from sugar burner to fat burner overnight. Eat whatever healthy starches you can handle and introduce the novel foods more slowly.

      Another Halocene Human wrote on September 10th, 2011
    • You could probably use some “digestive support”. I must admit to being rather sceptical of this – but I’ve found that I was wrong! Digestive support works exceedingly well for me.

      Mark mentioned the Now Food Super Enzymes (that Robb Wolf likes) at the end of the post. Take one with a meal. If you get a warming sensation, you’re done! Stop (try something else!).

      If not, keep taking one per meal for a three days. Then take two per meal. Keep that up until either you feel warmth (in which case, drop back to the number below that, where you felt no warmth) or you hit a maximum of five tabs (note that’s Robb’s recommendation – Chris Kresser works on a much larger dose of pure HCL/Pepsin being okay – I personally take that much larger dose of HCL/Pepsin (look for Thorne’s products) and find it helps more and more…)

      RedYetiDave wrote on September 25th, 2011
  33. OMG! I had never had acid reflux or heart burn until I was pregnant with our 3rd child. After that, each year got progressively worse. I discovered ACV after doing research because I was sure as he** not going to be on Zantac for the next 50 years. It definitely worked, but I wasn’t satisfied and kept digging. In the meantime, I went primal. Two months after going primal, I realized I had not had an episode of heartburn the entire time. Now, like Belinda, I only get heartburn if I over indulge in chocolate…cutting back on dark chocolate, I can live with…a lifetime on scary drugs, I cannot.

    Erin wrote on September 7th, 2011
  34. My MIL suffered with a hiatal hernia for years. She started reading about herbal remedies and discovered fresh cabbage juice. She couldn’t stand the smell and taste but it DID work. I have no idea why she stopped doing it. After taking the purple pills, she experienced damage from the medication which scarred her esophagus more. She ended up going through a horrific surgery and having to use a feeding tube while it healed. It took a few years. I think she is fine now. Though she didn’t treat the root cause. There’s always something wrong and it’s always complicated. It’s just not the esophagus now. Poor dear.
    I have suggested natural remedies many times. She could even go to Dr. Mercola because we are in the Chicago area. I think her faith is in conventional medicine.

    RadiantLux wrote on September 7th, 2011
    • Raw cabbage is a potential goitrogen, and I wouldn’t go to Mercola if my life depended on it. And it probably would–the man is an utter quack.

      Another Halocene Human wrote on September 10th, 2011
  35. If diet changes dont work – get tested for H. Pylori – my wife suffered for years and was finally diagnosed with H. Pylori – a short time on antibiotics cured it – she took kefir for a couple of weeks afterwards to rebuild her probiotics. she has been good for 3 months now – and can eat pretty much anything.

    John wrote on September 7th, 2011
  36. I had daily heartburn from age 12 until about age 27. Tums for a long time, then added a Zantac 75 habit, with Tums to back it up. It was just getting worse.

    In the summer of 1998 I tried The Carbohydrate Addict’s Diet. Only lasted 3 months on it, but one thing happened that greatly improved my life: no heartburn. And I’ve never had it since, even when I went back to a high-carb diet and continued to gain much weight. I have literally not had — nor needed — a single antacid of any kind since 1998.

    donkeyrock wrote on September 7th, 2011
  37. I also had GERD and each year it got worse. It seem to occur more when I ate fatty foods, so in my mind I connected the two. I cut out grains and no more GERD or upset stomach, no matter how much fat I eat!!

    Matt wrote on September 7th, 2011
  38. I’m on my twelfth day of primal eating and my heartburn is the worst it’s been in quite some time, occurring several times every day. I’m eating no grains, no dairy, no alcohol, but coffee daily. I’m not overweight, I don’t smoke, and I don’t use hormonal birth control. The daily coffee isn’t new and is usually two cups or less. Aside from the heartburn, I’m thrilled to be eating this way and I already see some physical benefits. I can’t pinpoint what’s causing this, so I hope it goes away as the weeks go by and my body adjusts to this different way of eating.

    April wrote on September 7th, 2011
  39. I used to have heartburn so bad that I carried a full-size bottle of Tums with me everywhere. Tums in my purse, my cubicle, my car, next to the bed….I couldn’t make it more than a couple hours without popping an antacid. I had it for years, and it had become a constant part of my life. This past July, after just a couple weeks of changing my diet, I realized I hadn’t had any Tums in a while. It’s just gone. I’ve only had it twice since then, and those were both days that I took ibuprofen for pain from sinus pressure.

    Kellz wrote on September 7th, 2011
  40. Hey Mark- Great article.

    Ironic I was reading it while waiting for my doc to re-diagnose a stomach ulcer caused by NSAIDs from before and after recent major knee surgery. So while I’m not excited about the acid reduction meds, they do help out with the damage the NSAIDs do to me. And the NSAIDs have a huge impact on knee pain and swelling so I need to take them.

    Ian M wrote on September 7th, 2011

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