need help with GERD/acid reflux
#368208 - 09/21/12 01:59 PM
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hey everyone,
hope your friday is going well.
was wondering if anyone has any treatment suggestions for my GERD/acid reflux. i developed this a few months ago. primary symptoms are belching (most noticeable when I lie down) and a frequent sore throat (hurts most when I am exercising vigorously).
OTC medications i've tried:
-zegerid (upset my stomach, so i had to discontinue)
-ranitidine (upset my stomach)
-pepcid ac (i can tolerate this, but doesn't seem to help much)
-tums (only helps a little, and very short-term)
I've also been taking deglycyrrhizinated licorice and slippery elm. These have helped to coat my throat, but I don't think they are addressing the core problem.
Today I picked up some marshmallow extract (the plant, not the candy :/)) - this is supposed to help with soothing the mucous membranes.
Any other recommendations for OTC medications or supplements?
I've only just started researching which foods promote acid reflux. I'm currently trying to do an EFI + FODMAPs elimination diet, so I'm not crazy about eliminating yet further foods. Soon I'll just be eating brown rice and might as well join a monastery.
If I do end up scheduling an appointment with a GI doc, any suggestions as to medications/treatments to explore or avoid?
Thanks,
Chris
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I have been dealing with severe GERD for many years. At the moment, it's actually much worse than my lower GI issues. While I don't have things completely under control, I definitely have learned a lot of helpful tips.
I know you mentioned not wanting to eliminate foods, but eliminating the few main GERD triggers (much fewer than the IBS triggers) makes a huge difference. My recommendation is to completely eliminate coffee, alcohol, chocolate & cocoa powder, tomato products, garlic and citrus. You will also want to be careful with vitamin c and citrus additives like ascorbic/citric acid in foods (you should be able to tolerate some). Also, as for IBS, large meals and meals high in fat exacerbate GERD.
I also recommend not laying down for a few hours after eating, and not laying flat when you sleep (sleep on several pillows or raise the head of your bed or mattress about 6 inches).
For OTC medications, gaviscon is very helpful. It's an antacid like Tums, but far superior. I would definitely give it a shot. It will help with both the GERD and the belching you mentioned. Mylanta gas should also help with burping, but won't do anything for the acid. I use both frequently.
In terms of PPIs, I take Zegerid (prescription strength), but Aciphex is the one with the least side effects. It unfortunately does not come over the counter, but is worth trying if Zegerid and Prilosec both bother you.
I also use slippery elm, and it definitely coats a bit when you're throat's already irritated, but I agree it does nothing to actually stop the acid.
I hope this helps a bit! Let me know if you have anymore questions.
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IBS A (more D than C). Severe GERD & Hiatal Hernia as well.
"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future." Jeremiah 29:11
Edited by nutritionlover (09/22/12 09:22 AM)
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Thanks so much for these helpful details.
I haven't tried Prilosec, Gaviscon, Mylanta Gas or Aciphex, so thanks for those recommendations.
I agree it's important to eliminate triggers. I don't drink coffee, but do drink a good bit of green tea. Is there something particularly bad about coffee, or is the idea to eliminate all caffeine?
It sounds like acidic foods could be an issue as well. Have you noticed benefit in cutting back on other acidic foods? For example, I'm wondering if I should eliminate vinegar?
One more question: What is the benefit of seeing a GI doc for GERD/acid reflux? I guess I'm just wondering why treatment options this type of doctor would be able to offer? For example, can they merely rule out other pathologies but not really offer any good treatment options (as in the case of many GI docs and IBS)?
Thanks again!
Chris
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Your welcome!
Beyond the caffeine, coffee is extremely acidic. It's definitely worse than green tea. However, all caffeine can have some impact on GERD, including caffeinated tea.
Some people actually claim that lemon juice and apple cider vinegar help their reflux, so with lemon and vinegar you might have to test how they affect you personally. As long as I'm not in a flare up, I can tolerate moderate amounts of both. They definitely don't affect me like tomato or other citrus would.
I would say GI doctors definitely have a bit more to offer for upper GI issues. The medications for GERD are more frequently used and more effective than most for lower GI issues. However, if you can get your acid under control with lifestyle changes and OTC medications, you're better off because PPI's do have long term effects on the body (and they are over prescribed). However, for someone like me I would be absolutely miserable without one, so they definitely have their place. You also want to make sure your acid is under control, because unlike IBS, untreated GERD can have negative ramifications many years down the line (greater risk of esophageal cancer). It's definitely worth at least going to see a Gastro. If they seem overly pushy with lots of tests or medications, you always get a second opinion or back off.
In case you're not familiar with PPIs (proton pump inhibitors), they include Prilosec, Zegerid, Aciphex, Prevacid etc. Most also come in over the counter forms, but the dosing is usually half of a prescription dosage.
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IBS A (more D than C). Severe GERD & Hiatal Hernia as well.
"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future." Jeremiah 29:11
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Thanks again for the helpful information!
One question:
It sounds like the first-line treatment pursued by GI docs for acid reflex is the prescription of PPIs. As I have not had success with the OTC versions of these, I'm wondering what more a GI doc would be able to offer.
Anyway, thanks again for the info!
I planning on raising the head of my bed a bit - hopefully that will ease symptoms some.
Chris
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The first line treatment definitely is PPI's. Which OTC ones have you tried, and how long did you take them for? Depending on the severity of the condition, you may need a stronger (prescription strength) dosage for at least a period of time to heal. Some people need to try several PPI's to find the one that works for them (including the ones that are not OTC). If you think you can manage with antacids and dietary modification, then you probably don't need to see a Gastro. But if you have significant symptoms, then I wouldn't give up on them helping you yet!
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IBS A (more D than C). Severe GERD & Hiatal Hernia as well.
"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future." Jeremiah 29:11
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thanks again.
i've tried most of the OTC PPIs, but i only took them for a very short period of time.
i'll probably go ahead and schedule an appointment. thanks again for all the helpful advice.
one more question if i may:
i know that "spicy" foods are supposed to be problematic for GERD. do you know if this refers to spices in general or simply to spicy "hot" foods such as peppers.
Heather makes the point - with regard to IBS - that it's often the fat that accompanies spicy foods that's problematic, not the spices themselves. I was wondering if this is true in the case of GERD.
For example, I often use Indian spices such as coriander, turmeric, cumin, etc. While these are spices, I would not consider them "spicy" hot (such as cayenne or foods that actually create a burning sensation). So are all spices generally considered problematic with GERD or simply those spices that create that burning sensation?
thanks!
chris
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I have actually wondered this myself, as the only spicy food I like is ginger and I'm torn as to whether it aggravates my reflux or just burns when I'm already irritated. According to my GI Dr, only true spicy foods like hot pepper are triggers. With GERD, I think they actually are triggers, although fat will certainly make them worse. I think you should be safe with things like turmeric. If it doesn't burn, then it probably won't aggravate your symptoms.
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IBS A (more D than C). Severe GERD & Hiatal Hernia as well.
"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future." Jeremiah 29:11
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Thanks for your reply 
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Try an HCL supplement. I know a few people who went from doctor to doctor with acid reflux and got no help. You're better off trying change of diet and either OTC or supplements. Attached are a couple of links with some info. also Solray makes an HCL W/Pepsin capsule. http://www.livestrong.com/article/296666-hcl-supplement-for-acid-reflux/
http://www.modernherbalist.com/betaine.html
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If ANYONE has been taking the PPI's to cut down on the last stage of acid, you would have to wean of it with antacids slowly, or you'll have BAD rebound. Many are prescribed PPI's when the symptoms are very similar to "not having enough" acid, especially as we get older. Then once someone is used to the extra acid and esophagus has healed, THEN explore apple cider vinegar "tablets" with no citric acid added, to see if your stomach responds favorably to what should have been diagnosed as too low stomach acid. Don't even touch the betaine hydrochloric acid (hcl) until absolutely sure you need more acid without trying the aforementioned methods. Even then, it could be that it's the IBS that caused it all beforehand, which was my case;Work on that first.
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