Advice on acid reflux that worsens when you add acid and bitters?

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A condensed version can be found at the bottom of this post.

Months ago I had my first real acid reflux reaction (at least that’s what my doctor suspects it was) - it felt like something had burst inside my left side in the upper stomach area, and it was followed by an excruciating squeezing pain. It happened while having a cocktail - something with blueberries, some hard liquor (gin/vodka), and who knows what else. I immediately felt like something was wrong because I had never experienced anything like it before, and I actually felt mentally out of whack for the rest of the night.

A couple of days later, I just could not shake off the fatigue, the yawning, and issues with what I call the 4 B’s: bloating (constant), breathing (can’t fully expand diaphragm to inhale), burning (stomach/heartburn), and burping...all the time. Nowadays I mostly get “LPR” (laryngopharyngeal reflux - mostly throat/nose symptoms, which make sleep quality go down)

Each symptom has mildly improved through avoiding irritants and by my sequentially trying out all the supplements that have previously worked for me (I got something akin to CFS’ish some years ago, along with a bunch of food intolerances) in the digestive department. The only things that have mildly improved me (I’m somewhat functional now) were resistant starch, colostrum, and diatomaceous earth.

Keeping in mind that I already have food intolerances to gluten and lactose, I now can no longer tolerate acidic (e.g. blueberries, fermented foods) and bitter foods (e.g. most herbs) either - they give me upper abdominal bloating and acid reflux. They don’t get absorbed, either, and my energy and mood go to crap. This is unsustainable in the long run: bitter and acid (sour) foods have a lot of important nutrients and medicines to provide, and I find it puzzling that the body could block off intake of these valuable inputs. A few days ago I had a deathly migraine and I couldn’t even take the Neem leaf capsules that made it go away last year. I also don’t want to run out of food I can eat: food intolerances + this acid/bitter reflux will have me drinking water and eating ice until death.

Does anyone have any other ideas on how to fix this thing?


The usual advice of “add acid” (through Betaine HCL, apple cider vinegar, lemon juice, etc.) clearly does not apply to me - they make me worse, and it’s not dieoff. My best bet at the moment is it’s some kind of gut bug, or a hiatal hernia - but I’ve read about plenty of people with hiatal hernias who are fine with bitter foods so I’m confused.

List of things I’ve tried that not only didn’t help, but made me worse: blackstrap molasses, neem, chanca piedra, various forms of clay, charcoal, apple cider vinegar, digestive teas, collagen hydrolysate, kefir, sauerkraut, sheep yogurt, raw sheep cheese, lemon.

List of some stuff I’ll try eventually: mastic gum, Primal Defense probiotics, baking soda, larch tree arabinogalactan.

............

The condensed version:
  • I appear to have a type of acid reflux that gets worse with the consumption of bitter and acidic foods (so apple cider vinegar will not help - only worsen)

  • Primary symptoms: bloating, inability to fully expand belly to breathe, reflux in sleep, LPR (“silent” reflux in throat and nose), lots of burping, can no longer eat bitter herbs or berries or fermented foods without bloating and fatigue and reflux

  • I’ve tried a bunch of stuff (list above)

  • What might I be missing? (other than “You’re screwed, manage your symptoms by avoiding the irritants”)

  • What else would you try?
 

wonderoushope

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I know reflux quite well as I have been diagnosed with GERD. I have mainly silent reflux. Mine manifests with very ocassional reflux (and small amounts), but mainly bloating, beltching, nausea, and bitter taste in mouth with certain foods. Those same symtoms happen for gastris for me, but probably more magnified.

But personally, I would go and see a gastroenterologist and see if you can get an endoscopy done with biopsies taken. Make sure you get biopsies too, as that was the only way gastritis showed up for me. It could be gastritis, which is something I get. I get recurring gastritis. The last time I had mild chemical gastritis.

I feel reflux and gastritis can be interconnected.

I personally do not like taking PPI's hence I wanted to find out if indeed I had gastritis when I got symptoms to see if I actually needed them. I actually came to the conclusion that because I was getting reoccurring gastritis and I have intolerances to food, that I suspected that the gastritis was occurring from food intolerances. So I wanted to tackle it from a food perspective and get to the root of food issues rather than taking PPI's.

So I found a good dietician dealing with food intolerances and CFS. I went on a strict elimination diet. Unfortunately, the elimination diet didn't come up with hard conclusive evidence of what foods to avoid, but rather it showed I do much better without preservatives, low fodmap, and keeping away from certain foods including some fruits and vegetables, at the time I also reacted to certain ingredients in supplements and certain medicines. I also now have come to the conclusion that a big piece of the pie is gut health and get the gut bacteria back on track. I am now able to tolerate a lot more foods without getting reflux or stomach bloating and nausea.

I do not take any PPI's and I have so far over a year had my gut health been the best has been in a long time. It's by no means perfect, but definelty bloating, beltching, nausea, bitter taste, was a big issue for me, and at least they have died down considerably. I still occasionally see those symptoms rearing, but it's usually due to something I ate and if I go back to my "go to foods" it settles down and I go back to normal.

So conclude, I think initally I got REFLUX from a bad diet or too much ibuprofen, having IBS and exacerbating my gut issues, which made gut bacteria go out of whack, which made me get food intolerances, which magnified issues with gut to include gastritis. Then the trick was to work on getting food issues sorted, getting gut bacteria back on track, to help reflux and gastritis heal.

I personally wouldn't take any supplements or herbs whilst you are like this, they can exacerbate issues whist you are like this. I would also suggest working with a dietician to help with your reflux issues.
 
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kangaSue

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It's complicated and you can never really tell what the issue is without doing pH manometry testing.
Symptoms of having too much or too little stomach acid can the same.
Symptoms of bile acid reflux and GERD can the same.
Symptoms of having too much or too little bile acid can be the same as for GERD symptoms.

Make sure you don't have a vitamin B12, folate, iron or vitamin D deficiency as these all go towards not making enough stomach acid. Too much bile can be helped with a bile acid binder. Too little bile can be helped with an ox bile supplement.

I have severe gastroparesis where doctors just kept loading me up with increasing doses of both H2 blockers and PPI's, all the while the problem getting increasingly worse. I've also been down the road where the usual suspects (Betaine HCL, apple cider vinegar, lemon juice) just make things worse and sodium bicarbonate alone just makes me burp and vomit.

What has worked for me though is in ditching all the acid blockers and taking sodium bicarbonate and apple cider vinegar together, one hour before meals , 3 x a day. This is another remedy commonly bandied about on the health websites and I nearly didn't bother with trying it as nothing else had worked and I don't tolerate either ingredient separately but I am now very glad that I gave it a crack.
 

Starlight

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I have severe gastroparesis where doctors just kept loading me up with increasing doses of both H2 blockers and PPI's, all the while the problem getting increasingly worse. I've also been down the road where the usual suspects (Betaine HCL, apple cider vinegar, lemon juice) just make things worse and sodium bicarbonate alone just makes me burp and vomit.

What has worked for me though is in ditching all the acid blockers and taking sodium bicarbonate and apple cider vinegar together, one hour before meals , 3 x a day. This is another remedy commonly bandied about on the health websites and I nearly didn't bother with trying it as nothing else had worked and I don't tolerate either ingredient separately but I am now very glad that I gave it a crack.[/QUOTE]

I'm glad to find this here today . I have been drinking ginger tea to help with this issue. It has helped but not enough to resume any kind of eating a normal sort of diet . I'm glad you are succeeding Kanga Sue and would like to know what kind of quantities of soda and cider vinegar you are using. I'd like to try this rather than take PPI s. Myself.
 

kangaSue

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I'm glad to find this here today . I have been drinking ginger tea to help with this issue. It has helped but not enough to resume any kind of eating a normal sort of diet . I'm glad you are succeeding Kanga Sue and would like to know what kind of quantities of soda and cider vinegar you are using. I'd like to try this rather than take PPI s. Myself.
I've tried varying doses but find I do best with 1/8th tsp sodium bicarbonate to 2 tsps ACV and diluted in 100 ml warm water. I take this 3 times a day, one hour before food. I have to add the bicarb and ACV together first until effervescing stops before adding the water otherwise I don't tolerate it.

Just be aware with stopping PPI's that some people can get rebound acidity which can cause reflux that is more severe than it was while taking the med and I quit the PPI first (for 3 months of misery before it settled back) then stopped ranitidine about a month later and started bicarb/ACV the next day.

It then took another two weeks before reflux was much better controlled. Still get flare ups of it but nothing constant like it was being on the meds.
 
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These kind of issues are "usually" becouse alkaline stomach , and problems with the valves in there. Also lactic acid can start go up becouse of no acid in the stomach . dr. Eric Berg have some good videos about the whole thing , maybe listen if he have some ideas to give . I dont know why Betaine HCL did not help you, and bitters are usually most helpfull, did you try take Swedish Bitters tonic ?






Stomach acid itself needs some nutrients, sodium, potassium ,zinc and thiamine


Another video from dr.Berg : You Need Potassium to Make Stomach Acid (HCL)

 

wonderoushope

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I just want to say, I couldn't tolerate anything like Swedish bitters when I had these issue.

I went to a naturopath too and they started off with very simple concoctions (as I warned them that I would probably react) they then gave me a simple tea, and I reacted to those too. So they recommended going back to my gastroeneroglist and said that it's best not to have any potent herbs until stomach issues are rectified.
 
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Well odd , only thing that comes to my mind is that if you had low acid stomach and some pathogens started living there ( it should be sterile environment ) causing at least inflammation but maybe infection, then anything that can cause "disinfecting effec"t will be like pouring betadine disinfenctant to open wound, it hurts .

Or...is it possible you have some sort of sulfate/sulfite intolerance ?


I dont know , all i know is our stomach is made to tolerate strong acid , and it goes usually down by age, and with no acid microbes can start grow there like H.Pylori . You are right it really is unsustainable situation in the long run . Have you tryed something softer disinfenctant like colloidal silver like Argentyn 23 ,i doubt silver would be as irratating substance. And dont they even give recommendations not to use Betaine HCL in case of ulcers in stomach . If you do have ulcer it`s no wonder it hurts when trying ACV / Betaine HCL etc.


What heals ulcers are animal vitamin A , zinc for start ,aloe vera juice , Silica and vitamin C .


If you have for example h.pylori there and it screws in to the tissues, making tiny holes...then it all cause inflammation/infection .



Sorry, i dont know can my ideas help, just tryed to thŕow some ideas..
 
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So I found a good dietician dealing with food intolerances and CFS. I went on a strict elimination diet. Unfortunately, the elimination diet didn't come up with hard conclusive evidence of what foods to avoid, but rather it showed I do much better without preservatives, low fodmap, and keeping away from certain foods including some fruits and vegetables, at the time I also reacted to certain ingredients in supplements and certain medicines. I also now have come to the conclusion that a big piece of the pie is gut health and get the gut bacteria back on track. I am now able to tolerate a lot more foods without getting reflux or stomach bloating and nausea.

I do not take any PPI's and I have so far over a year had my gut health been the best has been in a long time. It's by no means perfect, but definelty bloating, beltching, nausea, bitter taste, was a big issue for me, and at least they have died down considerably. I still occasionally see those symptoms rearing, but it's usually due to something I ate and if I go back to my "go to foods" it settles down and I go back to normal.

So conclude, I think initally I got REFLUX from a bad diet or too much ibuprofen, having IBS and exacerbating my gut issues, which made gut bacteria go out of whack, which made me get food intolerances, which magnified issues with gut to include gastritis. Then the trick was to work on getting food issues sorted, getting gut bacteria back on track, to help reflux and gastritis heal.

I personally wouldn't take any supplements or herbs whilst you are like this, they can exacerbate issues whist you are like this. I would also suggest working with a dietician to help with your reflux issues.
This is a very helpful post (as have been all the other responses - thank you guys so much!) for me - would you care to share some details and strategies?

  • For example, what does the list of your "go-to foods" look like?
  • Once you sorted out your food issues, how did you get your gut bacteria on track?
  • And if you don't recommend taking anything while I'm like this, are you suggesting that I just eat real food and rest while it naturally heals? I've tried this approach but it seems that things rarely get better unless I try things out.
Also, does anybody know why bitters would increase upper abdominal bloating and make me feel like crap now? Herbs like Neem used to make me feel really good inside and were extremely useful, but not anymore. Have you heard of other cases like this?
 

wonderoushope

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@Chieftain - Sure I can share more details.
For example, what does the list of your "go-to foods" look like?
Low FODMAP, no condiments whatsoever (including vinegar, lemon and chilli) at least 3 servings of vegetables I can tolerate (they are low FODMAP and the key is not gas producing). I won't have anything acidic at that time, so I cut out tomatoes for a few days. My dietician suggests to me " 3 cups of tolerated vegetables and herbs daily, minimal sugars, refined starches and processed foods" and if I am bad I am meant to go in this for 1-2 weeks to see if symptoms subside.

Once you sorted out your food issues, how did you get your gut bacteria on track?
By doing the above. The key was eating at least 3 cups of veggies. I was initially told to have 1 cup of lentils ( I could tolerate) per day, but I just can't seem to tolerate it (too much wind, cramps, bloating). Removing all foods that I seem to react to, including preservatives, additives. It took about 6-7 months on a strict elimination diet to see changes. This is quite a time, and usually, you should not be on that sort of diet for so long. I did not any supplements, probiotics, kept away from fermented foods too, and kept to a pretty low histmaine diet as well, as I was reacting to histamine foods like eggplant (mainly sneezing a lot and feeling woozy).

And if you don't recommend taking anything while I'm like this, are you suggesting that I just eat real food and rest while it naturally heals? I've tried this approach but it seems that things rarely get better unless I try things out.
In a way, but it's so individual. The thing is I have learnt it's not just about eating "real food", it's about eating "real foods" that your body can tolerate. I was reacting to things like eggplant, chickpeas, beans. They are "real foods" but they were not right for my body at the time and eating them were exacerbating my symptoms without me realising it. That's why I think if you can see a dietician dealing in food intolerances because it's not as simple as eating healthy foods. Some people react to amines (like with meats, cheese, wine, avocados) others can react to salicylates (in a lot of fruit and vegetables) at the time I was reacting to Glutamates (soy sauce, msg, tomatoes, spinach, grapes). I also reacted to simple things, like the coatings on medications. On that diet, you also had to have a certain toothpaste, shampoo, conditioner. It was very detailed. At the time I was very sensitive to chemical smells (the diet actually for me increased my sense of smell, so much that I could smell everything and it made me feel sick, luckily it died down after about 3-4 weeks).

Also, does anybody know why bitters would increase upper abdominal bloating and make me feel like crap
I would like to know this too. I get a lot of upper abdominal bloating (or did). I am not sure why I reacted to bitters so much, but I guess it just had to do with my gut been so out of whack that anything too strong just sent me over the edge. When I had the herbs from naturopath (which were very bitter) I really reacted. Including upper abdominal bloating, cramping, wind and nausea.

Oh by the way, I don't technically fit the requirements for food intolerances, as true intolerances usually are very obvious and have clear pattern. My reactions to food kept on changing. So dietician still thinks I have food intolerances but just I don't fit the actual normal criteria.
 

kangaSue

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I dont know why Betaine HCL did not help you, and bitters are usually most helpfull
According to at least one author, if it causes burning, this is an indication that your mucosal barrier is damaged and it is more likely that a person with a damaged mucosal barrier will be producing low levels of hydrchloric acid and have a need for more stomach acid, but not until the mucosal barrier is repaired first.
https://metabolichealing.com/the-hcl-challenge-why-the-conventional-test-is-dead-wrong/