GERD-like symptoms that go away after a proper meal

Wolfcub

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Acid reflux and heartburn or GERD that goes away after a full meal (dinner)?
....GERD that eases when lying flat on my back to go to sleep -usually about 4 hours ater eating anything late evening? And not waking with any sore throat, nasal /sinus issues etc

.....Which gets worse (REALLY bad) after breakfast or small amounts of food. I don't eat as soon as I get up, usually about 2 hours later.
...Which also causes a horrible anxiety-like reaction in whole body (trembling....wired.....etc), definitely set off from stomach area, missed heartbeats and brief times of afib-like fluttering? And causes the most deathly exhaustion after eating breakfast?
Bad when getting hungry in the daytime or early evening, yet fine after a long fast (overnight)

But mainly okay after a full dinner. No anxiety-like effects after dinner, like there are after breakfast.
I wondered if it was gluten, yet I can eat foods with gluten in the evening and be fine.
I don't think it's sugar (I frequently have a small amount of fruit with breakfast) because chocolate after dinner is okay.

Not set off by or eased by, any specific foods, though I haven't risked rich food. My diet is plain.

It basically seems that after a long fast -okay. After a big meal -okay (when there is more weight in the stomach). After a small ish meal -bad (light food in stomach). After a short fast (6hrs) -bad.

"Poor man's" stomach acid test with baking soda -1st day results say low stomach acid (which may have been caused by an indigestion tablet I took the night before) . 2nd, 3rd and 4th days results say stomach acid normal.

Has anyone ever heard of acid reflux which behaves that way? Probably not, but need to ask.
 

Pyrrhus

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I sometimes get reflux (laryngopharyngeal reflux) on an empty stomach.
Taking a calcium antacid or some light food often resolves the symptoms.
 

EddieB

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Hi there,
Acid reflux and heartburn or GERD that goes away after a full meal (dinner)?
I’m just seeing this for the first time, have you had any success?

I have some strange reflux-related symptoms as well. My 30+ years of cfs has always revolved around gastro troubles, but in the past few years, the upper gi has become a bigger problem.

...Which also causes a horrible anxiety-like reaction in whole body (trembling....wired.....etc), definitely set off from stomach area, missed heartbeats and brief times of afib-like fluttering?
Yes. Mine often feels like it radiates from the lower right. Shortness of breath, frequent mouth sores. Horrible nausea too. Just had another endoscopy, doctor said “not that bad” and prescribed antidepressants for “chemical imbalance in the gut ”....

Since I had gut troubles long before the reflux, I feel the reflux is more of a symptom than the root problem. Looking at SIBO, or some other form of dysbiosis as a cause.
 
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Pyrrhus

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In case anyone is interested, there are actually three different types of reflux, each associated with three different valves (sphincters) in the upper digestive system.

  1. Gastro-esophageal reflux is when the lower esophageal sphincter fails to close, allowing the contents of the stomach, such as acidic enzymes, to flow back up into the esophagus. This often results in heartburn.
  2. Laryngo-pharyngeal reflux is when the upper esophageal sphincter fails to close, allowing contents in the esophagus to flow back up into the back of the throat and then back down into the lungs. This often results in coughing fits and a feeling of "nasal drip" on the back of the throat.
  3. Duodeno-gastric reflux is when the pyloric sphincter fails to close, allowing contents in the small intestine, such as bile, to flow back up into the stomach and allowing stomach acid to continuously leak into the duodenum. Symptoms may include pain, nausea or vomiting. Vomit may have the dark brown color of bile. One patient describes it here: https://forums.phoenixrising.me/thr...y-disorder-duodenum-and-gaping-pylorus.79344/

It is apparently common to have multiple types of reflux at the same time. All three valves (sphincters) in the upper digestive system are controlled by the autonomic nervous system, which means that all three types of reflux are types of dysautonomia.
1632971384715.png


EDIT:
Someone has pointed out that there is, in fact, a fourth type of reflux dysautonomia, associated with the ileocecal sphincter in the lower digestive system.

The ileocecal sphincter allows food to pass from the small intestine into the large intestine, while preventing bacteria from the large intestine from flowing backwards into the small intestine. (Although bacteria are normally found in the large intestine, they are mostly absent from the small intestine.)
1641765739680.png
 
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Wolfcub

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Just had another endoscopy, doctor said “not that bad” and prescribed antidepressants for “chemical imbalance in the gut ”....
That's likely to be our old pal, Serotonin. Yes, a low dose antidepressant could perhaps help that. But maybe it's an experiment to see if that works?
The thing is though -what causes serotonin to go haywire in the first place?
 

Wolfcub

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Well, this thing that I call "reflux" (but isn't heartburn exactly....feels more like indigestion) may be quite mild in my case. But enough to be uncomfortable. It keeps changing shape, Now I can get it up to two hours after eating dinner as well.
A very odd thing....it can be plaguing me an hour or so after dinner, and then I eat some chocolate, and it goes away. I don't know why that would happen.
It also goes away completely at times. I just had four whole days without it, then it comes back. (not caused by a food I can't tolerate.)
It makes me think I'm making headway with the things I'm taking for it. But nope, obviously not.
 

EddieB

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Yes, a low dose antidepressant could perhaps help that. But maybe it's an experiment to see if that works?
The thing is though -what causes serotonin to go haywire in the first place?
Hello there,
I went down this bunny trail last year with a previous gastrologist. After some horrible start up side effects I did have an improvement with an antiD, but short lived. It might work for some in some cases, but I doubt it long term.

I’ve recently posted about this elsewhere, but my thinking of late is that dysbiosis/overgrowth in the gut is the root cause. I’m not saying this is everyone’s problem, but for those of us with gastro issues, it’s a piece of the puzzle. My symptoms seem to be more of a gas/ vapor reflux that takes place at night while asleep.

There’s a close relationship between gut bacteria and serotonin; mess with one and you mess with both. And the fact that antiD’s (or your chocolates) can have an influence makes the point. I’ve been reading several studies on the effects of antiD’s on gut bacteria. I would speculate, that the bad reactions (or possibly the good as well?) that some people get from antiD’s are caused by changes to the gut.

I think some of these doctors know all this as well, however, there is a great distance between the scientists testing lab mice and doctors treating humans. Someone, by chance, had their gastro symptoms improve after taking an antiD, and it went from there. I’ve had three different gastrologists hand me antiD’s, so it’s obviously become part of their MO. They are treating/ guessing based on what they’ve heard, hoping for a good response. But using antiD’s for this, IMO, is like using a hatchet instead of a pair of tweezers. There has to be a better way.
 
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EddieB

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..Which also causes a horrible anxiety-like reaction in whole body (trembling....wired.....etc), definitely set off from stomach area, missed heartbeats and brief times of afib-like fluttering? And causes the most deathly exhaustion after eating breakfast?
Those are pretty upsetting. I wish I had better answers for you, but I’m looking for some myself. The chocolate helping is interesting...
Have you had any digestive issues prior, or is this all brand new?
 

Wolfcub

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Have you had any digestive issues prior, or is this all brand new?
No, my digestion has always been strong as a rock. I could, and did, eat anything.
When ME/CFS started (suddenly after what felt like a flu)early in 2018 I got a slight lower gut upset for a few days only, then that went and didn't come back until around the time I got Covid, last Spring. Until December 2020, around Christmas, I had no upper gut symptoms at all!

I really really miss eating some foods. I am mainly on low FODMAP now except I appear to have no bad reaction to gluten, so do eat a few gluten containing foods.

I wonder if it's connected to the vagus nerve. I often get the same peculiar "flipping" sensations in my esophagus as I used to get whenever I dived into cold water. Like a kind of "gasp" from my stomach.
Sometimes if I put ice cold water on my face, neck and chest, it stops the "reflux-y" sensation temporarily.
 

EddieB

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I wonder if it's connected to the vagus nerve. I often get the same peculiar "flipping" sensations in my esophagus
I don’t know what causes that, but I know it well. It’s an unnerving feeling, that’s been around for many years. I can sometimes go for months without it happening then have it start in again. I’ve asked a number of doctors about it, they just don’t know. I had a full heart and lung work up done years ago looking for the problem, no answers.

I’ve heard/ read it could be a vagus nerve response to reflux, or from gas pressing the stomach against the heart.

But I feel that it’s a symptom or reaction to something that’s going on further down the pipeline. All my problems started in the lower gut, and I think, for me, that where it originates from.
 

hapl808

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I get this all the time. Cheese (like mozzarella) can help. Chocolate can also help, but depends on the chocolate (which maybe could be varying histamine / amine content). But definitely confusing since sometimes it will go away. In my experience, it also seems to correlate a bit with PEM - so it gets worse right before a PEM crash.
 

Booble

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Acid reflux and heartburn or GERD that goes away after a full meal (dinner)?
....GERD that eases when lying flat on my back to go to sleep -usually about 4 hours ater eating anything late evening? And not waking with any sore throat, nasal /sinus issues etc

.....Which gets worse (REALLY bad) after breakfast or small amounts of food. I don't eat as soon as I get up, usually about 2 hours later.
...Which also causes a horrible anxiety-like reaction in whole body (trembling....wired.....etc), definitely set off from stomach area, missed heartbeats and brief times of afib-like fluttering? And causes the most deathly exhaustion after eating breakfast?
Bad when getting hungry in the daytime or early evening, yet fine after a long fast (overnight)

But mainly okay after a full dinner. No anxiety-like effects after dinner, like there are after breakfast.
I wondered if it was gluten, yet I can eat foods with gluten in the evening and be fine.
I don't think it's sugar (I frequently have a small amount of fruit with breakfast) because chocolate after dinner is okay.

Not set off by or eased by, any specific foods, though I haven't risked rich food. My diet is plain.

It basically seems that after a long fast -okay. After a big meal -okay (when there is more weight in the stomach). After a small ish meal -bad (light food in stomach). After a short fast (6hrs) -bad.

"Poor man's" stomach acid test with baking soda -1st day results say low stomach acid (which may have been caused by an indigestion tablet I took the night before) . 2nd, 3rd and 4th days results say stomach acid normal.

Has anyone ever heard of acid reflux which behaves that way? Probably not, but need to ask.

I can relate to this. I don't think it's actually acid reflux though. I think it has something to do with morning digestion cycles. Without getting too TMI-y --- does it also happen around making a morning ..errr....poop?
 

Wolfcub

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I can relate to this. I don't think it's actually acid reflux though. I think it has something to do with morning digestion cycles. Without getting too TMI-y --- does it also happen around making a morning ..errr....poop?
Booble, I'm sorry you get the same/similar. But wow....someone knows exactly what I mean.

Sometimes it does get worse after doing a poop. In the morning when I and my body are still, and there's nothing inside me, and nothing "happening" everything's quiet and I feel better (in that respect) Then the first drink ( a camomile and fennel tea) starts things naturally moving of course.....the day has started.....the toliet....then the stomach starts to ask for food. I have fasted for 14 hours.
It's then I first start to feel a slight discomfort. Like something starting to "flip" inside (not actually anything acidic, just this flipping feeling, which I presume is the LES. That comes with missed heartbeats too. Sometimes four or five a minute (feels like going down in an elevator a few times a minute!)
 

Booble

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Yes, I'm there with you. I can feel relatively normal in the morning -- thinking, hey this is going to be a good day, I feel pretty good today -- and then I eat or poo and and get very fatigued. I've done some researching and for the poo thing it's believed to related to the vagus nerve as mentioned above. It runs a long way through the body and drops blood pressure which makes your heart need to go into action. In my case I also think my intestines prefer to be full rather than empty. My only guess is related to endometriosis adhesions and scar tissue or maybe something else. When I don't poop for several days I feel great.

On the eating part, I think it's also related to digestion cycles. Our bodies are still processing the previous day up to about noon time. Some nutritionists back in the 1980s used to say to only eat fruit in the morning because that can pass through your body easily and wait to eat anything else until noon time.

It's funny that people mention chocolate because I drink a cup of plain cocoa powder in hot water each morning instead of coffee. It has lots of good antioxidants, it's good for your arteries, it gives a little serotonin happy boost, a tad bit of caffeine and is a good blood sugar level-er. And no fat or calories. The wonder drink.
 

EddieB

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No, my digestion has always been strong as a rock. I could, and did, eat anything.
When ME/CFS started (suddenly after what felt like a flu)early in 2018 I got a slight lower gut upset for a few days only, then that went and didn't come back until around the time I got Covid, last Spring. Until December 2020, around Christmas, I had no upper gut symptoms at all!
So to understand, you did not have this prior to covid? Did you have to take antibiotics or medications for the covid, that may have unbalanced your gut bacteria?
 

ljimbo423

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So to understand, you did not have this prior to covid? Did you have to take antibiotics or medications for the covid, that may have unbalanced your gut bacteria?

Studies are showing that Covid itself is causing lasting GI problems in some people. Studies are showing that Covid 19 infects the GI tract. Here is a quote from one.

Abstract

The novel coronavirus disease is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Betacoronavirus genus that also includes the SARS-CoV and Middle East respiratory syndrome coronavirus.

While patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain.

Studies have identified the SARS-CoV-2 RNA in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 was found to be highly expressed in gastrointestinal epithelial cells.

These suggest that SARS-CoV-2 can actively infect and replicate in the gastrointestinal tract. This has important implications to the disease management, transmission, and infection control. In this article, we review the important gastrointestinal aspects of the disease.
https://pubmed.ncbi.nlm.nih.gov/32215956/
 
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LPR most often presents after a viral infection, so it is expected to present after Covid-19 too. It has been also linked to laryngopharyngeal hypersensitivity or neuropathy. Symptoms include laryngeal irritation such as throat irritation, dysphonia, foreign body sensation in the throat, stridor and chronic cough.
It can be treated by neuromodulators, like amitriptyline and gabapentin, or more conventionally with PPIs and H2 blockers. The most conservative-safe way to treat is with liquid Gaviscon Advance from UK with high sodium alginate concentration.
For those that chronic fatigue presented after a viral infection, LPR can be a co-symptom too.
 

Booble

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I had LPR during and for months after my bad virus (Dec 2019 - January 2020).
I was shocked when the ENT doc said everything looked good around my vocal chords. It felt like the bad coughing (to the point of gagging with each cough) had wreaked havoc on the vocal chords. Once when I tried to gargle, that whole area was not working. I literally couldn't do the gargle thing and the water just spilled out my mouth. I did not do any treatment for the LPR and eventually it resolved on its own. The only remnant pretty much is that my voice is now a little lower and I sound like an old lady. Ok, I am an old lady (late 50s) but I never sounded like one before!