GERD-like symptoms that go away after a proper meal

[Booble]

Right now, the lpr is killing me. Nothing seems to help, it’s like a gas/vapor reflux that comes up at night.
The gaviscon advance doesn’t help much, and the algenate/ fillers really aggravates my lower gut problem, where the root cause is.

Eddie, have you tried apple cider vinegar? I'm not one of the ACV nutjobs but it does work really well and immediately on that kind of reflux.

 

[EddieB]

Eddie, have you tried apple cider vinegar? I'm not one of the ACV nutjobs but it does work really well and immediately on that kind of reflux.

Yes, unfortunately it burns worse. Enzymes and supplements make it worse too, I’ve really tried it all.

 

[Booble]

Yes, unfortunately it burns worse. Enzymes and supplements make it worse too, I’ve really tried it all.

Oh, that's too bad. For my husband a few capfuls of vinegar diluted in a glass of water does the trick, even when the reflux is at its worst.
Hoping things get better for you.

 

[hapl808]

Have you tried slippery elm and aloe vera? Those have helped me a bit recently, but I still get reflux before any PEM type crash, just less so. I tried a lot of other stuff that did nothing (DGL, probiotics, carnosine, enzymes, etc). The slippery elm seems to help the most so far, but I'm still experimenting as it's far from cured and one of my most frustrating and consistent symptoms for years.

 

[EddieB]

Have you tried slippery elm and aloe vera?

The slippery elm aggravates gut symptoms. I’ve tried aloe Vera water (George’s) but it too seemed to make it worse. I checked the ph and it was pretty acidic. Is there a better source/ form of aloe vera that’s better?

 

[hapl808]

The slippery elm aggravates gut symptoms. I’ve tried aloe Vera water (George’s) but it too seemed to make it worse. I checked the ph and it was pretty acidic. Is there a better source/ form of aloe vera that’s better?

I'm not sure if there's a better version - and since slippery elm helps me, maybe we have different etiologies. The aloe vera I'm using is a Lily of the Desert one that's organic with none of the usual preservatives (they have different versions). I find the slippery elm helps stop the reflux from starting (like taking before bed) where the aloe vera is soothing when my stomach is empty and it's already hurting a bit.

 

[Shanti1]

Eddie, have you tried apple cider vinegar? I'm not one of the ACV nutjobs but it does work really well and immediately on that kind of reflux.

I think ACV could work well for people who have low stomach acid. The idea is that acidity (low pH) triggers the lower esophageal sphincter to close. When you don't have enough acid, it remains open and, meanwhile, your food just sits in your stomach without enough acid to start the digestive process and move onto the next digestive phase, leading to a reflux situation.

My understanding is that, when ACV makes things worse, there could be gastric/esophageal irritation that needs to be healed, or hyperacidity.

Many pwME report mast cell/histamine issues. For those who have mast cell activation/excess histamine, this can lead to excess acidity and reflux because histamine triggers acid release in the stomach, this is why H2 blockers work for reflux. (ref)

Other things to consider are SIBO, which can put upward pressure on the diaphragm due to gas production, and a hiatal hernia or sliding hiatal hernia. The sliding variety can be hard to detect, but when the stomach (or part of it) moves up above the diaphragm, it can cause reflux and put pressure on the heart, leading to tachycardia and other symptoms. A classic home remedy is "heel drops". If doing them gives relief, hernia could be something to look into.

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.

I can see how irritation of the vagus nerve from reflux or from a hiatal hernia could lead to other symptoms, including mental and PEM symptoms.

 

[hapl808]

Other things to consider are SIBO, which can put upward pressure on the diaphragm due to gas production, and a hiatal hernia or sliding hiatal hernia. The sliding variety can be hard to detect, but when the stomach (or part of it) moves up above the diaphragm, it can cause reflux and put pressure on the heart, leading to tachycardia and other symptoms. A classic home remedy is "heel drops". If doing them gives relief, hernia could be something to look into.

I've wondered if a hiatal hernia could be involved for me. The heel drops are unfortunately beyond my physical ability to try, though.

 

[EddieB]

Lily of the Desert

I was looking at that one, could you give a little more info about it? Some reviews complained about the ones with additives.

My understanding is that, when ACV makes things worse, there could be gastric/esophageal irritation that needs to be healed, or hyperacidity.
I have unexplained gastritis, possibility from entero virus.

Many pwME report mast cell/histamine issues.

Other things to consider are SIBO, which can put upward pressure on the diaphragm due to gas production, and a hiatal hernia or sliding hiatal hernia.

SIBO test negative, gastric empty- normal, endoscopy- no hernia, mild gastritis.

Also going to look into mast cell next, have some symptoms.
Thank you.

 

[Shanti1]

I've wondered if a hiatal hernia could be involved for me. The heel drops are unfortunately beyond my physical ability to try, though.

I know there are other "self-adjustment" techniques for hiatal hernia, but I don't have experience with them. They are done lying down on the back with the knees bent and you are basically trying to pull down on the stomach with the hands. Here is a video showing how it is done if you are interested.

 

[Shanti1]

mild gastritis

H. pylori?

 

[EddieB]

H. pylori?

H pylori, candida, parasites, negative

 

[Judee]

I was looking at that one, could you give a little more info about it? Some reviews complained about the ones with additives.

There are videos on yt regarding making your own aloe vera juice. I know the skin of the aloe has something that upsets the stomach so make sure you remove that well.

I tried the Lily of the Desert years ago when I think they were still using citric acid for the preservative. Now it looks like they are using lemon juice instead. https://lilyofthedesert.com/product/preservative-free-juices/ (The old formula used to make my throat burn and tingle a bit.)

So kinda like half dozen of one and six of the other.

The other thing I was thinking was cabbage juice. I know we talked about sauerkraut but if that is too strong could you still do cabbage juice??? https://tasteinsight.com/how-to-make-cabbage-juice/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1643665/

That article talks about it having antipeptic ulcer factor (vitamin U) which is suppose to prevent the development of histamin-induced peptic ulcers in guinea pigs.

???

 

[EddieB]

There are videos on yt regarding making your own aloe vera juice. I know the skin of the aloe has something that upsets the stomach so make sure you remove that well.

I tried the Lily of the Desert years ago when I think they were still using citric acid for the preservative. Now it looks like they are using lemon juice instead. https://lilyofthedesert.com/product/preservative-free-juices/ (The old formula used to make my throat burn and tingle a bit.)

So kinda like half dozen of one and six of the other.

The other thing I was thinking was cabbage juice. I know we talked about sauerkraut but if that is too strong could you still do cabbage juice??? https://tasteinsight.com/how-to-make-cabbage-juice/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1643665/

That article talks about it having antipeptic ulcer factor (vitamin U) which is suppose to prevent the development of histamin-induced peptic ulcers in guinea pigs.

???

Yeh, that citrus added probably wouldn’t go well. I get that they need preservatives though.
I was using George’s aloe vera water, but it’s like a ph 4-5, fairly acidic.
Cabbage juice could be helpful, I’ll try that thanks.

 

[Pyrrhus]

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

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

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.)

 

[EddieB]

I think I have all of the above

 

[GreenMachineX]

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.

I was just diagnosed with lpr! I didn't know what it was at first, so I went to the ER acouple times when I thought something was stuck and scratching the back of my throat! Then waking up coughing or gagging, tight throat, pain in Adam's apple, stridor...I was a mess. The ENT said I have lpr only. The best description I've heard so far was it feels like a huge scab in the back of the throat.

 

[EddieB]

I was just diagnosed with lpr! I didn't know what it was at first, so I went to the ER acouple times when I thought something was stuck and scratching the back of my throat! Then waking up coughing or gagging, tight throat, pain in Adam's apple, stridor...I was a mess. The ENT said I have lpr only. The best description I've heard so far was it feels like a huge scab in the back of the throat.

Not sure where you are on your journey...
LPR, GERD, and gastritis can cover a broad range of possible causes. For many people, which is what doctors are used to dealing with, the problems are simple. Poor diet, overweight, drugs/ medications that irritate the stomach. etc. For these, a short course of PPI, dietary changes, not laying down after eating, and symptoms usually resolve.

The next level, if symptoms do not improve, is endoscopy, tests for h pylori, and possibly SIBO. Depending on symptoms, an empty test for gastroparisis may be needed. If something turns up here, you may find improvement from conventional treatments.

But for some of us, the problems extend beyond, and conventional medicine is almost useless.

There seems to be a great deal of LPR/ GERD/ gastritis/ gastroparisis attached to ME/CFS. The speculation is either a viral component is responsible (in my case enterovirus), or vagal/ neuro damages from a previous virus.

I have terrible LPR, you are not alone.

 

[GreenMachineX]

Not sure where you are on your journey...
LPR, GERD, and gastritis can cover a broad range of possible causes. For many people, which is what doctors are used to dealing with, the problems are simple. Poor diet, overweight, drugs/ medications that irritate the stomach. etc. For these, a short course of PPI, dietary changes, not laying down after eating, and symptoms usually resolve.

The next level, if symptoms do not improve, is endoscopy, tests for h pylori, and possibly SIBO. Depending on symptoms, an empty test for gastroparisis may be needed. If something turns up here, you may find improvement from conventional treatments.

But for some of us, the problems extend beyond, and conventional medicine is almost useless.

There seems to be a great deal of LPR/ GERD/ gastritis/ gastroparisis attached to ME/CFS. The speculation is either a viral component is responsible (in my case enterovirus), or vagal/ neuro damages from a previous virus.

I have terrible LPR, you are not alone.

I'm not sure where I'm at on my journey either
Thanks for the reply though. I'm trying to stay off the PPIs though because I'm already very sensitive to b12 orally, and if I use PPIs they block oral absorption and I'm already dealing with b12 deficiency. Just not ready to try sublingual and have a freak out.