Gerd treatments: A survey of efficacy and side effects/contraindications

[stevenski]

As someone whose GERD seems to be getting gradually worse, and is not fully controlled by PPIs(Nexium/esomazprazole 40 mg) per day, i am in intersted in looking at other people's GERD/acid reflux remedies, especially where the GERD presents with diagnosed non-cardiac chest pain and discomfort, and when lying down(even one a half hours after eating small to medium meal). ALL contributions welcome, but especially off people who also have diagnosed oesaphageal dysmotility/ineffective oesaphageal motility, which I think, after 10 years, led to my GERD developing
I am currently myself trialling
aloe vera juice-10mg x2 per day
supplemental broad spectrum digestive enzymes

I Take Gavascon Advance, containing sodium alginate to stop acid/food regurgitating from lower esaphageal shpincter(LES) into esaphagus/gullet; and sodium bicarb in form of "Resolve" sodium bicarb and paracetamol mainly)

There is a reputable scientific trial showing bethanacol and buspirone enhance esaphageal motility but both NHS(UK) and private specialists say not even available in the UK,even ON label, never mind OFF label.Anyone in Uk managed to get these for esaphageal dysmotilty

What are people's eperiences of the below things, and how long have they needed to take them for to see proven(to themselves) benefits?

slippery elm

Molasses(honey-manuka or otherwise, even highish strength didnt work for me)

Probiotic yoghurt or pill supplementation

Cipralex/lexapro is out for me as is ssri and can't tolerate them. L_Glutamine has a significantly enough poor side effect profile, so i dont choose to risk that

anything else, natural or allopathic, including:

H2 antagonists(ranitidine etc)

D-Noltab(bisimuth)

H2 antagonists combined with PPis

I cannot tolerate domperidone("motilium") and metaclopromide doesnt work; cissapride is banned in UK(these are pro-motility/pro-kinetic medications, more than for GERD)

anything else at all!?

Thanks Steve Benson("Stevenski" in chat)

 

[Sushi]

Hi Steve,

Have you heard that the symptoms of GERD and low stomach acid are much the same? Patients like us are more likely to have low stomach acid and the need to supplement with HCL. Some doctors are not able to recognize the difference and treat for hyperacidity when it is actually hypoacidity.

Have you had your gastric PH measured? I am one of the ones who has low stomach HCL and have had it measured and confirmed.

Best wishes,
Sushi

 

[stevenski]

Sushi, can u have ur gastric ph measured wihout having 24 hour ph ambulatory manometry?. i cannot tolerate this test; tried once already and physiologist said I was too ill to have it cos, ironically, coming off PPIs for 5/6 days, i had 2 terrible days of acid rebound and could only eat one biscuit, so was too weak. is there another test to check for ur acid v. alkaline levels, ie to ascertain whether u got too much or too little acid. The evidence from scientific papers on the net is TOTALLY contradictory on this issue of too high or too low acid, so an acid measuring test is the only way round it; but it would have to be an alteranative to the one i mentioned. I HAVE had usual "stage"(ie one off, short) manometry, gastroscope/endescope, barium swallow and nuclear medecine stomach empyting tests, none of which, i think, measure acid/alkaline. Thanks Steve PS. is HCL betaine ?

 

[Sushi]

Sushi, can u have ur gastric ph measured wihout having 24 hour ph ambulatory manometry? PS. is HCL betaine ?

I have had this test: "One method of gastric analysis, the Heidelberg radiotelemetric device." http://findarticles.com/p/articles/mi_m0ISW/is_250/ai_n6112459/

Basically, you fast overnight, swallow a tiny radiotransmitter on a string which reads out to a receiver and measures PH. Then they have you drink a certain amount of baking soda and time how long it takes the stomach to restore the healthy PH. It is an older technique and far less invasive than newer ones. I failed! My stomach wasn't able to restore a normal level of acidity within a reasonable time.

HCL is Betaine Hydrochloric Acid. I take a couple of capsules with each meal and this helps with digestion. Many others I know take HCL as well.

Dr. Rich Van Konynenburg has told us about a very simple (though not so precise) test you can do at home. First thing in the a.m. drink a quarter teaspoon of baking soda in a glass of water and time how long it takes you to burp. If it takes longer than 2 minutes, you have low stomach acid.

Hope this helps!

Sushi

 

[dmholmes]

If I had to go through it again I would be starting with DGL and mastic gum. I had an endoscopy after years of GI issues, found mild gastritis, and told I'd need to take Nexium endefinetly. I did a trial shortly after of eating gluten-free and had rapid improvement. No more GI issues.

 

[Crappy]

stevenski

I have been wanting to engage in this topic because I have the same problem and much experience. But I haven't gotten thoughts together to converse yet. I would strongly urge caution on arbitrarily adding acid. Gastroenterology is another fast changing field that the average practitioner is behind the curve.
You can safely add it in small amounts, but watch closely for problems, I suspect you will end up only worsening the root problem, "Metabolic Acidosis". Inflammation and Acidosis are both known precursors to the end stage disease process.

What age are you? How long have you suffered? Initially I would advise getting Capra Mineral Whey, and try to use it in place of your topical treatments; NOT in place of H2 or PPI's. I suspect you need to work on decreasing systemic acidosis. Simple sugars like molasses will aggravate the condition. Also, good full breathing will help, work on getting a little more ventilation than you need. I think the final answer is to get the organisms out of your body, so it will stop trying to kill them by using a self destructive "kill everything before it kills us" approach.

I'll try to share more if you want.

 

[caledonia]

My naturopath prescribed this for me: http://pureformulas.com/gi-benefits-30-servings-by-davinci-labs.html?CAWELAID=532162915

It's sort of a grab bag of everything that's supposed to help heal your gut/esophagus. I'm supposed to take it for 3 or 4 months, then the problem (nighttime acid reflux) is supposed to be fixed. I've only been on it for little over a week, so I don't have any improvement to report yet. It actually tastes ok, and I'm tolerating 1/2 scoop 2X (lower end of a normal dose).

I used to take Betaine HCL, probioitics, etc. but don't need them anymore. I've been working on methylation and adrenals the past year or two, so I would attribute any improvements to that.

 

[jps]

Hi... about slippery elm

In fact I used slippery elm for quit a while... in the form powder to make a tea. And it really helps to keep away heartburn for some time. I use it regulary. No side effects up to now. I also tried lots of pills, however these help temporarily. I use one of the guides I bought online. Cannot tell you about the results yet... I only hope for these. Just for your reference here is a video for this guide http://gerdremedies.net

Hope this will help!!!

 

[maryb]

Steve I don't know whether you could see Dr Myhill, I did the acid test through her website and was found to have the lowest stomach acid the lab had recorded, a Gastroenterologist I'd seen a couple of months previously had given me acid reducing stuff - now wonder I felt so ill, I had Helicobacte Pylori infection as well, your doc could test for this. I could never take probiotics, but after some a/biotics for H/P I am tolerating Culturelle.

 

[searcher]

help with diet

I had pretty horrible burning for about 6 months before getting an endoscopy that got me an official diagnosis of GERD. I took PPIs for a week or so but then got concerned that it wasn't getting at the root of the problem.
For now I am eating a "paleo" diet + some fermented dairy, like creme fraiche and kefir. I also take DGL before meals, and occasionally take HCL before high-protein meals (although I haven't had an official pH test done so don't take it regularly.) I also take daily probiotics and eat lots of homemade chicken broth. My GERD has lessened greatly-- I feel an occasional burn every few days but otherwise am back to my normal indigestion.
I haven't read the book, but following the intro GAPS diet for a week was a nice kickstart: http://gapsdiet.com/INTRODUCTION_DIET.html

wow, there's a lot of acronyms in my post

 

[sleepy237]

If I had to go through it again I would be starting with DGL and mastic gum. I had an endoscopy after years of GI issues, found mild gastritis, and told I'd need to take Nexium endefinetly. I did a trial shortly after of eating gluten-free and had rapid improvement. No more GI issues.

After eating a ready made sauce on Thursday, I woke up Friday in great discomfort, with throat tightening all day. Checked the sauce packet: Gluten Wheat Soya, have been away from Gluten and seems in CFS, Gluten is a beast. Well at least I know Gluten is a BIG culprit. Found a site today Steven, ever tried the Cider Vinegar yet?
http://costohope.blogspot.com/search/label/Apple Cider Vinegar

 

[dmholmes]

After eating a ready made sauce on Thursday, I woke up Friday in great discomfort, with throat tightening all day. Checked the sauce packet: Gluten Wheat Soya, have been away from Gluten and seems in CFS, Gluten is a beast. Well at least I know Gluten is a BIG culprit.[/url]

It is for me, big time. I would have never guessed at the time that gluten was causing my chronic digestive problems. And major bonus, a few months after going gluten-free I noticed I wasn't having nocturnal panic attacks anymore. I had been having them a few times a week for years. Such a blessing. A gluten elimination trial would seem wise, especially when it doesn't always present with GI issues and testing doesn't seem accurate for gluten intolerance.

 

[taniaaust1]

I was on Nexium for the GERD.

It turned out that in my case that the GERD was being caused by my diet as once I started a diet for the hyperinsulemina I was found to have (extremely low carb diet), I never get GERD now. As soon as I break the diet and eat something like a pasty, the GERD is back (showing itself up worst then it did originally).

 

[Adster]

Just a heads up that Nexium(and possibly similar PPI drugs) can cause b12 deficiency.

 

[toddm1960]

Steven I'm in the same boat, slow motility, crappy monometry, bad GERD and a 120 hour transit time. I switch PPI's every few months because they stop working if at all. The PH test you want is called a BRAVO, it's the small capsule they attach to your esophagus and it sends a signal back to a receiver you ware on your belt. The bottom line for me was a dysautonomia diagnosis, your autonomic nervous system controlls all the smooth muscles in your GI tract. My lower esophageal sphincter pressure is very weak (I'll guess yours is also) so not only does acid flow back up but so do all of your stomaches enzymes. The root of your problems sound just like mine, weak and slow smooth muscles in your GI tract, and it's been a nonstop fight, nothing has seemed to help me or change things. But that doesn't mean that I'm not interested in other ideas, good luck I you find somthing that helps.

 

[svetoslav80]

Juice fasting (20-30 days) or even water fasting (up to 5 days) may help, I even think it can cure you completely. But it's difficult.

 

[insearchof]

Hi Steven

I think there is a breath test that can be used now to determine low stomach acid, as well as the possibility of HB infection.

I think most ppl here have covered all the bases. I would focus on diet, low acid levels and gut bugs. I would stay away from increasing HCA though until you really know what your acid levels are.

The simple home test of carb soda mentioned previously is easy and might give you insight on whether you have low levels of acid.

People mentioned probiotics and digesitive enzymes - all good too.

Giving the digestive system a rest is also good - so a couple of days of juicing (free of known things that antagonise reflux - tomatoe, citric acids etc) as someone else said, is also good.

There are also important digestive enzymes in saliva.(Which is why you are meant to chew your food so many times). Increasing saliva production will help sooth your throat / too. Also, saliva contains important anti microb/bacterial properties. So if it is a gut bug giving rise to your issues (reflux and chest pain - which is possible) - stimulating saliva production will help this too. How to do this? Believe it or not, its really simple, cheap and effective if you keep it up: chew gum - before and after meals and as often as you can in between. Chew, Chew, Chew. It is also the reason why dentists recommend it - it kills plaque related bacteria that are believed to cause decay.

The other thing - if it is some kind of bug or other condition that has over proliferated in the gut - it might be a good idea to get tests done to see what you have in your stomach and in your stools and look at killing them off. Also, once you know what you have, you can then introduce the right probiotic strains to send them on their way.

My own theory on this is that its due to a gut bug and diet/medications and the relationship they have to the gut bugs.

Good luck

 

[minimus]

I have the same problem...GERD with "referred" pain to my neck and chest. I had the manometry test and a 24-hour pH study (basically, a test that measures how high stomach acids are reaching from the esophogas all the way to the throat and sinuses). The 24-hour pH study was very uncomfortable (to say the least). In any case, it doesn't seem to have any treatment implications.

In the 24-hour pH study I was found to have an abnormally high number of incidents of reflux all the way up to my throat. The doctor who did the test said the only medication that might help is domperidone, but everything I have read about it suggests it is contraindicated in CFS. For really severe GERD and associated Barrett's esophagus, some doctors recommend a surgical procedure called fundoplication, although the gastroenterologists I have seen in New York say it has a relatively low success rate and often terrible side effects.

The gastroenterologist who did the 24-hour pH study did not think PPIs were worthwhile, which mirrors my experience with those medications. Apparently, they reduce the acidity of what you reflux but may increase your tendency to reflux in the first place.

I have tried a number of supplements, including Spry chewing gum, DGL, Seacure, digestive bitters. None has made a noticeable difference.

I know that some of the sleep medications I take, most notably Klonopin and doxepin, are associated with GERD. Like peppermint and fennel, they relax the esophageal sphincters, increasing the tendency to reflux. These drugs are also central nervous sytem relaxants, so I suspect they also lower gastric motility.

I guess I would rather have GERD than chronic insomnia and the resulting added exhaustion.

The only thing that seems to help is eating small meals and very little food close to bedtime. Unfortunately, the only time I usually have any appetite is around bedtime.

I guess the only real treatment is to stop eating altogether, as some here have suggested.

 

[Sean]

Had it very badly for many years, every day, almost crippling at times. Used a large bottle of Gaviscon a week. Then tried omeprazole ('Probitor'), killed it stone cold dead, able to eat whatever I want now and no problems at all. The only one of my various chronic health problems I have been able to eliminate, or at least fully control - when I stop taking omeprazole it all returns within 2-3 days, just as bad as before.

It is a horrible problem to deal with, and I am very sympathetic to anybody who has trouble controlling it.