How to manage a no-coffee GERD diet while also needing to do shit?
April 6, 2015 11:01 AM Subscribe
Asking for a friend: I have been in a challenging engineering graduate program for about three years now. Two years ago, I was diagnosed with acid reflux / GERD. It seemed to be chronic but I found I could manage it with OTC medications and eliminating coffee and other caffeinated drinks from my diet. If I do this and don't overeat, I barely notice any symptoms.
However, I've always used caffeine (and in the past, nicotine, but no more) to get my schoolwork done. I'm a hard worker and a good student-- or I was, until I stopped drinking coffee. In the last year I've tried everything: getting regular sleep, getting various amounts of sleep, staying hydrated, eating high protein diets, anything at all. But I suck! I never have enough energy. I also work a job with a lot of daytime hours and it's almost impossible to focus on schoolwork at the end of the day, after working. Normally I could have a small coffee or a shot of espresso and get the rest of my evening work done, but now I'm just super tired, try to make myself a nutritious dinner, then stare at the walls until it's socially acceptable to go to sleep. This is a mild exaggeration-- I still get things done-- but I'm not as driven, my work isn't as high quality, and I don't go above and beyond anymore. I do the bare minimum and my grades, while not awful, reflect that.
UNTIL: This month, I started drinking coffee again. It started when I was on vacation and wanted to sample the local roasts, but I just started drinking coffee every day with breakfast and not giving a shit. When I came back to school, I kept at it, and holy shit I can work again. I can feel again! I'm excited about my work and I work hard. I've been treating my depression in the meantime so I know what depression feels like, and I wouldn't say I'm depressed without caffeine-- just naturally tired, because I have a lot to do. I can't rearrange my life to be more humane right now-- plus it will leave me with a pretty limited ability to do anything other than work a full-time job. I can't imagine raising kids without caffeine, for instance. I want to have the energy to get the most out of this program, not just eke by. And coffee has gloriously done that for me for the last few weeks.
But sure enough, despite drinking dark roast (the least acidic), my GERD is back and it's pretty bad. I'm losing my voice from the reflux. I keep eating cough drops because the acid is burning me and it freaking hurts. I know I can't keep drinking coffee, because I feel like shit and I'm going to give myself Barret's esophagus and / or cancer. I feel like I am sick and have asthma as it is.
If you're in the same boat-- what have you done? I recently ordered a bag of trücup coffee (reduced acid coffee) but I've also read that it's the caffeine that loosens the gastric sphincter, so acid or no acid it won't help me all that much. What else can I do besides play fast and loose with caffeine to not feel like such a lazy ass? To be honest, I'm tired of handling myself with kid gloves all over some stupid GERD. Eat this, sleep like that, don't drink coffee or eat chocolate or a bunch of fruits and vegetables... aughhhhghghdghhhh.
One last thing: I hate napping and it tends to affect my GERD as well. I assume this is because "don't eat for three hours before bed" doesn't play nice with "eat many small meals over the course of the day" and also randomly sleeping.
Also, I'm 26, so pretty young. I smoked for about a year when I was 20 but I no longer smoke and I tend to eat a healthy, balanced diet. I also used to exercise and run, but that has mostly come to a halt as both running and lying in weird positions for body weights tends to give me reflux too. I take two doses of OTC Prilosec a day. (Right now I'm taking Zantac in prep for a stool sample, but then it will be back to Prilosec.)
However, I've always used caffeine (and in the past, nicotine, but no more) to get my schoolwork done. I'm a hard worker and a good student-- or I was, until I stopped drinking coffee. In the last year I've tried everything: getting regular sleep, getting various amounts of sleep, staying hydrated, eating high protein diets, anything at all. But I suck! I never have enough energy. I also work a job with a lot of daytime hours and it's almost impossible to focus on schoolwork at the end of the day, after working. Normally I could have a small coffee or a shot of espresso and get the rest of my evening work done, but now I'm just super tired, try to make myself a nutritious dinner, then stare at the walls until it's socially acceptable to go to sleep. This is a mild exaggeration-- I still get things done-- but I'm not as driven, my work isn't as high quality, and I don't go above and beyond anymore. I do the bare minimum and my grades, while not awful, reflect that.
UNTIL: This month, I started drinking coffee again. It started when I was on vacation and wanted to sample the local roasts, but I just started drinking coffee every day with breakfast and not giving a shit. When I came back to school, I kept at it, and holy shit I can work again. I can feel again! I'm excited about my work and I work hard. I've been treating my depression in the meantime so I know what depression feels like, and I wouldn't say I'm depressed without caffeine-- just naturally tired, because I have a lot to do. I can't rearrange my life to be more humane right now-- plus it will leave me with a pretty limited ability to do anything other than work a full-time job. I can't imagine raising kids without caffeine, for instance. I want to have the energy to get the most out of this program, not just eke by. And coffee has gloriously done that for me for the last few weeks.
But sure enough, despite drinking dark roast (the least acidic), my GERD is back and it's pretty bad. I'm losing my voice from the reflux. I keep eating cough drops because the acid is burning me and it freaking hurts. I know I can't keep drinking coffee, because I feel like shit and I'm going to give myself Barret's esophagus and / or cancer. I feel like I am sick and have asthma as it is.
If you're in the same boat-- what have you done? I recently ordered a bag of trücup coffee (reduced acid coffee) but I've also read that it's the caffeine that loosens the gastric sphincter, so acid or no acid it won't help me all that much. What else can I do besides play fast and loose with caffeine to not feel like such a lazy ass? To be honest, I'm tired of handling myself with kid gloves all over some stupid GERD. Eat this, sleep like that, don't drink coffee or eat chocolate or a bunch of fruits and vegetables... aughhhhghghdghhhh.
One last thing: I hate napping and it tends to affect my GERD as well. I assume this is because "don't eat for three hours before bed" doesn't play nice with "eat many small meals over the course of the day" and also randomly sleeping.
Also, I'm 26, so pretty young. I smoked for about a year when I was 20 but I no longer smoke and I tend to eat a healthy, balanced diet. I also used to exercise and run, but that has mostly come to a halt as both running and lying in weird positions for body weights tends to give me reflux too. I take two doses of OTC Prilosec a day. (Right now I'm taking Zantac in prep for a stool sample, but then it will be back to Prilosec.)
Two things:
1 - cold brew coffee is less acidic. Put grounds in water in the fridge. Let sit overnight. Strain. Cold brew voila!
2 - find out whether you have a vitamin deficiency. Fix that. Then try quitting coffee again.
And remember that caffeine is an addiction, so it's hard to quit, even if you have incentive. I quit because it gives me migraines. What helped me quit was allowing myself to have coffee up to once monthly.
But do look into a vitamin deficiency.
posted by aniola at 11:17 AM on April 6, 2015
1 - cold brew coffee is less acidic. Put grounds in water in the fridge. Let sit overnight. Strain. Cold brew voila!
2 - find out whether you have a vitamin deficiency. Fix that. Then try quitting coffee again.
And remember that caffeine is an addiction, so it's hard to quit, even if you have incentive. I quit because it gives me migraines. What helped me quit was allowing myself to have coffee up to once monthly.
But do look into a vitamin deficiency.
posted by aniola at 11:17 AM on April 6, 2015
I also have a medical issue that means I shouldn't have any caffeine at all (so you have my sympathy!), but have found that many teas and some caffeinated sodas don't trigger any symptoms for me even though coffee and some other sodas (particularly diet coke) do. I would try out some alternate caffeinated beverages to see if any of those work at keeping you alert without the terrible symptoms.
Also, is it possible for you to be stricter about the rest of your dietary restrictions to buy yourself some more wiggle room for caffeine?
I would also think about figuring out how to add back in exercise, even if it's just walking outside on your lunch break. Getting some sun and some moving in will probably help you feel less like a zombie when you get home from work and may help you focus better.
Finally, I just need more sleep than anyone else I know (probably to do with the fact that I can rely less on caffeine to function). It's annoying when my life is busy since I wind up with no time to myself, but if you haven't tried letting yourself have a lot (9+ hours) of time to sleep on a regular basis - give that a shot.
posted by snaw at 11:25 AM on April 6, 2015 [2 favorites]
Also, is it possible for you to be stricter about the rest of your dietary restrictions to buy yourself some more wiggle room for caffeine?
I would also think about figuring out how to add back in exercise, even if it's just walking outside on your lunch break. Getting some sun and some moving in will probably help you feel less like a zombie when you get home from work and may help you focus better.
Finally, I just need more sleep than anyone else I know (probably to do with the fact that I can rely less on caffeine to function). It's annoying when my life is busy since I wind up with no time to myself, but if you haven't tried letting yourself have a lot (9+ hours) of time to sleep on a regular basis - give that a shot.
posted by snaw at 11:25 AM on April 6, 2015 [2 favorites]
Have you tried coffee alternatives like tea, green tea, mate etc? I feel for you - I tried to give up coffee a for a while several years ago and the lack of focus was horrifying. Whilst by no means a perfect replacement I do remember these helping. When I now overdo coffee to the point where my tummy complains my go to is very weak green tea, it has to be v weak as strong gr tea makes me nauseous. Also, cold brewed coffee is supposed to be a lot less acidic. Not sure if that would be enough of a reduction to help with your symptoms but may be worth a try as well.
posted by koahiatamadl at 11:26 AM on April 6, 2015
posted by koahiatamadl at 11:26 AM on April 6, 2015
Best answer: what drugs are you taking ?
I'm on protonix (generic) so it's pretty cheap. BUT, to clear everything up took maybe 6-8 months for me. I did two 6-week runs of OTC prilosec at double-dose, then a endoscopy etc to get to protonix because nothing was working. Then more time to get body adjusted to protonix, and had to cut coffee out plus garlic, onions, tomato sauces and dark chocolate for several months to get back to "normal". (as in, after a week or two of feeling OK, I'd try a trigger, and relapse in symptoms, and was miserable enough to suck it up and get through it to be healed). That was 2008-2009.
Now ? I take protonix still every morning, 30 mins before eating breakfast. I drink two cups coffee in the morning (black). I really have to watch out for over-eating (and especially over-eating tomato-based things) but otherwise am OK.
posted by k5.user at 11:26 AM on April 6, 2015 [1 favorite]
I'm on protonix (generic) so it's pretty cheap. BUT, to clear everything up took maybe 6-8 months for me. I did two 6-week runs of OTC prilosec at double-dose, then a endoscopy etc to get to protonix because nothing was working. Then more time to get body adjusted to protonix, and had to cut coffee out plus garlic, onions, tomato sauces and dark chocolate for several months to get back to "normal". (as in, after a week or two of feeling OK, I'd try a trigger, and relapse in symptoms, and was miserable enough to suck it up and get through it to be healed). That was 2008-2009.
Now ? I take protonix still every morning, 30 mins before eating breakfast. I drink two cups coffee in the morning (black). I really have to watch out for over-eating (and especially over-eating tomato-based things) but otherwise am OK.
posted by k5.user at 11:26 AM on April 6, 2015 [1 favorite]
Why does it have to be coffee? Caffeine is available through a bunch of other forms, too. Tea is obviously less caffeinated than coffee, but if you drink a lot, it still perks you up. Energy drinks are probably too acidic for you (and you said no carbonation), but something like Mio Energy essentially gives you caffeinated koolaid. One squirt has about the caffeine of a cup of coffee, and in my experience the red one tastes the best.
If you want straight up caffeine bang for buck, there are always caffeine pills. You can find them in most drugstores. They pack around 200mg per pill, which is a hell of a kick.
posted by themadthinker at 11:27 AM on April 6, 2015 [2 favorites]
If you want straight up caffeine bang for buck, there are always caffeine pills. You can find them in most drugstores. They pack around 200mg per pill, which is a hell of a kick.
posted by themadthinker at 11:27 AM on April 6, 2015 [2 favorites]
Caffeine pills might be worth a try. I have no idea if they would mess you up acid-wise, but it would be a cheap and easy experiment. You can find them in larger pharmacies, some grocery stores, and online.
When I use them, it's usually half a pill or less, which works (for me) as a gentle energy boost and not a huge jittery jolt.
posted by jessicapierce at 11:27 AM on April 6, 2015
When I use them, it's usually half a pill or less, which works (for me) as a gentle energy boost and not a huge jittery jolt.
posted by jessicapierce at 11:27 AM on April 6, 2015
Best answer: There are at least one or two reflux medicines that have a stronger dosage in prescription than the OTC one. Added benefit is if your Rx insurance is decent, it'll be a lot cheaper than buying it OTC.
posted by a manly man person who is male and masculine at 11:28 AM on April 6, 2015
posted by a manly man person who is male and masculine at 11:28 AM on April 6, 2015
Response by poster: Quick note from asker: "I drink tea-- have a barracade of tea boxes at my desk at work-- but green tea makes me nauseous like another commenter here and black tea makes me feel nauseous and crazy. Not sure why coffee is the only caffeine with bite for me. I can only drink so much tea without feeling sick, and the caffeine boost is too gentle-- leaves me feeling unfocused and irritable instead of focused and productive. Haven't tried soda, but I don't like soda."
posted by stoneandstar at 11:31 AM on April 6, 2015
posted by stoneandstar at 11:31 AM on April 6, 2015
What about just caffeine pills?
posted by mskyle at 11:37 AM on April 6, 2015 [1 favorite]
posted by mskyle at 11:37 AM on April 6, 2015 [1 favorite]
Have you looked at your blood sugar when you are off caffiene? If the coffee really spikes your gerd than I think you might have a real problem as the rational thing to do is to trade off productivity for long term health. I have a friend whose dad died of esophogeal cancer and it is pretty horrible. Unfortunately, as I know, rational smashional. Losing a drug with addictive properties from your life can be like losing your best friend, its always there for you and you get emotionally attached. What would you say to someone who said they could only get their work done on meth?
posted by Pembquist at 11:46 AM on April 6, 2015
posted by Pembquist at 11:46 AM on April 6, 2015
Response by poster: Last note: I will try caffeine pills! Thank you. As for the addiction comments: Yes, caffeine is an addiction, thankfully one much less harmful than meth. If I couldn't function without meth, obviously I would quit the meth. But I also can't function without antidepressants, and for the moment I am sticking with those (and I am quite emotionally attached). Obviously I quit caffeine for about a year with these health risks in mind so I am not ignorant of the risks and that's precisely why I'm asking this question. And now I'll butt out-- thank you for all the answers!
posted by stoneandstar at 11:50 AM on April 6, 2015
posted by stoneandstar at 11:50 AM on April 6, 2015
Best answer: Have you seen a GI doctor? In the practice where I worked as a nurse reflux was the most common reason for visiting the doctor. Some patients were found to have h.pylori, a bacteria that can live in the stomach and sometimes causes ulcers - antibiotics to eliminate h.pylori can dramatically reduce reflux for some people, although the regimen for eradication is a pain and doesn't always work.
If your suspicion is correct that this is garden-variety reflux, keep in mind that OTC meds are typically half of the prescribed dose, so doubling up on the OTC meds might help. You could also add a bedtime dose if lying down worsens your symptoms.
Avoiding caffeine seems to help, along with tomato sauce, spicy food, and carbonated beverages. Avoid eating late at night and especially avoid alcohol late at night. You might also have personal triggers - I had a patient once who got terrible reflux if he ate nuts. Also weight management, especially if you have a large belly, and exercise that doesn't contribute to reflux symptoms can help.
This is worth getting control of, as persistent reflux causes inflammation to the lower esophagus and there is some evidence that this may eventually promote esophageal cancer.
posted by citygirl at 11:54 AM on April 6, 2015
If your suspicion is correct that this is garden-variety reflux, keep in mind that OTC meds are typically half of the prescribed dose, so doubling up on the OTC meds might help. You could also add a bedtime dose if lying down worsens your symptoms.
Avoiding caffeine seems to help, along with tomato sauce, spicy food, and carbonated beverages. Avoid eating late at night and especially avoid alcohol late at night. You might also have personal triggers - I had a patient once who got terrible reflux if he ate nuts. Also weight management, especially if you have a large belly, and exercise that doesn't contribute to reflux symptoms can help.
This is worth getting control of, as persistent reflux causes inflammation to the lower esophagus and there is some evidence that this may eventually promote esophageal cancer.
posted by citygirl at 11:54 AM on April 6, 2015
Pepto Bismol might calm down all of those acid burning feelings, but I'm not sure how long you could take it day after day.
But might help to take it for a day or two to settle down your current symptoms.
posted by littlewater at 11:56 AM on April 6, 2015
But might help to take it for a day or two to settle down your current symptoms.
posted by littlewater at 11:56 AM on April 6, 2015
I don't see any mention of whether the person is putting milk in their coffee. Dairy/fat really cuts down on the acid response for me. I count it as part of my fat and protein for the day, and I don't add sugar. (Skim milk does nothing.)
posted by wintersweet at 12:03 PM on April 6, 2015
posted by wintersweet at 12:03 PM on April 6, 2015
Best answer: Oh, this is me. I love coffee, love/need a dose of caffeine in the morning, it gives me GERD, I've spent like 5 years trying to figure this out. Some tips:
1. Cold brew coffee!! It's so much less acidic and tastes amazing if you like iced coffee. Easy to make, too!
2. Lattes. I splurged a few years back on a Nespresso machine and its life changing. The fact that there's more milk by volume than coffee makes a big difference.
3. Take your prilosec 20 minutes BEFORE you eat breakfast or drink coffee in the morning. I don't always do this when im running late and when I don't want the appropriate amount of time I can REALLY tell. I tell my patients this as well (I'm an MD) but I think it gets overlooked. You can also try experimenting with taking 40mg at a time vs 20 in the morning, 20 at night and see which helps your symptoms the most.
4. Most of them are gross but try energy drinks. V8 makes a good one called v8 fusion energy that has fruit and veggie juice in it. Rockstar lemonade is decent as well. For me at least, it's not the caffeine that triggers my GERD but the acid in the coffee itself.
5. See a doctor. Some people respond better to the newer PPIs (nexium, dexilant, protonix). Some people have conditions like H pylori that need diagnosis and treatment.
Message me if you like. I'm serious when I say I could have written this question myself. Good luck!
posted by pimmscup at 12:05 PM on April 6, 2015 [2 favorites]
1. Cold brew coffee!! It's so much less acidic and tastes amazing if you like iced coffee. Easy to make, too!
2. Lattes. I splurged a few years back on a Nespresso machine and its life changing. The fact that there's more milk by volume than coffee makes a big difference.
3. Take your prilosec 20 minutes BEFORE you eat breakfast or drink coffee in the morning. I don't always do this when im running late and when I don't want the appropriate amount of time I can REALLY tell. I tell my patients this as well (I'm an MD) but I think it gets overlooked. You can also try experimenting with taking 40mg at a time vs 20 in the morning, 20 at night and see which helps your symptoms the most.
4. Most of them are gross but try energy drinks. V8 makes a good one called v8 fusion energy that has fruit and veggie juice in it. Rockstar lemonade is decent as well. For me at least, it's not the caffeine that triggers my GERD but the acid in the coffee itself.
5. See a doctor. Some people respond better to the newer PPIs (nexium, dexilant, protonix). Some people have conditions like H pylori that need diagnosis and treatment.
Message me if you like. I'm serious when I say I could have written this question myself. Good luck!
posted by pimmscup at 12:05 PM on April 6, 2015 [2 favorites]
Definitely get a blood workup next time you're at the doctor to check things like your iron levels. I've been on and off of caffeine over the years, and when my iron levels were normal my energy would be about as good with or without caffeine. But when I'm anemic like I am now I'm completely in the weeds without caffeine to give me that extra boost.
posted by MsMolly at 12:08 PM on April 6, 2015
posted by MsMolly at 12:08 PM on April 6, 2015
But I also can't function without antidepressants, and for the moment I am sticking with those (and I am quite emotionally attached).
Some antidepressants can be sedating. Is it worth talking to your prescribing doctor about whether that might be part of the issue?
posted by jaguar at 12:10 PM on April 6, 2015 [1 favorite]
Some antidepressants can be sedating. Is it worth talking to your prescribing doctor about whether that might be part of the issue?
posted by jaguar at 12:10 PM on April 6, 2015 [1 favorite]
Since you say you're also worried about the potential effects of caffeine on the gastric sphincter and you aren't opposed to trying pills, you might also try analogous compounds like theobromine and theophylline if the caffeine still exacerbates your GERD (standard reminders to avoid stacking up multiple stimulants on top of each other and to check in with your doctor about any supplements.)
posted by kagredon at 12:24 PM on April 6, 2015
posted by kagredon at 12:24 PM on April 6, 2015
You can buy caffeinated gum (designed for the military!) on Amazon. It comes in several flavors, and they're all pretty bad - they taste fine at first, but after a minute or so you taste the bitterness of the caffeine and it's pretty gross. However, I think it's worth it - the caffeine is absorbed through your mouth, not your stomach, so it's very fast acting and much less likely (in my experience) to upset your stomach.
posted by insectosaurus at 12:41 PM on April 6, 2015
posted by insectosaurus at 12:41 PM on April 6, 2015
Best answer: Umm, please don't take theophylline or other random supplements, or modafinil (barring the presence of a sleep disorder diagnosed by a doctor, of course). They could have side effects far worse than GERD.
Also, I forgot that you had mentioned antidepressants. If you're on an SSRI, have you played around with the time of day you take it? Also, might be worth a shot talking to your MD about switching to bupropion -- it's more of a stimulant than other antidepressants such as SSRIs are.
Getting more sleep may help, but life isn't always that easy. I wish I could snap my fingers and have time for 8 hours of sleep every night, but with my job it's physically impossible and I do need a cup of coffee or other caffeinated beverage in the morning. Yes, it's a mild addiction, but it's one that is shared by probably 75% of adults in the world, and unless you're chugging 10 red bulls in a row every day or something, a cup or two of coffee per day is very, very unlikely to cause you any harm in any way.
posted by pimmscup at 1:20 PM on April 6, 2015 [3 favorites]
Also, I forgot that you had mentioned antidepressants. If you're on an SSRI, have you played around with the time of day you take it? Also, might be worth a shot talking to your MD about switching to bupropion -- it's more of a stimulant than other antidepressants such as SSRIs are.
Getting more sleep may help, but life isn't always that easy. I wish I could snap my fingers and have time for 8 hours of sleep every night, but with my job it's physically impossible and I do need a cup of coffee or other caffeinated beverage in the morning. Yes, it's a mild addiction, but it's one that is shared by probably 75% of adults in the world, and unless you're chugging 10 red bulls in a row every day or something, a cup or two of coffee per day is very, very unlikely to cause you any harm in any way.
posted by pimmscup at 1:20 PM on April 6, 2015 [3 favorites]
Have you been screened for ADHD? I was self-medicating mine with a lot of coffee and I was getting caffeine rebound headaches. While I was cutting back on coffee, I got evaluated for ADHD and I now take Concerta every day.
My doctor has said to me that my coffee drinking to treat my ADHD was pretty common, and the reason I was low on energy so frequently (and I had had blood tests and such done, so not like I was anemic or anything) was because being unfocused and trying to focus is a lot of work. My mind would be buzzing everywhere and doing anything all the way to completion was exhausting.
The Concerta helps me focus and even though it's a stimulant, it calms my brain down enough for me to complete tasks.
posted by sutel at 1:24 PM on April 6, 2015
My doctor has said to me that my coffee drinking to treat my ADHD was pretty common, and the reason I was low on energy so frequently (and I had had blood tests and such done, so not like I was anemic or anything) was because being unfocused and trying to focus is a lot of work. My mind would be buzzing everywhere and doing anything all the way to completion was exhausting.
The Concerta helps me focus and even though it's a stimulant, it calms my brain down enough for me to complete tasks.
posted by sutel at 1:24 PM on April 6, 2015
I have both GERD and ADHD, and while some stims have no affect on the GERD, others can. For instance, Dexedrine was horrible for my GERD, yet great for my ADHD. So, be aware of that.
Personally, I take a low dose of Strattera, a nonstimulant. It doesn't inflame my GERD at all, and it also helps my ADHD and anxiety. However, it can also be sedating. Your doctor will be able to ive you answers.
posted by spinifex23 at 2:10 PM on April 6, 2015
Personally, I take a low dose of Strattera, a nonstimulant. It doesn't inflame my GERD at all, and it also helps my ADHD and anxiety. However, it can also be sedating. Your doctor will be able to ive you answers.
posted by spinifex23 at 2:10 PM on April 6, 2015
I feel like a) placebo effect and b) addiction to caffeine are factors here. Caffeine is not a requirement to get things done or to feel like you have energy. It's become a mental crutch and a physical one, but you don't need coffee.
I would look at working out everyday, if you can. Getting yourself to go for that first week is tough, but once it's part of your routine, the amount of energy you have all day, every day is amazing. To me, it sounds a little less like coffee is the issue and more like you are in a rut. Lack of physical activity can do that.
You say you stopped running because it caused issues with your GERD, but I think instead of looking for coffee replacements, you should look for different exercises or way to stop exercise GERD. Simple things like: Avoid food for two-ish hours before you work out; opt for more low-impact exercises (like an elliptical machine instead of running); get plenty of water throughout the day so you don't end up dehydrated and pounding down jugs of water quickly; take your anti-GERD medicine shortly before you work out; etc.
If you try caffeine pills, be careful.
posted by AppleTurnover at 2:23 PM on April 6, 2015 [1 favorite]
I would look at working out everyday, if you can. Getting yourself to go for that first week is tough, but once it's part of your routine, the amount of energy you have all day, every day is amazing. To me, it sounds a little less like coffee is the issue and more like you are in a rut. Lack of physical activity can do that.
You say you stopped running because it caused issues with your GERD, but I think instead of looking for coffee replacements, you should look for different exercises or way to stop exercise GERD. Simple things like: Avoid food for two-ish hours before you work out; opt for more low-impact exercises (like an elliptical machine instead of running); get plenty of water throughout the day so you don't end up dehydrated and pounding down jugs of water quickly; take your anti-GERD medicine shortly before you work out; etc.
If you try caffeine pills, be careful.
posted by AppleTurnover at 2:23 PM on April 6, 2015 [1 favorite]
I have this problem with coffee too. I was able to do cold-drip for a while (I used a Toddy), then I had to give it up altogether. Luckily, tea doesn't bother me.
I'd probably go with caffeine pills. I take them occasionally when I don't have time for or access to tea. Just...go slowly. I think I have 100mg pills but I only take 1/2 at a time. You can end up a jittery mess if you take too much at once.
posted by radioamy at 2:30 PM on April 6, 2015
I'd probably go with caffeine pills. I take them occasionally when I don't have time for or access to tea. Just...go slowly. I think I have 100mg pills but I only take 1/2 at a time. You can end up a jittery mess if you take too much at once.
posted by radioamy at 2:30 PM on April 6, 2015
Out of curiosity, what antidepressants are you on? Wellbutrin and Cymbalta are what originally gave me GI problems. (Unfortunately even though I've been off them for years, my stomach is as sensitive as ever. The gift that keeps on giving...)
posted by radioamy at 2:32 PM on April 6, 2015
posted by radioamy at 2:32 PM on April 6, 2015
Switch or augment the antidepressant. Fatigue, inability to focus, poor motivation indicate that the current meds are not doing their job.
posted by crazycanuck at 3:02 PM on April 6, 2015
posted by crazycanuck at 3:02 PM on April 6, 2015
If you like the idea of caffeine pills, you could try Penguin Mints. They have about 7mg of caffeine per mint, so you can titrate your dose much more finely than with the standard over the counter pills, and since they're mints a lot of the caffeine gets absorbed through your mouth instead of your stomach.
On the downside, 7mg is not that much (I feel like it used to be more; I wonder if they've adjusted the recipe?) and they are made with sorbitol, which doesn't agree with everyone.
posted by fermion at 3:35 PM on April 6, 2015
On the downside, 7mg is not that much (I feel like it used to be more; I wonder if they've adjusted the recipe?) and they are made with sorbitol, which doesn't agree with everyone.
posted by fermion at 3:35 PM on April 6, 2015
Best answer: If you try caffeine pills, be careful.
I was really hoping that link would go exactly where it did.
But seriously, if you try caffeine pills, really do be cautious. It may seem obvious, but it's just so much easier to over do it when each pill has about 200 mg of caffeine. I've been there, done that.
I do have to say that it's worth pursuing alternate caffeine sources. I know that caffeine all by itself can be problematic, but any coffee, even decaf, is majorly problematic for my GERD, whereas caffeinated tea is usually okay in moderation.
Also, have you tried taking zantac before drinking caffeine? (In addition to prilosec/prevacid, assuming that's okayed by your doctor.)
Lastly:
Caffeine is not a requirement to get things done
As someone with ADHD, stimulants are basically a requirement for me to be a productive human being. Sure, I made it through two and a half decades without them, and I can cope on my days off, but it really is night and day.
So yeah, maybe go see a mental health practitioner about attention issues, although it sounds like your big issue is the trying to get school stuff done after the work day.
posted by litera scripta manet at 3:36 PM on April 6, 2015 [1 favorite]
I was really hoping that link would go exactly where it did.
But seriously, if you try caffeine pills, really do be cautious. It may seem obvious, but it's just so much easier to over do it when each pill has about 200 mg of caffeine. I've been there, done that.
I do have to say that it's worth pursuing alternate caffeine sources. I know that caffeine all by itself can be problematic, but any coffee, even decaf, is majorly problematic for my GERD, whereas caffeinated tea is usually okay in moderation.
Also, have you tried taking zantac before drinking caffeine? (In addition to prilosec/prevacid, assuming that's okayed by your doctor.)
Lastly:
Caffeine is not a requirement to get things done
As someone with ADHD, stimulants are basically a requirement for me to be a productive human being. Sure, I made it through two and a half decades without them, and I can cope on my days off, but it really is night and day.
So yeah, maybe go see a mental health practitioner about attention issues, although it sounds like your big issue is the trying to get school stuff done after the work day.
posted by litera scripta manet at 3:36 PM on April 6, 2015 [1 favorite]
As you may know, the ulcer-causing bacterium Helicobacter pylori appears to exert a protective effect against GERD:
And if you happen not to have H pylori, you might want to consider finding a doctor who would reintroduce it for you to see whether it could control your GERD.
posted by jamjam at 3:36 PM on April 6, 2015
the prevalence of H. pylori is inversely related to gastroesophageal reflux disease (GERD) and its sequelae, which include Barrett's esophagus and esophageal adenocarcinoma.But if you turn out to be one of those individuals with H pylori and GERD, taking proton pump inhibitors over the long term to reduce stomach acid has significant risks
Superimposed upon these observations are reports that long-term acid suppression induced by proton-pump inhibitors (PPIs) in conjunction with H. pylori colonization may enhance the development of atrophic gastritis, a well-recognized histologic step in the progression to intestinal-type gastric cancer. ... if patients are to receive long-term acid suppressive therapy, they should be tested for H. pylori and treated if positive, due to the potential for PPIs to accelerate atrophy within H. pylori-infected mucosa.so I think it would be very reasonable to ask your doctors for the very simple breath-test which detects H pylori.
And if you happen not to have H pylori, you might want to consider finding a doctor who would reintroduce it for you to see whether it could control your GERD.
posted by jamjam at 3:36 PM on April 6, 2015
Oh, and speaking of Wellbutrin, if you haven't tried it, you may want to look into it. Of course, YMMV, but it can be one of the more activating antidepressants, and it's often used to augment SSRIs.
posted by litera scripta manet at 3:37 PM on April 6, 2015
posted by litera scripta manet at 3:37 PM on April 6, 2015
Best answer: Please do not ask your doctor to "reintroduce" H. pylori into your body. There is no scientific basis for that whatsoever. The relationship between ulcers, gastritis, h pylori, and various upper GI cancers is complex but I can assure you that is not something that would ever be done. Inversely proportional does NOT mean protective effect. Plus, it's not like GI doctors keep vials of bacteria in their office they could just feed you... I know this comment is slightly off topic, but I don't want OP to go to their doctor misinformed. (Although, OP, you seem very reasonably informed about what's going on with your body. Kudos. I hope you find something that works for you!)
posted by pimmscup at 4:38 PM on April 6, 2015 [1 favorite]
posted by pimmscup at 4:38 PM on April 6, 2015 [1 favorite]
Here's a review article from uptodate.com I didn't link in my earlier comment because most of it is behind a paywall:
The main body of the article is paywalled, but the references -- updated through March of this year -- are not; you might want to check them out, pimmscup.
posted by jamjam at 5:25 PM on April 6, 2015
Helicobacter pylori and gastroesophageal reflux diseaseNote that the author of this review does not scruple to draw a causal connection between H pylori colonization and protection from some effects of GERD.
. . .
Suspicion of an interaction between H. pylori and gastrointestinal reflux disease (GERD) stems from epidemiologic data showing that as the prevalence of H. pylori decreased in Western societies, the prevalence of GERD and adenocarcinoma of the esophagus increased [1]. This trend led several investigators to examine the prevalence of H. pylori in patients with GERD.
Several reports have suggested that H. pylori positive patients were less likely to have GERD, and, when present, the severity of esophagitis was decreased compared to those who were H. pylori negative [2-4]. A lower prevalence of Barrett's metaplasia and esophageal adenocarcinoma has also been described in individuals who were H. pylori positive [5,6].
Some studies suggested that H. pylori strains positive for Cag A (strains strongly associated with the development of corpus gastritis) may be particularly protective against the development of esophageal adenocarcinoma [7-9]. Thus, the available data suggest that colonization with H. pylori, particularly Cag A strains, may be protective against the more severe forms of GERD. Unfortunately, Cag A positive strains have also been associated with gastric adenocarcinoma. ...
The main body of the article is paywalled, but the references -- updated through March of this year -- are not; you might want to check them out, pimmscup.
posted by jamjam at 5:25 PM on April 6, 2015
I've had GERD for years, because of a slightly defective sphinter at the top of my esophagus. I was pre-cancerous when I had it diagnosed, about 10 years ago. The alternatives were surgery or Prilosec/Nexium. The drugs have done wonders, and I've had a couple of endoscopies that show complete healing. And I still drink coffee.
posted by lhauser at 9:27 PM on April 6, 2015 [1 favorite]
posted by lhauser at 9:27 PM on April 6, 2015 [1 favorite]
Best answer: I will nth the suggestion of getting onto some serious prescription (not OTC) PPIs or appropriate meds. I have had GERD for many, many years (20+) and was on a prescription med for most of that time. I test negative for H.pylori.
When I recently switched doctors, I commented that I wished my reflux would go away completely (instead of the "mostly' that I had with the meds I was taking). My doctor prescribed Dexilant and holy cats, it was life changing. Sleeping all night! No more burning! No mouthful of my own stomach contents at 3 am! (Sorry)
I still drink coffee in the morning (sometimes all morning) and the only thing that now causes the GERD to act up is tomato-heavy foods or attempting to go to bed with a really full stomach.
Good meds are life-changing and I wish I had known about them sooner so I could have spared myself a lot of discomfort. Go visit your doctor!
posted by VioletU at 6:17 AM on April 7, 2015
When I recently switched doctors, I commented that I wished my reflux would go away completely (instead of the "mostly' that I had with the meds I was taking). My doctor prescribed Dexilant and holy cats, it was life changing. Sleeping all night! No more burning! No mouthful of my own stomach contents at 3 am! (Sorry)
I still drink coffee in the morning (sometimes all morning) and the only thing that now causes the GERD to act up is tomato-heavy foods or attempting to go to bed with a really full stomach.
Good meds are life-changing and I wish I had known about them sooner so I could have spared myself a lot of discomfort. Go visit your doctor!
posted by VioletU at 6:17 AM on April 7, 2015
Best answer: For those saying that OTC meds aren't as strong as prescription, the 2 doses per day of OTC prilosec OP is taking is 40mg of omeprazole, which is exactly the same as the maximum strength of prescription omeprazole a doctor would prescribe. Some people respond better to one PPI vs another, but "strength" is not the issue here. I've even asked GI doctors I work with if there's one PPI that works the best in their experience, and they say it is completely patient dependent and they still prescribe good old omeprazole as first line for almost everyone, and if it doesn't work they might try something else down the line. I will say that the main difference between OTC and Rx versions is the price; if you can get a prescription, generic omeprazole is substantially cheaper.
posted by pimmscup at 10:20 AM on April 7, 2015
posted by pimmscup at 10:20 AM on April 7, 2015
I have chronic gastritis from bile reflux, with acid reflux. I drink chai for my daily caffeine. It's not as harsh as coffee. I drink iced tea or a chai latte when I need an extra boost. You can also try eating chocolate covered espresso beans. You don't need many to give you a jolt.
If I've had something that I know might give me issues, I take a shot of aloe vera juice, and then take a slippery elm. Slippery elm has helped my stomach issues so much.
posted by hotelechozulu at 11:11 AM on April 7, 2015
If I've had something that I know might give me issues, I take a shot of aloe vera juice, and then take a slippery elm. Slippery elm has helped my stomach issues so much.
posted by hotelechozulu at 11:11 AM on April 7, 2015
If you live in a place that has well trained practitioners of acupuncture and East Asian (Chinese, etc.) herbal medicine,
I recommend giving that a serious try. The symptoms you report (GERD, low energy, hard to focus, depression) all describe a pattern that is often relatively easy to treat with this particular medical paradigm.
posted by Otterone at 6:07 PM on April 7, 2015
I recommend giving that a serious try. The symptoms you report (GERD, low energy, hard to focus, depression) all describe a pattern that is often relatively easy to treat with this particular medical paradigm.
posted by Otterone at 6:07 PM on April 7, 2015
Response by poster: Howdy, y'all-- thank you for all the great info! There's a lot to think about here. In response to the "get healthier" style advice-- it's great advice, but I've found that even at my healthiest, running every day, staying hydrated, clean eating self, I have more general energy but not more focus. Caffeine is the drug that makes my life go 'round, would seem. It's possible I have ADHD and would benefit from medication; I just got a handle on my depression so I'll look into that in the future.
Update on my progress: Since I was temporarily on Zantac while doing a super fun stool sample, I tried switching back to Prilosec, which at first had zero impact. Then I realized I was taking the stupid tablet Prilosec, and that I'd had much better results in the past with the capsule, so I bought the capsules OTC. Guess what! They work way better. I have no idea why, they're the same generic (Walgreens) brand.
I also bought a bottle of Gaviscon and that shit is disgusting (tastes like stale cake foam!!) but works like magic. For "breakthrough" acid, it's very effective (it forms some kind of alginate/gel screen over your stomach? Or something? idk, but it works better for me than Tums).
Finally, I tried cold brewed coffee and the low acid trucup, which just came in the mail today. I am still evaluating if these make a difference; since my medication is working so much better, I am not sure! Hopefully it will stay that way. The trucup definitely feels less acidic and so far isn't giving me garbage-stomach-mouth, so I would look into it if you're in a similar bind.
posted by stoneandstar at 11:23 AM on April 10, 2015
Update on my progress: Since I was temporarily on Zantac while doing a super fun stool sample, I tried switching back to Prilosec, which at first had zero impact. Then I realized I was taking the stupid tablet Prilosec, and that I'd had much better results in the past with the capsule, so I bought the capsules OTC. Guess what! They work way better. I have no idea why, they're the same generic (Walgreens) brand.
I also bought a bottle of Gaviscon and that shit is disgusting (tastes like stale cake foam!!) but works like magic. For "breakthrough" acid, it's very effective (it forms some kind of alginate/gel screen over your stomach? Or something? idk, but it works better for me than Tums).
Finally, I tried cold brewed coffee and the low acid trucup, which just came in the mail today. I am still evaluating if these make a difference; since my medication is working so much better, I am not sure! Hopefully it will stay that way. The trucup definitely feels less acidic and so far isn't giving me garbage-stomach-mouth, so I would look into it if you're in a similar bind.
posted by stoneandstar at 11:23 AM on April 10, 2015
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posted by stoneandstar at 11:04 AM on April 6, 2015