Please help me with self helping my acid reflux.
July 18, 2011 2:56 AM   Subscribe

Please help me with self helping my acid reflux.

So after 18 months my doctor diagnosed me (and my symptoms) with acid reflux disease. I am currently on Nexium (esomeprazole), which is the only medication I've been on that works that doesn't give me serious side affects. I'm a healthy and fit 21 year old and wish to find a solution for my acid reflux that doesn't require me to be on medication for the next 80 years.

I've found (over a range of different sources) that putting a foam/memory foam bed wedge in your bed to make you sleep at an angle will re-enforce gravity and help keep the acid in the stomach (my symptoms are most frequent in the morning either from being woken up by it or waking up and then having it).

I've seen different sized wedges by means of depth and length and am not sure which would be the better choice for me to sleep comfortably with. I'm based in the UK and am finding it difficult to find a bed wedge for a reasonable price. (I find it difficult to comprehend how a lump of foam can be justifiably sold for £60.)

One last add on to this question; I've found several different lists of alkaline foods to eat to balance my stomach ph level but the lists all disagree with each other. Does anyone know just a couple of 'super alkaline foods' that I could try/eat that are really good for having acid reflux.
posted by sockpim to Health & Fitness (31 answers total) 14 users marked this as a favorite
 
I've seen different sized wedges by means of depth and length and am not sure which would be the better choice for me to sleep comfortably with. I'm based in the UK and am finding it difficult to find a bed wedge for a reasonable price. (I find it difficult to comprehend how a lump of foam can be justifiably sold for £60.)

Put a couple of breezeblocks under the legs of the bed, at the head end.

What's your weight like?

Eat smaller meals, avoid spicy food, don't eat after 7PM. In my experience, you'll get more mileage out of avoiding bad foods than eating good foods, as there aren't really any good foods, only neutral ones.
posted by Leon at 3:21 AM on July 18, 2011 [2 favorites]


Ten years ago I used to get really bad pain from gastric reflux: at first I literally thought I was having a heart attack. I was prescribed and took omeprazole for a while - maybe a year? Anyway, the symptoms didn't come back when I stopped taking it, although I still sometimes get reflux if I eat too much. This is not at all what my doctor had said would happen: he had said I'd need surgery to fix it permanently. Anyway, my point is that this isn't necessarily a life sentence. If I were you I'd take my meds until you're symptom-free for a good long time, then ask your doctor if you should try going off them. I try to give virtuous advice even if I didn't act that way myself.
posted by Joe in Australia at 3:49 AM on July 18, 2011


Response by poster: Due to the structure of the bed I'm sleeping on, I can't do the breeze blocks idea, but thanks anyway. My weight it 11stone (70kg).
posted by sockpim at 3:50 AM on July 18, 2011


Response by poster: is*
posted by sockpim at 3:51 AM on July 18, 2011


IANAD (always wanted to say that).

I suffer from Gastro-Oesophageal Reflux Disease and have done since I was about 10. It's a bit of a bastard.

Firstly, let me say this - please don't ignore anything just to stay off pills. As a result of ignoring it for too long (and a doctor prescribing useless gaviscon) I have scarring at the bottom of my gullet, where constant acid backwash has damaged the sphincter. Getting food stuck there isn't fun.

Right... To do any good, I was told that you need to lift the head of the bed by six inches. If that's a wedge doing half your body, you may only need 3 inches of lift. It's going to be expensive because it's going to support your body all night. Cheap foam will degrade quickly. Expensive foam (hopefully) won't.

That said, I've never bothered with a wedge. The other thing the gastro specialist told me was to try lying on my left hand side. Why this works I never really figured out, but it does help.

The worst things for loosening your oesophageal sphincter are (in my experience) coffee, grease, alcohol and hot spices. So is pretty much any stimulant. Allegedly, peppermint is also bad (although I haven't found it so) and over the counter antacids (apart from from ranitidine/Zantac) can actually negate the use of the -prazole family of drugs.

Despite the fact it's slightly acidic, I've found milk to be helpful as a bedtime drink - especially if taken with a nightly (prescribed) Zantac.

I've been on either lanzoprazole or omeprazole (I can't remember which one right now) for about ten years, and I have to say that I find it no more hassle or side-effecty than taking a daily vitamin.
posted by sodium lights the horizon at 4:09 AM on July 18, 2011


(The left-side thing works because of the anatomy of the abdominal cavity. Your stomach is somewhat to the left, so if you lie on that side the acid has to fight gravity to get out. If you lie on the right, the sphincter has to do all the work. This is why the first aid "recovery position" always has the patient on the left; if they vomit, they are significantly less likely to aspirate. IANAD.)
posted by charmcityblues at 5:04 AM on July 18, 2011 [3 favorites]


I've had about four friends cure their acid reflux with unfiltered apple cider vinegar. It doesn't sound intuitive, and frankly the websites you can find about this look sketchy at best. (There's an AskMe that debates this as a cure, and even more here where you can find both scoffers and testimonials.) However, my friends were all helped and vinegar is pretty cheap, so it might be worth trying.
posted by Houstonian at 5:13 AM on July 18, 2011


Make sure you read what sodium lights the horizon wrote, twice if necessary. GERD is a disease. Long time acid damage to your intestines can lead to cancer. Taking a PPI each day, if recommended by a doctor, is a cheap and easy way to control the condition and minimize potential problems from it later.
posted by COD at 5:25 AM on July 18, 2011 [1 favorite]


There are some triggers to avoid:
- chocolate
- alcohol
- eating before sleeping
- large meals
- citris
- tomatoes

I like the Mayo Clinic's site for patient information, personally.
posted by noonday at 5:29 AM on July 18, 2011


Well, Nexium isn't what I'd call cheap (about $2.50/day), but when I've tried to save money by using commercial stuff it's never worked out well (most recently destroyed my teeth with too much uncontrolled reflux). Stay on the stuff.
posted by L'Estrange Fruit at 5:37 AM on July 18, 2011


Once you see the bill for an upper endoscopy to clean out 20 years of acid damage, $2.50 a day will seem like the bargain of the century.
posted by COD at 5:46 AM on July 18, 2011


Guys - the OP said foam costs £60. That means it's a fair chance that he's not paying any dollar amount for his pills. Assuming he pays full NHS prescription charges, the most he'll be paying is about 24p a day. That's 38 cents...
posted by sodium lights the horizon at 5:59 AM on July 18, 2011 [1 favorite]


I've found several different lists of alkaline foods to eat to balance my stomach ph level but the lists all disagree with each other.

IANAD, but my understanding of the situation is that your stomach's contents are normally much more acidic than anything you could comfortably ingest (hence the pain of heartburn) and that leads me to suspect that eating enough of anything alkaline to try to maintain your stomach's pH in a more neutral range would be futile.
posted by Inspector.Gadget at 6:21 AM on July 18, 2011 [1 favorite]


This is my pet hobbyhorse, but acid reflux was my first acute symptom of Celiac disease. If I hadn't pushed my doctor, she would have been happy for me to take omeprazole for the rest of my life. If you have any of the other symptoms on this list, you might want to get it checked out.

My acid reflux is now almost completely gone; it flares up when I've been exposed to gluten.
posted by sugarfish at 6:43 AM on July 18, 2011 [1 favorite]


Since I've begun avoiding carbs, as in: sugar, rice, pasta, potatoes, cereals (not even religiously), stuff like this has vanished for me, while I do consume everything on the following list:
- chocolate
- alcohol
- eating before sleeping
- large meals
- citris
- tomatoes
(I always thought that I was especially sensitive to pork fat, but even that's gone, too. However, give me a large meal with pasta, potatoes, rice, I can bet on waking up in the middle of the night with symptoms like you describe.)
I know that these things are individual, but low-carb may be worth a try, seen the discomfort involved with gastric re-flux.
posted by Namlit at 7:02 AM on July 18, 2011 [1 favorite]


IAAD, but IANYD.

Personal story: My aunt has acid reflux disease, but refused to take PPIs for it. She was diagnosed with Barrett's oesophagus several years ago. Her doctor prescribed PPIs, which she again refused to take. Last January, she was admitted for a perforated ulcer and underwent an exploratory laparotomy.

I'm not saying that not taking esomeprazole will lead to a disease progression similar to my aunt's. But do please consider staying on this drug.
posted by onegoodthing at 7:03 AM on July 18, 2011


In a pinch, several pillows piled up will raise your head the required amount.
posted by notme at 7:24 AM on July 18, 2011


I have a hiatal hernia, and have had one for over 10 years. It means the sphincter between my esophagus and stomach doesn't close properly. Started on Zantac / ranitidine, which worked in increasing doses over the years, and now am all the way to Prilosec / omeprazole. And although I can skip it one night (say, if I forget) I cannot skip it two times in a row or I pay dearly for it. I've had an endoscopy, and now, even though I have followed all instructions from my doctor regarding meds, I am diagnosed with Barrett's esophagus.

My food list to avoid is the same as noonday's, ESPECIALLY chocolate and tomatoes and all citrus, with an added dollop of carbonated caffeinated beverages.

I guess what I'm saying is don't mess around.
posted by clone boulevard at 7:31 AM on July 18, 2011


A side effect of a low-carb, low (almost no) sugar, generally healthy diet with a lot of fiber and salad resulted in an end to my reflux issues. Even having strayed from the diet pretty seriously has not caused it to reappear.
posted by InkaLomax at 7:56 AM on July 18, 2011 [2 favorites]


Gluten (and, to a lesser extent, corn and other grains, although white rice seems fine) seems to be what triggers it for me, too. (Also alcohol, particularly non-distilled booze.) The sudden appearance of gastritis was the last straw that pushed me into a fully grain-free diet.
posted by restless_nomad at 8:00 AM on July 18, 2011 [1 favorite]


To echo the idea that food triggers may be very specific to the individual: I've found that chamomile tea, while widely regarded as a heartburn remedy, actually causes heartburn for me. (Same with bananas.) The "usual suspect" foods are a good place to start, but you may also be able to greatly improve your results through careful observation over time.
posted by hsieu at 8:02 AM on July 18, 2011


IANAD. I repeat, IANAD.

Except after a tremendous amount of a damage has occurred, GERD is a metabolic disease not a mechanical disease. Try this: Time how long it takes right after you swallow your last bite before you start experiencing symptoms.

I will bet you fifty bucks that you start getting reflux sensations between 2.5 and 3.25 hours after a meal. Every single time. This time-frame is postprandial. For most kinds of meals, digestion is finishing, your stomach is mostly empty, and everything is well on its way into your intestines.

So why would reflux start at the three hour mark? For whatever reason, your body doesn't want stuff going into your intestines, so it gets sent backwards. Your nervous system loosens the esophageal sphincter and your stomach contracts. Again, this is not a mechanical issue, where your sphincter is genetically too loose or something. It is a nervous system mediated event. (Yes, if your sphincter is scarred to hell from years of acid, there might be a true mechanical issue. But not necessarily.)

Tilting your bed will only help a little bit. Sleeping on your left side will only help a little bit. Getting surgery to squeeze your esophagus tighter will only help a little bit. Pills will imperfectly treat what's a symptom not a cause.

The cause is metabolism. There is a mismatch between the food your body is expecting (how much your body can store and how fast it can burn it) and what's actually in your stomach.

The solution:

1. Chew your food thoroughly and taste your food thoroughly. Savor it. Chewing mechanically stimulates digestion and tasting enhances flavor/calorie/nutrient associations that your brain is making between what you're swallowing and what the body is getting. If you do this you are giving your brain better information about what's going into your body.

2. Exercise long and gentle. You should take walks 2-3 times a week that average one hour long. This does magical things to your metabolism, in terms of energy storage and utilization. At least two times per week is non-negotiable. If you don't have the time for it, that's one thing, but if you find the idea of this boring and exhausting, see step three.

3. You are not eating enough of a particular macronutrient, vitamin, or you're not eating enough in general. You need to eat more. Your body is running too slowly. If you eat a meal that's slightly too big, your body doesn't know what to do with it. You need to eat larger meals to train your body to handle digestion more effectively. You need to push your satiety reflex out farther and farther, say if your meals are typically 700 (1000) calories, you need to work to be able to effortlessly consume 1000 (1300) calories in one sitting. I guarantee you that the 700 (1000) calorie meal will no longer cause reflux.

This last step is undertaken over months to a couple years. It takes a while to alter your metabolism. If you're afraid you'll get fat, read this blog:

http://180degreehealth.blogspot.com/ or here: http://180degreehealth.blogspot.com/2010/08/rrarf-addendum.html

If you are following some kind of fad diet (low-carb, low-fat, vegetarian) you need to stop. You are not getting enough of something. Don't let logic get in the way ("but our ancestors...," etc.). Your logic and information is partial and incomplete. You're working off of pop information.

Try tweaking your ratios of fat, carbs, and protein. Tweak them again in a month. Eventually just eat to taste. Stay away from refined sugar. Don't worry about much else. Listen to your food cravings for weird stuff. Your body is healing itself.

IANAD.
posted by zeek321 at 8:08 AM on July 18, 2011 [2 favorites]


I don't know about this alkaline business. My experience with diet is that I have completely different reactions to foods than other people do and I need to pay close attention to what works for me. Spicy food? I have no problem with it. Coffee? Totally fine. Yogurt? ACID FOUNTAIN OF DOOM.

So, diet-wise, listen to your body first and foremost.

Wedges can be pricey, which sucks, but I love mine. If I sleep anywhere without one, I get miserable. Mine is long enough for the taper to start at around my ribs, which is comfortable, although it took a bit of getting used to. It's about 6 inches high (15 centimeters).

I've slept on one that was higher and found it uncomfortably drastic.
posted by the young rope-rider at 8:28 AM on July 18, 2011


I've seen a device in the past that goes in the bed and raises your head up. It sort of resembles a deckchair, with three different heights that it can be set to. I think it was in one of those Old Person Aides magazines that you sometimes get with the Kleeneze book. Failing that, have a look in Yours magazine next time you're in a newsagents. I think they were in the region of £15.
posted by Solomon at 9:07 AM on July 18, 2011


This is kind of out there, but some company makes wedge things for, ahem, sex and maybe that'd help too? And agreed about alcohol and super acidic or oaxalate (sp)-y foods (citrus, dark greens, sorrel, etc.)--if you drink, stop entirely for a while and see if it helps. Alcohol's a biggie.
posted by ifjuly at 12:55 PM on July 18, 2011


I cut out all carbonated beverages, caffeine and alcohol for six months, while raising the head of my bed by sticking phone books under the top mattress. I also tossed out any control-top pantyhose and tight clothes, as a squeezed midriff can worsen reflux. After half a year, I was able to slowly reintroduce carbonation and caffeine to my diet in small amounts, and I now have a beer or wine most days after work. If I overdo it, I get mild reflux and stop with the bad stuff for a few days or a week before bringing them back.
posted by croutonsupafreak at 1:51 PM on July 18, 2011


IANAD...but I did the competitive intelligence work for two major pharma companies when the PPI's and the H2+antacids went OTC.

I have also developed acute GERD in the last year and was scoped three weeks ago.

First. Some foods - like the tannins in wine and the capsicum in spicy food - directly irritate the lining of the esophagus, leading to GERD-like symptoms but do not themselves actually induce GERD. That's not to say you should or shouldn't avoid them, but they have nothing to do with the long term damage reflux causes your upper GI as they do not cause reflux per se.

Second, there is so little difference between OTC omeprazole and esomeprazole as to be laughable; it was entirely an economic trick to get a bit more patent protection for what was (then) the single largest drug catagory in the world. Yes, the left enantiomers tend to have better efficacy and side effect profiles, but, really, in the case of PPIs this was just barely significant enough to get past Stats at the Agency. TL:DR, OTC is (almost certainly) just as good.

Seconding getting checked out for hiatus hernia. If, like me, that's one of the problems, PPIs will help a bit but not much. The only thing is to do what zeek321 suggested.

If you find a better solution for the love of the FSM memail me, as I would love to hear it! For real. This is NOT fun.
posted by digitalprimate at 5:33 PM on July 18, 2011


Also, fun fact: in order to reliably induce GERD in the Phase IIIs, they settled on giving trial subjects a MacDonald's sausage biscuit and black coffee for the prilosec trial. I shit you not. No one had ever designed an OTC trial for something a patient would literally take for the rest of their lives, which caused all sorts of interesting problems from many perspectives.
posted by digitalprimate at 5:36 PM on July 18, 2011 [2 favorites]


coupla things...I am not a doctor...I too have acid reflux and also have found that Nexium is the only one that works for me...I still take calcium carbonate (TUMS/ROLAIDS) in the am when I have the acid reflux and that certainly helps. also, my doctor mentioned that you can take pepcid in addition to nexium...nexium in the am and pepcid at night...to be honest, i tried that and it didn't help much...perhaps i wasn't taking enough...for me just taking the calcium carbonate has the most impact...plus not eating before bed...but it's hard to resist that temptation! good luck with this...
posted by gilast at 5:32 PM on July 19, 2011


Response by poster: Thank you to everyone who has given me advice. I will in turn try all of the ideas to work out which best helps me and pick out the best bits of all the answers for my needs.

Thanks again,

Sockpim
posted by sockpim at 6:31 AM on July 20, 2011


Mine cleared up when I stopped eating wheat.
posted by sudama at 4:51 AM on July 26, 2011


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