Please help my stomach!
September 22, 2017 2:26 PM   Subscribe

Need advice on coping with my reflux/gastrointestinal issues which have been going on way too long. I'm getting really frustrated - details below.

YANMD! I am a 50+ woman. I've been in to see my PCP a few times and I have an appointment with gastroenterology, but I couldn't get in until November and I'm hoping to get some ideas to help me through. About 3 1/2 months ago I was prescribed an antibiotic (Keflex) to prevent an infection from a wound I suffered from a fall, and it really screwed with my stomach - I thought the reflux, burning, and globus sensation in my throat would subside eventually after I stopped taking it. But the feeling of having something stuck in my throat and the frequent burping stuck with me. So several weeks after it wouldn't go away I dragged myself into the doctor, they diagnosed me with esophagitis and prescribed a course of omeprazole, which made my stomach even worse - I was able to stay on it for three weeks but there was no improvement at all and I got discouraged.

In the middle of this I had a thyroid ultrasound and biopsy for nodules I've had for years (the biopsy came back negative), but that experience made me even more anxious. I thought the globus would go away after I relaxed a bit, but it's still there, along with burning in my mouth which came on after I started taking the drugs (I've had burning mouth off and on for 12 years after a round of antidepressants in the 00's).

So I've tried all sorts of things to get my digestion back on track - yogurt, probiotics, enzymes - and I've cut out a lot of acid-producing food and drink like tomatoes, chocolate, spicy stuff, coffee, the usual suspects. So now I'm thinking, is it some sort of food that I can't handle anymore? Do I have an ulcer? Will my throat ever feel normal? How long will it take to get better? My digestion has always been a little weird, I've never been able to eat huge amounts of food but then bouts of heartburn have been few and far between. I have also cut way down on gluten and dairy. In the meantime should I find a naturopath who specializes in digestive health issues, if just to get another angle on my symptoms? I'm tired of relying on Dr. Google, I think it's just making me feel worse.

Anyway, thanks in advance for any insight you can share with me.
posted by plasticpalacealice to Health & Fitness (16 answers total) 5 users marked this as a favorite
You might see if you can get what's called a swallow test while you wait to see the specialist, which will hopefully show if there is something structured going on.

In the meantime, maybe meditation? Also, long (30 minutes, brisk) walks every day have been shown to help with digestive motility. Walks also help with all kinds of other health concerns, so even if they don't do any benefit for your digestion, it's good for the joints and the heart.

I'm really sorry you're having to deal with this. If sucks to navigate the healthcare system.
posted by bilabial at 2:34 PM on September 22, 2017 [2 favorites]

Best answer: My story is similar to yours except with two pregnancies which exacerbate acid reflux and endless rounds of antibiotics which wiped out my stomach bacteria. I also thought I had a stomach ulcer. I drastically cut down on all the food items you mentioned which helped, while doctors investigated what was causing this. (Keeping in mid this is a journey which happened over the course of about three years while I figured it all out).

Anyway, barring any suitable drug I could take in the meantime, I started taking high doses of olive leaf extract (read up on this before you take it, don't go overboard) and an intestinal powder for soothing the lining of my stomach which included aloe Vera and slippery elm. The natural therapist told me it would take a long time to see results because damage down to the stomach takes a very long time to fix but it does actually work.

Sure enough, now I am much better, I started to see results in about two weeks and by about three months my stomach was no longer hurting after I ate. After I have tomato or chocolate or wine, I still have major throats clearing but that's about all and I now just limit these things. (There's no way I'm cutting down on coffee, sorry.) But yes, this may always involve a bit of a lifestyle change. Best of luck, I have no idea if what I did was a lucky fluke, I imagine everyone is different but it can't hurt to try. The herbs are cheaper than a doctor anyway!
posted by Jubey at 2:51 PM on September 22, 2017 [1 favorite]

Best answer: Can you be more specific about the dietary changes that you've tried? E.g., are you eating NO tomatoes, chocolate, spicy food, coffee? When you "cut way down" on gluten and dairy, did you track food intake religiously and make sure that you ate NONE of it for at least a week?

Keeping a food diary and carefully eliminating food groups may not solve your problem, but it's low-cost and can be done before November. You don't need to go cold turkey on all possible triggers at once--that would be super hard and might also be a digestive-system stress to make such a big change--but try one category (gluten, dairy, high acid) at a time. Keep records and read labels like you've suddenly developed.a life-threatening allergy. Before eating or ordering any kind of prepared food, ASK whether it contains any of the stuff that you're avoiding. Gluten and dairy, especially, are quite insidious about being in everything.
posted by serelliya at 2:57 PM on September 22, 2017 [2 favorites]

I have a duodenal ulcer (I'm pretty sure, going by symptoms) and I take DGL and marshmallow root capsules for it. I've also taken boswelia tablets. All 3 seem to work, within an hour or so. A dose of any of these seems to last the day, at least. I've heard 'mastic gum' can help, too, but I haven't tried it yet. Leavened wheat products and refined sugar both seem to contribute to flare-ups. Of course, ymmv, but these might be worth a try. The marshmallow especially is pretty cheap, too. Oh, yeah- I'll also vouch for the above-mentioned slippery elm!
posted by JulesER at 3:03 PM on September 22, 2017 [1 favorite]

Best answer: Two things come to mind- SIBO and LPR. Many, many people have found success/symptom relief following something called The Fast Tract Diet. There's a group on FB, a couple of books and an app. Worth a quick read to see if you think it might work for you.
posted by PorcineWithMe at 3:22 PM on September 22, 2017 [1 favorite]

Best answer: I had a similar problem after taking antibiotics, down to globus and reflux plus fluffy, unformed poo 3x a day or more. After months of seeing doctors and trying everything, it just went away at about the 6 month mark. My theory is that my gastrointestinal flora were finally fully repopulated and everything just went back to normal. I am not advocating for doing nothing, but my anecdotal experience may offer you some hope that you can recover. I did find that sucking on hard candy really helped with that globus sensation and I also had some relief from Zantac.
posted by xyzzy at 3:48 PM on September 22, 2017

Try the probiotic VSL #3. You should be able to find it locally but a doctor can also write an RX so your pharmacy can get it. It's expensive. It may take a couple of weeks of it making you kinda bloated but it really helps. Other OTC probiotics (Culturelle, etc) never worked well for me and gave me more stomach issues.

Some people also do better with different types of antacids. You can try stuff like Zantac OTC or pepto or something. Eat small meals. Raise your head up when you sleep.

(I have chronic IBS/GERD/Endo/POTS and have done many many stomach things, including treating a candida overgrowth. VSL definitely helps and I take it daily now.)

ETA: Always take a probiotic during taking an antibiotic - a few hours apart.
posted by Crystalinne at 3:49 PM on September 22, 2017 [1 favorite]

Do you have post-nasal drip that could be contributing to the problem?
posted by Dressed to Kill at 4:31 PM on September 22, 2017

This is a small thing but look at any supplements that you are taking as well. Vitamin C for example can contribute to reflux.
posted by vignettist at 4:36 PM on September 22, 2017

My histamine intolerance is what made me miserable--watery eyes, plugged-up ears, stuffed up nose, etc. I take an OTC acid reducer and an OTC H2 anti-histamine every day, and sometimes twice a day. I try to avoid foods that trigger the histamine release.
posted by Ideefixe at 5:28 PM on September 22, 2017

Take a probiotic, go buy Walgreen's house version of what a prescription would be. Take it for 60 days. Meanwhile...

Eat smaller meals
Do not drink before bed
Take meals without drinking
Drink small amounts between meals
Take a calcium pill at night
(Kirkland vanilla soy milk soothes my stomach if something irritates it.)
If you have to take rescue inhalers for asthma, they will open the sphincter at the top of your throat and top of your stomach and give you reflux.
Nothing is permanent post an episode of antibiotics, you will get back to normal. Probiotics help restore normal.

The square stemmed spices mint, oregano, thyme, and even rosemary can give reflux.

Here is an exercise, for sleep apnea that also works to exercise the muscles that close your throat. Take a deep breath, open your mouth slightly, and make the short a sound silently, and notice how it closes the back of the throat. Take a breath, and do 18 of these, and do fifty between breaths, each evening. Do practice swallows after these to reestablsh tautness back there.

Eat yogurt, even gargle with a little bit of it at night, until you get back to normal. Avoid antacids permanently if you can. Eat a small dinner, at least a couple of hours before you go to bed, the earlier the better.
posted by Oyéah at 8:30 PM on September 22, 2017

I have IBS-C, hypothyroidism, GERD, and a bunch of other stuff... I was treated for h.pylori about six months ago and am taking medication for an ulcer right now. I've also cut out the high acid foods like tomatoes, garlic, &c...and I've cut out all things nightshade. I take a probiotic... It's been a long, hard road, and I still have pains and gas. I know your pain.

I don't have a tried and true solution, but I could suggest that you try the FODMAP elimination diet. It's for IBS sufferers. It's not easy, but it's a good way to see what types of foods (if any) could be causing you pain. It's suggested that you do the FODMAP under the guidance of a nutritionist, and there's all kinds of information online. I couldn't afford a nutritionist, so I read the books, did my research and did the diet myself. Good luck.
posted by patheral at 10:33 PM on September 22, 2017 [1 favorite]

Here is what helped me after my doctor and I realized I had silent reflux and severe gastritis. She figured it was brought on by the hormones of pregnancy, stress and trauma of pregnancy loss, and antibiotics prescribed after the D&C. It took me over six months of the following:
  • a daily prescription PPI
  • no tomatoes
  • no citrus
  • no alcohol
  • no caffeinated or decaffeinated drinks (even decaf has caffeine)
  • no carbonated beverages
  • no chewing gum
  • no mint
  • no chocolate (there's something in it in addition to the caffeine that loosens your esophageal sphincter)
  • as little fat as possible, including even "good fats" like avocado; only the tiniest amounts of low-fat cheese
  • no eating after 7:00 pm
  • absolutely NO ibuprofen or NSAIDs
  • no tight clothing around the stomach
  • sleeping sitting up order for my gastritis to be reduced to "moderate." Six months. And not complete healing, just halfway there. I was still in quite bad shape at the 3.5 month mark where you are at, and I think that's normal for bad cases like you and me.

It's been a year and I have now been able to reduce my PPI dosage (warning, you must do this gradually, not cold turkey) and eat small amounts of the foods on my no-go list except for tomatoes, citrus, mint or coffee. I never take ibuprofen any more. I still can't handle a lot of fat--again, even the "good" kind. I had to be extremely committed to the diet. No cheating ever or it would set me back. It was difficult but worth it, because I had to heal the damage.

So: bad news, it may take you much longer to heal than you hope. Good news: you can heal a lot of the damage within a year. I'm still hoping to one day get back to eating tomatoes and oranges.

Good luck--this is honestly one of the most frustrating things to deal with.
posted by hurdy gurdy girl at 11:05 PM on September 22, 2017 [4 favorites]

I have bad stomach issues and reflux due to Barrett's esophagus and a hiatal hernia plus IBS-C and a diseased gallbladder that's coming out soon. I follow a low fodmap diet that's also low in fat and I don't eat chocolate, drink alcohol or eat spicy foods (it sucks but reflux sucks worse). I also take omeprazole and follow everything else on hurdy gurdy girl's excellent list but the number one thing that helps me is making sure to sit up for 2-3 hours after eating. I used to eat and then lie down on the couch or eat right before bed - no more.

If you want to try probiotics I recommend kefir. I can't have it because it isn't low fodmap but in your case it could help repopulate the good bacteria in your gut that got wiped out from antibiotics. Dr Michael Mosely did a programme here in the UK on how to help your gut and kefir came out on top, especially if you make your own at home. Google his name plus kefir to find out about it.
posted by hazyjane at 11:47 PM on September 22, 2017 [1 favorite]

So, if you take PPIs regularly and then have flare-ups when you stop, it may be acid rebound hypersecretion. Disclaimer: I've been hospitalized twice for gastritis and esophagitis. The last time was so bad in 2009 they warned me I could've bled to death internally, so I have had the exact same treatments you had.

It freaking sucks, and I'm sorry you have to deal with this. Anyway.

After nearly 8 years daily on OTC omeprazole, I had an acute kidney injury last month. I now have one functioning kidney. The nephrologist has already treated one woman on dialysis whose acute interstitial nephritis was PPI-induced (PPIs increase your risk of kidney failure by 96% and the onset is very rapid -- I lost 30% of my functionality in about 3 years, and we're doing a biopsy to ensure it is definitely PPI-related and not, well... cancer).

I've weaned down to just Zantac/famotidine, 4 pills daily, for the last two weeks after literally years of PPIs. The pain has been horrific, but I have to stop until I can get my biopsy done next month to see if literally any of the damage is still reversible.

I'm letting you know this because if you can, wean down or stay on only things like famotidine or regular TUMS as needed. When you stop taking PPIs or 2 Tagamets or another high-dose H2 blocker after regular use, it's notorious for the rebound acid hypersecretion effect. Essentially, if you take more than 8 weeks of PPIs daily, you'll end up producing 36% more stomach acid at night for awhile after you stop or step down drastically.

I've had some "slept less than 2 hours and had to sit awake all night belching in horrific pain" days lately and am just barely hanging on with my job and life stuff from all the pain now. Here's a link to the study I mentioned.

I didn't see anyone else mention ginger, which really does work well for stomach issues. You can also just mix some baking soda in water and drink it, too.

You may have malabsorption issues due to your digestive system being out of whack, too. Stomach meds are notorious for making you develop anemia, chronic vitamin B12 and D deficiencies and even osteoporosis. It's possible that part of your healing process is craving foods that you shouldn't eat or eating more than you really should because you're missing a key nutrient. Only saying you should check your vitamin levels because this has plagued me constantly in recent years and back when I was originally hospitalized. Constant hunger despite eating plenty was an obvious sign, but I felt significantly better when my vitamin levels were within normal range. When they weren't, I was hungry all the time and ate too many carbs.

If you wake up at night with indigestion, try sleeping on your left side. That positioning holds your esophageal sphincter closed; lying on your right side should be discouraged as it can be prone to gradual weakening/leaking acid when you're asleep.
Good luck, this is a constant battle!
posted by Unicorn on the cob at 10:09 PM on September 24, 2017 [3 favorites]

Response by poster: Wow, thanks everyone for all the advice this has been a big help. Yes I've started keeping a food diary; I'm cutting out the gluten first and see how that goes. Also, I'm looking into the SIBO angle because it covers a lot of the syptoms I've been having, and the FODMAP diet looks promising. I'm not on PPIs anymore, just relying on the occasional Tums, as well as baking soda, and I've been taking probiotics. It's good to know that healing is a long term proposition, if just to calm my anxiety!
posted by plasticpalacealice at 6:47 AM on September 25, 2017 [1 favorite]

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