The dirt on reflux

October 16, 2006 12:04 PM

What things help a mild case of acid reflux?

I looked at the reflux article over at Wikipedia and it rattles off a laundry list of things to avoid, then it cancels itself out by saying "evidence for most dietary interventions is anecdotal". This is why I'm turning to you all... I want to hear your own anecdotes and experiences.

The article also waves a finger at calcium but fails to explain why... one would think milk and antacids would help.

I'd also like to know about foods and dishes that don't aggravate reflux or perhaps help it.

So... how do different foods, drinks, and OTC drugs stack up? I'm sure pharmaceuticals like Prevacid work fine, but my case is pretty mild and I'm not sure I need to pursue that course right now (unless Prevacid has healing qualities).

posted by chef_boyardee to Health & Fitness (29 answers total)

eponysterical.
posted by Ambrosia Voyeur at 12:10 PM on October 16, 2006

My dad swears by a teaspoon full of olive oil in the morning. He says it usually works all day. On occasions when he still has problems, he might take an additional spoonfull.
posted by tperrigo at 12:20 PM on October 16, 2006

Response by poster: Olive oil -- that's really interesting as I'd been taking a close look at trying the shangri la diet.
posted by chef_boyardee at 12:27 PM on October 16, 2006

Avoid the Chef Boyardee line of foods. :)

I generally find it's a case of avoiding eating too many acidic or dairy products in one day. (For me dairy is bad because I'm lactose intolerant; I don't know why it's supposed to be a bad thing for reflux.) I can have a slice of pizza, or I can have a cup of coffee. But if I add up too many of those no-no foods in a 24-hour period, everything gets yucky for a little while.

Trigger foods are, I think, different for everyone (thus the anecdotal thing). So if you realize that you have a bad time after two cups of coffee but not after one, that might be something to note. My doctor wanted me to keep a food journal, but of course I didn't.

I never noticed a difference when I took Nexium or really any sort of medication, but The Boyfriend swears by Prilosec OTC. Personally, I just eat a lot of Tums. Although they say that if you eat too many antacids, it has the effect of your stomach thinking there's no acid and then creating more. So it's supposedly bad for you because you're not combatting the real problem.
posted by brina at 12:41 PM on October 16, 2006

Not to continue a derail, but since it was the OP, I have had success with the Shangri La diet. I am losing slowly on it and am happy with the way I feel. I also have not had any acid reflux while on it, but not really before either.
posted by JohnnyGunn at 12:41 PM on October 16, 2006

One thing to consider, and get a doctor's advice in ruling out or treating, is that you might have a Helicobacter pylori stomach infection. About 50% of people are infected with H. pylori, and it is now believed to be the major cause of stomach ulcers in people without another primary cause, such as high dosages of aspirin or other anti-inflammatory drugs.

Prilosec and some of the other anti-acid OTC drugs are helpful adjuncts to treating H. pylori infections, but unless you use them with an appropriate course of multiple antibiotics, too, you may not get rid of an underlying infection. The tests for H. pylori are simple, and the treatment is inexpensive and reliable oral medications, so it is worth seeking medical help if you are having recurring reflux episodes, so that you don't have to suffer longer, and wait for them to develop into more serious problems, if this is the underlying cause.
posted by paulsc at 12:57 PM on October 16, 2006

Hi , I'm posting on my wife's account here. Prilosec (prevacid, aciphex and nexium are all bascially the same, just modifications of the same idea) is a an OTC drug that sort of has healing properties. It blocks stomach acid production so your stomach and esophagus can heal. It can take a while to work because some of the heartburn pain might due to irritated lining of your GI tract. It is kind of expensive ( $20 a month) if this is just a minor annoyance. Other things like tums or a glass of milk might alleviate the pain for a short time but you'll have to keep doing it until your stomach stops producing acid.
There are also H2 blockers like tagamet and zantac which might help as well.
You should just get a hold of bunch of these things and try them out over a month or so. As far as the diet goes you will need to experiment. There are broad recommendations (no caffeine, chocolate ,spicy foods) but these don't apply to everyone.

-Tom (a doctor)
posted by jessicak at 12:57 PM on October 16, 2006

(prevacid, aciphex and nexium are all bascially the same

If you have a good doctor, s/he will likely give you a month's supply or more of free samples of one of these drugs as they are among the most marketed pharmaceuticals.
posted by mattbucher at 1:03 PM on October 16, 2006

IANAD, but my husband was advised by his to try this 'trick' for mild (and *only* mild) attacks - chew some sugarless gum. We found that we liked Bubbleyum Sugarless the best. The reason given is that gum chewing stimulates digestive juices and will provide some "balance" (for want of a better way to describe it). It works like a charm for us - and is a cheap thing to try.
posted by dbmcd at 1:03 PM on October 16, 2006

pepcid complete rocks. i also have very mild, only occasional reflux, and it gets rid of it in minutes.
posted by misanthropicsarah at 1:07 PM on October 16, 2006

Raising the head of your bed (not just the mattress, the entire bed) can help a lot. Phone books are just the right size.
posted by Carol Anne at 1:08 PM on October 16, 2006

Zantac is awesome.
posted by radioamy at 1:16 PM on October 16, 2006

Another vote for Pepcid or its generic equivalent, famatodine. IANAD, but a pharmacist recommended Pepcid because she claimed it caused fewer drug interactions. And it seems to have some sort of healing qualities, because using it for a while can stave off attacks for months. It's also been prescribed for my dog for more serious problems (in much, much smaller quantities), with excellent results.
posted by walla at 1:24 PM on October 16, 2006

I've got reflux with a hiatal hernia. Without drugs, I die. It takes a while and there's lots of choking episodes and ulcers, but it ends with me dead (just ask the Air Force).

To keep from dying, I take an OTC Prilosec every day. And I mean EVERY DAY, or I'm in trouble.

It used to be Nexium, but Nexium is too expensive, and molecularly, Nexium and Prilosec are almost identical. Pepcid and Tums do nothing whatsoever for me.
posted by SlyBevel at 1:31 PM on October 16, 2006

***BUT*** (And I should have said this the first time...)

If this is a recurring thing, YOU REALLY NEED TO SEE A DOCTOR. I had no idea how badly off I was the first time I went to a real GI doc.
posted by SlyBevel at 1:35 PM on October 16, 2006

When making red sauce for pasta, i add brown sugar. When drinking coffee, I add cream. Both of these things seem to help a great deal. When the burning is really bad and I don't have antacids to help, I eat a piece of white bread. I also use to have daily problems until I took zantac every day for about two years. Now I just have occasional issues.
posted by nadawi at 1:46 PM on October 16, 2006

I seem to have problems when I eat and then lay down too soon afterwards. And for me it is bread products that seem to trigger it, but I'm sure that it is different for everyone.

I just take some Tums and it seems to settle it down....
posted by Gooney at 1:57 PM on October 16, 2006 [1 favorite]

I've suffered from this on and off for a while. But I got it under control. Oily foods, fried foods, caffeine alcohol (especially whiskey) and tabacco will all cause acid reflux so consume in moderation. Any combination of those late at night is guaranteed heartburn hell. Bad over processed pasta sauce will as well, (and most of it is bad). Make it fresh from peeled tomatos and paste. Cook it on Sunday afternoon in a big pot of it slowly over 3 hours and let the water boil out slow slow slow (or it'll burn and get acidic) and use a pinch of baking powder to cut the acidity YMMV so experiment. Put it in jars and use it over a week.

The other thing is that lying down after eating is terrible. The normal healthy acid in your stomach, breaking down food flows upinto the opening at the top (or entrance) of your stomach and irrates the delicate esophagal lining. Over time it will burn tissue and this can get worse and worse. A quick 5 minute walk can do wonders. Good news is that the damage to your esophagal lining will heal up if you give it a chance (a month or two). The other thing that's helped is eating fresh baby carrots before dinner or a small veg. salad w/o dressing. Avoid food from a can with a chef on it.
posted by Skygazer at 2:35 PM on October 16, 2006

Response by poster: Avoid food from a can with a chef on it.

Oh, you mean that rapscallion Emeril, eh?
posted by chef_boyardee at 3:05 PM on October 16, 2006 [1 favorite]

Triggers: over-eating and acidic foods.

Remedies: I also vote for Pepcid. I have to take two for it to work, but it's worth it. I've tried other OTC remedies and they don't work for me. Also, sleep on your left side, because of where your organs are it helps keep the acid where it belongs. Food-wise, I'll have a slice of toast or two and that'll help a bit. Just about anything starchy would probably help.

I've discussed this with my doctor and because it's a fairly mild case, we're on a "watch and wait" regimen. You should, of course, get it checked out by your doctor.
posted by deborah at 3:05 PM on October 16, 2006

I have brutal heartburn/acid reflux due to being pregnant. What I found to work really well is taking papaya enzyme with every meal. You can find it at health food stores or places like GNC. It works for about 4 hours after each meal, as long as I take it as soon as I'm done eating. I also sleep sitting up, which took a little getting used to but is pretty comfortable now.
posted by true at 3:11 PM on October 16, 2006

The H. Pylori connection paulsc brings up deserves very strongly to be explored, I think. Broccoli turns out to be surprisingly effective in inhibiting the growth of H. Pylori, but evidently will not eradicate the bacterium.

If you want to take the approach of lowering the acid in your stomach, which is one of your most important protections against infections, I would eliminate all carbonated drinks before taking the relatively drastic step of using acid suppressors. The stomach contains an enzyme, carbonic anhydrase, which takes carbon dioxide into solution in order to balance the Ph effects of secreting acid, so carbonated drinks could be expected to increase stomach acid.
posted by jamjam at 4:10 PM on October 16, 2006

Gummy bears, like Haribo's gummybears. Trust me, it works. You don't need many either, 2-4 pieces. I used to have an ulcer and it saved my life. Not as harsh on you like the antacids or zantacs. Tried those too.

(It is actually the gelatin it seems)
posted by lundman at 7:45 PM on October 16, 2006

I had bad acid reflux. It started off mild and got worse and worse (check my previous questions). Most disconcerting was that nothing would stop it, it did not directly relate to what I ate or what I drank.

It only stopped when I took away the stress factor, which I didn't even realize was a stress factor. I have a habit of not turning down work and believing I can do everything. I was working at a stimulating job and going to school full time. For some reason the amount of work doesn't bother me but juggling a lot of different tasks (2-3 at a time at work, 5 classes at school) took its toll.

Another thing I noticed was my reflux did not go away when I eased back. Not until the summer came and I only focused on my job did symptoms subside (and then only about a month out). No drug except Aciphex ($80/mo) helped me. It took about 3-4 months for it to start working. That and propping my bed up ~6 inches worked as I found that most my reflux came at night. After that it stopped but I will still get it occasionally if I find myself working 80+ hours a week.

So don't be discouraged if nothing ends up working for you (in fact that probably made it worse for me). And realize it takes time after you remove stressors or whatever causes reflux before things return to normal. Or at least that's what happened to me.

If you really can't figure out what works for you or things don't work out I would in all seriousness:

1. Change diet as suggested pretty much everywhere.
2. Stick to Zantac or whatever pills are prescriped.
3. Try your best to remove stressors.
4. Prop bed up six inches.
5. Take as long as a vacation as you can. Seriously, and this is someone who went 4 years without one vacation day.

Does that seem drastic? Probably, but if it starts burning up your throat it can be very, very uncomfortable for a long time until it gets a chance to heal.

I just don't think stress is outlined enough as a cause of chronic heart burn. Everyone will tell you to avoid foods which cause it but if you are having a hard time pin pointing it try to figure out if it is stress/anxienty.
posted by geoff. at 7:57 PM on October 16, 2006 [1 favorite]

Prilosec OTC. I have reflux due to an insufficiently tight sphincter at the top of my esophagus. It can be treated surgically, and I'll probably have that done someday. I went several years with the reflux before seeing a doctor. I had the precancerous tissue in my esophagus.

I used Aciphex for awhile (worked great, healed up the damage) and started using Prilosec OTC when it came available. I can go most of a day without it, should I forget. Probably Zantac and others would work...but Prilosec is easy, not all that expensive, and it works. Occasionally (a couple of time a month or so) I wake up late at night with some acid problems and gulp down a couple of Tums and that works fine until I get the Prilosec at my usual time.
posted by lhauser at 10:53 PM on October 16, 2006

The very best OTC drug for acid reflus is Gaviscon Tablets. Look for them in foil wrappers, the bottles go stale.

These tablets foam when you chew them. You chew them up, swallow it down with a manditory glass of water. Relief is nearly instant.

This is for occasional problems. If the problem is presistent, then you would look at other things such as Pepcid or the other pills which inhibit the production of acid.

Everyone has different food sensitivities. Many blame coffee. For me, coffee is no problem, but I can't drink hot tea.
posted by Goofyy at 5:43 AM on October 17, 2006

For me, it's bell peppers and corn products (but corn on the cob is OK). With either of these (especially the corn, which is in everything) it's bad -- real bad, as in mouth-full-of-nastyness and one trip to the emergency room bad. But without it I'm fine, for the most part, save a week of mild heartburn here and there.

Oh, and for the record, I had the H. pylori test done (after the hospital visit), and it was negative.

Pepcid Complete works well -- as convenient as Tums, but more effective. But my advice is to try to pinpoint the trigger foods -- you might be surprised, as I was (corn?!). At least for me, I hardly consider myself someone with GERD if I avoid the trigger foods, which isn't terribly hard.
posted by penchant at 7:22 AM on October 17, 2006

I have the same thing and most of the time it's pretty minor. I take prevacid as needed. If I've been getting flare-ups I'll take it for 3-4 days, and stop. Usually the "phase" subsides and I'm good to go.

The worst thing to do is take Tums. Don't condition yourself or your stomach to rely on them. Your best bet for over the counter is like zantac or prevacid. Prescription you can do Prilosec, although if you're minor I doubt you'd need it. Speak to your doctor, he'll recommend the best and cheapest option.
posted by PetiePal at 9:25 AM on October 17, 2006

Purely anecdotal.

Triggers: over eating fatty food. Temporary Fix: teaspoon of bicarb in milk + panadol or other pain relief. Fix: losing weight. Not much, but I find if I'm under a certain weight, I don't get reflux.
posted by kjs4 at 8:25 AM on October 20, 2006