Beating acid reflux

This is a bit ‘off-topic’ from my normal themes.

But this article needed a home.

So apologies to my younger readers !

Huge numbers of people, especially amongst the older generation, suffer from an incredibly painful and miserable condition known as Acid Reflux.

Until quite recently, I was amongst those people.

About a year and a half ago, I stumbled across a diet that has ‘cured’ my acid reflux, or at least resolved the symptoms.  And I am quite often asked to share my experiences with friends and acquaintances still struggling with this horrid problem.

Gimme the cure!

The ‘cure’ is not my invention, I hasten to add, and there is a great deal of information available on the subject if you know where to look.

I recently wrote a brief list of links to the best sources of information for various friends and acquaintances who wanted ‘in’ on my secret.

Me being me, of course, the brief list soon began transforming itself into a lengthy essay on how and why GERD is such a problem for the over fifties, and what the options are for treating it.

So, if you are one of the 25% of over fifties that have been diagnosed with GERD you’ll have to read on for the denouement!

What is acid reflux

Your oesophagus is the tube leading from your throat down to your stomach.  Acid reflux is what you experience when powerful stomach acid defies the forces of gravity and escapes upwards from your stomach and into your oesophagus.

If it is mild and occasional, we call this indigestion.  But sometimes it gets a lot more serious.

Unlike your stomach, your oesophagus is not designed to deal with acid.  And when acid gets into it, it hurts.

If acid repeatedly gets into your oesophagus, the lining becomes very inflamed, and every subsequent acid bath hurts even more.  Essentially, the delicate lining of your oesophagus is being seriously damaged by acid.

Symptoms?

A viscious pain behind your sternum that takes your breath away is a common symptom.   But there are others:  check out the numerous medical websites, and the links at the foot of the page,  for more information.

Not diagnosed yet?

If you think you have acid reflux you must see your GP as some of the symptoms are similar to other more urgent conditions.

And not least of all because reflux itself in the long term, can cause serious damage to your oesophagus and even put you at risk of oesophageal cancer.

There, now I’ve put the frighteners on you, lets see what modern medicine can do for acid reflux!

Medical treatments

Before I go into this I should state where I am coming from.  Those who know me, will be aware that I am a huge supporter of modern medicine, and a huge skeptic when it comes to alternative therapies.

So this is not about me being ‘anti-drugs’ or anything like that.   I’m all for drugs (or alternatives) provided that they work.

Lowering acidity levels

Because the pain of acid reflux is caused by acid, it seems logical to treat reflux by treating the acid.

So the convention medically is to treat the acidity in your stomach, rather than the fact it is escaping to a place where nature did not intend it to be.

Reflux for many sufferers is far too severe to respond to over the counter antacids, so like most others, I left my GP clutching a prescription for a Proton Pump Inhibitor.

Proton Pump Inhibitors

PPIs are powerful drugs that reduce the production of acid within the stomach.  And sure enough, within a few days, Lansoprazole had my symptoms under control.  Not gone completely, but much relieved.

So that was that.  Or so I thought.   I would probably have to take them for life, but hey, it was great to be pain free.   And having to take a few pills is probably the price we pay for living a little longer.

I was happy.  For a while.

Unfortunately (or perhaps fortunately), I am one of the few people that develop a nasty reaction to Lansoprazole, and over a period of several weeks I became more and more unwell, and had to come off the drug.

I should have tried a different PPI which may not have had the same effect, but I decided to give myself a few weeks ‘drug free’ and a chance to think about where I was going with this.

The rebound acidity when I stopped taking the drug was awful, but with my daughters wedding just a few weeks away, I put it to the back of my mind.

Getting thinner

Like so many ‘mothers of the bride” I determined to get thinner for the big day and because I had left it a bit late to lose the stone or so I wanted to shift, I decided on a quick weight loss diet.  I went ‘Low Carb’

I know, I know, crash dieting is not good for you.  But vanity and all that..

Within a couple of weeks I had lost quite a lot of weight, but interestingly,  my GERD symptoms were subsiding too.

At first I thought perhaps I was imagining it, but as hours without pain slipped into days, and days without pain slipped into weeks, I came to the conclusion that the weight loss had relieved my acid reflux.

After the wedding, I went back to my normal eating, but was careful not to put the weight back on.  I didn’t eat too much, and I spent a lot of time on my treadmill.

And we’re back

I managed to avoid gaining any weight, but within a few days the GERD came back with a vengeance.   I was devastated and fascinated at the same time.   If it wasn’t the weight loss that had cured my reflux, what was it?

My scientist ‘hat’ now went on and I started searching the internet for connections between GERD, weight loss, and the other factor I had changed: the amount of carbohydrates in my  diet.  Here is what I discovered

 Older people have lower acidity

The first piece of evidence that really struck me is that stomach acidity actually declines with age.  Quite steeply.   A teenager’s stomach may be twice as acidic as yours.  Yet GERD is more common as we get older.

This seems rather at odds with our practice of lowering stomach acidity even further in GERD sufferers.

Carbohydrates in our diets cause GERD

What I discovered next really interested me.  There is a theory that carbohydrates can actually cause GERD.  The theory is not mine, but supported by scientists like microbiologist called Norman Robillard and John Wright MD who have both written books on the subject (listed below).

It seems that carbohydrates are insufficiently digested in the stomach, especially in older folk with less acid.   And the carbs that are not digested become a breeding ground for bacteria

Increased pressure in the stomach

These bacteria give off a gas  which raises the pressure in the stomach itself.  And it is the raised pressure that forces the acid upwards into the oesophagus.

This can happen, even in people on PPIs because they are even less efficient at digesting carbs than the rest of you.

Lowering carbs reduces pressure

Lowering the proportion of carbs in the diet, reduces the pressure within the stomach itself and that is the mechanism  (or one of them) by which a low carb diet relieves GERD

So why are not more doctors prescribing this solution to their patients?

Is there a lack of evidence?

The evidence

There is evidence now to support the above theory.   The websites listed below give links if you want to read up on the research. One I read,  a small clinical trial carried out in 2006 on some obese patients  found that low carb diet significantly reduced oesophageal exposure to acid and improved symptoms.

The evidence that is gathering does not seem to have quite filtered through the system yet.  I guess these things take time. Perhaps what we need is a big study carried out on sample of the general population.

But who is going to fund it?  Certainly not the manufacturers of PPIs.

Giving it a go

If you are tempted to give it a go,  you may want to know whether or not low carbohydrate diets are safe, and how difficult it is to do.

You probably know that most of our carbs come from grains and from starchy vegetables like potatoes and squashes, and from fruits.  Aren’t these exactly what we are supposed to be eating?

Is it safe?

Is low carb living safe?  After all,  this is not something you can do for a few weeks, be cured and then go back to your old ways.  If you relapse the reflux will return (I have that T-shirt).   This is a long term commitment.

Haven’t the western governments declared low fat to be the key to a healthy life?  And aren’t we meant to eat lots of healthy wholemeal grains and pasta.  Jacket potatoes without the butter.  Tons of fresh fruit etc.

And doesn’t fibre keep our guts clean?  Won’t yours get all clogged up without your daily wholemeal bread or cereal?

To find the answers to these questions, we can look at a number of sources.

Living examples

We can look societies like the Innuit, where until recently, people survived almost entirely on meat and fat with very little vegetable matter at all.  And did so in good health.

We can also look at people that have deliberately experimented with living this way and survived in good health.  And at the growing online communities of people living without many carbs.

Even better,  we can now look at the results of studies into low carb diets that are now being published in increasing numbers.  Studies that turn our beliefs about a healthy diet on their heads.

There are some seriously good, science based, sources of information now available and the overwhelming evidence is that low carb living is not only safe, it may just be healthier than any other lifestyle.   This is not my speciality so do consult the experts for more information.  People like Mark Sissons (Mark’s Daily Apple), Michael Eade MD and Kriss Kressor.  You’ll find links to their sites below.

The drawbacks of low carb living

Before we go any further, lets be completely honest about this.  I am not promoting something which is necessarily easy to do.  Unfortunately, low carbohydrate living is not quite the bed of roses that some low carb proponents will claim.

Since Ancel Keyes initiated the vilification of fat that has defined western health advice since the 1960s, western diets have become entirely based around the carbs we consider as staple foods.

Bread, pasta, rice, and breakfast cereals dominate our lives and you cannot avoid them

It can be tough living without these foods.   I can only say, that for me, it has been worth it to be free of a debilitating condition and the effects of the drugs that the vast majority of sufferers take every day.  After a couple of brief relapses, I have learned a thing or two about sticking to a low carb diet, and I’ll talk about those in a moment.

There is just one other drawback to low carb living, that for many people in our society is actually a bonus.

Weight loss

I can tell you that after I resumed my low carb diet, having lost the weight I planned to lose for my daughter’s wedding, I continued to drop pound after pound.

The weight loss continued until I was begining to worry.  Then it levelled out at about ten pounds under my target.  I now weight about the same as I did in my early twenties.  And am what most people would describe as skinny,  though possibly exactly what nature intended.

Whether or not that would bother you is a personal thing.  I think it is worth it to be healthy.

How to stick at a low carb diet

The hardest part can be the first couple of weeks.   This is because there are two very different ways of fuelling the human body.  When you are a low carber, your body runs on ketones,  when you eat lots of carbs,  your body runs on glucose.   These are quite different fuels and they are processed in different ways.

Your body, and the bodies of most of your friends and relatives, are running on glucose.  And your body is adapted to this.  When you make the switch to ketones,  your body is not adapted to the process. It needs time to get itself sorted out.

Someone made the analogy to a car factory being told that from tomorrow they would be making ipads.   They would need time to get in supplies and adapt or replace their machinery.  Your body has to do the same.  So for a few days, you may feel like crap.

It is sometimes referred to as low carb flu’.  Some people find it lasts for weeks rather than days, but it does go eventually.

The food diary

I remembered feeling ill when I tried the Atkins diet in my thirties so I planned in advance and cut down my carbs quite gradually.  I kept a low carb diary and recorded the carbs I ate each day.  And each day tried to eat a few less than the day before.

I still had some low carb symptoms when I dropped under 50 grams of carbs a day,  but far less than on previous attempts.

Coping with deprivation

Something many low carb diet books skirt around or ignore is the problems with living a low carb diet in a high carb environment.

It is hard to turn down cake when others are eating it.  Tough to avoid sweets, chocolate, and all the other goodies that surround us every day.

We each have our own passions.  I found it very hard to give up my breakfast toast.  Cutting down gradually from one slice, to three-quarters, to half a slice.

And I am lucky in that my whole family supported me.  We no longer have bread (my weakness) in the house and we all eat more meat and more leafy and low carb vegetables like broccoli and cauliflower.

The upside

For many people the upside is simply that weight loss we have talked about.  For others it is freedom from Acid reflux and other conditions that have been linked to modern carbohydrate intake (type 2 diabetes, acne, obesity, and so on)

Fortunately, low carb living has another huge trump card.  If you stick at it for a few weeks, your low carb diet will remove hunger and craving for sweet things.

Like many women I have spent a lifetime dieting and being hungry.   Now, for the first time in my life, I hardly ever experience hunger pangs and can easily miss a meal without even noticing.

If you have lots of questions to ask about low carbing,  things like “how many carbs should I aim for” and “what kinds of foods can I eat”, do head over to Mark’s Daily Apple.  It was my lifeline when I first embarked on this new way of eating.

Warnings

I am not a doctor.  I cannot advise you on what you should eat, or whether this is suitable for you.  I can only tell you what it did for me, and relate what is has done for others.  Please, please see your doctor if you have reflux symptoms.  They can be serious.

Don’t scupper your chances of low carb living by trying to cut out fat.  If you are going to succeed on a low carb diet, you need to eat plenty of meat, and fat.  If you try and go low fat at the same time, you will fail.

Low carb and low fat is just a low calorie diet and you will be absolutely starving all day.  Eventually the cracks will appear and you will cave in a haze of delicious sugary snacks.

And if you eat sufficient fat, not only will that help prevent hunger, it will keep your insides moving nicely!

Is it Paleo?

Many people refer to this kind of very low carb diet as a Paleo diet because it mimics what our stone age forbears ate.

But a truly paleo diet would exclude dairy food and I do not do this.   You’ll need to research the options and pick a way that suits you.

I hope you have found this interesting and that you are able to find relief from the horrible condition that is Acid Reflux.  Do check out the links below, as these people are the experts, not me!

Further reading

Books

Why Stomach Acid is Good for You
by Jonathan Wright

Fast Tract Digestion Heartburn: Clinically Proven Diet Solution to Treat and Prevent Acid Reflux and GERD without Drugs
by Norman Robillard

Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health by William Davis MD

More general books about low carbohydrate living and the problems with modern diets

The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable  an exceptionally detailed book by Jeff Volek  – packed with information

Trick and Treat: How Healthy Eating is Making Us Ill by Barry Groves and Howel Buckland Jones

The Paleo Diet
by Loren Cordain  –  this one is a little outdated with regard to ‘fat’ but still worth reading

 

Excellent internet sources

What everyone ought to know about heartburn and GERD by Chris Kresser

GERD: symptoms, causes, and remedies, by Mark Sissons on the Mark’s Daily Apple website

GERD: treat it with low or high carb diet?  by Michael Eade MD  on his blog