Simple exercise to eliminate gastroesophageal reflux (2022)(ncbi.nlm.nih.gov)
ncbi.nlm.nih.gov
Simple exercise to eliminate gastroesophageal reflux (2022)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106553/
238 comments
I'm still unsure about the position, they should have added a drawing.
Kneel; now put your head on the ground.
(I am guessing, I don't have extra knowledge.)
Or you could put the plate on the floor and bend your upper body down from the bed. Should achieve the same result.
Are you saying I should eat in bed, my plate on the floor, me hanging half out of bed? It doesn't sound like a posture I would associate with healthy eating habits, but I'm willing to make that sacrifice.
Seems easier to just try drinking alkaline water first, to neutralize the stomach acids somewhat. If that doesn’t help, then try all this contortionist stuff next.
It's not about neutralising stomach acid (for which there are many methods already), but training the muscles around the entrance of the stomach to keep that stuff in your stomach.
I was diagnosed one or two years ago with a problem where my lower esophageal sphincter doesn't close properly (took an endoscope rummaging around in my stomach; not a pleasant experience), and I think my lower esophagus is too wide. It causes stomach acid to flow up, especially at night, and especially if I ate something late in the evening.
They said quite a lot of people had this problem (1 in 20? 1 in 5?), making it sound like some unavoidable problem that I just need to treat by not snacking in the evening, taking daily pills that reduce the amount of acid my stomach produces, and maybe sleeping on my left side, so gravity keeps the contents of my stomach where they need to be. But if it's possible to train these muscles, that might be worth trying too.
I was diagnosed one or two years ago with a problem where my lower esophageal sphincter doesn't close properly (took an endoscope rummaging around in my stomach; not a pleasant experience), and I think my lower esophagus is too wide. It causes stomach acid to flow up, especially at night, and especially if I ate something late in the evening.
They said quite a lot of people had this problem (1 in 20? 1 in 5?), making it sound like some unavoidable problem that I just need to treat by not snacking in the evening, taking daily pills that reduce the amount of acid my stomach produces, and maybe sleeping on my left side, so gravity keeps the contents of my stomach where they need to be. But if it's possible to train these muscles, that might be worth trying too.
How on earth can you eat like that?
> "This required food being swallowed to be pushed up an incline. I began eating part of each breakfast (oatmeal) and sometimes lunch (a sandwich) in the exercise position. I would kneel on a platform (which happened to be 6 ½” high), take a normal mouthful, chew it as needed, and prepare to swallow. I would then lay my forearms and the backs of my hands on the floor, rest my head on my hands, and complete the swallowing process. With a little practice, I was soon able to initiate and complete the swallowing process with my head resting on my hands on the floor. I did not attempt to determine what the optimal height of the platform might be or if, indeed, any was necessary."
How it's described in the article.
How it's described in the article.
Take a bite and chew, but don’t swallow. Then assume the position. Then swallow.
It's probably also a good way to make yourself slow down when eating and take more time to eat so you feel fuller sooner in the meal.
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These physical posture papers really need to be accompanied by a youtube "video for dummies" link.
Well what the heck, I've been working on handstands and my GERD went away. I also lost weight so I attributed it to that, but this might be part of it. "after beginning daily LES exercises, I noticed that I could bend over at the hip and pull weeds in my garden without acid running into the back of my throat" - At the start of training headstands I'd have reflux so I had to do them at the right time of day to not make it terrible. Over time this went away and I'd have to eat a full meal right before to feel the same now. I wonder if I trained this muscle similarly.
Clearly you need to add an "oesophagus day" to your training regimen.
PHOUL?
I used to get a strange reflux from sleep apnea (which can be mitigated by exercising and losing weight)
Basically, when you are sleeping and your throat collapses, you breathe in, and instead of pulling air via the throat, your lungs pull stomach fluid up your esophagus and sometimes into the lungs. I would wake up sometimes with GERD feelings, and sometimes as I was throwing up into my mouth.
Basically, when you are sleeping and your throat collapses, you breathe in, and instead of pulling air via the throat, your lungs pull stomach fluid up your esophagus and sometimes into the lungs. I would wake up sometimes with GERD feelings, and sometimes as I was throwing up into my mouth.
This is one of the worst experiences one can have. Add that the fact that you are sleeping... It's so terrible
This is one of those posts that could change my life. Thanks for sharing. Sorry to not add to the discussion but I have terrible acid reflux and sometimes it feels like it runs my life. I often don't sleep well because of it.
I'll definitely give this a shot.
I'll definitely give this a shot.
Same, I'm going to give it a shot as well. 20 years of GERD with 10+ years of daily medicine that I'd like to stop taking. I wonder if a yoga downward dog position might be equivalent?
Taking Mint, in form of raw washed leaves, in tea form or even in capsule form (pudin hara) has greatly reduced my acid reflux. Might be worth trying.
Strength: Capsule > Leaves > Mint tea
Usually we eat the raw leaves. They are tasty! You can make a salad out of it.
At night drink some mint tea.
And in emergency take a capsule.
Strength: Capsule > Leaves > Mint tea
Usually we eat the raw leaves. They are tasty! You can make a salad out of it.
At night drink some mint tea.
And in emergency take a capsule.
Mint is actually bad according to my GI doctor because it relaxes the muscle and allows more acid into the esophagus?
For me mint was a trigger of worse reflux, but apparently it helps some people.
I have a prescription for daily 40mg pantoprazol, which reduces the amount of acid my stomach produces.
But I've also noticed that it doesn't work as well if I eat too much or eat too late in the evening. It makes sense that your stomach produces more acid in response to eating, so simply eating less can also lead to less reflux. Losing some weight would be a nice bonus for me, but I haven't been very successful at that yet.
That said, training my oesophagus to keep the acid in my stomach also sounds like a good idea.
But I've also noticed that it doesn't work as well if I eat too much or eat too late in the evening. It makes sense that your stomach produces more acid in response to eating, so simply eating less can also lead to less reflux. Losing some weight would be a nice bonus for me, but I haven't been very successful at that yet.
That said, training my oesophagus to keep the acid in my stomach also sounds like a good idea.
A book I read recently called "Why Stomach Acid Is Good for You" has a section on bitters (which I believe would include mint) are good for reflux - their prescription is chew/eat bitters ~5 minutes before a meal.
I have a serious case of acid reflux, I eat 4-6 maalox a day and sometimes another one or two during the night if the pain wakes me up. It never goes into my mouth or throat but the stomach pain is really annoying.
Will try this as well although pictures of the positions would have been welcome.
Will try this as well although pictures of the positions would have been welcome.
You may not have acid reflux if it acid never gets into your throat. I have at least a yearly episode of waking up choking and the epiglottis is stuck shut protecting my lungs from acid. It's horrible to wake up like that but am always fine after the episode and yet every time it happens I can't shake off the sheer panic I'm in. I could say I got used to it and yet when it happens it's horrifying.
There's degrees. For many years, I'd sometimes have a pressing pain somewhere on the left side of my chest. For years I wondered if it was something with my heart or my lungs, but it turns out that's what it feels like if stomach acid enters your oesophagus. It doesn't have to get all the way up to your throat to be a problem, though that also sometimes happens recently.
Took years for me to get this diagnosed, but now I take pills to reduce stomach acid production, I eat less in the evening, and maybe I'll add this training now.
Took years for me to get this diagnosed, but now I take pills to reduce stomach acid production, I eat less in the evening, and maybe I'll add this training now.
wow, I have the same issue but not related to acid or GERD. mine is triggered by water or saliva. My throat would close up, and I couldn't breathe. It has a name, and on YT, you can see a video of an episode happening. it looks and feels like an asthma attack. And even though I'm always fine, I still fight back the panic. I have gotten better. I can quickly close part of my throat before the water or saliva touched the part of the throat that triggers it. I also learned not to fight it. do not try too hard to breathe, especially through the mouth. instead, I breathe slowly and gently through the nose. I then relax and maybe let out a cough or two, then I can breathe again.
I had acid reflux from the time I was 15 years old. By the time I was 22 it had eaten holes almost through my esophagus, so I had Laparoscopic Nissen fundoplication surgery. They basically wrapped part of my stomach around the valve and it tightened it up. No more heartburn.
On the down side, I no longer can vomit, so there's that. (Confirmed after the not-so-smart decision to try every booth at a chili cook-off.)
On the down side, I no longer can vomit, so there's that. (Confirmed after the not-so-smart decision to try every booth at a chili cook-off.)
So what happens when you'd normally need to vomit?
Nature finds a way :) (Door #2)
I suppose if it was an alcohol poisoning situation or something like that, I have to get my stomach pumped.
I suppose if it was an alcohol poisoning situation or something like that, I have to get my stomach pumped.
You should be taking omeprazole rather than antacids.
For those not in the know, antacids control the acidity levels. Omeprazole signals to the stomach receptors to reduce/stop producing the acid in the first place. The difference is that, when your body senses a pH change upon taking the antacid, it provides some intermediate relief, but eventually the body senses the reduction and produces more acid to compensate for the shortfall, resulting in an even greater amount of acid. This can turn into a very vicious cycle very badly.
Ideally, you should be taking both Maalox with each meal and omeprazole on a regular basis every day, till your physician directs you to change course. 4 Maalox a day is actually a lot.
For those not in the know, antacids control the acidity levels. Omeprazole signals to the stomach receptors to reduce/stop producing the acid in the first place. The difference is that, when your body senses a pH change upon taking the antacid, it provides some intermediate relief, but eventually the body senses the reduction and produces more acid to compensate for the shortfall, resulting in an even greater amount of acid. This can turn into a very vicious cycle very badly.
Ideally, you should be taking both Maalox with each meal and omeprazole on a regular basis every day, till your physician directs you to change course. 4 Maalox a day is actually a lot.
Stomach acid exists for a reason. I worry a lot about the long term effects of suppressing it. Gallbladder problems are often mentioned.
Proton pump inhibitors like Omeprazole does have issues, but trying to mitigate GERD symptoms with antacids and failing to suppress it fully cauaes worse issues. It takes massives doses to significantly suppress the stomach acid - typical doses just reduces it a bit.
If you need PPIs for extended periods of time you absolutely should talk to a doctor to rule out potentially serious possibilities, though.
If you need PPIs for extended periods of time you absolutely should talk to a doctor to rule out potentially serious possibilities, though.
Yeah, I did and this is what he prescribed me. PPI is one of the most prescribed drugs, if not the most.
That's why this article is really interesting
That's why this article is really interesting
That's why I said, as per the physician's guidance. The Maalox-Omeprazole duo is the best route to suppressing reflux, but the dosage you need to take them is as per the physician's recommendation.
Me too. I take pantoprazol to reduce my acid production, but messing with it too much sounds like a bad idea. Training these oesophagus muscles might be a better idea if it works.
I replied to another sub-thread.
Why don’t you get proper medication to deal with this as opposed to antacids? I also had bad reflux and Omeprazole took care of it pretty quickly. OTC antacids were no help really.
Taking a PPI (I think it was generic protonix) truly cured very severe heartburn I'd developed from eating a funny diet. After a few months, I got my doctor to prescribe me a half-size pill, then tapered off and I've been permanently free of heartburn. Maybe footnotes to https://en.wikipedia.org/wiki/Proton-pump_inhibitor#Indicati... explain why. But I remember reading that the PPI permanently shut down a bunch of acid production in your stomach, so after a while, you may be in a good state.
I took omeprazole and similar derivatives for extended periods and while they annihilate symptoms, after a couple weeks of not taking them, symptoms always come back. Also it gives me itches in the long run which is part of the list of side effects. I probably have work to do around diet and need to consult a doctor, definitely (they are prescription medicine where I live and it's not always easy to get an appointment).
There aren't any proper medications that I'm aware of. Proton pump inhibitors have documented long term use downsides.
Those downsides are better than Barrett's esophagus and esophageal cancer.
Very fair point.
Proton pump inhibitors and friends have their own side effects. Protonix, for example, made me shaky for some reason.
Food for thought. A few things work for me. First, eat your last meal early - we eat dinner around 6 and are in bed anywhere from 10pm to midnight.
Second, natural apple cider vinegar... If you are getting that terrible burning feeling that isn't subsiding, take a small sip of apple cider vinegar out of the fridge. Rinse or brush your teeth right away as it's hard on them. I feel like as with everything else this should be done in moderation.
Another thing to add for me personally is no alcohol a couple hours before bedtime, especially bourbon/whiskey/etc. And absolutely no spaghetti or red sauces anywhere close to bedtime.
Good luck and I hope it gets better for you.
Second, natural apple cider vinegar... If you are getting that terrible burning feeling that isn't subsiding, take a small sip of apple cider vinegar out of the fridge. Rinse or brush your teeth right away as it's hard on them. I feel like as with everything else this should be done in moderation.
Another thing to add for me personally is no alcohol a couple hours before bedtime, especially bourbon/whiskey/etc. And absolutely no spaghetti or red sauces anywhere close to bedtime.
Good luck and I hope it gets better for you.
Doesn't maalox cause your stomach to generate more acid? That is counterproductive.
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Same. I've had GERD for a looong time and I'm tired of taking a pill for it.
I remember being a kid and thinking that animals that bend down to drink from a pond must be forcing the water to travel up their esophagus. Hmm, I wonder if humans can do that. So I filled my mouth with water, did a head stand, then swallowed. Yes, no problem. Newfound respect for my body that day.
My 8th grade science teacher showed us this back in 1960: he had one of us do a handstand and drink water from a cup using a straw with no choking or gagging.
Also, astronauts can eat and drink in zero gravity.
Zero gravity is easier than opposing gravity in this case.
It’s literally half as hard.
Sure, but it still means that your body has to force the food/drink down (er, or "in" if you're in space, I guess) rather than just letting gravity do the work.
Entertaining the silly argument we have gotten ourselves into: Solid food does not just fall into our stomachs normally, the processes of swallowing is quite complex and involves mechanically pushing food down through peristaltic waves in multiple phases. Liquids are another story though.
It is entirely baseless of course, but I imagine that the difference for solid foods between a the small aid of gravity, unable to make the food move on its own, and having no aid is probably significantly less than the difference between no aid and an opposing force. And yet in either case, the process of swallowing remains exactly the same, always having to force the food down with the same motion but different effort.
It is entirely baseless of course, but I imagine that the difference for solid foods between a the small aid of gravity, unable to make the food move on its own, and having no aid is probably significantly less than the difference between no aid and an opposing force. And yet in either case, the process of swallowing remains exactly the same, always having to force the food down with the same motion but different effort.
Your story reminds me of this segment from Mr. Wizard that I saw as a child. This kid eats an apple while doing a hand stand, and I remember being amazed by it.
https://youtu.be/bC6jJnVe1LI?t=1072 (starting at 17:52)
https://youtu.be/bC6jJnVe1LI?t=1072 (starting at 17:52)
> Gastroesophageal reflux results from weakness or relaxation of the lower esophageal sphincter (LES) [1]. Personal experience with this problem lead me to think about it, repeatedly.
LOL.
More seriously: Is there something about a modern diet or lifestyle that tends to cause this weakening? Or have anatomically-modern humans just always had a similar rate of reflux, for this reason?
LOL.
More seriously: Is there something about a modern diet or lifestyle that tends to cause this weakening? Or have anatomically-modern humans just always had a similar rate of reflux, for this reason?
We don’t drink directly from streams or pools of water. Pre-technology humans would have had to use their hands to scoop water to their mouths and it’s more efficient when your mouth is closer to the water source since you don’t lose as much on the way up. We also just don’t spend much time bending over anymore which is probably another source of resistance that is missing.
Getting an illustrated children's Bible 22 years ago, I was most surprised by when God told the commander to tell his soldiers to drink from a stream and they were wildly idiosyncratic, some lapping like cats, some cupping the water into their hands etc.
Spoiler alert: commander did multiple tests, each selecting for idiosyncrasies, resulting in a force a fraction of the original size, and won the battle.
Spoiler alert: commander did multiple tests, each selecting for idiosyncrasies, resulting in a force a fraction of the original size, and won the battle.
There is an episode in Andrew Hubermans' podcast which goes into the details of this. Overall if you are keeping your digestive track in "digestion mode" frequently thus not letting it rest will eventually building up constant acid (to digest the food) resulting in reflux. The digestive track goes into "rest mode" about 3-4 hours after your most recent food intake.
We eat a lot of processed foods which are softer compared to chewing tough meat for example. This is known to affect jaw and palate development (which in turn affects teeth alignment, tongue position, and even breathing). [1] Seems like it could also affect the esophagus.
[1] https://news.stanford.edu/2020/07/21/toll-shrinking-jaws-hum...
[1] https://news.stanford.edu/2020/07/21/toll-shrinking-jaws-hum...
Fascinating link thanks.
I had a small hunch that it could also be related to how thoroughly we chew. I've noticed over the years that I chewed less and less while eating and started swallowing most pieces whole. Since a few months ago I started to make an effort to really chew on my food until it's properly minced.
According to the link that seems to be part of the problem.
I had a small hunch that it could also be related to how thoroughly we chew. I've noticed over the years that I chewed less and less while eating and started swallowing most pieces whole. Since a few months ago I started to make an effort to really chew on my food until it's properly minced.
According to the link that seems to be part of the problem.
I suffered from this in my teens and early 20s. It was pretty terrible, and I'd often vomit. Turns out not eating like shit fixed it.
Yep, I had a terrible diet a few years ago which flared up some moderate acid reflux whenever I had certain sugary drinks. Fanta and Coke were the worst for me. I think the likely culprit was the aspartame. I very rarely drink those types of beverages now and I don't have acid reflux anymore.
Anecdote:
I used to suffer from very bad reflux in my early 20's. I tried all sorts of things. Today I no longer suffer from reflux at all.
The following either didn't work, or only reduced the severity of my reflux:
- Medicines were helpful but not an outright fix.
- Dietary changes did not help at all.
- Sleeping upright helped but only so much. And my sleep quality was terrible.
- A medical device that applies light pressure to your Adam's apple. This actually helped a lot, but was not fun to sleep with.
The two things that I think actually got rid of my reflux for good are:
- Intermittent fasting
- Vomitting cat exercise
The following either didn't work, or only reduced the severity of my reflux:
- Medicines were helpful but not an outright fix.
- Dietary changes did not help at all.
- Sleeping upright helped but only so much. And my sleep quality was terrible.
- A medical device that applies light pressure to your Adam's apple. This actually helped a lot, but was not fun to sleep with.
The two things that I think actually got rid of my reflux for good are:
- Intermittent fasting
- Vomitting cat exercise
Say more about "Vomitting cat exercise"
Step 1: Sit on all fours like a cat/dog.
Step 2: Suck in your gut and arch your back like a cat does when they are startled.
Step 3: Exhale
There is also a variation where you don't arch your back: https://hiitacademy.com/hiit-exercise-how-to-do-cat-vomits/
I basically found myself running out of things to try. My poor sleep quality was especially affecting me and I was desperate to get the reflux under control. And so I spent a lot of time thinking deeply about what could be causing my reflux.
It's difficult to explain why I thought to try this combination (fasting + cat vomitting exercise). It was sort of like I suddenly understood where the weakness was in my esophagus, and that this specific motion/exercise, in combination with giving my esophagus a break for 10 hours/day would relieve the reflux. I fully committed, and in not very long (3-4 weeks if I remember right), my reflux was mostly gone. Only had a few memorable reflux instances in the months that followed and now its been years since I've had any issues at all.
I still practice intermittent fasting 5 days a week but I don't do the cat vomit exercise. Part of me feels strongly that if I hadn't done both those things at the same time, I wouldn't have fixed my reflux, but obviously I have no evidence to prove that.
I also feel its important to mention that reflux has different causes. I felt like what I was experiencing, combined with all the reading I did about reflux, allowed me to settle on this particular regimen.
I am definitely not trying to suggest that this is some secret magical cure that big pharma doesn't want you to know about.
Step 2: Suck in your gut and arch your back like a cat does when they are startled.
Step 3: Exhale
There is also a variation where you don't arch your back: https://hiitacademy.com/hiit-exercise-how-to-do-cat-vomits/
I basically found myself running out of things to try. My poor sleep quality was especially affecting me and I was desperate to get the reflux under control. And so I spent a lot of time thinking deeply about what could be causing my reflux.
It's difficult to explain why I thought to try this combination (fasting + cat vomitting exercise). It was sort of like I suddenly understood where the weakness was in my esophagus, and that this specific motion/exercise, in combination with giving my esophagus a break for 10 hours/day would relieve the reflux. I fully committed, and in not very long (3-4 weeks if I remember right), my reflux was mostly gone. Only had a few memorable reflux instances in the months that followed and now its been years since I've had any issues at all.
I still practice intermittent fasting 5 days a week but I don't do the cat vomit exercise. Part of me feels strongly that if I hadn't done both those things at the same time, I wouldn't have fixed my reflux, but obviously I have no evidence to prove that.
I also feel its important to mention that reflux has different causes. I felt like what I was experiencing, combined with all the reading I did about reflux, allowed me to settle on this particular regimen.
I am definitely not trying to suggest that this is some secret magical cure that big pharma doesn't want you to know about.
Sounds partly like marjari asana of hatha yoga.
Cat pose or cat cow pose.
Google it.
Cat pose or cat cow pose.
Google it.
That does look the same/similar.
Web search says it's an abdominal breathing exercise where you are positioned on the ground on your hands and knees (similar to "cats and camels" for those familiar with that one).
I have recently had a significant improvement in acid reflux symptoms. The key for me was to just eat less.
I am not morbidly obese. I have a pretty small frame and am about 5 ft 6 in tall. My BMI before cutting my portion sizes down was on the upper end of the normal weight range (24.9).
I tend to be a fast eater, and I think that did me no favors.
It makes a lot of sense in retrospect. But when you're not obese, cutting your portion sizes is not the first thing that comes to mind as a method for improving health.
I am not morbidly obese. I have a pretty small frame and am about 5 ft 6 in tall. My BMI before cutting my portion sizes down was on the upper end of the normal weight range (24.9).
I tend to be a fast eater, and I think that did me no favors.
It makes a lot of sense in retrospect. But when you're not obese, cutting your portion sizes is not the first thing that comes to mind as a method for improving health.
> I tend to be a fast eater, and I think that did me no favors.
Chewing thoroughly until the food almost liquefies helps the stomach digest faster and empty its contents into the intestines.
Chewing thoroughly until the food almost liquefies helps the stomach digest faster and empty its contents into the intestines.
My wife recently berated my for swallowing part of my food before I'd properly chewed it. I'm trying to pay more attention to it now, and she's right. I take a big bite, chew twice, swallow part of it, and then chew the rest. Another thing I need to unlearn.
I have had GERD since 2012 after a surgery and it has been extremely unpleasant to say the least. The author mentions Rantadine which I also took but the problem with that drug was it was found to contain carcinogens and I promptly stopped taking it. I now take pepcid AC 20MG daily and would love to find a way to stop taking it altogether.
In case you are wondering(and I have been to the Dr many, many times about this), triggers for GERD are stress(for me it is the strongest trigger) caffeine, heavy fried foods, spicy foods, cabbage and soy. Methods to avoid acid reflux flare ups are eat slowly(I eat really fast!) eat at least 2-3 hours before bed, and also avoid huge meals. I am truly thankful to OP for this article and will apply its techniques right away, hope the stuff I mentioned helps others as well.
In case you are wondering(and I have been to the Dr many, many times about this), triggers for GERD are stress(for me it is the strongest trigger) caffeine, heavy fried foods, spicy foods, cabbage and soy. Methods to avoid acid reflux flare ups are eat slowly(I eat really fast!) eat at least 2-3 hours before bed, and also avoid huge meals. I am truly thankful to OP for this article and will apply its techniques right away, hope the stuff I mentioned helps others as well.
GERD is multicausal, which is why there's so many responses already. Personally I went from occasional heartburn to GERD during a period where I was eating spicier food more often, eating more overall, and consuming more alcohol. The latter two are modern problems, spiciness might be as well.
When I was seeing doctors for stomach issues years ago, I remember being told to avoid spicy food among other things. However, population studies don't show a higher rate of GERD/stomach ulcers for groups who report eating spicier food. I think it just irritates damage that is already there that you might not have noticed.
For me, it turned out I was reacting to something in my well water and a bit after switching to bottled water, I could go back to chocolate/coffee/alcohol/spicy food with no problems.
For me, it turned out I was reacting to something in my well water and a bit after switching to bottled water, I could go back to chocolate/coffee/alcohol/spicy food with no problems.
Among many others, obesity is a big risk factor.
It's not just weakening that's the problem, but also more pressure from below, and obesity can cause the stomach to be pushed up.
I have a hiatal hernia, where there's a too large opening allowing part of the stomach to slipe through the diaphragm, and that massively increases my acid reflux if I don't take medication.
Weight changes dramatically affects the strength of my symptoms. As I've lost weight the symptoms have largely disappeared again.
It's not just weakening that's the problem, but also more pressure from below, and obesity can cause the stomach to be pushed up.
I have a hiatal hernia, where there's a too large opening allowing part of the stomach to slipe through the diaphragm, and that massively increases my acid reflux if I don't take medication.
Weight changes dramatically affects the strength of my symptoms. As I've lost weight the symptoms have largely disappeared again.
I think sitting all day causes it
This explains a lot. I’ve done nothing but sit for months and I can’t eat anything even remotely acidic anymore.
Sitting all day is just one of many things that likely cause it. Sitting pushed organs around in a different way from standing or laying down.
Oily greasy food, not exercising, extra weight on the chest, and alcohol that further relaxes the muscle all contribute in my experience.
Obesity and a sedentary lifestyle will cause mitochondrial dysfunction throughout the body and prevent muscles from working effectively, including the esophageal sphincter. I don't know that causality has ever been directly proven there but it seems likely.
hiatal hernia runs in my family, so it's genetic for me
not sure where you're coming from but LOL for a disease that definitely leads people to die of esophageal cancer on a regular basis not to mention makes living and exercising difficult seems....inappropriate ?
not sure where you're coming from but LOL for a disease that definitely leads people to die of esophageal cancer on a regular basis not to mention makes living and exercising difficult seems....inappropriate ?
Their "LOL" was in reference to the author's statement of "...personal experience led me to think about this, repeatedly" (which is the author presumably making a joke)
Insulin Resistence. Almost half the people with diabetes also have GERD.
I would posit that chronic inflammation of the stomach mucosa due to the SAD diet could cause neuromuscular problems in the regions that control the LES.
I think tons of anxiety and stress can also weaken the muscle, which can make it more susceptible to been weakened by an external physical trauma.
It turns out drinking 4 cups of coffee a day for a few decades isn't great for your esophagus.
Anecdotally and subjectively drinking coffee can trigger reflux but yerba mate (another source of caffeine) did improve digestion.
coffee doesn't have to be scalding hot, or even hot at all to be enjoyed.
I thought it was a reference to PH, not temperature?
> LOL
What's funny...?
What's funny...?
> Personal experience with this problem lead me to think about it, repeatedly.
It's a comically-understated way to say "I kept having acid reflux, just, so very many times, and it hurt like a motherfucker so I became preoccupied with fixing it".
It's a comically-understated way to say "I kept having acid reflux, just, so very many times, and it hurt like a motherfucker so I became preoccupied with fixing it".
Some of the most significant progress we made as a species was because some relatively smart and lazy person got really annoyed with some kind of problem.
OP deploying a bit of wit with the comma and the word "repeatedly" at the end. I don't what you'd call it exactly - gallows humor?
Presumably the understatement of it.
Uh, there's likely more than a few confounders here, which are, at a minimum, undocumented in the report. Intuitively, one would expect lower caloric consumption with altered eating habits, which would lead to decreased fat and decreased intra-abdominal pressure. There's also no test of LES function prior to initiation of the experiment, so no delta was actually measured.
There's also a bit of misunderstanding, I suspect, in the pathology report: 0.2 x 0.5 x 0.3 cm is a perfectly reasonable size for an esophageal biopsy, and it was almost certainly measured with a ruler like (1) or (2).
I've passed this to a GI friend to get their thoughts, but suffice to say, more study is required before making this any sort of recommendation.
(1) https://www.neobits.com/thermo_fisher_scientific_nc9759439_r...
(2) https://www.aaawholesalecompany.com/fis-s40641-pk.html
There's also a bit of misunderstanding, I suspect, in the pathology report: 0.2 x 0.5 x 0.3 cm is a perfectly reasonable size for an esophageal biopsy, and it was almost certainly measured with a ruler like (1) or (2).
I've passed this to a GI friend to get their thoughts, but suffice to say, more study is required before making this any sort of recommendation.
(1) https://www.neobits.com/thermo_fisher_scientific_nc9759439_r...
(2) https://www.aaawholesalecompany.com/fis-s40641-pk.html
Valid points but strategies with low or no risk can be recommended to try even with very little evidence.
It’s great that he wrote it up in such a nice format so others can now run more sophisticated studies.
Imo journals should encourage such articles along the lines of “here’s a neat idea that we tried and that appears somewhat plausible, and we’re not even going to pretend to do statistics”.
Imo journals should encourage such articles along the lines of “here’s a neat idea that we tried and that appears somewhat plausible, and we’re not even going to pretend to do statistics”.
I look forward to hearing what your colleague reports.
I quote: "Just what everyone wants upside down LES kegels <laughing to tears emoji>"
Note that there's also a less known type of Acid Reflux called Laryngopharyngeal Reflux (LPR), also known as Silent Reflux, which doesn't manifest with "usual" symptoms like heartburn or a sour taste in mouth, but instead with symptoms like sore throat or hoarseness. For a long, long time I didn't understand why so often after eating my throat was full of phlegm and I had to constantly clear it, I thought it has something to do with paranasal sinuses because I rarely experienced symptoms commonly associated with Acid Reflux, but after some research I found out about the Silent Reflux so I modified my diet and the symptoms mostly disappeared.
I battled what I believe to be silent reflux for years. For me it started out as a weird persistent sore throat. Then after months I started getting bouts of nausea and a feeling of swelling in my ears and throat. After a lot of doctor visits (who kept repeating GERD) and various medicines, I totally gave up coffee. It wasn’t immediate but after a few months I felt better and after a year I was totally back to normal.
In case someone out there is searching for a success story.
It was really hard because nothing worked immediately. I still can’t be completely sure it was the coffee but I feel better now and will never go back to try again.
In case someone out there is searching for a success story.
It was really hard because nothing worked immediately. I still can’t be completely sure it was the coffee but I feel better now and will never go back to try again.
I have a little bit of silent reflux, and it will cause me to gag occasionally. I definitely attribute it to coffee + alcohol. While I've cut alcohol down dramatically, I've also tried lowering the acidity of coffee, using darker roasts, adding more water, seems to help a little.
Lots of internet recipes to add baking soda to each cup of coffee or even your batch of coffee powder, to improve both taste and acidity.
Ugh, I’ve had this for over a decade. It’s a real bummer. Unfortunately, neither diet nor medicine seems to help mine, so I just constantly feel like I have a mild cold, even if I’m not eating anything.
I had (have?) this, too. I went to my doctor because I was clearing my throat all the time. This was the diagnosis. This actually scares me, because I believe it's likely (I'm not a Dr, so this is a guess) that having silent reflux for a long period of time could cause esophageal cancer.
I understand there's lots of caution in this thread about about this paper/post. It's definitely worth a try and it seems like there couldn't be much of a downside.
I understand there's lots of caution in this thread about about this paper/post. It's definitely worth a try and it seems like there couldn't be much of a downside.
I’m pretty sure I’m suffering with that. Sore throats so bad I can’t sleep. Mucus feeling at the back of my throat.
It seems to goes away if I use Gaviscon, have my last meal at 5pm and avoid spicy/fatty foods.
It seems to goes away if I use Gaviscon, have my last meal at 5pm and avoid spicy/fatty foods.
> Mucus feeling at the back of my throat
This is a textbook GERD symptom for me... took me a long time to recognize it as such, because I thought it was just a post-nasal drip, but it was so bad it would wake me up in the middle of the night.
Drinking a couple sips of Alka-seltzer always fixes that choking feeling and lets me fall back asleep.
This is a textbook GERD symptom for me... took me a long time to recognize it as such, because I thought it was just a post-nasal drip, but it was so bad it would wake me up in the middle of the night.
Drinking a couple sips of Alka-seltzer always fixes that choking feeling and lets me fall back asleep.
Ive been wondering if I had this, since i get cold symptoms and my gf that i live with never seems to catch them.
How did you modify your diet?
Diet in GERD/LPR is a quite tricky and complex topic, when you start reading what types of food and drinks should you avoid it can easily overwhelm you, because besides obviously unhealthy stuff there's also a lot of healthy stuff (including many vegatables and fruits) that you should avoid and a lot of "basic" things that many people will find hard to eliminate like chocolate, coffeine, milk, cheese, butter, pepper, mint and many, many more. The thing is that there are certain types of food and drinks that will most definitiely cause acid reflux in anyone with GERD/LPR, but there's also a lot of stuff that possibly could cause acid reflux, but you must check yourself if it's good for you or not. Personally in my diet I have heavily reduced stuff like whole milk, cheese, eggs, pepper, chocolate, onions, lemons, oranges, tomatoes (including ketchup), anything spicy or fried, soft drinks - at first avoiding all that stuff is burdensome, but with time you get used to it.
Some of the complexity (I think) is that there are at least two different things going on:
Some foods might increase the extent to which the contents of one's stomach end up in their esophagus.
Some foods might increase the extent to which it is unpleasant if or when the contents of one's stomach end up in their esophagus.
Some foods might increase the extent to which the contents of one's stomach end up in their esophagus.
Some foods might increase the extent to which it is unpleasant if or when the contents of one's stomach end up in their esophagus.
How long does it take for you to realize if cutting something off your diet helps?
Since I feel like some foods can take days to affect my GERD it can be difficult to tell what helps and what doesn’t.
Since I feel like some foods can take days to affect my GERD it can be difficult to tell what helps and what doesn’t.
I've started changes in my diet with an "acid reflux detox" for a month, which meant eating a very limited group of foods that most definitiely shouldn't cause acid reflux and drinking pretty much only water, after that I've started slowly introducing stuff that potentially could cause acid reflux and observing how I feel, in my case I get acid reflux almost immediately after eating something that I shouldn't, so it's quite easy to eliminate.
One thing people can do is to never eat chocolate or take ibuprofen (and many drugs like it) before laying down. These things relax the sphincter at the bottom of your esophagus. If you pay attention, you'll often notice an immediate burp when you eat chocolate.
I restrict chocolate to nothing after 2pm (ish).
My gastroenterologist told me to treat my stomach like a hot cup of coffee. When it is full, be very careful to tip it over, otherwise you will get burned.
I restrict chocolate to nothing after 2pm (ish).
My gastroenterologist told me to treat my stomach like a hot cup of coffee. When it is full, be very careful to tip it over, otherwise you will get burned.
I've had reflux for 10+ years, and noticed that in the last 2 years, it hasn't really bothered me. I was attributing it to a dietary change (went from mostly vegetarian to vegan), but at the same time, I also started working out with a personal trainer. He loves to have us doing plenty of things with our feet above our head (push-ups with feet up on a bench, burpees, but kicking up on to a bench). My reflux bothered me during workouts at first, especially if we worked out in the afternoon instead of first thing in the morning. But, now I never have reflux issues working out, and rarely have them when sleeping...
Title isn't completely accurate, as the author states they were kneeling bent-over, creating an incline for the food to travel up. That being said, I've never thought of the esophagus was a muscle that could be trained. Very cool!
Edit: there's a 6" riser that the author describes kneeling on, while their head is then lowered closer to the floor, supported by their arm(s).
Edit: there's a 6" riser that the author describes kneeling on, while their head is then lowered closer to the floor, supported by their arm(s).
Maybe I should try this. I've been having trouble with this lately.
>The incline is established by kneeling with the head bowed lower than the stomach
Shouldn't it be upside down if the head is below the center of mass?
Shouldn't it be upside down if the head is below the center of mass?
I think this would be one way to describe upside down, but my feeling is I wasn't the only one picturing someone fully inverted with feet above head.
One likely cause that's not mentioned so far, is that paradoxically the stomach doesn't produce enough acid. The sphincter usually closes when the stomach begins digestion, but this only happens if a certain pH threshold is reached. There are some receptors in the stomach that detect this pH level and signal the sphincter to close. The lower acidity output is typically caused by unhealthy diet and frequent meals. To fix it, apart from reducing the frequency of meals, you can ingest more acid, in the form of vinegar or lemon juice. This is counterintuitive but I can confirm it works, it helped me a lot to mitigate the problem.
So the one-spoon-of-apple-cider-vinegar-everyday people might be onto something?
Clever & sensible.
One potential concern with this would be the possibility of 'upper airway obstruction(s)' (aka, choking). Not necessarily because this position is inherently problematic*, but because it would be a novel position to consume food** in (to presumably most people) and it's a position that most people are likely not used to in the present day, period (i.e., we usually sit up, lie flat, etc., we aren't typically in orientations like this for any real length of time, if at all).
Seems like a clever way to exercise an area that is not easy to exercise in any typical way, but I'd strongly advise caution and awareness of potential aspiration / choking issues if trying it out, at least in initial trials.
* In any anatomical way I can think of off the top of my head
** I would avoid trying to consume liquids in this position, at least initially - aspiration is far easier with thin liquids etc. The author seems to focus on food, in any case.
One potential concern with this would be the possibility of 'upper airway obstruction(s)' (aka, choking). Not necessarily because this position is inherently problematic*, but because it would be a novel position to consume food** in (to presumably most people) and it's a position that most people are likely not used to in the present day, period (i.e., we usually sit up, lie flat, etc., we aren't typically in orientations like this for any real length of time, if at all).
Seems like a clever way to exercise an area that is not easy to exercise in any typical way, but I'd strongly advise caution and awareness of potential aspiration / choking issues if trying it out, at least in initial trials.
* In any anatomical way I can think of off the top of my head
** I would avoid trying to consume liquids in this position, at least initially - aspiration is far easier with thin liquids etc. The author seems to focus on food, in any case.
Could drinking water in this position be a potentially safer alternative?
I'm sorry this comment doesn't add much to the discussion, but all I can think of is the South Park episode where Eric eats with his butt.
that was my immediate reaction, too
I cured my acid reflux by taking antibiotics to kill off an H. Pylori bacterial infection, which apparently affects 30%-40% of the US population.
It is a widespread infection across the world, but for most people there are no symptoms. It is not usually the cause for reflux symptoms.
When I started having these symptoms it was the first thing my doctor tested for though, since it's such an easy fix. Unfortunately for me that wasn't the issue.
I suspect the anti-acids they gave you along with the antibiotics helped heal the esophagus.
Yes but it is the cause of many gastric ulcers and is undertested for at least in my community. Where I can easily do the test in the ER, I diagnose and treat many people with previously-unexplained epigastric abdominal pain syndromes.
Has anybody here had false negative results on an H. Pylori test? My breath and stool tests came back negative, but I'm wondering if it makes sense to give it another look, since infection/overgrowth still seems like a reasonable guess for my current woes.
I have bloating and heartburn that has come on very rapidly after taking a mild antibiotic, and persisted for months after stopping. I'm 19 BMI, don't drink, and mostly cook veg-heavy meals at home. Almost no fast food and the like. Never had this problem in my life beforehand. It seems like there's a clear cause and effect at play, but nothing's showed up in the tests so far. Kind of stumped how to follow it up without sounding like a crazy person to the doc.
I have bloating and heartburn that has come on very rapidly after taking a mild antibiotic, and persisted for months after stopping. I'm 19 BMI, don't drink, and mostly cook veg-heavy meals at home. Almost no fast food and the like. Never had this problem in my life beforehand. It seems like there's a clear cause and effect at play, but nothing's showed up in the tests so far. Kind of stumped how to follow it up without sounding like a crazy person to the doc.
I've read a theory for acid reflux in older people that it's caused by not enough stomach acid.
One research I was listening to said that it doesn't make intuitive sense that we make less acid in our stomachs as we age and yet the occurrence of reflux increases in older populations, and yet we prescribe proton pump inhibitors to reduce acid production.
Therefore the suggestion was that the lack of acid caused food to digest slower and for fermentation to occur and aggravate whatever acid that is there, upwards.
One research I was listening to said that it doesn't make intuitive sense that we make less acid in our stomachs as we age and yet the occurrence of reflux increases in older populations, and yet we prescribe proton pump inhibitors to reduce acid production.
Therefore the suggestion was that the lack of acid caused food to digest slower and for fermentation to occur and aggravate whatever acid that is there, upwards.
The lower acidity also favors any H. pylori infection you might have (i.e. makes life easier for the pathogen). It was suggested to me that that's the main problem with antiacids and PPIs.
(IANAD. I had GERD for weeks after a surgery but avoided PPIs for this reason.)
(IANAD. I had GERD for weeks after a surgery but avoided PPIs for this reason.)
PPIs suck big time (going off omeprazole was hell), but I've had good experiences with famotidine, which is actually an antihistamine! So if the GERD menace ever comes back I recommend picking up some Pepcid.
Thanks -- that's good to know.
There are several studies showing that “inspiratory muscle training” can be effective for GERD. Basically you train by breathing in through small device that makes it harder to inhale, and that strengthens your esophageal sphincter.
I did this for some time and anecdotally I do believe it helped me. There are several studies showing it to be effective, but the big caveat is most if not all of these studies were small and were funded by PowerBreathe, the company that manufactures these devices.
I did this for some time and anecdotally I do believe it helped me. There are several studies showing it to be effective, but the big caveat is most if not all of these studies were small and were funded by PowerBreathe, the company that manufactures these devices.
In case this helps someone, GERD can be caused by a bacterial infection by H. Pylori. (According to the Wikipedia, the frequency of infection is at >50% but most people never experience any symptoms.) It was getting worse after eating a lot, eating certain foods , just like for many other commenters here. After getting rid of the infection the symptoms disappeared and never returned.
https://en.m.wikipedia.org/wiki/Helicobacter_pylori
The link to the diseases caused by the bacteria has a crazy discovery story I encourage everyone to read
https://www.nobelprize.org/prizes/medicine/2005/press-releas...
https://en.m.wikipedia.org/wiki/Helicobacter_pylori
The link to the diseases caused by the bacteria has a crazy discovery story I encourage everyone to read
https://www.nobelprize.org/prizes/medicine/2005/press-releas...
Is it normal to publish a personal anecdote in this manner? I've never seen something like this on pubmed.
Yes. It is normal and they're called medical case reports.
See:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686928/
> A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports usually describe an unusual or novel occurrence and as such, remain one of the cornerstones of medical progress and provide many new ideas in medicine.
See:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686928/
> A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports usually describe an unusual or novel occurrence and as such, remain one of the cornerstones of medical progress and provide many new ideas in medicine.
In hopes that this helps others. I have had terrible reflux for the last ~10 years. 10-15 tums a day every day for years. About 4 months ago I started taking a scoop of glutamine (the workout supplement / amino acid) powder in water at night before bed (not sure if the timing of when it's taken matters). 2 weeks later and my heartburn/reflux was essentially gone and has stayed gone. I take maybe 1 tums a week now. Many weeks it's 0.
Jumping off this topic.
I have GERD. It sucks. Reducing alcohol seemed to help a bit. A daily pantoprazole pill for it really seems to work, but has side effects.
What should I try? What has worked for you?
I have GERD. It sucks. Reducing alcohol seemed to help a bit. A daily pantoprazole pill for it really seems to work, but has side effects.
What should I try? What has worked for you?
I've been on and off Omeprazole, which helps immensely but makes me paranoid about long term effects (like a decade+ - I'm in my 30's).
One thing that has helped a ton is Gaviscon Advance imported from the EU, which contains Sodium Alginate. This was recommended to me by a GI specialist at MGH; the sodium alginate floats to the top of the stomach and forms a sort of physical barrier for a few hours to prevent acid from coming up (alongside other antacids like you'd find in tums). For reasons I don't understand almost nothing is marketed in the US containing it.
The tablets like these (https://www.amazon.com/gp/product/B08GCN88WX/) are honestly pretty palatable - I chew them a couple times and then wash down with water, and it avoids some of the gumminess reviewers describe.
There's also a liquid that I think might find a bit more effective, but less palatable and convenient on-the-go (https://www.amazon.com/Gaviscon-Advance-Aniseed-500/dp/B01N4...).
One thing that has helped a ton is Gaviscon Advance imported from the EU, which contains Sodium Alginate. This was recommended to me by a GI specialist at MGH; the sodium alginate floats to the top of the stomach and forms a sort of physical barrier for a few hours to prevent acid from coming up (alongside other antacids like you'd find in tums). For reasons I don't understand almost nothing is marketed in the US containing it.
The tablets like these (https://www.amazon.com/gp/product/B08GCN88WX/) are honestly pretty palatable - I chew them a couple times and then wash down with water, and it avoids some of the gumminess reviewers describe.
There's also a liquid that I think might find a bit more effective, but less palatable and convenient on-the-go (https://www.amazon.com/Gaviscon-Advance-Aniseed-500/dp/B01N4...).
I'll second the sodium alginate.
It forms a raft which physically stops the acid from rushing up.
I use life extensions esophageal guardian, which are chewable tablets. (Don't confuse it with esophacool, which is just an anti-acid)
It forms a raft which physically stops the acid from rushing up.
I use life extensions esophageal guardian, which are chewable tablets. (Don't confuse it with esophacool, which is just an anti-acid)
In the US I was recommended this: https://refluxgourmet.com/ and have to say it worked reasonably well for me.
I had unbearably bad heartburn for years, especially at night, which made it difficult to sleep.
I started avoiding trigger foods like dark chocolate and started front-loading my meals earlier in the day. Still drink lots of coffee.
I now have my final meal about 4.5+ hours before bed, and it's usually small.
My new routine became habit and all symptoms and suffering completely disappeared. And it's not like my body changed, because if I do eat too late, I get bad heartburn like I always have.
Also worth mentioning that I have a very slim build and have a diet high in fiber with minimal processed foods which probably helps too.
I started avoiding trigger foods like dark chocolate and started front-loading my meals earlier in the day. Still drink lots of coffee.
I now have my final meal about 4.5+ hours before bed, and it's usually small.
My new routine became habit and all symptoms and suffering completely disappeared. And it's not like my body changed, because if I do eat too late, I get bad heartburn like I always have.
Also worth mentioning that I have a very slim build and have a diet high in fiber with minimal processed foods which probably helps too.
Losing weight has significantly reduced my symptoms (my symptoms are pretty unambiguously down to a hiatal hernia). If you haven't, you may also want to get tested for H. Pylori.
Depending on what kind of pill you take you might want to try an alternative. E.g. ranitidine vs omeprazole or other proton-pump inhibitor.
But I presume you've seen a doctor? Because there are some really serious issues that can also trigger it and suppressing the symptoms can mask issues like stomach cancers so you don't want to self-medicate without at least checking with a doctor first.
Depending on what kind of pill you take you might want to try an alternative. E.g. ranitidine vs omeprazole or other proton-pump inhibitor.
But I presume you've seen a doctor? Because there are some really serious issues that can also trigger it and suppressing the symptoms can mask issues like stomach cancers so you don't want to self-medicate without at least checking with a doctor first.
Yep, like someone else mentioned, mine wasn't classic symptoms but throat and sinus issues. He prescribed pantoprazole but said I could stop taking it after a while. I've found that not to be the case.
He also said it was odd to have it at my age and weight but I've since found others in my family have it as well, so maybe genetic?
He also said it was odd to have it at my age and weight but I've since found others in my family have it as well, so maybe genetic?
If you experience dramatically worse symptoms at night when attempting to sleep and therefore laying down flat, first: sleep on your left side. Due to the physics/geometry of the esophagus, sleeping with your left side facing down is the most helpful in terms of preventing acid from being able to work its way up the esophagus. Don't quite get why, but it just works.
Second, investing in a full length bed wedge that goes either under your mattress (and extends the entire length of the mattress from head to foot) or the same but as a memory foam topper, it really does alleviate the night time unable to sleep problem. I used one made by Avana comfort with a ton of success. The partial bed wedges or pillow bed wedges are too uncomfortable for me personally but the ones that go from head to foot at a gradual gentle incline are fine.
Figuring out dietary triggers is also a huge factor for many.
For me, I discovered if I eat any tomato at all, even tiny pieces - I will have acid reflux symptoms for like at least 12 hours. So I just don't it anymore except at a rate 11am lunch and even then I still often suffer.
For me, cutting out coffee is the other biggest solution, but I'm an addict and can't stop permanently, but I've found that cold brew (NOT hot brew over ice - aka many 'iced coffee' methods) - with specifically those labeled Dark Roast - to be the least aggravating (because both the cold brew extraction method and the darker roasts have a lower amount of acidity) and adding milk to make it less harsh as well, for me I do a 1:1 ratio between cold brew and almond milk, and finally only drinking it first thing in the morning as soon as possible after a breakfast, is fine.
I don't need the bed elevator/wedge if I follow my proper dietary alterations (barring certain late night alcohol situations).
Second, investing in a full length bed wedge that goes either under your mattress (and extends the entire length of the mattress from head to foot) or the same but as a memory foam topper, it really does alleviate the night time unable to sleep problem. I used one made by Avana comfort with a ton of success. The partial bed wedges or pillow bed wedges are too uncomfortable for me personally but the ones that go from head to foot at a gradual gentle incline are fine.
Figuring out dietary triggers is also a huge factor for many.
For me, I discovered if I eat any tomato at all, even tiny pieces - I will have acid reflux symptoms for like at least 12 hours. So I just don't it anymore except at a rate 11am lunch and even then I still often suffer.
For me, cutting out coffee is the other biggest solution, but I'm an addict and can't stop permanently, but I've found that cold brew (NOT hot brew over ice - aka many 'iced coffee' methods) - with specifically those labeled Dark Roast - to be the least aggravating (because both the cold brew extraction method and the darker roasts have a lower amount of acidity) and adding milk to make it less harsh as well, for me I do a 1:1 ratio between cold brew and almond milk, and finally only drinking it first thing in the morning as soon as possible after a breakfast, is fine.
I don't need the bed elevator/wedge if I follow my proper dietary alterations (barring certain late night alcohol situations).
Sleeping on my left side is what really helped me.
The esophagus approaches the stomach from the right side, then hooks in to meet it. When you sleep on your right side, and the sphincter muscle is weak, the fluid just goes down like a drain. When you sleep on your left side, even if the muscle is weak, the fluid would need to go up, or the stomach be entirely full, to get into the esophagus.
Pictures to aid understanding: https://www.google.com/search?q=esophagus+stomach&tbm=isch
The esophagus approaches the stomach from the right side, then hooks in to meet it. When you sleep on your right side, and the sphincter muscle is weak, the fluid just goes down like a drain. When you sleep on your left side, even if the muscle is weak, the fluid would need to go up, or the stomach be entirely full, to get into the esophagus.
Pictures to aid understanding: https://www.google.com/search?q=esophagus+stomach&tbm=isch
I shared my experience above (https://news.ycombinator.com/item?id=36060204).
This improvement for me has been really recent. Maybe it helps you too. Good luck!
This improvement for me has been really recent. Maybe it helps you too. Good luck!
Do you drink coffee or some other caffeinated beverage? For me, caffeine is THE trigger for reflux. Secondary trigger is portion size. If I don't drink caffeine and I keep my meals relatively small I'm generally fine.
That could be it. My mom had reflux and had to stop coffee. I'm pretty hooked though. I guess I should try stopping.
My experience fwiw:
A wedge pillow helped a little. Keeping some alkaline water at my bedside to sip helped more. These were to ameliorate the symptoms to give my body a chance to heal on its own (over a few weeks). I didn't want to take omeprazole, and without these ameliorations I might've been driven to that. I followed a carnivore diet.
A wedge pillow helped a little. Keeping some alkaline water at my bedside to sip helped more. These were to ameliorate the symptoms to give my body a chance to heal on its own (over a few weeks). I didn't want to take omeprazole, and without these ameliorations I might've been driven to that. I followed a carnivore diet.
I did a month's course of Omeprazole in the morning and Pepcid before going to bed. It got much better, and now I rarely have to take something. Before that, I was taking sodium bicarbonate every day, which is apparently bad for you and can worsen the symptoms over time.
Speak to a specialist about the Stretta procedure. Application of RF energy to the lower esophageal sphincter in a short outpatient procedure. More effective than PPIs, but less so than fundoplication, which is much more invasive and permanent.
Exercise/weight loss or a diet change seem to be common fixes.
Laying off of greasy foods has helped immensely for me. Reducing alcohol (as you mentioned) has also been a minor improvement, though definitely not as much as what I mentioned prior.
Laying off of greasy foods has helped immensely for me. Reducing alcohol (as you mentioned) has also been a minor improvement, though definitely not as much as what I mentioned prior.
How did you jump off the topic? You asked a question that the exercise described above is designed to solve. There is no other known solution if you have a failing LES.
I got rid of my reflux by entirely cutting alcohol. It took me a while to figure it out because merely reducing consumption was not enough.
I need images to understand how this person was eating.
It should look a lot like the Muslim prayer position (sujud):
https://i.imgur.com/Ih1Nfzh.png
Food goes on a slightly elevated tray off the floor for hygene purposes. Put your face relatively close to the food as you consume, to maintain the premise. Prop your body weight up with hands and elbows (in a way that makes sense for your body/strength). Some things would be fairly easy to eat this way, others would be quite difficult.
You could increase the angle by adding a platform or step to it, where your knees/body area is elevated and there is a drop-off where the face/food area is located (in this case you'd want to have enhanced traction I imagine, grippy shoes and or rubber mats).
https://i.imgur.com/Ih1Nfzh.png
Food goes on a slightly elevated tray off the floor for hygene purposes. Put your face relatively close to the food as you consume, to maintain the premise. Prop your body weight up with hands and elbows (in a way that makes sense for your body/strength). Some things would be fairly easy to eat this way, others would be quite difficult.
You could increase the angle by adding a platform or step to it, where your knees/body area is elevated and there is a drop-off where the face/food area is located (in this case you'd want to have enhanced traction I imagine, grippy shoes and or rubber mats).
No need to put the food near the floor. Take a bite, assume the position (while chewing) and then swallow.
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I think it is impressive he figured this out as a layman. This article is from one year ago, it would be interesting to see a response from some researchers. For example, have there been any studies to see if this method is valid?
Hmm seems he is a retired researcher, although it doesn't mention his background. The problem is it's quite a step up from anecdotal evidence from one guy, to doing any kind of trial involving volunteers, and it would need momentum and money behind it.
It does seem there is some evidence already on breath re-training / diaphragm strengthening: https://www.europeanreview.org/wp/wp-content/uploads/4547-45...
It does seem there is some evidence already on breath re-training / diaphragm strengthening: https://www.europeanreview.org/wp/wp-content/uploads/4547-45...
Personally I found that the following caused reflux: fiber consumption, drinking tap-water that hasn't been boiled, consuming lentils, consuming too much red meat - e.g. 2 x large steaks a day. FYI.
That's funny, that diet literally reduces my gerd
I wonder if drinking water in that position would work as well as food?
What cured my GERD is, I only drink one hour before and one hour after the meal. I don't lie down or put myself in incline position. Fruits and vegetables.
Saw a similar study - dry swallowing but head still below stomach.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550520/ Will be trying both exercises myself.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550520/ Will be trying both exercises myself.
After reading this paper and the comments on HN, further googling (actually braving) led me to buy this book:
Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD by Jonathan Wright
https://www.amazon.com/Why-Stomach-Acid-Good-You-ebook/dp/B0...
Recommended
Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD by Jonathan Wright
https://www.amazon.com/Why-Stomach-Acid-Good-You-ebook/dp/B0...
Recommended
Isn't a full solution, but changing from belt to suspenders helps an unreasonable amount for me. If folks want other things to try.
> It also remains to be seen if any contraindications exist for the LES exercise.
Exacerbating the condition one is trying to alleviate comes to mind.
Exacerbating the condition one is trying to alleviate comes to mind.
This is brilliant, but do we have to eat in this pose? I'd rather just do a stretch X times a day and try this out.
I had severe GERD for years. On an off PPI's for almost 5 years, several endoscopies, pain 24h per day.
It was so the bad I almost went for surgery.
Then I tried the low fodmap diet and it went away.
Now I only have to avoid alcohol, onions, garlic and sweet fruits to keep it at bay.
A few friends who started reporting GERD all the time at the start of the pandemic, didn't make the connection between working and eating in bed or the sofa at times, and the gradual worsening, compounded with the usual inflammatory foods and sleeping on the wrong side or without any inclination, the body's buffer depletes so to speak and those issues appear more frequently.
I learned the same a few years ago. I have voluntary control of the lower sphincter and clamp down on it when I feel my stomach contents rising or am getting heart burn. Now that I use it more I can mostly control my heartburn.
Luckily mine just goes away with some milk. I also seem to get it a lot less now since I cut back on sodium and generally eating healthier overall. I shall add this GERD yoga gymnastics to my regimen.
a few routines to help w/ barret's esopahgus and gerd:
https://routineshub.com/public/popular/tags/Barrett's%20Esop...
https://routineshub.com/public/popular/tags/Gastroesophageal...
https://routineshub.com/public/popular/tags/Barrett's%20Esop...
https://routineshub.com/public/popular/tags/Gastroesophageal...
This is awesome. I’m gonna try this.
Is there some way to train other sphincters?
Is there some way to train other sphincters?
[deleted]
Amalaki (Sanskrit) / amla (Hindi) / nellikai (Tamil) / Indian gooseberry is said to be good for acidity in Ayurveda. The fruit part of the plant, phyllanthus emblica, IIRC. Very widely used in India in different forms for many ailments. There is amla eaten raw, amla juice, amla murabba (a sort of sweet dried or wet candy), amla in honey (just had it today), in triphala, etc. Rich in Vitamin C and has many benefits.
I use it.
Triphala, another Ayurvedic remedy, is said to be a general-purpose cleanser / gut detoxifier/ digestive tonic. Very commonly prescribed by Ayurvedic doctors.
I use it.
Triphala, another Ayurvedic remedy, is said to be a general-purpose cleanser / gut detoxifier/ digestive tonic. Very commonly prescribed by Ayurvedic doctors.
I've had a lot of luck with sodium alginate... An acquaintance mentioned doing diaphragm / breathing exercises helped him.
Sodium alginate didn't help me at all (same as OP- weak LES muscles).
I've been taking Nexium for 15 years and recently tried stopping, while replacing with sodium alginate. Sure I'd expect a few weeks of withdrawals, but even after over a month the reflux was still absurd. I was popping sodium alginate and calcium carbonate (TUMS) throughout the day.
No, I had to go back to Nexium. All reflux symptoms stopped the following day.
I do suspect it's long-term Nexium that's causing 5 years of foot whip in my gait, but I have no way to prove it (MRIs are normal, neurologists don't think it's Parkinsons/MS/ALS). While I was off Nexium that month the foot whip seemed to almost disappear. Now it's back full strength.
Magnesium on my bloodwork seems on the low edge of normal range. I'm gonna redo my B-12 serum levels next week and check if it's low.
Can long-term PPIs cause foot whip on every walk (after 1000 steps or so)? I haven't seen any literature on this.
But it's clear to me I can't easily get off long term PPIs.
I've been taking Nexium for 15 years and recently tried stopping, while replacing with sodium alginate. Sure I'd expect a few weeks of withdrawals, but even after over a month the reflux was still absurd. I was popping sodium alginate and calcium carbonate (TUMS) throughout the day.
No, I had to go back to Nexium. All reflux symptoms stopped the following day.
I do suspect it's long-term Nexium that's causing 5 years of foot whip in my gait, but I have no way to prove it (MRIs are normal, neurologists don't think it's Parkinsons/MS/ALS). While I was off Nexium that month the foot whip seemed to almost disappear. Now it's back full strength.
Magnesium on my bloodwork seems on the low edge of normal range. I'm gonna redo my B-12 serum levels next week and check if it's low.
Can long-term PPIs cause foot whip on every walk (after 1000 steps or so)? I haven't seen any literature on this.
But it's clear to me I can't easily get off long term PPIs.
> While I was off Nexium that month the foot whip seemed to almost disappear.
Your gait problem kind of sounds like a weak form of some https://en.wikipedia.org/wiki/Metabolic_bone_disease — i.e. bone wasting due to lack of vitamin D (or its transports, like magnesium) — leading to bones becoming softer and even slightly bendy [gradually, under load]. Think "rickets", though there are many metabolic bone diseases (really: bone formation syndromes) that can arise from the same metabolic causal factors.
(Something extremely well-documented on the Internet that you can look at, is metabolic bone disease in reptiles — commonly observed by pet owners due to inadequate terrarium setup: when these animals don't get enough UV light to produce Vitamin D, their leg bones soften so much [or stay so soft during development] that they buckle under their weight; their legs can end up literally curled due to this.)
My speculation is that that PPIs can negatively impact bone formation — possibly by suppressing vitamin D uptake into bone cells. (So your bloodwork wouldn't say your vitamin D levels are bad; in fact, your blood vitD levels would be high if anything.) The power of this effect would be magnified by having already-low magnesium levels.
And Wikipedia says that some doctors share this speculation:
> High dose or long-term use of PPIs carries an increased risk of bone fractures which was not found with short-term, low dose use; the FDA included a warning regarding this on PPI drug labels in 2010. [...] A study from 2019 showed that PPI use alone and together with histamine H2-receptor antagonists was associated with an increased bone fracture hazard, which was amplified by days of use and earlier initiation of therapy. The reason is not clear, increased bone break down by osteoclasts has been suggested.
Your gait problem kind of sounds like a weak form of some https://en.wikipedia.org/wiki/Metabolic_bone_disease — i.e. bone wasting due to lack of vitamin D (or its transports, like magnesium) — leading to bones becoming softer and even slightly bendy [gradually, under load]. Think "rickets", though there are many metabolic bone diseases (really: bone formation syndromes) that can arise from the same metabolic causal factors.
(Something extremely well-documented on the Internet that you can look at, is metabolic bone disease in reptiles — commonly observed by pet owners due to inadequate terrarium setup: when these animals don't get enough UV light to produce Vitamin D, their leg bones soften so much [or stay so soft during development] that they buckle under their weight; their legs can end up literally curled due to this.)
My speculation is that that PPIs can negatively impact bone formation — possibly by suppressing vitamin D uptake into bone cells. (So your bloodwork wouldn't say your vitamin D levels are bad; in fact, your blood vitD levels would be high if anything.) The power of this effect would be magnified by having already-low magnesium levels.
And Wikipedia says that some doctors share this speculation:
> High dose or long-term use of PPIs carries an increased risk of bone fractures which was not found with short-term, low dose use; the FDA included a warning regarding this on PPI drug labels in 2010. [...] A study from 2019 showed that PPI use alone and together with histamine H2-receptor antagonists was associated with an increased bone fracture hazard, which was amplified by days of use and earlier initiation of therapy. The reason is not clear, increased bone break down by osteoclasts has been suggested.
Rebound on PPI’s is ridiculously bad. I made a video on how I weaned myself off of them
https://youtu.be/jMUKsFgKfXg
https://youtu.be/jMUKsFgKfXg
1 tbsp of apple cider vinegar in a glass of water during meals works for me
> sodium alginate
Now you've got me wondering whether the problems of "cattle producing too much methane" (which sodium alginate is a treatment for), and "humans producing too much stomach acid" have some strong link. Maybe every feed supplement that the agro industry has invented to lower methane emissions in cattle, is actually also a treatment for GERD?
Now you've got me wondering whether the problems of "cattle producing too much methane" (which sodium alginate is a treatment for), and "humans producing too much stomach acid" have some strong link. Maybe every feed supplement that the agro industry has invented to lower methane emissions in cattle, is actually also a treatment for GERD?
To extrapolate this technique to its logical extreme, does this mean pooping upside down strengthens your rectal sphincter?
This could drastically change my health.
I just have to explain my children that daddy has to eat upside down now.
As someone who has gerd it’s worth a shot. Little bummed to see there was nothing about controlling for at least diet.
Does anyone here get a low level nausea from their GERD but almost not other symptoms?
I wonder how big the risk of choking with this exercise is. Be careful!
only a matter of time before this joins in a hegelian synthesis with the soylent crowds' ideas and we're all stuck eating bugs off the floor with paper forks
Accompanying diagram or a video would be so helpful.
Need more ppl to try it out (safely) and report back here
I've been doing it for the last four days and eating as I otherwise would. I think it's helping. My tongue is noticeably less inflamed. I'm still getting acid in my mouth when I lay down to sleep, though. I recommend trying it with small mouthfuls of food until you're confident you won't choke.
That's pretty cool.
i need something similar for my eustacian tube dysfunction.
Try to shut your nostrils with your hand and blow your nose as if you want to remove mucus on a tissue. Another thing to do is to do tongue exercises, keep your tongue on the roof of your mouth and stuff like that...
AKA the Valsalva maneuver: https://en.wikipedia.org/wiki/Valsalva_maneuver
I've used it to gently raise the pressure of my inner ear. (My eustacheans often clog up due to allergies.) But make sure you know what you're doing. It can drive mucus _into_ your inner ear.
I've used it to gently raise the pressure of my inner ear. (My eustacheans often clog up due to allergies.) But make sure you know what you're doing. It can drive mucus _into_ your inner ear.
Oh yes, I forgot to mention to clear the mucus first before doing that. I didn't know it was called the Valsalva maneuver, thanks.
The reason I want to fix it is because I dive, so
so basically eat upside down?
I fixed it by drinking concentrated lemon juice (one lemon in one coup) thirty minutes before every food. There were not enough stomach juices for proper digestion, and stomach tries to push undigested food out after while. Lemon juice triggers stomache juice excretion and helps to start it. It has to be concerned, mild will just dilute juices.
I am prescribed hydrochloric acid supplements for the same reason. They've eliminated reflux for me and have helped my digestion.
when you have a high fiber diet, this is never an issue, it's like a sponge in your digestive system retaining water and stuff
I always eat whole wheat bread, plenty of vegetables and other fibery stuff, but I still have acid reflux.
> bread
that's probably not the fresh and rich fiber our guts really want, you didn't describe the other fibery stuff, but processed food, meat, cooked things are not ideal, now currently I'm eating a few large onions (raw & slighly fermented), 10 red long peppers (raw & same with a start of fermentation, tastes better and better for digestion), tomatoes too (same, they're not like the "plastic" tomatoes without taste you see in supermarket, it's italian ones, deep color and taste), many dates (else I'd eat lentil or quinoa or rice)
maybe my digestive system is working well with that, probably since I eat like a monkey (sometimes I can eat fish or eggs, or fish'eggs recently too)
that's probably not the fresh and rich fiber our guts really want, you didn't describe the other fibery stuff, but processed food, meat, cooked things are not ideal, now currently I'm eating a few large onions (raw & slighly fermented), 10 red long peppers (raw & same with a start of fermentation, tastes better and better for digestion), tomatoes too (same, they're not like the "plastic" tomatoes without taste you see in supermarket, it's italian ones, deep color and taste), many dates (else I'd eat lentil or quinoa or rice)
maybe my digestive system is working well with that, probably since I eat like a monkey (sometimes I can eat fish or eggs, or fish'eggs recently too)
> The resistance was provided by positioning my head below my stomach in a kneeling posture. This required food being swallowed to be pushed up an incline. I began eating part of each breakfast (oatmeal) and sometimes lunch (a sandwich) in the exercise position. I would kneel on a platform (which happened to be 6 ½” high), take a normal mouthful, chew it as needed, and prepare to swallow. I would then lay my forearms and the backs of my hands on the floor, rest my head on my hands, and complete the swallowing process. With a little practice, I was soon able to initiate and complete the swallowing process with my head resting on my hands on the floor. I did not attempt to determine what the optimal height of the platform might be or if, indeed, any was necessary.