Get rid of heartburn and GERD forever in three simple steps

heartburncure

Note: this is the sixth and final article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II, Part III, and Part IVa, and Part IVb before reading this article.

In this final article of the series, we’re going to discuss three steps to treating heartburn and GERD without drugs. These same three steps will also prevent these conditions from developing in the first place, and keep them from returning once they’re gone.

To review, heartburn and GERD are not caused by too much stomach acid. They are caused by too little stomach acid and bacterial overgrowth in the stomach and intestines. Therefore successful treatment is based on restoring adequate stomach acid production and eliminating bacterial overgrowth.

This can be accomplished by following the “three Rs” of treating heartburn and GERD naturally:

  1. Reduce factors that promote bacterial overgrowth and low stomach acid.
  2. Replace stomach acid, enzymes and nutrients that aid digestion and are necessary for health.
  3. Restore beneficial bacteria and a healthy mucosal lining in the gut.
  • Reduce factors that promote bacterial overgrowth and low stomach acid

Carbohydrates

As we saw in Part II and Part III, a high carbohydrate diet promotes bacterial overgrowth. Bacterial overgrowth – in particular H. pylori – can suppress stomach acid. This creates a vicious cycle where bacterial overgrowth and low stomach acid reinforce each other in a continuous decline of digestive function.

It follows, then, that a low-carb (LC) diet would reduce bacterial overgrowth. To my knowledge there have only been two small studies done to test this hypothesis. The results in both studies were overwhelmingly positive.

The first study was performed by Professor Yancy and colleagues at Duke University. They enrolled five patients with severe GERD that also had a variety of other medical problems, such as diabetes. Each of these patients had failed several conventional GERD treatments before being enrolled in the study. In spite of the fact that some of these patients continued to drink, smoke and engage in other GERD-unfriendly habits, in every case the symptoms of GERD were completely eliminated within one week of adopting a very low carbohydrate (VLC) diet.

The second study (PDF) was performed by Yancy and colleagues a few years later. This time they examined the effects of a VLC diet on eight obese subjects with severe GERD. They measured the esophageal pH of the subjects at baseline before the study began using something called the Johnson-DeMeester score. This is a measurement of how much acid is getting back up into the esophagus, and thus an objective marker of how much reflux is occurring. They also used a self-administered questionnaire called the GSAS-ds to evaluate the frequency and severity of 15 GERD-related symptoms within the previous week.

At the beginning of the diet, five of eight subjects had abnormal Johnson-DeMeester scores. All five of these patients showed a substantial decrease in their Johnson-DeMeester score (meaning less acid in the esophagus). Most remarkably, the magnitude of the decrease in Johnson-DeMeester scores is similar to what is reported with PPI treatment. In other words, in these five subjects a very low carbohydrate diet was just as effective as powerful acid suppressing drugs in keeping acid out of the esophagus.

All eight individuals had evident improvement in their GSAS-ds scores. The GSAS-ds scores decreased from 1.28 prior to the diet to 0.72 after initiation of the diet. What these numbers mean is that the patients all reported significant improvement in their GERD related symptoms. Therefore, there was both objective (Johnson-DeMeester) and subjective (GSAS-ds) improvement in this study.

It’s important to note that obesity is an independent risk factor for GERD, because it increases intra-abdominal pressure and causes dysfunction of the lower esophageal sphincter (LES). The advantage to a low-carb diet as a treatment for GERD for those who are overweight is that LC diets are also very effective for promoting weight loss.

I don’t recommend VLC diets for extended periods of time, as they are unnecessary for most people. Once you have recovered your digestive function, a diet low to moderate in carbohydrates should be adequate to prevent a recurrence of symptoms.

An alternative to a VLC is something called a “specific carbohydrate diet” (SCD), or the GAPS diet. In these two approaches it is not the amount of carbohydrates that is important, but the type of carbohydrates. The theory is that the longer chain carbohydrates (disaccharides and polysacharides) are the ones that feed bad bacteria in our guts, while short chain carbohydrates (monosacharides) don’t pose a problem. In practice what this means is that all grains, legumes and starchy vegetables should be eliminated, but fruits and certain non-starchy root vegetables (winter squash, rutabaga, turnips, celery root) can be eaten. These are not “low-carb” diets, per se, but there is reason to believe that they may be just as effective in treating heartburn and GERD. See the resources section below for books and websites about these diets, which have been used with dramatic success to treat everything from autism spectrum disorder (ASD) to Crohn’s disease.

Another alternative to VLC that I increasingly use in my clinic is the Low FODMAP diet. FODMAPs are certain types of carbohydrates that are poorly absorbed by some people, particularly those with an overgrowth of bacteria in the small intestine (which, as you now know, tends to go hand-in-hand with heartburn). See this article and my book for more information.

Be careful to avoid the processed low-carb foods sold in supermarkets. Instead, I suggest what is known as a “paleolithic” or “primal” approach to nutrition.

Fructose and artificial sweeteners

As I pointed out in Part II, fructose and artificial sweeteners have been shown to increase bacterial overgrowth. Artificial sweeteners should be completely eliminated, and fructose (in processed form especially) should be reduced.

Fiber

High fiber diets and bacterial overgrowth are a particularly dangerous mix. Remember, Almost all of the fiber and approximately 15-20% of the starch we consume escape absorption. Carbohydrates that escape digestion become food for intestinal bacteria.

Prebiotics, which can be helpful in re-establishing a healthy bacterial balance in some patients, should probably be avoided in patients with heartburn and GERD. Several studies show that fructo-oligosaccharides (prebiotics) increase the amount of gas produced in the gut.

The other problem with fiber is that it can bind with nutrients and remove them from the body before they have a chance to be absorbed. This is particularly problematic in GERD sufferers, who may already be deficient in key nutrients due to long term hypochlorydria (low stomach acid).

H. pylori

In Part III we looked at the possible relationship between H. pylori and GERD. While I think it’s a contributing factor in some cases, the question of whether and how to treat it is less clear. There is some evidence that H. pylori is a normal resident on the human digestive tract, and even plays some protective and health-promoting roles. If this is true, complete eradication of H. pylori may not be desirable. Instead, a LC or specific carbohydrate diet is probably a better choice as it will simply reduce the bacterial load and bring the gut flora back into a state of relative balance.

The exception to this may be in serious or long-standing cases of GERD that aren’t responding to a VLC or LC diet. In this situation, it may be worthwhile to get tested for H. pylori and treat it more aggressively.

Dr. Wright, author of Why Stomach Acid is Good For You, suggests using mastic (a resin from a Mediterranean and Middle Eastern variety of pistachio tree) to treat H. pylori. A 1998 in vitro study in the New England Journal of Medicine showed that mastic killed several strains of H. pylori, including some that were resistant to conventional antibiotics. Studies since then, including in vivo experiments, have shown mixed results. Mastic may be a good first-line therapy for H. pylori, with antibiotics as a second choice if the mastic treatment isn’t successful.

  • Replace stomach acid, enzymes and nutrients that aid digestion and are necessary for health

HCL with Pepsin

If you have an open-minded doctor, or one that is aware of the connection between low stomach acid and GERD, ask her to test your stomach acid levels. The test is quite simple. A device called a Heidelberg capsule, which consists of a tiny pH sensor and radio transmitter compressed into something resembling a vitamin capsule, is lowered into the stomach. When swallowed, the sensors in the capsule measure the pH of the stomach contents and relay the findings via radio signal to a receiver located outside the body.

In cases of mild to moderate heartburn, actual testing for stomach acid production at Dr. Wright’s Tahoma clinic shows that hypochlorydria occurs in over 90 percent of thousands tested since 1976. In these cases, replacing stomach acid with HCL supplements is almost always successful.

Although testing actual stomach acid levels is preferable, it is not strictly necessary. There is a reasonably reliable, “low-tech” method that can be performed at home to determine whether HCL supplementation will provide a benefit. To do this test, pick up some HCL capsules that contain pepsin or acid-stable protease. HCL should always be taken with pepsin or acid-stable protease because it is likely that if the stomach is not producing enough HCL, it is also not producing enough protein digesting enzymes.

Note: HCL should never be taken (and this test should not be performed) by anyone who is also using any kind of anti-inflammatory medication such as corticosteroids (e.g. predisone), aspirin, Indocin, ibuprofen (e.g. Motrin, Advil, etc.) or other NSAIDS. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer.

To minimize side effects, start with one 650 mg capsule of HCL w/pepsin in the early part of each meal. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation. At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage.

In Dr. Wright’s clinic, most patients end up at a dose of 5-7 650 mg capsules. In my experience, this dose is too high for many people. In fact, some have trouble with even a single 650 mg capsule. I’ve also found that the addition of cholagogues (agents which promote bile flow from the gall bladder into the small intestine) and pancreatic enzymes can help tremendously, especially in the initial stages.

For these reasons, I created by own combination of HCL and enzymes called the AdaptaGest Duo. AdaptaGest Core contains acid-stable protease (to support protein digestion and complement HCL), cholagogues, and enzymes. AdaptaGest Flex contains HCL, but in a lower dose (200 mg per capsule) than is typical for standalone HCL products. This allows better fine-tuning of your HCL dosage. In my clinic, I prescribe AdaptaGest Duo for anyone struggling with heartburn and other digestive issues related to low stomach acid production. If you’d like to try it, you can order it here.

Bitters

Another way to stimulate acid production in the stomach is by taking bitter herbs. “Bitters” have been used in traditional cultures for thousands of years to stimulate and improve digestion. More recently, studies have confirmed the ability of bitters to increase the flow of digestive juices, including HCL, bile, pepsin, gastrin and pancreatic enzymes. 1

Unsurprisingly, there aren’t many clinical studies evaluating the therapeutic potential of unpatentable and therefore unprofitable bitters. However, in one uncontrolled study in Germany, where a high percentage of doctors prescribe herbal medicine, gentian root capsules provided dramatic relief of GI symptoms in 205 patients.

The following is a list of bitter herbs commonly used in Western and Chinese herbology:

  • Barberry bark
  • Caraway
  • Dandelion
  • Fennel
  • Gentian root
  • Ginger
  • Globe artichoke
  • Goldenseal root
  • Hops
  • Milk thistle
  • Peppermint
  • Wormwood
  • Yellow dock

Bitters are normally taken in very small doses – just enough to evoke a strong taste of bitterness. Kerry Bone, a respected Western herbalist, suggests 5 to 10 drops of a 1:5 tincture of the above herbs taken in 20 mL of water.

An even better option is to see a licensed herbalist who can prescribe a formula containing several of the herbs above as appropriate for your particular condition.

Apple cider vinegar, lemon juice, raw (unpasteurized) sauerkraut and pickles are other time-tested, traditional remedies that often relieve the symptoms of heartburn and GERD. However, although these remedies may resolve symptoms, they do not increase nutrient absorption and assimilation to the extent that HCL supplements do. This may be important for those who have been taking acid suppressing drugs for a long period.

It is also important to avoid consuming liquid during meals. Water is especially problematic, because it literally dilutes the concentration of stomach acid. A few sips of wine is probably fine, and may even be helpful.

Finally, for those who have been taking acid stopping drugs for several years, it may be necessary to replace the nutrients that are not absorbed without sufficient stomach acid. These include B12, folic acid, calcium, iron and zinc. It’s best to get your levels tested by a qualified medical practitioner, who can then help you replace them through nutritional changes and/or supplementation.

  • Restore beneficial bacteria and a healthy mucosal lining in the gut

Probiotics

Because bacterial overgrowth is a major factor in heartburn and GERD, restoring a healthy balance of intestinal bacteria is an important aspect of treatment. Along with performing several other functions essential to digestive health, beneficial bacteria (probiotics) protect against potential pathogens through “competitive inhibition” (i.e. competing for resources).

Researchers in Australia have shown that probiotics are effective in reducing bacterial overgrowth and altering fermentation patterns in the small bowel in patients with IBS. Probiotics have also been shown to be effective in treating Crohn’s disease, ulcerative colitis, and other digestive conditions.

Probiotics have also been shown to significantly increase cure rates of treatment for H. pylori. In my practice I always include a probiotic along with the anti-microbial treatment I do for H. pylori.

I am often asked what type of probiotics I recommend. First, whenever possible I think we should always attempt to get the nutrients we need from food. This is also true for probiotics. Fermented foods have been consumed for their probiotic effects for thousands of years. What’s more, contrary to popular belief and the marketing of commercial probiotic manufacturers, foods like yogurt and kefir generally have a much higher concentration of beneficial microorganisms than probiotic supplements do.

For example, even the most potent commercial probiotics claim to contain somewhere between one and five billion microorganisms per serving. (I say “claim” to contain because independent verification studies have shown that most commercial probiotics do not contain the amount of microorganisms they claim to.) Contrast that with a glass of homemade kefir, a fermented milk product, contains as many as 5 trillion beneficial microorganisms!

What’s more, fermented milk products like kefir and yogurt offer more benefits than beneficial bacteria alone, including minerals, vitamins, protein, amino acids, L-carnitine, fats, CLA, and antimicrobial agents. Studies have even shown that fermented milk products can improve the eradication rates of H. pylori by 5-15%.

The problem with fermented milk products in the treatment of heartburn and GERD, however, is that milk is relatively high in carbohydrates. This may present a problem for people with severe bacterial overgrowth. However, relatively small amounts of kefir and yogurt are therapeutic and may be well tolerated. It’s best to make kefir and yogurt at home, because the microorganism count will be much higher. Lucy’s Kitchen Shop sells a good home yogurt maker, and Dom’s Kefir site has exhaustive information on all things kefir. If you do buy the home yogurt maker, I suggest you also buy the glass jar that Lucy’s sells to make it in (rather than using the plastic jar it comes with).

If dairy doesn’t work for you, but you’d like to get the benefits of kefir, you can try making water kefir. Originating in Mexico, water kefir grains (also known as sugar kefir grains) allow for the fermentation of sugar water or juice to create a carbonated lacto-fermented beverage. You can buy water kefir grains from Cultures for Health.

Another option is to eat non-dairy (and thus lower-carb) unpasteurized (raw) sauerkraut and pickles and/or drink a beverage called kombucha. Raw sauerkraut can easily be made at home, or sometimes found at farmer’s markets. Bubbies brand raw pickles are sold at health food stores, as is kombucha, but both of these can also be made quite easily at home.

All of that said, probiotic supplements are sometimes necessary and can play a crucial role in treatment and recovery. But not all probiotics are created alike, and in the case of small intestinal bacterial overgrowth (or SIBO, which is commonly present with GERD), certain probiotics may make things worse. SIBO often involves an overgrowth of microorganisms that produce a substance called D-lactic acid. Unfortunately, many commercial probiotics contain strains (like Lactobacillus acidophilus) that also produce D-lactic acid. That makes most commercial probiotics a poor choice for people with SIBO.

Soil-based organisms do not produce significant amounts of D-lactic acid, and are a better choice for this reason. In my clinic, I use a product called Prescript Assist when treating SIBO and GERD. You can purchase it here. Other popular choices include Gut Pro from Organic 3 and D-Lactate Free Powder from Custom Probiotics. I used these in the past, but have much better success with Prescript Assist so I now use that exclusively.

Bone broth and DGL

Restoring a healthy gut lining is another important part of recovering from heartburn and GERD. Chronic stress, bacterial overgrowth, and certain medications such as steroids, NSAIDs and aspirin can damage the lining of the stomach. Since it is the mucosal lining of the stomach that protects it from its own acid, a damaged stomach lining can cause irritation, pain and ultimately, ulcers.

Homemade bone broth soups are effective in restoring a healthy mucosal lining in the stomach. Bone broth is rich in collagen and gelatin, which have been shown to benefit people with ulcers. It’s also high in proline, a non-essential amino acid that is an important precursor for the formation of collagen. Bone broth also contains glutamine, an important metabolic fuel for intestinal cells that has been shown to benefit the gut lining in animal studies. See this article and this one for more information about the healing power of bone broth, and how to make it.

Although I prefer obtaining nutrients from food whenever possible, , as I explained above, supplements are sometimes necessary – especially for short periods. Deglycyrrhizinated licorice (DGL) has been shown to be effective in treating gastric and duodenal ulcers, and works as well in this regard as Tagamet or Zantac, with far fewer side effects and no undesirable acid suppression. In animal studies, DGL has even been shown to protect the stomach lining against damage caused by aspirin and other NSAIDs.

DGL works by raising the concentration of compounds called prostaglandins, which promote mucous secretion, stabilize cell membranes, and stimulate new cell growth – all of which contributes to a healthy gut lining. Both chronic stress and use of NSAIDs suppress prostaglandin production, so it is vital for anyone dealing with any type of digestive problem (including GERD) to find ways to manage their stress and avoid the use of NSAIDs as much as possible.

When natural treatments may not be enough

There may be some cases when an entirely natural approach is not enough. When there is tissue damage in the esophagus, for example, a surgical procedure called “gastroplication” which repairs the LES valve may be necessary. These procedures don’t have the potential to create nutrient deficiencies and disease the way acid blockers do. It is advisable for anyone suffering from a severe case of GERD to consult with a knowledgeable physician.

Conclusion

The mainstream medical approach to treating heartburn and GERD involves taking acid stopping drugs for as long as these problems occur. Unfortunately, because these drugs not only don’t address the underlying cause of these problems but may make it worse, this means that people who start taking antacid drugs end up taking them for the rest of their lives.

This is a serious problem because acid stopping drugs promote bacterial overgrowth, weaken our resistance to infection, reduce absorption of essential nutrients, and increase the likelihood of developing IBS, other digestive disorders, and cancer. The manufacturers of these drugs have always been aware of these problems. When acid-stopping drugs were first introduced, it was recommended that they not be taken for more than six weeks. Clearly this prudent advice has been discarded, as it is not uncommon today to encounter people who have been on these drugs for decades – not weeks.

What is especially disturbing about this is that heartburn and GERD are easily prevented and cured by making simple dietary and lifestyle changes, as I have outlined in this final article.

Unfortunately, the corruption of our “disease-care” system by the financial interests of the pharmaceutical companies virtually guarantees that this crucial information will remain obscure. Drug companies make more than $7 billion a year selling acid suppressing medications. The last thing they want is for doctors and their patients to learn how to treat heartburn and GERD without these drugs. And since 2/3 of all medical research is sponsored by drug companies, it’s virtually guaranteed that we won’t see any large studies on the effects of a low-carb diet on acid reflux and GERD.

So once again it’s up to us to discover the truth and be our own advocates. I hope this series of articles has served you in that goal.

I have created a “myth busing report” page for heartburn and GERD which contains an index of these articles, as well links to books and other offsite resources. If anyone you know is suffering from heartburn and GERD, please direct them to http://chriskresser.com/heartburn.

  1. Wright, Jonathan M.D. Why Stomach Acid is Good For You. M Evans 2001. p.142

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GERD & Heartburn

Comments Join the Conversation

  1. Amy says

    Hi Chris ,
    I commented in your previous article but wanted to fallow up here as well. I have gone on a low carb diet for about six months and I am feeling 90 percent better. I still have what I would call silent heartburn. I feel the need to belch but don’t and then I have a warm to hot sensation in my chest and throat. That is the only symptom I have left along with asthma at night. I was on prilosec for seven years and I am wondering how long this process is for most people? I have taken probiotics and glutamine to heal my stomach lining. I have never taken HCL because I was worried it was something I would have to take forever. Is HCL somehting that people eventually wean themselves off of?

    • Rhett J Dudley says

      When i cut out grains, caffeine and sugar my acid reflux and gerd stopped I know longer suffer from it. And I eat the way atkins diet is defined, I tried Paleo but it doesnt fit my way of eating.

    • Jamie says

      My primary care doctor prescribed me HCL. They are not habit forming, no way! They actually retrain your body to make the proper amount of stomach acid again itself. You titrate up on them until you feel burning or heaviness. After you find the appropriate dose to take before meals, one day you will again feel burning or heaviness. At which point, you start titrating down. The idea is eventually you will no longer need the supplement, as they will become intolerable and your body has been re-trained. Good luck!! I tolerated them immediately, and am feeling improvement fairly quickly. I would highly recommend trying them. If low stomach acid is not your problem, you will not be able to tolerate even one pill before meals. It’s a good test to see if it’s really your problem or not.

      • Deborah says

        I found that Hydrochloric acid upset my stomach and it made my skin become itchy and then break out. As interesting and useful as these articles are, I’m always a little wary when the writer is promoting/selling products at the same time – are there any disclaimers regarding affiliations with supplement companies that be taken into consideration?

    • Dora Lemus says

      This is a most informative website for Gerd and other intestinal problems. I was checking it out because some people had mentioned a product the manufacturer no longer made which was the only product which had helped them. When I looked it up I got your website. Hopefully I will find some long searched for natural help here.

    • STU DAVIES says

      Hi I have just been to hospital and told I have Acid Reflux and been given 3 lots of medication (nasal spray, gaviscon and some other tablets) and told to come back in 6 weeks. If you read the advice basically you shouldn’t drink any alcohol and cut out fats and citrus fruits / juices. My symptoms are a couch a nasal drip (which i have had for over 12months) thats it…..anyone had similar symptoms and can share experiences

  2. says

    Yes, the Paleolithic diet is the way to go. The primary reason to follow a paleo diet is to avoid the diseases of civilization that now plague us. If you want to avoid these diseases, you need to avoid all the foods of civilization. It is really that simple. To do this you do not need to buy any books. There is ample information on the web. To get started a complete and concise explanation is here: http://paleodiet.com/definition.htm

    • Heidi says

      Although I agree that the Paleo diet is great for many people, going on Paleo is what caused my GERD! I never had digestive problems before and after two months on Paleo, I was wreck. GERD and LPR and tooth enamel issues. Four months later, and I am still struggling. The high fat and meat content of the diet obviouosly stressed out my digestive system. Not every “mircale” diet works for every person.

      • Julie says

        Heidi, just a month ago I posted on here all the problems I was having with horrid acid reflux with the slightest bit of fat. I knew there had to be a ‘reason’; this is not normal or how our bodies should work. I made an appt with my naturopathic doc and got in right away, and did some research on my own in the meantime. It appears we have a problem digesting fat because we have a problem with our gallbladder and even a sluggish liver. Turns out that’s exactly what my doc said too. She told me to increase my digestive enzymes and had me start on ox bile. What a difference! I am slowly increasing the dosage and have just started adding HCL as well. (I tried this once or twice in the past with no relief). I even had a tablespoon of Coconut oil today with no reflux or pain! This was impossible to even think about eating a month ago. I likely will not try it again tomorrow, as my doc said I need to take it slow and basically train my digestive system to be able to tolerate and digest fats again.

        By the way, I have been eating Paleo style for years, it controls my ulcerative colitis nicely – without any drugs.

        • Grace says

          GERDS can cause inflammation of the lungs and esphogas even make you feel like your having some sort of crazy attack …the shortness of breath, the sinus issues and even feel like your having heart issues and slight stomach pressure and even back pain it hard to imagine that this is GERDS t I thought I was going to die from the major weight loss and all the symppoms .GERDS has far reaching and debilitaing the symptoms I had the HIDA SCAN and my gallbladder is functioning at 98% which was astonishing to my surgeon I had endoscopy 2 colonscopies and number of other tests, but all negative however I wonder if you can have GERD like symptoms and be like right on the verge of getting it. I’m on the SCD diet after reading Breaking the viscious cycle ( has tons of fun recipes in the book ) My ND told me to start drinking probiotics take the capsules of probiotics ( I use bacillus subtilus and floraster few others ) empty the conrents in a cool glass of water( not hot it will kill the probiotics) swish in your mouth and then drink it down it coats the entire mouth throat and stomach to help heal your body ND told me to STAY away from all sugars, wheat dairy …I’m a vegan so change is super easy for me… .TAKING Glutamine helps tons and another miracle tea drink lots of ORGANIC Chamomile tea drink the tea 20 minutes after meal you might be surprised. Licorce root also helps. Like any issue stay on top of the research …For my sinus issue I do this at least 10x a day collodial silver bottle with / one drop of peppermint and one drop of tea tree oil in in the bottle put some in my Neti pot and nose spray, Plus I used a ND prescribed SSKI /dmso (sea salt saline) this has done wonders!

          • traci says

            Hi Grace
            It was good to hear that I was not dying of some awful disease after you described your symptoms. Can you share with me if you also ate a very low carb diet as well. I see you mention eliminating sugar, what about dairy. I would be so happy and relieve if you would reply. I have felt so alone for so long. My family think that I am a hypochondriac when I tell them what I am feeling. When you read upon symptoms for Gerd so never list the ones you mentioned. Thanking you in advance for sharing your knowledge.

            • Grace Anderson says

              I read all of these post. I was amazed to see that I’m not dying! My MD gave me a prescription for dexilant. I just don’t know where to begin and I’m just so overwhelmed with what to and not to eat. I’ve even noticed my hair falling out. Any recommendations? I have all the GERD symptoms.

              • JN says

                Grace, My husband was just recently on Dexilant and this drug caused more problems than helped! He has been in a digestive nightmare for over 2 years now. He has been on all kinds of PPI’s and OTC drugs and they have done nothing but make it worse. He went from simple heartburn to severe gastritis and gall bladder problems. We had enough of the merry-go-round we were on and took matters into our own hands. We weaned him off all the drugs, started doing some of the things these articles suggest and we have finally got him to 90% better in just a month or so. DO NOT take the PPI drugs! Find what works for you from some of the suggestions in these articles. You will save yourself a lot of pain and suffering!

                • James says

                  The only real purpose for a PPI is that it allows the esophogus and throat to heal. After that I don’t see the purpose. To me acid reflus is a digestive issue, a weak digestive system. A PPI does nothing to stop reflux, it only makes the contents of the reflux less acidic. In fact, it might increase the likliehood of refluxing because it further weakens the digestive system. Read everything you can about digestion and everything you can do to strengthen it. Maybe you have low stomach acid or not enough digestive enzymes. Anything that gets your food digested and out of your stomach the quickest should help. A low fat diet a helped me the most. Carbs actually digest teh quickest, while proteins and fats take the longest and are very hard to digest. Chew your food thoroughly. No liquids with your meals at all. Diaphramic breathing and melatonin could strengthen your lower sphinter. Heal and settle your stomach. probiotics help, digestive enzymes help. HCI helps. Take a 15 minute slow walk after your biggest meal to help digestion.

          • Laura says

            Wow! You’ve just described my symptoms and tests for the last year and a half….still with no true understanding of what is wrong, I might add. Some good points here, but not sure where to start. I was on Prilosec (40) for a year or better but switched to Nexium a month ago…single dose. Feeling a bit better. Anyhow, I am hesitant to ditch Nexium all together because I was MISERABLE before I started taking PPI. Prilosec helped my significant secondary symptoms improve within three days. I KNOW I want to be rid of PPI’s, just not sure how to go about doing it. Any thoughts?

        • deborah says

          Julie, what is Ox Bile? And, also, digestive enzymes…. And, where do you get it? I’ve been low carb for almost a year now..recently started eating more fat( good fat, as i was instructed to to lose weight) I’m having extreme AR, although not on a daily basis, but enough to make me miserable…I’ve always taken Acid Reducers, but now i’m thinking i should STOP taking them…any tips?

      • Fg says

        Paleo caused my GERD too! Ironically at first I thought it was because my body was detoxing fom SAD but I’ve come to realize the high protein high fat diet destroyed my digestive system and my skin. I had no problems with either pre Paleo. The paleo community encouraged me to stick it out and my body would adjust. Unfortunately that made the problem much much worse. Moral of the story, listen to your body!

        • Glynis says

          I absolutely agree. Your gut has wisdom worth following. I read Dr. Natasha Canpbell-McBrides take on foods and gut feelings. She describes proteins and fats as building and repair foods, essential for healing, and fruits/veg as cleansing. Our body requires different things at different times. She also has patients who favour either one or the other and do very well with what might be considered an “unbalanced” diet. She also advocates eating the foods that make you salivate. Basic but a great tip.
          At present, I am favouring proeteins and fats and my skin has never looked better. I came of the PPIs six months gao, after almost ten years of taking them and almost as long of feeling”off.” I had lost my gut feeling. Now that it is back, I am thriving and gently losing weight withour even trying. The reflux is not entirely cured, but slowly slowly things improve.
          So listen to your gut, and let us know if things improve.

        • Angel says

          The same happened to me, the diet just made my symptoms worse. But I don’t think it caused it. The diet made evident that my stomach was low on HCL acid.

  3. Elias says

    For the last couple of weeks, I started feeling bloating in my stomach and a mild heartburn after a meal. I searched all over the internet for info about heartburn and GERD but I was not satisfied. Today, I stumbled over your site and I am glad I did. I read all the previous 6 articles and was waiting eagerly for this last article! Very inclusive and clear. Now I am satisfied and ready to take action.
    Thank you very much!

      • Darren says

        Hi Chris

        Very glad I stumbled across your articles…you talk a lot of sense in a world with a myriad of confusing web info. Thank you.

        I’ve been on Omeprazole (proton pump inhibitor) for over a year to help cure reflux that was causing chronic coughing. It did stop my cough but sadly about 3 months ago I developed very bad IBS type symptoms. Had all the doctors tests and tried many things but nothing could really help. Since reading your articles last week I’ve stopped my proton pump inhibitors and my IBS symptoms have almost gone in in only 3 or 4 days. I’m convinced low stomach acid has caused bacterial/yeast overgrowth and bloating/pain symptoms that I had. Sadly however my cough is beginning to return. I’ve been on a low carb/no sugar/no milk/low gluten diet for 3 weeks now also (and following a FODMAP plan that decreases especially fructose intake significantly). Therefore my diet is pretty good but still getting the cough. I also get very bad sinus issues, with sometimes a blocked nose or sometimes post nasal drip type symptoms caused by the acid. I don’t get heartburn at all, just the cough and sinus issues.

        I don’t want to start my acid suppressing drugs ever again but do you think my course of action now should be HCl/pepsin supplements and/or I’ve heard Prokinetic drugs may help? I’ve heard Prokinetics can help tighten the LES (I am concerned however that they empty the stomach faster…maybe leading to undigested food that can lead to other issues???). Also concerned that you can’t take them for more than 6 weeks and that they may just help for short periods (not to mention bad press about Reglan causing other diseases).

        What do you think? I’m almost going crazy thinking of new solutions

        Many thanks
        Darren

        • Shirley says

          Hi Darren…thanks for your questions….I too have the same issues and the cough…I just discovered this article too and want to ditch my Dexilant 60mg. which I’ve been on for months. Let me know what you decide on to get rid of the cough which I have also. Just thinking that I read somewhere else the bad bacteria (specifically yeast) could possibly get into the lungs during previous reflux times. Not sure if this is what is giving me a cough….I sure could use some tips since I am behind you and have not even started the elimination diet yet or for that matter ended the Dexilant…..but it is coming soon!!!! Thanks bunches. Shirley

          • Missy says

            Same here. The cough is how I was diagnosed with silent reflux about a year ago. PPI’s kicked it right away, but I didn’t want long term use of them. He had me on them at a high dose for months, but I cut it in half early on due to leg cramps, and haven’t taken any at all this past week.
            After a bad flu in January, the cough/mucous flared up worse than ever. I’ve been incapacitated by it and getting little sleep. I thought it might be allergies, but now think it’s just a more severe reflux flare-up. It’s hard to go anywhere, not knowing when a sudden coughing spasm may start.
            I think this article series makes perfect sense and I’m a big believer in looking for the cause instead of treating symptoms. I’ll be trying these suggestions right away.

            • SB says

              Wow, this is confirming my suspicions. I have been taking Nexium or Prilosec off and on for a few years now. Nausea is not listed as a symptom for silent reflux, but my main symptom is nausea (and bloating/gas and just a hint of heartburn). The meds clear up the nausea right away. Well, I just found out I am pregnant, and have had post nasal drip and a vicious cough for over 2 months (since the very beginning of the pregnancy). I suspect pregnancy made the symptoms from low stomach acid issues flare up again. I had serious trouble breathing early one morning, after waking up coughing, and it scared me so badly that I went to the doctor later that same morning. She prescribed an antibiotic. (Of course she did!)
              But I suspected my stomach issues were behind the cough, and after reading all this info (I read all of Chris Kresser’s articles on this, and everyone’s posts are helpful too), I will not be taking any more Prilosec! I also plan to change my diet, take apple cider vinegar, and possibly take HCL and/or bitters. Thankfully, I just started making my own water kefir (probiotic), and will keep drinking that.
              Anybody else out there have nausea as their main symptom? It would go away for quite awhile– maybe even up to a year– but always come back. The doctor said it might be acid reflux or an ulcer, and prescribed Nexium, which cleared it up quickly. After awhile I switched myself to Prilosec, since you can get it OTC.
              (By the way, I have not had any nausea in a few months, not even from morning sickness.) :)
              I guess I should decrease my fat intake, but should I avoid coffee, tomato sauces, and other things which typically cause heartburn flare-ups?

              • JM says

                Hi SB- That is so ironic that you mentioned the nausea. I have had that for a couple of years-not bad but just an underlying feeling and not all of the time. Last week I had an endoscopy due to very severe pain in upper abdomen which my doctor was suspicious of ulcer. The text showed I had some polyps and a lot of inflammation in the duodenum. He prescribed pro tonics (which I haven’t filled rx as yet) I have been trying other natural products from a local health food store. The products I purchased were Aloe Herbal Stomach Formula which contains (besides aloe) apple extract, peppermint leaf, chamomile, borage, marshmallow root, ginger root, Pau D’ Arco, Blessed thistle herb, slippery elm bark, & Fennel seed. I drink a couple of ounces before meals and it is supposed to coat the stomach. It does seem to help some but the other product is deglycyrrhizinated licorice chewable tablets. I think they seem to help even more. You have to take those 20 min before eating. I am traveling this weekend so those will be very handy to have. I have appreciated the info. regarding yogurt and other diet changes as I know those will make the biggest difference. I going to start that right away, but trying to get direction in that area also. Paleo has seemed to be problematic for some and to me doesn’t seem to be well-balanced. I will continue reading/researching and see to which my body responds.

        • hugo says

          Darren, did you find out why your cough came back? I have just gone off my omeprezole and my cough is starting to come back too.
          can you write me if you find an answer?

      • Kat says

        So what was it. Same thing happens to me. I hate bloated. It’s weird that I eat paleo and an. Listed. Why I wonder?

        • Trig says

          When one has too little acidity in the stomach, the stomach contents call chyme just churn in the stomach and slow to exit.
          The PPI meds result in a long term elevated gastrin level which cause the stomach to go high acid when on quits the med. Further these meds can cause gastric atropy. I took these meds for several years and they caused tenderness deep in the abdomen, tenderness in the groin, reduced testosterone, the skin hurt when midday sun hit it, dental decay, a infection that started to go into the lungs, and neurological symptoms. Betaine HCL with pepsin got my food moving and stopped the reflux. Melatonin also helps with nocturnal reflux. I took the betaine HCL for about a year with a gradual tapering down. PPI meds shouldn’t be used long term and even the FDA has said as much at times. Conventional medical people are pretty clueless (even hostile) for resolving the problem long term.

      • Elizabeth c. says

        Hello Chris ,
        I have barely started dealing with gerd for a month and wanted to follow this plan of recovery you have talked about , but i wanted to know what are some low carb foods that i should eat to help my healing process?
        Thank you

  4. jean says

    This is a wonderful series. Thank you so much. I have implemented many of your suggestions, and am almost free of gas. Is that a reliable indicator of a healthy gastric environment? (I have no more heartburn).
    Secondly, sweeteners. I do have a sweet tooth and have used stevia for quite a while now. My TCM practitioner is urging me to decrease it’s use. It’s the one part of LC that I have found difficult. Does stevia contribute to bacterial overgrowth? Apparently, in TCM, the TASTE of sweet can be disrupting. But from a western point of view does the stevia promote overgrowth? I have made progress, but the substance (or sweet taste) is very addictive for me; I easily find myself using more and more to get the level of sweetness I want.

    • Chris Kresser says

      Jean,

      Being free of gas is certainly a good sign that your digestive symptom is functioning properly, as is not having heartburn.

      The fact that you have such strong cravings for sweet taste does suggest that you may have a blood sugar imbalance. A high-fat, low-carb diet would likely be of benefit. The herb gymnema can be helpful in reducing sweet cravings.

  5. Chris Kresser says

    Amy,

    As I mentioned in my response to your previous comment, replacing stomach acid is a crucial aspect of restoring normal digestive function and eliminating heartburn.  If you don’t want to use HCL, you can try bitters, lemon juice, apple cider vinegar, or sauerkraut.  Note that these alternatives are not as strong as HCL and will likely not have the same effect in terms of reducing bacterial overgrowth.

    Some people only need HCL for a short time, which suggests that their stomach acid production kicked in on its own again.  This was my experience, in fact.  Others find that they need to continue taking HCL for a longer period.  However, when compared to the alternative (taking PPIs or other antacids, or suffering from heartburn and GERD), HCL is clearly a better choice.

    • Rick says

      I have been looking into the possibility that low stomach acid and candida could be linked to my rosacea. I have quite a few of the symptoms for both, including the bad skin, anxiety, low energy, heartburn, bloated feeling after eating, verticle grooves in the fingernails, and others. I’ve found so many articles with conflicting ideas on how to fix these internal problems. I haven’t figured out if low stomach acid can cause candida or if candida can cause low stomach acid or if fixing the low acid issue will fix the candida issue. It seems I find conflicting information everywhere I look. Its all very confusing and then you throw in rosacea and it becomes even more confusing… For many years when I was younger I was on antibiotics for acne and then recently I was on minocycline for 3-4 years for my rosacea. The ones I took when I was younger really upset my stomach so I also took a lot of antacids. I’ve only recently discovered how bad antibiotics and antacids are for the system, which was very disappointing to find out. Especially since I was never told this by any of my dermatologists. I’m sure the years of not having a great diet and living on soda only made things worse. I’ve been thinking about trying the HCL supplements, but I wasn’t sure if they would help to get my stomach producing the correct amount of acid on its own eventually. I’ve read long term use is bad. I’ve also thought about probiotics, but also read that they can be bad. Right now I’m kind of leery of taking anything… I really just want to get my body back to where it can work correctly on its own and hopefully in turn get my facial issues solved. Any help would be greatly appreciated.

      • Stacey says

        Rick it’s all connected! You body is just showing symptoms of being unbalanced. What are you eating? The articles Chris has written are excellent, and believe me I have done my research on the internet and elsewhere. It’s all the same, No sugar! No grain! No processed food, and All organic. Supplement where needed. Plain and simple. It works, it’s what your body needs so… what are you waiting for? Natural is best even if it takes awhile. You can do it!

        • Rick says

          I was kind of thinking that it was probably all connected. I don’t really feel like I eat too unhealthy. Lately I eat very little for breakfast, maybe some eggs or whole grain cereal. Then for lunch a turkey or ham sandwich and a few chips. For dinner usually some protein(beef, chicken, pork, or fish) and vegetables. I used to drink soda quite often throughout the day and snack on sweets or a granola bar, but in the last few weeks I’ve only been drinking water or tea and haven’t been snacking much. I also used to get heartburn quite often, but in the last few months I haven’t noticed it much at all. And I wouldn’t say I have out of the ordinary bowel movements.

          I’ve really just been researching this to find out what could be the main source of my skin problems because lately its been causing me the most worry. I discovered all the antibiotics I’ve taken in the past could be the overall cause and I have been reading up on ways to try and correct the problem. Nothing I eat seems to directly effect my skin problems, but I would assume its happening gradually over time because of problems inside my body. Do you have to completely cut out sugar or is there an allowable amount? No grain is gonna be hard. Could you list some of the things you eat and what some good supplements are maybe? I’ll read more of Chris’s stuff and figure out more of what I need to do.

          Thanks so much for the reply Stacey

          • Dana says

            There you go. You’re still eating grain. With the exception of an occasional bowl of popcorn, I don’t eat grain anymore. I’m not where I want to be healthwise yet, but I’m a lot better off than I was two years ago. Over fifty pounds down, as well.

            If you’re really loath to give up grains, just try it for thirty days and see what happens. If nothing changes you can always go back to them later.

          • Shirley says

            Hi Rick, from all I’ve read on the internet regarding the same health issue as yours, you’ve got to go grain-free, sugar-free, starch-free and that does include potatoes….You need to start from scratch and do bone-broths, probiotics like kefir, kombucha, sauerkraut, grass-fed beef, organic veggies, real butter, meat fats and eggs. Just like our ancestors. Check out all of Chris’ site for info as well as GAPS introduction diet for tons of info on the good stuff to HEAL your digestive system and all these issues. I’m getting ready to start soon….lets do it!

            • Ijunanya says

              Shirley, I have read everything you mentioned re: bone broths, no grain, no sugar, starch-free, sugar-free, and each time I go for it, I end up still very hungry and losing too much weight, my doctor told me I can’t lose any more weight, and more than anything I have to take a sleeping pill every night . Any help I would appreciate!

      • Mrs. RMG says

        @ Rick who posted about Rosacea…

        I have been suffering from SEVERE almost disfiguring Rosacea. I also have Hashimoto’s (auto-immune disease of the thyroid, ‘low thyroid’), Type 2 diabetes, clinical depression, high blood pressure, high cholesterol, hay fever, GERD (so bad I was vomiting acid), Irritable Bowel Syndrome, Chronic Fatigue Syndrome, Fibromyalgia and overactive bladder. All this along with going through menopause and having the worst hot flashes imaginable! I would break out in sweats and become absolutely drenched in sweat.

        I had been doing some research online for my Rosacea and I kept reading article after article on how pure raw goat’s milk soap and pure raw goat’s milk moisturizers help with Rosacea. So I found an online source of where to buy these and within 3 days of using these my Rosacea was gone! My skin now looks like it did when I was in my 20′s and I’m in my 50′s! My skin is glowing and healthy and soft and silky. It’s just amazing! I still have yet to figure out how to heal all my other health problems. But if you Rick, or anyone else here is suffering from Rosacea, I highly recommend trying pure raw goat’s milk soap and moisturizers. The key is to use lukewarm water to wash your face twice a day. Water too hot or too cold will make Rosacea worse. Don’t rub with a wash cloth. Rubbing makes it worse. Best to gently use only your hands to wash your face. Pat your face dry with a very soft towel. Let your face dry for about 15 minutes and then put on the moisturizer. You need to do this twice a day…religiously! If you don’t, the Rosacea will come back. I also recommend using a pure raw goat’s milk night cream. This will keep your face very moisturized which is extremely important for Rosacea sufferers because Rosacea gets worse with dry skin. Also stay out of the sun and try to stay cool and comfortable. Rosacea tends to flare up with sun exposure and heat.

    • Marti says

      I agree with your solutions to GERD, also, in regard to restoration of stomach acid production v. just control, have you checked out Dr. Tennant’s website (Texas M.D. turned more natural theoretician)? He recommends a regiment with every meal to help restore the natural functioning of the digestive process. Wondered your opinion.
      Thanks for your marvelous website,

    • Jennifer says

      Does HCL have side effects? I take a beta blocker for Sinus Tacychardia and lately the ppi drugs have caused anxiety and increased heart rate. I was on ppi drugs for 15 years and just quit cold turkey. It has been a month and I have burning in my stomach throat and mouth. Scared to try natural products as I am allergic to all trees, grasses and weeds. Please advise on what might be safe. Also should you try the vinegar if you think you have an ulcer?

  6. says

    Another great series Chris! GERD is such a common problem and the solutions are so simple. It’s a shame there is so much misinformation about the subject, mainly from those who profit from selling “medicines” to treat GERD symptoms without addressing the underlying causes. Hopefully the seeds you have planted here will grow and help to spread the truth.

    As a footnote, when on rare occasions I get indigestion after a meal, I get quick and complete relief by drinking a small glass of homemade kefir. I make a batch of kefir from real kefir grains and raw milk every week.

    • Chris Kresser says

      Bryan,

      I’m glad you enjoyed the series. I too make kefir at home, and it helps me tremendously. I can’t imagine not drinking it daily!

      • Angie says

        Hi Chris, I would like to ask if you have any advice for someone like me whos allergic to all meats and most fish? Not sure how to handle no grains at all. I am allergic to all of those as well except rice.

  7. Forty2 says

    Thanks to the first couple of articles in this series, I stopped taking Aciphex almost a month ago. During the first two weeks I had a couple of painful episodes but they were short-lived. The last two weeks I haven’t had any issues at all. I have been eating “paleo” since mid-January and I’ve also lost 25lbs since then despite not exercising and continuing prodigious consumption of wine and cigarettes (yeah yeah, I know). I figure I have another 10-15lbs to go.
     
    For the first month or so of going primal I had terrific flatulence, I suppose a result of my guts reasserting themselves over microbe populations, but this faded away. I was more or less a 1-man tuba quartet while it lasted.
     
    I had been on Nexium since about 2002 and Aciphex since last summer and have had GERD on and off since the late 1980s. I’m 48, male.

    • Chris Kresser says

      Incredible testimonial. Thanks for keeping us posted and I’m very glad to hear you’re doing so well.

  8. says

    Hi Chris ,
    I commented in your previous article but wanted to fallow up here as well. I have gone on a low carb diet for about six months and I am feeling 90 percent better. I still have what I would call silent heartburn. I feel the need to belch but don’t and then I have a warm to hot sensation in my chest and throat. That is the only symptom I have left along with asthma at night. I was on prilosec for seven years and I am wondering how long this process is for most people? I have taken probiotics and glutamine to heal my stomach lining. I have never taken HCL because I was worried it was something I would have to take forever. Is HCL somehting that people eventually wean themselves off of?

  9. Renee says

    Wow, this is super interesting and make so much sense to me. I’m 33 years old, weigh about 170, and have been on Prilosec almost 2 years due to a ‘silent reflux’ that was causing me severe throat pain. When I asked the ENT about what I could do to make the esophageal sphincter function normally, he said there was nothing I could do, and I’d have to take the Prilosec forever.
    Would you recommend completely stopping the med and going on the VLC diet all at once? Do you need to wean off the Prilosec slowly? I take it twice a day.
    Also, forgive me if I missed this, but do you need a script for HCL, or is that something I can get at a health food store?
    Thanks so much for the great information.

    • Chris Kresser says

      Hi Renee,

      I can’t make any specific recommendations about medication. I can say that there is no danger in stopping Prilosec “cold turkey” unless you have tissue damage in your esophagus or a precancerous condition like Barrett’s Esophagus (BE). In general, I think making changes slowly is a good idea.

      HCL is a supplement and can be purchased at a health food store.

      • Anne says

        Chris,

        You mention that their is no danger in going “cold turkey”, unless you have tissue damage. I previously have, although that has been many years now. What do you recommend for patients that are aspirating in their sleep? Due to neck and back issues, sleeping on a major incline is not possible, but going off the drugs within a couple hours I am aspirating reflux directly into my lungs when asleep. Once this started I was put on Protonix twice a day (was on pepcid previously) and that stopped the aspirating. I would think Lung damage would be very worrisome.

      • Jon says

        Hi Chris
        I have ultra short section barrets and have been on omeprazole for 4 months but GERD, although better at first has returned along with other symptoms synonymous with mal nutrition. Have recently Started a VLC diet. Is it OK to take HLC with Barrets?

        Thank you
        Jon

        • Glynis says

          Hi Jon,
          I am very interested in the naswer to your question about taking HCL when you have BE? Have you found an answer? Did you take it successfully?

          • Amanda says

            I was just curious if anyone got an answering about taking HCL when you have Barret’s Esophagus if it’s safe or not? Thanks!!

      • Amanda says

        Hi Chris,

        Can you elaborate on what you said above about “I can say that there is no danger in stopping Prilosec “cold turkey” unless you have tissue damage in your esophagus or a precancerous condition like Barrett’s Esophagus (BE).” Do you think it would make sense for someone with that condition to stay on the proton pump inhibitors then?

      • Ginny says

        Ok I tried stopping Lansoprazole after cutting out grains/veg oils/refined sugars/legumes and eating much more healthy than I ever have before. I am taking a probiotic kefir. I was ok for a few days and then I noticed increasing heartburn and pain in my esophagus and food getting stuck there ( like it was before I started the drug almost 2 yrs ago. I’m really frustrated that I can’t off this drug!!!

        I have to admit the one step I did not try was the HCL/pepsin caps – I was hesitant to add more fire to the fire! Plus I can’t swallow pills larger than synthroid I would have to open the capsule and swallow the powder, which is probably a bad idea. Since there is damage to my esophagus, what should I do now? Chris I hope you see this and answer pretty soon. Til then I am taking a daily Mag citrate supplement (which does help some) and am only taking Lansoprazole about every two days. And I’m constipated. Help!

        • Mel says

          This is my understanding. Many people have rebound when they first stop taking PPIs. Your body has systems in place to tell whether or not your food is getting adequately digested in your stomach. If it isn’t your body releases more hormone telling your stomach cells to produce more acid. The entire time you are on PPIs the levels of that hormone go up and up trying desperately to get your stomach to pump out more acid, which it won’t do because of the drug blocking it. Once you stop the PPI, it takes a while for that hormone level to come back down to normal. It thinks it has to be that high to get your stomach to do anything! When I quit cold turkey, I pretty much couldn’t eat ANYTHING without having much worse heartburn than before I had gone on the drugs in the first place. It took a few weeks to even get back down to the pre-drug level. And then gradually improved from there.

  10. susan says

    I cannot tell you how happy I am that I found your series of articles.  I had a sudden on set of reflux one evening while at friends house for dinner this past January.  When I woke up the next morning it felt like my esophagus was raw.   I saw a specialist who told me I needed to go for test because he suspected stomach cancer. Keep in mind I had only had this condition for 4 weeks by the time I had seen him and this was a Saturday. After a weekend of worry I had blood work, ultrasound, upper GI and colonoscopy.  This was all the week before we were to go on a long planned family vacation. Needless to say my vacation was filled with worry that I was dieing.  I returned home only to have all my test return normal.  Now that was all well and good but I was still in pain. The burning in my back and sternum area was awful. I started on Prilosec which helped but I didn’t feel well on it at all and every trip to the antacid isle left me feeling that there was something terribly wrong with how this illness is being treated.
    So now this brings me to your articles.  I can honestly tell you that the after taking my first dose of probiotics and HCL I wanted to cry,  the relief was almost instant. I could tell something good was happening as after the first day I could drink water and not feel it washing back up my throat.  Before reading your articles I had two people tell me on separate occasions  “you need more stomach acid” and I thought they were crazy.  So all I can say to you is thank you, thank you, thank you a thousand times thank you.
    I have a couple of questions, about how long should one stay on this treatment and do you have any info on healing the esophagus?  I still have a tender area when eating certain foods.  From my research I have learned that it takes a long time but I guess I just was curious as to how long is long?
    Sue

  11. Chris Kresser says

    Sue,

    I’m very glad you found relief from probiotics and HCL.  You might try DGL and glutamine to assist in rebuilding the lining of your esophagus.

  12. Wendy Johnson says

    My son is 12 years old.  He was a healthy, active boy until this past December.  He took two doses of Augmentin for a sinus infection (the dr said it would kick the infection, but may also tear up his stomach) and then began throwing up 12-15 times daily.  We stopped the antibiotic, but the vomiting didn’t stop.  He’s been to a pedi gastro dr who has scoped him twice.  The first time diagnosed eosinophilic esophagitis and prescribed a steroid inhaler to swallow to heal the esophagus.  It took weeks, but he got better and the vomiting stopped.  Then he developed a problematic asthma-type cough that would not allow him to sleep, but it didn’t respond to the usual asthma treatments (breathing treatments, warm moist air, emergency inhaler) so we went to the allergy/asthma dr and she prescribed z-pack and a cough medicine with pseudophedrine to dry up the drainage which she said was causing his cough and that it wasn’t asthma because his spiromitry test was fine.  After 2 doses of the z-pack, he began throwing up again multiple times daily and to this day still is.  The gastro dr scoped again and his esophagus had healed, so took him off the steroid inhaler.  Has been prescribed prilosec and nexium as well as karafate and reglan.  No improvement, still throwing up.  Did allergy testing and he had severe reactions to many different things (environmental and foods) on the back scraping test, but the blood test showed no food allergies.  Gastro dr referred for an upper GI barium x-ray — normal.  Yesterday he prescribed 100 mg 3x daily of erithromycin.  I also stumbled on this article and started him on HCL w/pepsin and probiotics, took him off all carbs and off the nexium/prilosec/karafate/reglan.  He was still throwing up last night.  I’m guessing it may take a few days to see a difference.  Any other suggestions?  Are we headed in the right direction?

    • Chris Kresser says

      Wendy,

      Restricting carbs in your son’s case and using probiotics certainly seems wise. I would advise caution on the HCL since he is vomiting. It sounds like a somewhat complex case, and I can’t provide any specific advise without having seen your son. I’d recommend finding an acupuncturist or naturopath in your area who can work with your son, along with the doctors he’s already seeing. Good luck. These changes do take some time.

  13. susan says

    Ok so one might call me paranoid but I thought I would get everyone’s take on this. I found an article on the Health Sciences Institute which recommends trying a product called Potters Acidosis which helps to tighten the LES.  This product is only available in the UK but it states it can be ordered and it gives two or three links. So now when I go to the web sites it is not listed on a couple of them any longer and the one where it is listed has this statement:
    We regret that due to some recent advice received we are no longer able to supply shipments to addresses in the USA and Canada. We are very sorry to have to make this change but had no alternative.
    Is this weird or is it just me?
    Here is the Health Science Institute page I found it on:
     
    http://hsibaltimore.com/2002/01/22/potters-acidosis/
    I am interested in your perspective on this.
    Thanks
    Sue
     

  14. says

    Chris, thank you so much for this information.  I wish I’d found it 3 years ago, but I am healed now.  I am writing my story of getting off Nexium, and I’m wondering if I can have your permission to reprint (with credit to you and this series, of course) your Conclusion section on this post.  It sums it up so well.  Let me know, thanks!

    • Chris Kresser says

      Fantastic news! And yes, please feel free to use the material as long as it’s referenced and linked.

  15. Derek says

    An interesting series of articles,  thanks.

    For my own part,  I don’t usually get heartburn,  or acid in the throat,  but it does happen from time to time;  and I had a bad case of it over the last fortnight.  I do however seem to suffer from regurgitation,  and have done for > 30 years.  This involves some of my meal coming back in to my mouth,  but without any acid.  Say a bite of meat reappearing and hour after eating a main course and pudding.  So,  the suggestion of too little acid strikes a chord,  especially since I have been increasingly suffering from belching in the last few years.

    I do however have a question about your use of HCl.  It obviously can’t be a suggestion to take Hydrochloric Acid,  since that would burn going down.  Also some dehydrated HCl seems unlikely,  as I guess it would hydrate and dissociate before it hit the stomach.

    Looking around,  I found something called Betaine HCl,  which seems to be Tri-methyl-glycine [(CH3)3)N+CH2CO2-] with a Chloride counter ion attached.  Is this what you’re referring to?

  16. Herve says

    Hi Chris.

    I was diagnosed with GERD in late Feb.  Tried eating clean without junk food (primarily with occasional failures along way) for about 10 days and couldn’t seem to control it.  So I gave in and went on Zantac at Doctor’s advice for 1 month.  It made me feel better for a few days but then still got main symptoms for me which were lots of phlegm from lower throat, stingy mouth, sour mouth occasionally, acid into mouth at times and through night, mild discomfort under breastbone.  Since early April I’ve been off pills trying to eat better although falling off wagon sometimes.  I made a slight attempt at low carb. a few weeks back but find it very hard to not eat carbs.  

    I was tested for H. Pylori a few weeks ago and I assume that was negative since I have not heard back from Dr.   Since I was negative for H. Pylori, is is still possible that the root of my problems would be bacterial overgrowth?  My doctor thought it was very unlikely that I had a Candida problem as I did not fit the typical profile or exhibit most of the typical symptoms.

    Been reading this site for a few days and yesterday started to try Specific Carb. Diet.   Also sometimes taking Probiotics and Dig. enzymes but I never feel fully sure that is helping me.

    Do you recommend the Low Carb diet or the SCD and any other key suggestions would be helpful.

    Thanks,  Herve.

    • Chris Kresser says

      Herve,

      It’s certainly possible (and even common) to have bacterial overgrowth without H. pylori.

      All of my recommendations are included in this article. Low-carb or SCD, HCL w/pepsin, probiotics and possibly bitters form the foundation of the strategy.

      Good luck!

  17. Denise says

    I am having a lot of trouble getting off the PPI.  I am already on a low carb diet. I could not find the Specific Carb diet. Do I just go to the health food store and ask for HCL with Pepsin?
    thank you, Denise

    • Chris Kresser says

      Yes, most health food stores should carry it. You might want to check out the GAPS diet. http://gapsdiet.com It’s similar to the specific carbohydrate diet, but better in my opinion.

  18. tasha says

    I have a 3 month old daughter who dr. said has acid reflux. She was very fussy and would cough/choke when laying on her back. She spit up at times. They started her on prevacid after zantac had no effect. She has also had a very bad gas issue. She seems less crabby after starting prevacid, but still gassy and occ. spit up. What would you recommend for a child her age. She also had kidney reflux and is taking sulfameth-trimeth susp once daily.

    • Chris Kresser says

      Hi Tasha,

      Unfortunately reflux is more difficult to address is an infant, because we can’t use HCL or a low-carb diet (assuming you’re breastfeeding). My guess is that your daughter’s gut flora is not as healthy as it could be. You might want to try giving her Natren’s Life Start, which is a probiotic especially formulated for infants.

  19. Forty2 says

    Just to follow up, it’s been a few months since I stopped the PPIs and aside from transient twinges, no burning, except when I indulge in a rare sweet or divine piece of artisanal bread slathered in butter of course, and  believe me, my desire for these “treats” diminishes constantly. So more or less I consider myself cured of GERD after taking PPIs since 2002.

  20. KG says

    These articles are great! Thank you so much. I have improved dramatically in 2 short days by: stopping nexium, cutting carbs, lowering surgar, and taking DGL & HCL.
    However, I am struggling to find foods that fit the low sugar, carb, fiber mold. It seems difficult to have a balanced diet with those restrictions. For example, Berries: they are one of the lower sugar fruits, but they are not recommended in low fiber diets. Would it be at all possible to put together an eating plan for your next article?

    • Chris Kresser says

      You may have to eliminate fruit entirely for a period of time until your bacterial overgrowth is reduced.

  21. KG says

    Chris,
    If that is what I have to do, I’ll do it. I will do just about anything to make these symptoms go away. It has been working great so far, in the early going. My one concern is where to get my nutrients from. I am very active, I play baseball and exercise a lot, so it is essential I am getting the fuel to supply that activity.  You mention “certain fibers”, once or twice. Does that mean certain foods with fiber are ok?
    Again thank for your these articles and your help.
    KG

  22. Chris Kresser says

    How much fiber is tolerated depends on the person.  Let your symptoms be the guide. Saturated fat will get you the calories you need.

    • chris D says

      Boy Chris, I find this article confusing.
      You say that these are OK
      non-starchy root vegetables (winter squash, rutabaga, turnips, celery root) can be eaten.
      But later you say high-fiber is NOT OK
      Wintersquash and the others above are HIGH FIBER. In fact wintersquash fills me up with gas.
      I am prone to bacterial overgrowth and have hard GERD for 2 years. I had to go on MOPRAL (PP inhibitor) 1 month ago to heal a VERY inflamed esophagus.

  23. D says

    Chris, a friend of mine has Barrett’s and anemia.  She is currently taking Aciphex.  She tells me that she doesn’t actually feel her heartburn, but the doctors tell her that she has that.  What do you recommend for her?  What should I ask her to tell/ask her doctor?  I’m going to suggest dramatically reduced carb intake and kefir, but I’m not sure how the medication plays in.  Also, how does alcohol affect this problem?

    • Chris Kresser says

      As I mentioned in the articles, with Barrett’ and esophageal damage it may be necessary to take an acid-inhibiting drug. I don’t have much experience with Barrett’s myself, but Dr. Wright, who I learned a lot of what I know about treating GERD naturally from, does suggest that Barrett’s patients may need to continue taking their medication.

      • Aaron Powell says

        Chris I have been diagnosed with Barrett’s. Is it possible to implement the 3 steps and continue to take PPI’s? I am currently on 40mg of Pantoprazole. I was all ready to get off the PPI’s and start the 3 step regiment until I read this last comment. Please advise

  24. D says

    Oh, and can you explain your stance on soups?  You recommend bone broths, but state that people should not take liquid with meals.

  25. Derek says

    Chris,

    I started following your plan about 3 months ago and stopped taking my daily 400mg omeprazole (Prilosec) about 6 weeks ago.  I’ve tried to stop several times before ‘cold turkey’ to horrible, painful results.  This time was different.  I implemented your plan as follows:

    1. Eliminated sugars and bread from my diet and other obvious carbohydrates. 
    2. Started using HCL at each meal.  I usually used 3 tablets per meal.
    3. I started eating greek yogurt every day and have dabbled in Kefir,Kombucha,Sauerkraut, and Kimchi.  I’ve also started taking an over the counter probiotic recently.

    The first week off my omeprazole was dicey but every single week since has seen steady and noticeable improvement.  I feel better today than I have in YEARS of taking my drug.  And I have discontinued taking the HCL with meals with no problems whatsoever.  I honestly think step 3 is the most important part of this plan in my case.  People have no idea just how important it is to maintain good gut flora.

    Thank you, Chris!  I am extremely grateful to have found your web site.

    Derek

  26. denise says

    Can you please explain again exactly  how to take the HCL with pepsin. 3 with meals for how
    long? Then do you reduce down to 2 with meals? I cant seem to find the directions on how to take this. is there any probiotic you recommend exactly
     
    Thank you Denise

    • Chris Kresser says

      Denise,

      The instructions are listed above in the article:

      To minimize side effects, start with one 650 mg capsule of HCL w/pepsin in the early part of each meal. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation. At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage.

      I recommend food-based probiotic such as kefir, yogurt, sauerkraut, kombucha, kim chi, etc. when possible.

      Natren and Jarrow are both trustworthy probiotic manufacturers.

      • Todd says

        Hi Chris –

        Could you please elaborate a tad more on the dosage of HCL. You say if there are no problems, increase the dosage. What constitutes a problem? I’m assuming the burning sensation you mention. If so, where is this sensation and how long after taking the pills would one notice?

        You also mention natural forms, such as ACV. How much would you recommend, frequency? dilute with water or no?

        Thanks a bunch, so glad I found this series

        • Chris Kresser says

          Dose: 600 – 750 mg per capsule. Problems would be mild burning sensation. Would occur 30-90 minutes after meal. ACV can be straight (harsh) or diluted. Brand: doesn’t matter, but Bragg seems popular.

    • Chris Kresser says

      I don’t know. The best strategy is probably to do a trial of the approach I recommend and see if it helps.

  27. Adam says

    I tried this about a month ago with little success. Granted, I was taking fiber supplements at the time, so that probably messed things up in terms of the overgrowth.
    My problem is that I get so hungry during the day and need to keep something on my stomach to prevent the reflux (I was having stress-related reflux and the acid went crazy without any food to digest). I am not overweight at all and my doctor was actually concerned I was losing too much weight.
    I would like to try this again in the future, but I need to A) Recover from the bout of reflux and B) find circumstances in which I can actually try it without messing up.

  28. Adam says

    Chris,
     
    How might you suggest one stay regular during the low carb diet? Any opinion on flax seed? Would that cause problems with the overgrowth?
     
    Thanks for any advice.

    • Chris Kresser says

      Constipation is almost always related to poor gut flora. Fiber isn’t necessary for proper regularity, because there are many traditional cultures that don’t eat much of it and are still regular. Probiotics and, if tolerated, prebiotics are helpful for this in the context of a low-carb diet.

    • says

      Speaking from experience, if I get enough fat in my diet while low-carbing, I don’t have much trouble with regularity. If you are dropping your carbs you need to make sure to get plenty of fat. Protein should not stand on its own in the diet.

      Flax adds excess PUFA to an already PUFA-laden diet, even if some of it is omega-3.

  29. Brittany says

    I don’t always feel my heartburn, but my throat sure does. I’ve been following a primal lifestyle for about a month or so now and I still have heartburn troubles sometimes. Yesterday, I woke up with a sore throat from it and I am still recovering from that, it is slowly feeling better. I am afraid about potential damage to my esophagus. I am 21 years old, had gastritis where I was given a 2 week course of prilosec. Other than that, I only took 2 zantacs when they gave them to me and stopped when I found out how they won’t fix the problem. I took probiotics for 2 months and will begin them again soon, as chewing a tablet of them tended to help the heartburn. In my situation, should I have a doctor investigate the heartburn? They investigated other digestive troubles before (constipation mostly), but now my main complaint is acid reflux. So, go to a doctor or jump right into trying HCL?

    • Chris Kresser says

      That’s entirely up to you. They are different approaches. The standard of care for acid reflux in conventional medicine is acid inhibiting drugs. I’ve explained what I think about that as an approach, and I’ve offered an alternative. It’s up to you to decide which path you’d like to take.

  30. Brittany says

    Well, I definitely refuse to take acid stopping drugs. What I was unsure about was whether or not I should have it looked into to see if there were other underlying causes. I also believe I am dealing with candida, and can see how HCL would help with that, so I shall be trying that soon I have decided.  Thank you for your articles.

  31. Tim says

    Hi Chris,
    What’s the difference between orange juice and other juices? A friend of mine gets heartburn when she drinks orange juice, but not when drinking for instance pineapple juice. What is there in orange juice that triggers the heartburn?

  32. Denise says

    Have you ever heard of a  vertical gastric sleeve? It is a weight loss surgery where they make you a smaller stomach. People who have had that done suffer from gerd because the stomach makes enough acid as if it were a normal sized stomach. Would the approach be the same even if you have had your stomach size reduced in this way?

  33. Brittany says

    Hey Chris! So, I’ve been doing this method of treatment for a couple weeks or so now, and I made my way to 3 capsules (4 produced slight burning).  It was helping and my indigestion was minimal, and heartburn gone. However, for a couple days now I’ve been getting heartburn regardless. Am I doing something wrong (or should I attribute this to a hormonal pms symptoms)? During this treatment will heartburn come back if you are taking too much or too little HCL?

    • Chris Kresser says

      Brittany: it’s often not a linear process. Stick with the whole program and you should continue to improve over time.

  34. marla says

    I didn’t see any mention of hiatal hernia in your discussion of causes of GERD.  I have a hiatal hernia and am wondering if your ideas and recommendations would apply in my case. very interesting reading. look forward to your response

  35. Chris Kresser says

    Maria: these recommendations aren’t specific to hiatal hernia, but there’s certainly no reason not to try them and see if they help.  Anything that reduces bacterial overgrowth and intra-abdominal pressure should ultimately help reduce symptoms.

  36. Jon says

    Thanks for the great series on GERD. I understand the simplicity of your 3 step plan to naturally eliminate GERD, but I’m having some trouble figuring out how to implement it personally.
    Here’s my background:
    I’m in my late 30′s and have suffered from occasional heartburn since high school. In my mid-20′s it became chronic and I’ve been taking Aciphex once per day ever since. If I miss a dose of Aciphex I’m usually okay, however if I miss two doses, then I’m in tons of pain. In that circumstance, even drinking water can cause unbearable heartburn pain. The good news is that I don’t have BE or any other esophagus damage. The bad news is that over the years, I have terrible bouts of IBS. Today, in fact, my wife wanted us to take the family shopping, but instead I’m stuck at home with cramps.
    I’m having trouble figuring out:
    The first step is to reduce fiber and carbohydrate intake. This is also highly relevant for me since I’ve taken a metabolic typing test which indicated I was a high oxidizer, and therefore should eat more meats and fats. However the problem with that is I feel horrible when I eat a lot of meat. For example, if I eat a nice big steak, I just have a general “icky” feeling all over my body. It also clouds my thought process, like I’m in some type of mental fog. Maybe that seems weird, but it’s the truth. Also if I eat a lot of meat, I get lethargic and soon will crave carbohydrates.
    I’ve long suspected that the Aciphex was causing my IBS and preventing me from properly digesting meat. However because I quickly get painful heartburn after stopping Aciphex for only two days, I’m just not sure how to proceed.
    Will taking HCL w/Pepsin supplements help solve this dilemma?
    Having GERD and then having the health problems from taking Aciphex for over 10 years is very frustrating to me and my family. I don’t want to live like this any more. So again THANK YOU for this series of posts. I guess I just need a little more clarification and encouragement on how to “get started.”
    God bless!

  37. Chris Kresser says

    Jon:

    Step 1 is to reduce carbohydrate intake.  Simultaneously start the HCL w/pepsin to improve protein digestion and address the low stomach acid often present in these conditions (make sure to follow the instructions in the article for introducing it carefully, though.  A rare percentage of people actually do over-produce stomach acid, so it’s important to make sure you’re not one of them.)  Good luck!

  38. Chris Kresser says

    For probiotics, stick with trusted names like Natren, Jarrow & Biokult.  Biokult is probably the best but its fairly expensive.  Choose products with multiple strains of bacteria in them.  I’m a little less choosy with HCL, but Now makes a good one and it looks cheaper than what you’re considering.

     

  39. says

    Thanks for the valuable info. My wife – current with a mild case of GERD – has been using apple cider vinegar (with some benefit) but based on this info I’ll suggest she switch to hCl.

  40. says

    The HCL w/pepsin that I ordered finally showed up last week. So I took one pill right before supper. That evening, I had an uncomfortable feeling, but it wasn’t a “burning” sensation. It’s hard to explain. Afterwards I had to burp more than usuall and had some intestinal gas. I’ve been too leery to try again. Any advice?

  41. Angela says

    Hi Chris,
    Thank you for a very helpful series of posts. Three years ago my gastroenterologist did an endoscopy and told me that I had GERD (I had a small hital hernia and h.pylori). I didn’t believe it at the time because I never had any symptoms. I was never treated for h.pylori. Last week, I found out that my h.pylori breath test was abnormal (I got tested because I’ve been having lower abdominal pains, heaviness, and nausea). I know that my gastroenterologist very conventional and will recommend the triple therapy. I don’t want to take antibiotics especially since I have struggled with yeast overgrowth for a couple of years. I’ve heard that mastic gum or manuka honey can be effective with h.pylori. What are your thoughts on these alternative treatments? Is it worth going back to my gastroenterologist to see if I still have GERD? I have plans to go on the GAPS diet and supplement with HCI.

  42. Chris Kresser says

    Angela,

    H. pylori is the primary cause of low stomach acid, so it’s important to address an overgrowth if present (which it sounds like it is). The GAPS diet will help rebalance your gut flora, and the HCL will help replace stomach acid in the short term, but you need an antimicrobial protocol (I would first suggest botanicals, and if you don’t have success there or if the infection is particularly severe, possibly the triple abx. therapy). Mastic gum has shown some activity against H. pylori. Not sure about manuka honey.

  43. Chris Kresser says

    P.S. You also have to consider appropriate strategies for repopulating the gut flora (i.e. probiotics), either during or after the antimicrobial protocol.

  44. Chris Kresser says

    I’m referring to any number of herbal/botanical medicines that might be appropriate. I think it’s best to work with a trained herbalist in these cases, rather than self-treating. Herbs can be powerful medicines in their own right, and should be used appropriately.

  45. DancinPete says

    Hi Chris,
    Love this series and your site in general. couple of questions.
    Is there a difference between fungal and bacterial overgrowth in symptoms and/or treatment?

    Also, what’s your thoughts on colonic irrigation/hydrotherapy? Most of your report implies that GERD is due to overgrowth in the small intestine, but many naturopaths promote colonic irrigation to clear out any pathogens in the colon.

  46. Chris Kresser says

    There’s a difference, but clinically the approach to treating is similar.

    I’m not a fan of colonics. I think they’re too harsh, and they clear out as much or more good bacteria as bad.

  47. DancinPete says

    thanks Chris,

    This may sound silly, but if the HCL supplements contain HCL similar to our own stomach acid, how do the pills release their contents once eaten?
    Obviously the casing is impervious to HCL otherwise you’d end up with a bottle of self-dissolving pills, and yet they’re designed to release their contents once in your stomach.
    What mechanism in your stomach is breaking up the pill’s coating?

  48. Jack Kronk says

    Ok Chris, I’ve been meaning to chime in here for a while. I’ve been trying to fight off a mild-to-moderate case of heartburn for about 2 months now. It comes and goes, whether I have just eaten or haven’t eaten for hours.

    A quick background:
    After a couple weeks, I went to the Doc. She gave my Nexium. Took it for 3 days until I found your series on GERD. I read all 6 parts and was very impressed with your thorough writeup.

    I eat a whole foods diet. Grass fed beef, organic eggs, pasture butter, organic cream, wild salmon/tuna, organic chicken, raw milk, pure cheeses, sprouted breads, sprouted nuts, relatively low carb (about 70g/day) no sugar, no vegetable oils, cook in coconut oil and red palm oil, take FCLO/HVBO blend, borage oil, whey cool raw milk protein powder, sweeten with pure stevia.

    I’ve been eating this way for about 3 months solid now, daily. When I made the switch from a “normal diet” to the low carb diet, I started getting the heartburn.

    If H. pylori is causing my esophagus to malfunction, thereby allowing stomach acid to irritate it, then getting my H.p. normalized would be my goal to fix the issue, right?

    You and Dr Ayers (Cooling Inflammation) believe that carbs feed the H.p., but I read an article on Perfect Health Diet that indicates a lack of carbs causes a deficiency in stomach mucus (mucin), which could then allow H.p. to throw a party and spread like crazy.

    PERFECT HEALTH DIET – MUCUS DEFICIENCY

    I began taking Betaine HCI at meals (350mg pills). Sometimes I take one, sometimes 2. Never gone above 2 at a time (700mg). And I haven’t been consistent, since I didn’t know if the increased acid would irradicate the H.p. I ‘think’ it helped a little, but honestly I’m not sure.

    I feel absolutely top notch otherwise, but I am trying to find the right balance and rid myself of this annoying issue. Could it be my gut flora hasn’t adjusted to my ‘new’ diet?

    What can I do?

    Thanks,
    Jack

  49. Chris Kresser says

    1. Get tested for H.pylori. Preferably a urea breath test which is more accurate than serum testing. If positive, you’ll need to deal with it.

    2. Take HCL as described in my GERD series. Increase dose until you feel burning, then back off. HCL won’t kill H. pylori, but it will make a less hospitable environment.

    3. I’m not advocating zero carb, just carb reduction. You’ll have to experiment to see what works.

  50. Jack Kronk says

    Chris,

    I will do all 3 steps above. I just read that link to urea breath test. At the end they say “When H. pylori infection is identified, the most widely used front-line therapy consists of 7 to 14 days of a proton pump inhibitor, clarithromycin and amoxicillin. ”

    Does that mean that taking Nexium for 2 weeks might actually be part of the plan to fix it. I thought that was bad advice.

    Anyway, I will do whatever it takes. I will immediately request the test kit from my doctor, as it says on their site that only physicians can order it.

    Thanks very much Chris.
    -Jack

    • Todd says

      Hey Jack – Good to see you here.

      I’ve found this gem of a series and reading up as much as I can (have heartburn as I type this) I notice this was a while back. Any status / progress update?

      Thanks

  51. Chris Kresser says

    That’s the typical mainstream advice, but I don’t necessarily advocate that approach. With H. Pylori it isn’t about eradicating it completely, but brining the intestinal flora back into balance.

    • Samantha says

      I can’t seem to get any relief, 2 weeks now, ulcers on my esophagus,burping to the point of vomiting, naseauted,dirreah, I have been in and out of emergency rooms, I feel hopeless and I am completely miserable, omeprozole, prilosec, prevacid, u name it I have been on it. My diet has not been good in past, I ordered some super enzymes, nothing is working, and I’ve been eating nothing but veggies and salads here lately, the gas and bloatness is horrific. I’m so miserable, please help!

      • Becca Um says

        I feel your pain. I have been in and out of emergency rooms for the last 3 months. My severe acid reflux started after taking two rounds of antibiotics. I am still figuring out what natural remedies work and which ones don’t work. I take digestive enzymes and DGL. I still have no real relief.

  52. sarah says

    Once stomach acid is high enough, back to normal so to say, why doesn’t it also kill the probiotics? How can they continue living in the stomach or travel to the intestine, especially the natural ones?

  53. Chris Kresser says

    Good question. Probiotics don’t live in the stomach, for the reason you described. And many commercial probiotics don’t survive the stomach acid to pass through to the large intestine. Some brands, such as Klaire, have proprietary technology that protects the live organisms from the stomach acids. Food-based probiotics seem to be better protected as well. And in large doses, it appears that some will survive the stomach acid anyways and make it to the L.I. Finally, I sometimes instruct my patients to do probiotic enemas.

  54. Howard says

    Are there a list of gas free vegetables that you can recommend? It seems like a lot of veggies found in low carb diets may also produce a lot of gas, such as broccoli.

  55. Chris Kresser says

    All of the squash (winter & summer), carrots (especially peeled), lettuce and cucumbers are all pretty safe from that perspective.

  56. Rob says

    I am a vegan and live mainly on a diet of fermented ( soaked/sprouted )
    grains and legumes. Can I stay on this diet and still have a chance of getting rid of the GERT?.

  57. Chris Kresser says

    Some people find that it helps, but if the problem is bacterial overgrowth, raw milk could potentially make it worse (because of the carbohydrate content). You’ll have to experiment to find out.

  58. Shyam says

    Hi Chris,

    I have been following your article series for some time. I have been suffering from GERD Grade “A” for the past 9 years and been constantly searching for a cure. Your articles are an eye-opener for any GERD sufferer!I also bought Dr. Robillard’s book on low carb diet and found relief in the low carb diet.

    I just read an article on the UK government website which seems to promote starchy foods and says that low-carb diets could cause heart related problems.

    The link for the article is:
    http://www.eatwell.gov.uk/healthydiet/nutritionessentials/starchfoods/

    Now, I am skeptical as to follow the low carb diet or increase the starchy foods which for sure would give me heartburn?

    Your comments?

  59. says

    The HCL w/ pepsin didn’t work for me. However about 2 months ago I gave up eating wheat. Yesterday morning I realized I had forgotten to take my evening Aciphex the night before, and had no symptoms. So yesterday I intentionally skipped my Aciphex, making it two nights in a row. Based on previous experience, I should have some heartburn already this morning if I miss two doses of the Aciphex, but I actually feel fine. So perhaps my heartburn was caused by an intolerance to cereal grains? (I’ve also had other medical symptoms that have cleared up or gotten much better since giving up wheat.) Now my stomach does feel strange this morning, but not painful or heartburn. Perhaps it’s the sensation of stomach acid that is now unfamiliar to me? Again though, it’s not painful and it’s not heartburn. Yay!

  60. FRIEDA says

    I HAVE BEEN ON PANTALOC FOR ABOUT 8 YEARS NOW, SINCE BEEN DIAGNOSED WITH HIATAS HERNIA. JUT A WEEK AGO, MY DOCTOR ASKED ME TO TRY A NEW DRUG “TECTA”, BASICALLY THE SAME AS PANTALOC, ONLY THAT THIS DRUG HAS MAGNESIUM AND PANTALOC CONTAINS SODIUM.
    AFTER TRYING TECTA FOR A WEEK, I CAN’T REALLY TELL A DIFFERENCE BETWEEN THE TWO. IS THERE A DIFFERENCE ?
    I GET SEVERE HEARTBURN, IT GOES UP TO MY THROAT ALSO. VERY SCARY.
    CAN’T DO WITHOUT THE PANTALOC, THIS REALLY HELPS ME DAILY AND ALSO STAYING AWAY FROM A LOT OF FRIED, SPICY FOODS. I TAKE 1 TAB DAILY. I AM HELPLESS, WHAT ELSE TO DO? MY IRON LEVEL IS DOWN…AND AFTER READING THE ARTICLE OF SOMEONE ON NEXIUM, THIS SENT A RED FLAG. PLEASE GIVE ME SOME POINTERS…THANKS KINDLY.
    GREAT JOB!!!! PS..I AM A FEMALE..

  61. miko says

    hi chris,

    i have been taking ppi for about a year now. i still have heartburn every day, even though i have been reducing sugar intake etc. (no “formal” no-carb-diet though). i want to get into the paleo-diet now.

    my question is:
    ppi lower hcl. that seemed to help me quite a bit at first. if i forget to take the ppi, the pain gets worse. wouldnt removing the ppi AND adding hcl+pepsin make it even worse?

  62. John Johnson says

    Hi Chris,

    I’ve been working on a low carb diet and ~4 to 7 HCl pills (650 mg) with meals for 4 months (even after 7 pills I never feel a burn). I’m not sure if it helps, I still have bloat/gas off and on. I have avoided heartburn when I sleep somewhat upright, but sleeping flat still gives a probability of severe heartburn.

    I am wondering what else I can do? How about fasting–do you have any opinion? (I would would have no problem fasting for several days if I thought it would help).

    Also, in the midst of heartburn what is the best temporary measure, e.g. baking soda? I realize permanently reducing the stomach’s acid level is not a good thing. But in my case, the onset is several hours after eating and maybe a temporary antacid is better than not — besides the pain, I’m afraid my LES getting bathed in acid is not good either…

    thanks!!!!
    John

  63. Chris Kresser says

    Testing for H. Pylori and other pathogens is the next step when dietary changes don’t have the desired effect.

  64. Matt says

    Hi Chris,

    I was diagnosed abroad by a GI specialist with H. Pylori, Chronic gastritis and inflammation of the esophagus on September 2010. I took Nexium and antibiotics to treat the infection. I finished taking the cocktail treatment on December 1st 2010. The GI specialist made a comment saying that I was born with a defect on my (LES). However, that did not make any sense I’m 23 Years old and if what the GI doctor said would have been truth; I think I would have experienced symptoms earlier in my life. Reading your articles give me hope so I can continue to treat my condition without medications. I recently got a lab work done and everything came back normal with the exception of my liver enzymes being slightly high.

    Based on my situation is it possible to conclude that my indigestion problems are due to low acid and i need to to take the HCI with Pepcin?

    Any suggestions would be appreciated.
    Thanks for reading

    PS: I’ve started taking the DGL, Probiotics, following lowcarb diet and gentle potency digestive enzymes.

  65. Matt says

    Thanks Kriss for your early reply

    I noticed that you wrote a warning of using HCL with pepcin if you use NSAIDS and Ibuprofen. My only concern using HCL with pepcin is the following:

    I have used both NSAIDS and Ibuprofen in the past.(Around July 2010 to be exact). Before I developed symptoms of heartburn, doctors in the U.S thought the reason for my migraines on my left temple were due to allergies. I used NSAIDS for two weeks and experienced nausea and vomiting. On my follow up appointment they gave me ibuprofen. At this moment I’ve had lost all my trust on the health care system so I only took about 5 pills and discontinued taking the rest of the medication.

    My concern is the following, would it be safe for me to take HCL with Pepcin after 5 or 6 months of having taken NSAIDS and Ibuprofen? Should i wait a few more months for my stomach lining to heal?

    I appreciate your feedback

  66. Amy says

    Hi Chris,
    I am on day 6 without my prescription Prilosec and am following the very low carb diets, HCL and probiotics and am also taking L-Glutamine to help heal my stomach and esophagus.
    I have been having mild heartburn everyday after meals and am wondering when I can expect this to subside? I am sure it will take time, however, is there anything I can take to help reduce these effects of being off the meds and getting my digestive system back on track? Its just pain after every meal. I am thinking maybe some sort of herb or supplement will help. Thank you so much for these articles, I am truly grateful for this information and help.
    Amy

  67. C. Wright says

    I’m currently taking both Prilosec for gerd and Symbicort for asthma. I’d like to get off both but am researching tackling the Prilosec first. You give a warning not to mix HCL with corticosteroids such as Symbicort. Until I quit the Symbicort, is my next best bet bitters? Anything else that would serve the purpose of the HCL?

  68. Amanda says

    Chris,
    I ordered and got Now Foods Betaine HCL capsule 650 mg. I find it difficult to swallow capsules which are big in size. Can I open up the capsules, mix the powdered contents with water, juice or protein shake and drink it? Will that help?

  69. Ross says

    I have been following your suggestions to get rid of my reflux and have got some confusing results. While the low/moderate carb diet does seem to help, taking betaine HCL gives me heartburn. I am taking betaine HCl pills before each meal with half a glass of water and eating the meals after a minute. Could water be the cause? If so, what alternatives do you suggest?

    Also, Could it be possible that my HCL levels have recovered since I have been constantly taking raw lemon juice with every meal for the last couple of months before trying betaine HCL?

  70. Linda says

    I saw a gastroenterologist in 2005 who did an endoscopy and diagnosed a hiatal hernia and GERD. I have taken Prevacid 30 mg for the last 6 years. Since 2007 I have been experiencing a violent cough that has become more prevalent over time and interferes with my work as a teacher . I saw my family physician who sent me to an ENT who sent me back to the gastroenterologist. Another endoscopy showed gastritis and gastric polyps. The polyps were biopsied (benign) and I return to the doctor tomorrow to discuss treatment options. I have been so frustrated I thought would insist on surgery. I have become increasingly anxious about the thought of the surgery and am thankful to have found your article in the nick of time. I read it thoroughly, but am overwhelmed. I believe a meal-plan (or a few meal plans with varying degrees of “low-carb” diets) which include which supplements to take and when would be helpful. Would you consider putting something like that together or can you point me in the right direction?

  71. john anderson says

    I am curious about how you account for the disparity between your advice to avoid fiber and somebody like Dr Weil who reccomends consuming 40g of fiber per day.
    While you mention that Carbohydrates that escape absorption are fuel for bacteria, presumably something like Metamucil which has 0g of sugar is not a carbohydrate and escapes this rule.
    If that does negate that argument against fiber, then is the possibility of nutrient binding the only thing that stands in the way of reccomending fiber supplemention(i.e Metamucil)?

  72. Chris Kresser says

    The idea that we need grain fiber for bowel health is preposterous. If that were true, then how did humanity survive for 85,000 generations before the invention of agriculture and the widespread consumption of cereal grains? How is it that people like the traditional Masai in Africa, who eat little to know plant foods or fiber at all (subsisting almost entirely on meat, milk and blood) have regular bowel movements and almost a complete absence of cancer and other modern degenerative disease?

    Fiber is only necessary when people have screwed up gut flora. 60-70% of the dry weight of stool is bacteria. Constipation = bad gut flora. Correct the gut flora, and no grain fiber is necessary. The reason that soluble fiber from starchy tubers and fruits/veggies is beneficial is because it feeds bacteria in the colon, which in turn produce short-chain fatty acids like butyrate that provide fuel for colonocytes. This prevents colon cancer.

    So soluble fiber from fruits and veggies – yes. Insoluble fiber from grains and things like Metamuecil – no.

      • Frances says

        Hi, My GERD problems developed after I had been on Psyllium husks to prevent constipation whilst dieting (on a low-carb diet). I think the problem may have resulted from an over-full stomach (and sitting badly after meals). This fibre absorbs a great deal of water and can produce a lot of gas.

  73. Tracey says

    Hi Chris,

    This is fascinating stuff. What do you suggest for temporary relief until the symptom subside? It’s impossible to sleep when the heartburn is so bad and I want to stay away from the drugs, but its hard not to take them when you know they’ll make the pain go away so you can sleep!

    I’m taking the HCL and Pepsin now, but have only been doing that a few days. How long does it typically take to help?

  74. says

    Hi Chris,

    Fantastic article! Found out about you through Robb Wolf’s podcast – really like everything you had to say on there. Anyways, I’m 24 years old and have suffered with on-again off-again heartburn for the last 7 months or so, never having had it before in my life. It came about during a really stressful time for me, so I’m assuming that this may have been a trigger. I’m a singer and my doctor immediately put me on PPIs back in September which gave me good results. After going off them in November I supplemented with small doses of enzymes and HCI to get everything back on track and things were going well. By Christmas I was back to normal eating without any heartburn and only took enzymes for really big feasts; I follow a pretty strict paleo diet, along with Leangains style intermittent fasting, although I have been prone to the odd neolithic carb binge. That said however, in the last month or so it seems my heartburn has returned with a vengeance. I’m linking this again to stress, but I’m also wondering if perhaps I have a hiatal hernia (a lot of family members are prone to them) that is being exacerbated by my massive meals, as I only eat about 2 times a day. I’ve dropped my carbs down to below 50g per day and have gone up to 6 caps per meal of HCI but am not seeing any improvements. In fact, since taking the HCI again I seem to be even gassier than before and get very bloated. Could I naturally just have a stomach that empties a bit on the slow side? Would I be better off trying a normal eating pattern with smaller meals before I give the HCI another go? Have you seen any correlation between meal frequency and GERD? I’m getting really frustrated as nothing seems to be working and I’m beginning to wonder if perhaps my stomach acid is fine and maybe I’m over-complicating things ie. eating smaller meals may be the only change I need to make. What are your thoughts? Thanks so much for your time!

  75. says

    Hi
    i am 16 years old and have had gerd for the past 3-4 months. The docter gave me Zantac for a month, but after i was off of it it still kept coming back. I dont know what to do, he put me back on the medication again. But i just want this gerd to go away…

    PEASE HELP!

  76. says

    What about using beer as a supplement? It’s high in folic acid, hops, and lots of B vitamins, including B12. I’ve read over and over again that Beer is a miracle food when consumed moderately…is this true when it comes to acid reflux?

    • says

      Grain… you can get gluten-free beer but I’m not sure it’s worth it.

      If this is a serious question, I bet homebrew’s better for you than Budweiser, though. :)

  77. says

    Actually, with the milk and carbohydrates thing, if you have fermented the milk into yogurt or kefir, it has far less carbohydrate at the end of the fermentation process. I am given to understand that the reason carb count seems so high on commercial unsweetened yogurt is that the liquid fraction of the original milk is still present (except in Greek yogurt) and the nutritional assayer’s definition of “carbohydrate” is different than the biochemist’s. Anything left over after you count the protein and the fat and the minerals is considered carbohydrate even if it’s not sugar at all. So they apparently count lactic acid as carbohydrate and the count goes up.

    Of course the other possibility is the commercial yogurt just isn’t fermented for long enough. Since it’s done with machines I think that’s probably fairly likely.

    The Specific Carbohydrate folks advocate fermenting a yogurt batch for about 24 hours. I can’t imagine there’s much lactose left in the stuff by the end of that.

  78. says

    Actually, with the milk and carbohydrates thing, if you have fermented the milk into yogurt or kefir, it has far less carbohydrate at the end of the fermentation process. I am given to understand that the reason carb count seems so high on commercial unsweetened yogurt is that the liquid fraction of the original milk is still present (except in Greek yogurt) and the nutritional assayer’s definition of “carbohydrate” is different than the biochemist’s. Anything left over after you count the protein and the fat and the minerals is considered carbohydrate even if it’s not sugar at all. So they apparently count lactic acid as carbohydrate and the count goes up.

    Of course the other possibility is the commercial yogurt just isn’t fermented for long enough. Since it’s done with machines I think that’s probably fairly likely.

    The Specific Carbohydrate folks advocate fermenting a yogurt batch for about 24 hours. I can’t imagine there’s much lactose left in the stuff by the end of that.

  79. says

    Hi Chris,
    I have read your heartburn series and have a question. I “came down with” acute reflux a few months ago, seemingly out of the blue. I eat dairy free moderate carb Paleo. I tested negative for h.pylori. I have RA, which is associated with low stomach acid, so I have tried adding hcl about a half dozen times these past months. Each time my reflux immediately gets worse so I discontinue. I also experimented twice with Prilosec, just to see, and my reflux got worse with that too. I have added cultured foods and probiotics to my diet. My question is – should I continue with hcl even though it makes the reflux worse, to give it more time? All other factors in my lifestyle and diet seem to be appropriate (from my perspective as a fairly knowledgable practitioner), with the exception perhaps of 1-3 cups of green or pu erh tea each day. I am not entirely sure if the tea could be a culprit. I tried 2 weeks off it and the reflux continued. So my main question is about the hcl use, but if you have any other suggestions I’d appreciate it. Love your site!

  80. James says

    Chris:

    Many thanks for your helpful advice. Since finding your website recently, I have learned a great deal from your articles and podcasts.

    Based upon the information provided in your series on heartburn and GERD, I have reason to suspect that my stomach acid is on the low side, and I would like to try supplementing with HCl and pepsin. I’m conflicted, though, because I also have slightly dark stool, which I’ve heard can be associated w/ ulcers. (I am in no pain, am generally in good health, follow a paleo diet, and have no other symptoms of an ulcer.) Would following the HCl-pepsin protocol above be inappropriate for me, or am I OK as long as I’m careful and I start out w/ the lowest possible dose?

    Thank you very much for sharing your knowledge.

    • Chris Kresser says

      An ulcer certainly isn’t the only explanation for dark stool. I can’t offer medical advice, but absent any symptoms it seems unlikely you have one.

  81. Sarah G. says

    Thank you for your insights! Will this dietary-change approach be effective for severe GERD caused by a hiatal hernia? Can I assume this falls in with the LES dysfunction you discuss?

  82. Cheryl says

    I am so confused! My 13 year old daughter was diagnosed with GERD two months after getting her period. ( We noticed a great deal of burping … I called them “manly burps” because they were so big coming from such a little thing – she’s 5’2″ and weighs 105 lbs. )
    At first we thought it was asthma because when she was running her airway would close and she would weeze terribly. After testing, it was determined that she had Paradoxical vocal chord dysfunction due to acid “splashing” on her vocal chords during physical activities. She was then put on a PPI. (prilosec). She had an adverse reaction and was then prescribed Prevacid.
    She recently had an endoscopy done and it was revealed that her body was producing too much acid (?). Everything else looked fine… no ulcers, the valve was OK, etc. The pediatric gastroenterologist doubled her dose of precacid which caused a systemic rash over her entire body. We took her off the Prevacid and they put her on Nexium. She had horrible stomach pains, excessive bruising, and nightmares. We took her off of the Nexium immediately. Her gastro was on vacation last week but the partner put her on Protonix…. Horrible!
    I stopped giving her the protonix because she “tasted puke in her throat” all day and had a severe stomache ache as well.
    Anyway, I am now giving her probiotics and dgl tablet before each meal. It has only been a few days, but she says that her stomache ache is gone but still has a little acid taste every now and then. (Still burping but not as much.) How long should it take to get the PPI out of her system? (She started taking them back in December 2010). Is it OK to give the DGL tablet with the probiotics? We tried yogurt when she was first diagnosed with GERD but were unaware that she was lactose intolerant! The probiotics that I am giving her now are vegetarian (lactose free)… does that matter?

    I am not putting her back on any kind of PPI as I really feel her body can not tolerate them. Is there anything you can recommend that is holistic / natural … she is only 13. Have there been any studies linking hormones to GERD? Please help us!

  83. says

    What is your opinion on treatment when one has an established diagnosis of Barrett’s esophagus and inflammation on EGD? She is currently not experiencing heartburn and is not using a PPI like she has had to in the past. She is using DGL licorice and glutamine along with tumeric, probiotics and digestive enzymes. She was treated for a parasite and has given up gluten b/c she tested sensitive to it. Her GI doc thinks she is absolutely crazy to not want to take a daily PPI with Barrett’s.

  84. Sarah says

    I have found that eating gluten, rice, red wine, vinegar and some other foods cause sever choking heartburn that lasts for 6 to 8 hours. I think food allergies can cause GERD due to the high carb explanation above but also due to them cause inflammation themselves as they pass down toe oesophagus,

  85. vanessa says

    Hey…i do not get the heartburn feeling at all, all i get is the gnawing, burning pain in my lower esophagus. I take 20 mg omeprazole a night, this sometime stops the burning, gnawing but not always.
    My question is the Omeprazole stops acid secretions, and therefore stops my pain, if i take the HCL this is acid? then wont it make it all worse? i have had an endoscopy, no major problems indicated. I was told i had esophagitis, due to gerd. Please can someone comment…Cheers

  86. Erica says

    How long should the Hcl with pepsin supplement be taken? Until symptoms subside? Or indefinitely? Thanks.

  87. cindy says

    My GERD is due to a hiatal hernia. I’ve been paleo (with dairy) for almost a year. I feel great and am at my ideal weight. After reading your GERD series and as a result gave up my daily Prilosec – just about 2 weeks ago. I also gave up most fruits (due to fructose malabsorption and/or sorbitol intolerance). I eat 8 ounces of fage yogurt a day. I’ve been doing diaphragm strengthening exercises as well as trying to “push” the stomach down and back into place.

    Still, since giving up the Prilosec, I have heartburn after every meal for several hours. Exercise exacerbates it to the point that I need to stop. Do you have any additional recommendations? I’m very close to giving up. Are Tums better than Prilosec? Is Pepcid better? Thanks in advance.

  88. Maria says

    Hi Chris,
    Thank you for sharing this great information! It has been really helpful with my gerd. I have been eating HCL with pepsin and other enzymes for 4 months now and I´m almost free of heartburn. Now I´m wondering if it is safe to eat HCL and enzymes when been pregnant?

    • Rebecca says

      Did you ever get an answer to this? There are other people on this comment thread that have asked the same thing. I’d really like to know!

  89. Gerald says

    Hi Chris,

    Congratulations on your GERD articles and site.

    I have been taking Prilosec 20mg for 15years and Seroxat (Paxil) 15yrs also, when I have tried tapering off Prilosec to say 10mg then all hell breaks lose, acid galore and have to go back on the Losec for relief and some sanity, I have tried the ACV and HCI and what seems to happen is that after about 5 days my proton pumps awaken with a vengeance, recently been taking chinese traditional medicine TCM and was okay the first week as I was still on my Losec, the second week stopped Losec and BANG!! 4 days into the therapy at night time had to start taking bicarb of soda and 5mg of Losec just to sleep, today I gave up and took the Losec 10mg as the right side of my throat/esophagus is burning, I had this burning a year ago when I last tried tapering off and had a endoscopy and was diagnosed with esophagus inflammation and put on Nexium and something to stop bile reflux for a month, then switched to my usual Losec dose, what go me to that point was 5 months of trying another TCM docs herbs!

    Now I am really going to try low carbing, I wonder if cooked or raw is better, one guy on the net Vonderplanitz eats raw meat and no veg only veg juice, raw eggs, raw milk, raw butter etc. Now I live in Beijing at the moment and we don’t have Raw milk, raw butter, raw cheese etc – I wonder if eating normal pastuerised milk and butter is okay, it’s the nearest thing available to me, eggs I get free range as many are fed with grains so opt for the free range and hope they are insect eating high omega3 variety eggs, so anyway I ate raw liver and chicken breast and raw eggs, the meats slightly scalded, just dipped in hot water for a few seconds after being defrosted, I gather the freezing will kill bacteria … the guy Vanderplanitz says that cooked meat is a problem, i.e. lipid oxides etc, I plan on eating cooked veg and meat as well.

    I am overweight and this I believe is part of my problem, I am 105kg down from 107 a few weeks back and 5ft,11inches and my ideal weight should be in the range of 73kg.

    Another thing, my other med Seroxat is connected to my gut as well, when I try tapering off that one I get sick feelings and pain in my stomach etc, recently tapered off completely so I could try taking Melatonin, B6 etc as in a Brazilian study where a doctor tried this group of supplements with apparently good results, cause both Melatonin and seroxat affect the brain I wanted to take the Melatonin on it’s own, did this for 5 days but didn’t experience any LES tightening effects and all my depression stomach aches started coming back and had to go back on the seroxat and stop the Melatonin, I was basically looking to tighten my LES.

    I have read that L-Glutamine, Calcium Citrate, Meadowseet help ‘tighten’ the LES, what do you think? Are there any other things that tighten the LES?

    Also here in Beijing I can only get Yoghurt with sugar, even the plain one has sugar! There is one brand that has Xylitol, not sure if that is healthy? Thanks Chris for any advice or help you may be able to give.

    Gerald, Beijing

  90. says

    Hi Chris,
    I love your articles, esp. this one. I quit the Prilosec and gave HCI a try. It caused more reflux and some research tells me that I might be in the 10% with plenty of acid. I’m not feeling too bad without the medication, but I do occasionally get reflux, mostly caused by exercise or anything that causes a little pressure on my stomach area. Is there anything natural that I can take for the occasional reflux, preferably something I can carry in my purse? Thanks!

  91. Josefa says

    Hi Chris
    First of all thank you for the wonderful information. I am very delighted I found you and specially what you explained about GERD. Sometimes I feel hopeless about this. My case is the following: I have frequent heartburn since I was 30, now I am 34, and went to see some doctors and they prescribed me medicines like Nexium and told me to follow a low fat, low acid and low dairy diet. I did try to following the diet and I was good for most part but it was a bit hard for me, and the treatments with medicine did not work. I am not overweighted. I usually eat a variety of vegetables and fruits during the day, whole wheat products and unsweetened almond milk, fish and lean meat but I eat some sugar throughout the day as well. But it did not help, so I started taking omeprazole 20mg once a day( I have been taken it for almost 2 years). The omeprazole keeps the burning sensation away, but lately I have had gas and bloating every day and my bowel movement is not regular. I often have migraines and I feel down a lot of times ad get irritated easily, so when I read your article this all lightened up to me. I tested for H. pylori last year and it came out negative. I also got an upper endoscopy last month and I do not have Barrett’s esophagus, I only have a small hernia. I also tested for iron and B12 last month and they came back normal. I would like to do the HCL/pepsin test that you suggested to see if I have low acid stomach. But is the HCL/ pepsin just a test or also the treatment? or both? And for how long do I have to do it? Do you suggest that I test again for H. pylori? Thank you. Looking forward to your response.

  92. Gerald says

    I just wanted to add that my problem I feel is the hiatus hernia, the foods changes and lifestyle changes are still good and may really help but we need to get our Hernia sorted out, you can tense the muscles of your abs if they are not so tight, do abdominal breathing to bring your diaphragm down and massage the les area down to the left along the underside of the ribcage, I do this all for Hiatus Hernia but only been doing for a few weeks will wait and see.

    Gerald

  93. Reub says

    My 98 yr old father, thin and frail, has been suffering from copious secretions, which he expectorates in the morning after waking, for the last few years. He has been diagnosed as having GERD. The doctor wants him on acid blockers but we are hesitating. He has also been told that that he has H. pylori and additionally suffers with constipation issues. How could GERD cause these copious morning secretions? Could pepto bismol help? I will make sure that he drinks some kefir every day but I worry about giving him HCl at his age. We have raised the head of his bed and don’t let him have caffeine products or eat after 7 pm. I give him apple juice but should I switch to apple cider vinegar? Are there other things that we can do for him? Thank you!

  94. Linda says

    Hi Chris,

    I took prevacid for 6 years but was told to get off of it because I had developed stomach polyps. I was given no direction as how to control high reflux once off the medication. Not without discomfort I managed to get off the Prevacid and over time seemed to be doing well, primarily just careful with diet and probiotics. After a family vacation and some indulging, I found myself miserable and desperate (primarily throat burn/cough.) I took the Glutamine and DGL and was relieved immediately. When I added in just the intial one dose of HCL, the throat burn was back. I took another one or two doses after the next couple of meals, but it did not seem right to do so knowing how it was going to make me feel after I had acquired relief. Does that mean that low acid is not my problem afterall? Thank-you for reading!

  95. Gerald says

    Reub,
    My Dad is 80 and has been taking <losec for acid reflux for years, you may think about the risks involved with not taking the acid blockers as erosion of the esohagus, barretts or even cancer could result if your dad doesn#t stop the acid eroding his esophagus and that is a reality, my mum was going through chemotherapy many years ago and I met a guy who had was diagnosed with esophagus cancer after only a few months of acid reflux symptoms, if I were you I#d put him on an acid blocker and then after lifestyle changes try coming off but stopping the acid is the main goal I would have thought.
    Linda I feel for you, as <i said before there could be other factors such as myself, i.e. Hiatus Hernia which would put a stop to any idea that you could just stop the acid via low carbing, although I believe it may help a lot. Those are my thoughts guys from one who has suffered and taken meds for 15yrs.

  96. Pam says

    I find all this info on GERD and PPI’s very interesting. I just recently stopped a PPI that I was on for 18 months. I have had bouts of heartburn and also this hunger/gnawing feeling in my stomach (nolt painful) but there, not always relieved by eating. I was treated successfully for H. Pylori, Any one experience this?
    I am trying to change my diet, but I have a hard time with this low carb diet. I also wonder how that can be
    healthy for a person, do we not need a certain amount for the body? I understand what Chris is saying about
    the carbs for acid reflux but can there be some modifications? Does anyone have or know of a reasonable diet- menu plan for this disorder without having to resort to supplements?
    Thanks
    Pam

  97. says

    Hi Pam,
    Chris would be the expert to comment on diet, although he may recommend the Paleo Solution? Have you read that book? The theory is that gluten intolerances and/or food allergies are the cause of many physical issues including GERD. After I read the book an Chris’ posts on the topic, I decided to move my diet in the Paleo direction. I’m not 100% Paleo…I follow Chris’ 80%/20% rule. I’m an athlete so I do include uncooked oats in my diet in the mornings, but for the rest of the day most of my carbs come from veggies like sweet potatoes. I’ll tell you, I feel good most days, I notice occasional reflux, usually tied to anxiety, sometimes spicy foods (which I love!) and sometimes abdominal squeezing resulting from exercise. Another Paleo diet recommendation is to include probiotics in the diet. The PPI’s kill the good intestinal flora and the thought is that lack of gut health plays a role in reflux. I’m just happy to be off the PPI’s. I actually quit PPI’s and birth control pills at the same time, both of which I had been on a long time and both of which have been suspected in destroying good gut flora. Maybe it’s the placebo effect or the freedom I feel from quitting the medications, but I feel happier also. Good luck!

    • says

      .Thanks kelly for the respsonse.
      I have not read the Paleo book but looked at some things on line about it. It sounds very restrictive. I still don’t understand how a low carb diet can be healthy, but I understand the rationale regarding acid reflux.
      After I stopped the PPIs I had heartburn and burning for about of week, rebound which is to be expected on discontinuation. Then things were very normal for several weeks. Actually I noticed how much better I felt without the PPI, food digested so easily. But now beginning to have bouts of heartburn off and on. This week I have this empty gnawing sensation, like hunger without heartburn, has anyone experienced that? Would that be high or low acid? I have been treated in the past successfully for H. Pylori so I don’t think it could be an ulcer. I would like to stay off the PPIs.
      Thanks

  98. Angela says

    Hello!
    I love your article/s! very informative.. My situation is a long.. drawn out expensive one and I STILL am not free of this illness! I have been on Prevacid OTC 15mg for almost a year on and off I have tired everything under the sun to cure this get off the PPI. I have tried HCL a few times .. still had symptoms I have been tested for H.pylori (blood)it was negative, changed my diet (I already eat very clean) tired acupuncture (just started), chinese medicine chiropractic, DGL, aloe vera, meditation, stress relief, etc etc
    I can’t seem to get rid of this! HELP! I have recently started getting really bad gas too and I always burp up what I eat…if I take the prevacid on a regular basis and eat clean I do pretty good. I am going to have a endoscope soon hopefully that will shed light on this too… I feel hopeless.. scared . sigh if you have any more suggestions I would truly appreciate it. With the DGL should I take that with a meal, after? and the HCL should I feel immediate results or does it take awhile? Thanks!!!!
    -A

    • Lila says

      Hi Angela,

      Have you considered food intolerances? I haven’t seen this topic addressed very much on this site (other than wheat/gluten). Like you, I tried every alternative approach I could find to eliminate the acid reflux with little success. I’d been on Nexium for two years and was very worried about what it was doing to my digestive system. Finally I tried eliminating dairy and after one week my symptoms were greatly diminished and I was able to stop taking the Nexium. 90% of all food allergies are caused by a small number of food groups (e.g., wheat, dairy, eggs, peanuts, soy). None of the GI docs I saw ever considered the possibility of food intolerances. I think a lot of people diagnosed with reflux are also suffering from undiagnosed food allergies/intolerances. It’s all inter-related. Once your digestive system gets off track, all sorts of other problems develop and this can be one of them. Check out this site for great info on food sensitivities. http://www.whfoods.com/genpage.php?tname=faq&dbid=30
      I’m in the middle of the elimination challenge diet to see if any of the other common allergy foods are a problem for me. I already suspect soy. Traditional allergy testing is notoriously unreliable. More and more allergists are using elimination challenge diets. You eliminate the most common allergy foods for a minimum of 4 days. Then introduce one of the foods and wait for 48 hours to see if you have a reaction. I’m on a very low carb diet and that has also helped. Good luck!

    • lila says

      p.s. This site has addressed lactose intolerance and that’s what I first thought was the problem. It turns I’m allergic to milk protein, casein.

  99. says

    Hi Chris!

    I read this page a month ago and felt it made perfect sense. I have been using PPI for 15 years and starting getting trouble with fatigue and bloating a year ago. This spring Candida overgrowth was detected through gastroscopy. A mycostatin cure took care of that. So I decided to get of the PPI. After a week on lowcarb I quit the pills, the fatigue disapeared and I havent had a problem in three weeks. It feels like a miracle. I traded all root vegetables, grains and legumes for cabbage, and it works great. No Betaine hcl yet. I did some research on cabbage and it seems to be wonderfood for people with stomach trouble. Thanks for a great page!

    • Josefa says

      Hi Frank
      I happy for you. I still could not get rid of mine and the omeprazol. But I have a small hiatus hernia maybe that is the problem. Also I havent had a change to look further into the GAPS diet or the EC diet. I try to eat healthy for most of the time, but many times I do not know which are the carbs are safe. I usually eat good amounts of fruit and salads with raw vegetables, leaf vegetables and legumes, and lean meat. So I would like to know How do eat the cabbage? Cooked or raw?Thanks in advance.

      • says

        Hi Josefa!
        I have a hiatus hernia as well. The beneficial stuff in Cabbage (google “vitamin U”) is very heat sensitive so I eat it raw. I like it and I digest it well without gas. Some recomend cabbage juice. I am also new to low carb so i google everything I eat to check, everything seems to be covered out there. Not so shure about legumes, though. I also take digestive enzyme supplements. Maybe that helps as well. Again I will recomend the following links:
        http://www.youtube.com/watch?v=QnAXNRzZV-U&feature=related
        http://www.youtube.com/watch?v=hrdNfaanpIs&feature=related

        Frank

        • Gerald says

          Frank,
          May I ask what you eat and what hernia exercises you do? you eat cabbage raw but do you eat lots of meat and eggs and other high protein foods? You were saying you are new to low carb so I was wondering what you did to make you feel better.
          I am putting myself and Dad through two weeks of low carbing and checking daily our weight, blood pressure, belly measurements, arthritis pain or lack of, acid reflux symptoms, energy increase or not and then after two weeks want to stop and give the Mcdoughal plan a try which is basically brown rice, sweet potatoes, green and yellow/orang veggies, so basically starchy vegan diet, it’s strange that some swear by low carb and some swear by this diet and some by another diet so we don’t really know until we try for ourselves.

          One thing I wanted to say about people in Africa eating low carb to Chris, the Okinawan example and the Japanese and oriental people in General eats lots of rice, tofu (bean) and yet in the Okinawans it didn’t effect their longevity, I mean their health. Almost all people that I know and I live in China, eat white rice with some meat and veggies, theirs is mainly a starch diet with little meat, meat was for people who could afford it, it is a luxury when you look at the price of meat.

          The theory of sugar, grains feeding bacteria is a good one I admit, but why don’t the millions of Chinese suffer from acid reflux and the like as they daily consume white rice in abundance as it’s cheap, yeah they do eat meat and veggies as well though and beans, grains – they don’t eat much bread though. I suppose rice is less of a digestive burden than bread.

          I was wondering though, does Low Carbing work for everybody? I ask this cause I have tried many times and it doesn’t work for me and I end up thinking either I am a failure or my body is unlike all those other people with their successes, or could it be that you only hear of others success and not of their failures?

          The HCI and apple cider you advise to take for me was a huge mistake and my acid went up through the roof, I percevered a week or so then had to stop, the damn stuff injured my esophagus so much I had an gastroscopy and they found grey or black areas they say inflammation when I told them what I took they said are you crazy? What could I say, some guy online advised me to take these things, they said anybody can write what they want online and from their advice if you die can you sue them? No, it is just opinion, I am not talking about Chris I am talking about another forum and yet I suppose I must include Chris as well to a point, in that the information may not work for a person because the theory may be wrong or not right
          for every situation and may do harm instead of good in some cases.

          I don’t know.

          • says

            Hi Gerald
            Yes I eat an ordinary lowcarb diet: lowcarb vegetables raw or baked in the oven, sauerkraut, all kinds of meat or fish, sausages, eggs, real butter, raw cabbage with almost every meal. I take enzyme supplements because after so many years on PPI I believe my levels are to low (only measured amylase so far, very low). Caffein gives me trouble still, so I changed to decaf. It works for me, but maybe our conditions are different. Here is a link for the hernia exercises;
            http://www.natural-indigestion-relief.com/hiatal-hernia-adjustment.html
            Frank

  100. Gerald says

    Frank that sounds absolutely great, I have been on Losec for 15yrs as well, currently low carbing as well, but not as successful as yourself, maybe cause I have a sliding hiatus hernia and this needs to be healed in order to come off the PPI’s I assume, docs say that hiatus hernias cannot be cured, is this true Chris?
    Well I am doing some exercises to help bring down the hiatus hernia and low carbing as well,losing weight and see if I could finally come off the PPI’s.
    Gerald

    • Tressa Breton says

      That might be because a lot of us are phrasing our questions in a way that asks for an individual diagnosis rather than referencing the general topic. Although it’s expensive, it might be worthwhile to pay for the personal consultation if you have unusual problems that need addressing.

  101. Hannah says

    Chris what diet would you recommend for someone with Celiac Disease and GERD? I am eating a Paleo diet right now and feeling a lot better. Also I am almost 100lbs over weight and would like to lose weight.

    • Chris Kresser says

      A low-carb Paleo diet is a good choice until the bacterial overgrowth has cleared; then you may be able to add some more carbs back in (i.e. fruit, starch).

  102. Josefa says

    Hi Chris
    I have Heartburn, small hiatal hernia, and recently I am having symptoms that seems to be IBS. I’ve been taking omprazol for almost 2 years. I am not over weighted. I already tried to take papaya enzymes and apple cider vinegar diluted in water but it did not seem to work. I’ve been reading your articles and other articles about what diets to follow but I am confused, do you advise that I follow a Paleo diet or a GAPS diet?
    Thank you in advance.

  103. Robert says

    I just wanted to say these recomendations have worked for me, but then I guess you knew they would! I was on my way to developing a serious problem till I found your site which convinced me to get off the drugs and try a different approach. I don’t even follow your guidelines religously but have realized a 95% improvement in my condition. That last 5% is due to me being a bad boy which I just can’t help sometimes :-) Thanks for improving the quality of my life.

  104. katie says

    Do some people seem to need more than 7 (650mg per meal?) Personally, I have a long history of bad nutrition with vegetarian/raw food diets that depleted me, and I found that I didn’t start to see positive results (improvements in zinc, bvitamin stores) until I got to 12-14 hcl caps (650mg) to feel some improvements.

    Is this something you have seen before?

    • Buddy says

      Katie/Chris, did either of you ever come up with an answer to your/Katie’s question? I am in the same boat, taking 4 – 600 mg B-HCl pills per meal (i.e., 7,200 mg/day). I don’t feel any “heat” and the heartburn is for the most part gone. I do get small burps throughout the day that may also be a result of low stomach acids. Thoughts? Is it safe to take up to 10,000 mg/day of B-HCl without worrying about developing an ulcer?

  105. Eden says

    I’m a 35 year old male, 155 lbs, ~10% body fat, lift weights, get some cardio, etc. I’ve been on PPIs (Omeprazole until it stopped working as well earlier this year, then Pantoprazole) for the past 10 years for painful GERD that when not well managed induces sore throats from sinus drainage, eye pain, headaches, bad colds, etc. About five years ago I accidentally discovered that gluten makes my GERD worse and found the symptoms were better managed by eliminating it from my diet. Over the years I have tried everything to beat the GERD and get off the PPIs, from ayurvedic diets to apple cider vinegar, and even briefly tried paleo a few years ago with no success.

    About two weeks ago I decided to start a 30 day strict paleo experiment, mostly with the intent of getting a bit trimmer for the sake of my vanity. I thought I should educate myself as I went and subscribed to the healthy skeptic podcast where I heard you talk about women and statins and came to your site for more info to share with my friends since I consider that to be a serious problem. While I was here I though “hmmmm, I wonder if this guy has anything about GERD” and found your GERD articles.

    I bet you can guess where I’m going next with this. Since I was already on a strict paleo diet with very low carb intake, I stopped taking my PPI and started taking HCL the next day. It has been 5 days and after *ten years* my life has changed! The first few days were a little touch and go. I felt a little off, but any burning acid feeling was minor compared to the past where even missing my PPI dose by a few hours induced severe symptoms. I plan to experiment over the next few weeks by trying small amounts of dairy, alcohol, chocolate, and “safe” grains to see what things work well for me now that I’m off the PPI. At some point I’d like to experiment to determine whether the HCL pill is always necessary, or if I can skip it for some meals or altogether.

    I highly recommend anyone suffering from GERD to give this treatment a go. It might be worth going paleo for a week or two before adding the HCL and dropping the PPI, since I noticed some changes in my gut function during the first week that may or may not have been relevant to my overall experience. I had good luck with a single 900 mg HCL pill before each meal. The first few days might not be perfect, but if the symptoms are tolerable stick with the plan.

  106. Sushma says

    Hello Chris, I am 29 yrs female. I am taking probiotics supplements from 1 week. I went to see doctor to complain about my burning and white coated tongue. Last year I have had c -section ( delivery) surgery. after 6 months that I had used antibiotics to treat my sinus infection. Since then my tongue problem started. Showed many doctors but they said no issues. Lately I went to doctor and he suspected because of the antibiotics all the bacteria might be removed and he prescribed me probiotics supplements. Positive side is that really my tongue became better but the same time lot of burping and gas in the chest and abdomen. Also my bowel moments reduced? is it becaues of proboitics supplements? Before delivery I never had any heartburn problems. should I stop the supplements or is it normal? Thank you

  107. Tina Young says

    Hi,
    I have been taking Omreprazole for ‘acid reflux’ for 14 years. over the years my symptoms of severe bloating, reflux, stomach, shoulder & arm pain have steadily gotten worse. i was finally diagnosed with coeliac disease 3 years ago but symptoms are still there (biopsy shows bowel villi have now healed) i was recently given Lanzroprazole to take which helps but is not curing my problems. i also have recurring thrush & am now told that i have developed IBS. I read your article & it was as if someone turned the light on! my partner was on a very low carb diet to lose weight last month & i followed it with him, it was the best month for me (symptom wise) in years & i hadn’t figured out why until reading your web pages. i am definately going to carry it on & have also ordered enzymes, bitters & probiotics from the health shop. I am angry that i was wrongly given PPI’s for years when i actually had coeliac disease, and after 11 years of taking them, i thought i was trapped into taking them for ever. Thank you so very much for taking the time to put this fantastic free information on the web, it’s so pertinent to my experiences.
    Tina

  108. KeithC says

    Hi Chris,
    My benign gastric ulcers have healed (no H-Pylori), and hiatal hernia was ruled out. However, I still get significant excess stomach acid (and stomach lining is mildly inflamed) alternating with times when I am not acidy, but then get a stuck feeling in my throat and solar plexus after I eat. I eat unpasteurized sauerkraut, yogurt, kefir, and take cholalcol a couple times a day as my CDSA showed I had low secondary bile acids. I can’t find anyplace that does a Heidelberg test in VA to confirm if I have hypo or hyperacidity. I take organic ACV occasionally in water which helps, but if I take it daily my stomach burns too much. Any suggestions? Specifically, would HCL tabs be easier on the stomach than ACV? Thanks.

  109. Tressa Breton says

    Dr. Kresser,
    I am a 25 year old female, and I’ve had steadily worsening reflux for three years. Even with the prescriptions I’ve been given, I’ve had to eliminate any hint of “trigger foods” from my diet, which for me
    includes all citrus fruits and berries (a nightmare). I’m going to start your program as soon as the holidays are over, and I’ve already had mild success by just taking bitters at the start of a meal rather than taking my prescriptions.

    My question is, a lot of literature says that these reflux trigger foods weaken the upper valve in the stomach, and contribute to reflux. By following the strategies in your program, will it lessen this issue? I desperately want to taste a cup of coffee or even an after dinner mint again, but I’m extremely gun-shy.

    Thank you for your research, and for making your plan free and accessible. Yours is the first program I’ve found that is finite, rather than an unrealistic, high-maintenance diet with no end in sight.

  110. Belle Black says

    Dear Dr. Kresser,

    I just want to thank you. I am in awe at the amount of effort you are expending in this site and on the radio show to help educate people about things that should have become (or were) common wisdom and practice ages ago. I am learning so much on here about things I’ve been banging my head against the wall over (figuratively) for years because the mainstream medical approaches I’ve sought and tried for various issues have not made sense nor worked. Finally I see some solutions that make sense, are systemic, are research-based, don’t stem from the prevailing disease-treatment/big pharma mindset, and hold the promise of real success and healing. I am so grateful. And hopeful. Your work is so appreciated. Thank you for all you are doing. Medicine for the 21st century indeed!

  111. Greg says

    Hi Chris,

    I am very interested on your take on the benefits of Melatonin as mentioned by Gerald – Dr. Michael Eades referenced it as a potential cure and there is a case study and controlled study to back it up.

  112. Mike says

    Chris,

    I started your program about a month ago. It’s working decently well, but I have a few questions that I really hope you can take some time to answer:

    - How important is it to cut carbs down? I was able to limit my carb intake for the first week or so of your program and it was just very difficult to stay committed to it.

    - How does the burning sensation in the stomach feel if too much HCL is taken? I increased my dose to 4 pills per meal at one point, and I felt a burning sensation deep in my gut, very similar to heartburn, though not quite.

    *****- While your program makes the symptoms of GERD 70% better for me, I still feel some heartburn after most meals, so I take antacids like Maalox or Tums as needed. Is this normal? The symptoms of my heartburn remain the same regardless of how many HCL pills I take (I’ve experimented with a dose between 1 and 4 per meal).

    - I began measuring the pH of my urine and saliva to help gauge how much HCL is appropriate for me, but the results are quite varied with each day and I’m having a hard time finding factual information about this in relation to GERD online. Can you speak on this?

    Thank you so much, Chris

  113. Jess Mullen says

    Hi Chris, thank you for writing up all this information. I had an h pylori infxn about 4 yrs ago and was dx’d with GERD at the same time. It was explained to me that my LES didn’t work properly (like it was a mechanical problem) and I’d need surgery or take PPI’s forever. I came across your info about 2 weeks ago. I have gone very low carb, avoiding much fiber, eliminating all fake sugar (used to do ALOT of sugar free gum and sugar free Popsicles and diet coke, gross, I know). I stopped the prilosec and have sort of taken the HCl – I’m not clear about that yet because I do get a warm, burning sensation but then I wonder if it’s just the heartburn. Anyway, the symptoms have changed and are less severe (less pressure and pain) but still burping and the middle of the day is still pretty bad. It sounds like this could be the process? I thought it would be better quickly but could it be possible that it takes time to kill off the bacteria and/or the malabsorption to carbs to right itself? And my main question, have you worked with (or heard stories from) folks that run a lot? When I run, it feels like the sphincter doesn’t work at all (and the heartburn is terrible) – wondering if it could be ‘lazy’ right now, or maybe there’s still too much pressure/gas or could it be possible that it just doesn’t work right? Any insight/suggestion you might have would be appreciated. And I do tend to run more than most (most often 100 mile races and since doing more than a few of those a year, it’s (GERD) been worse). Thank you for your consideration!

  114. Jenni says

    I’ve been reading your website for hours, Chris, and can’t seem to stop…

    I have had GERD now for about a year and a half (took Prilosec for about 2 months, haven’t taken it for almost a year). Also have hypothyroidism (non Hashimotos), asthma, and allergies. Knee problems also (cartilage degeneration). I’m 38 and female.

    I’ve been getting way into WAPF stuff and I’m thinking of just going whole hog and just eating solely bone broth soups for awhile, slowly adding fermented foods and ending up on the SCD.

    I know you probably don’t want to give out free medical advice, but I just thought I’d give it a shot. I’ve spent so much money on my health… it’s crazy. Anyway, just wondering if you had any thoughts after looking at that list of diagnoses.

    Thanks so much for this blog!

  115. mar says

    I have not read anything about Gerd causing phlem and wheezing at night….is this a symtom as well?
    I was being belching….gassy, and coughing up mucus and wheezing….no asthm…and read it was be a part of my gerd condition.

  116. Tressa Breton says

    A Problem I’ve Discovered with the Method and IBS:

    I’ve been doing the program for three weeks now, and I’ve come across a serious problem (for me). As Dr. Kresser points out in this series, I, like many reflux sufferers, also have IBS. Specifically, I have IBS-C which means that if I eat the wrong foods, it is difficult for any food to work its way through my system, and I experience significant abdominal bloating and cramping. Dr. Kresser explains that limiting carbohydrate intake reduces the amount of gas produced after eating, and prevents food from being forced back up the esophagus, but I found that following a Paleo diet intensely aggravated my IBS, and did the exact opposite; it produced large amounts of gas in my stomach and intestines, giving the food nowhere to go, and forced it back into my esophagus. I’m reading that soluble fiber, found in things like oatmeal, rice, white potatoes, etc. actually helps neutralize both IBS C and D, so eliminating them from my diet caused the exact symptoms I was trying to avoid.

    I’ve returned to a bland diet of oatmeal, soy milk, rice, etc, until I can identify my IBS trigger foods, because they are different for each individual, but in general, sticking to these easily digested grain-based foods has cleared up the symptoms very quickly. My reflux, however, is still there, I’m guessing after a week-long IBS bout exhausted the valve to my esophagus.

    I would say that in general, I’ve had luck with the HCl and probiotics, they’re working better than my prescriptions, which I’ve been clear of since I started this program (a big success), and the bitters are helpful in a pinch, but if you suffer from IBS C or D, take care with omitting foods.

    Dr. Kresser may have meant

  117. Tressa Breton says

    A Problem I’ve Discovered with the Method and IBS:

    I’ve been doing the program for three weeks now, and I’ve come across a serious problem (for me). As Dr. Kresser points out in this series, I, like many reflux sufferers, also have IBS. Specifically, I have IBS-C which means that if I eat the wrong foods, it is difficult for any food to work its way through my system, and I experience significant abdominal bloating and cramping. Dr. Kresser explains that limiting carbohydrate intake reduces the amount of gas produced after eating, and prevents food from being forced back up the esophagus, but I found that following a Paleo diet intensely aggravated my IBS, and did the exact opposite; it produced large amounts of gas in my stomach and intestines, giving the food nowhere to go, and forced it back into my esophagus. I’m reading that soluble fiber, found in things like oatmeal, rice, white potatoes, etc. actually helps neutralize both IBS C and D, so eliminating them from my diet caused the exact symptoms I was trying to avoid.

    I’ve returned to a bland diet of oatmeal, soy milk, rice, etc, until I can identify my IBS trigger foods, because they are different for each individual, but in general, sticking to these easily digested grain-based foods has cleared up the symptoms very quickly. My reflux, however, is still there, I’m guessing after a week-long IBS bout exhausted the valve to my esophagus.

    I would say that in general, I’ve had luck with the HCl and probiotics, they’re working better than my prescriptions, which I’ve been clear of since I started this program (a big success), and the bitters are helpful in a pinch, but if you suffer from IBS C or D, take care with omitting foods.

  118. Joan says

    .What is suggested if you also have esophageal spasms? on nexium, want to get off? downsized to 30 mg. can’t seem to go lower without mild spasming and tingling starting. also have gastritis, and mild ibs. tested positive for sibo. not taking antibiotics at all.

  119. says

    ?
    Questions about the possible side effects of taking HCL w/ Pepsin. I have been on Aciphex for nearly 7.5 years. I’m only 32 and don’t want to take this medicine for ever. I eat a paleo diet, but have been unable to quit the acipex based on diet alone. I forget my dose in the morning, I end up with sever heart burn. I read your series of articles and as of Tuesday 1/13/12 I have quit the aciphex and started with HCL w/pepsin 600mg. Everything seemed to be going ok. I have only had mild burning which I figured I might have to deal with for some time while my acid production gets back on track. However the last two days I have not had much of an appetite, I am bloated and when I do eat I have a really heavy feeling in my abdomen. I’m wondering if these are normal side effects or if I should be concerned?

  120. sicknotebro says

    I am currently on the 80/10/10 diet by doctor doug graham. its been a week and a half. many people have claimed to have cured chronic gerd with this. its a a high fruit 100 % raw vegan diet. You have a 10 banana smoothie for breakfast. 8 papaya and 8 oz of celery for liunch and for dinner you have a tangerine salad and 1 0z of nuts . its not worked yet but it could take up to 3 weeks – to 3 months. I am also taking vit b12 / vit d for winter/ and probiotics. I pray. i’ll leave a message if it works. the drugs aren’t working for me. Before this i was on a meat , grain , dairy diet.

  121. Lucas says

    I was curious what was your take on coffee. I love it and would like to keep drinking it. I am also convinced that that your method in treating GERD and IBS is far healthier and safer than methods proposed by my doctor. because coffee is high in acidity and my physician told me that too much acid was the problem, I correlated that coffee was a contributing factor. now that I have read your series i am not so sure about that. here is some background information about me that might provide insite.

    I have always had a lot of gas ever since I was a child. Along with this came lots of pressure pains under my breat plate as well as throughout what feels like my GI track. 5 years ago I started having acid reflux maybe once a month. I never really did anything, I might have taken a Rolaid, but eventually it would pass. when I moved up to Arcata in Northern California these episodes started becoming more frequent once or twice a week. This was at a time when I was 27 my metabolism was drastically changing but I also found out that the city of Arcata put fluoride in the tap water and theorized that this might have had something to do with it. I went to the college physician, and he treated my symptom with Prilosec. 2 years after I started taking it I went back to my physician and told him this has gotten worse and i would like an alternative because I have become completely dependent on this medicine. he told me this was the alternative just to keep taking it. it’s been 4 years since I started taking this crap and I can’t go a day without having massive burning pains in my sternum and throat. I recently asked a very well trained nutritionist about this problem and if he could find a dietary alternative to taking these pills and he linked me your series. I just finished reading the series and haven’t not tried any methods yet but plan on doing so immediately. I do run into the problem of being in Norway where health food stores are hard to find and the culture here has a history of high card diets. bread slices with butter (margarine) cheese and meat slices are a very common daily meal for both breakfast and lunch. I can work around this but as I have been researching high probiotic foods I keep comming across yogert, and different types of Asian foods that are not easy to come by along with Kefir which I haven’t seen here. are there any other types of foods rich in probiotics that are typically found in your normal stores? one can’t live off of yogert alone.

    • Frank Ludvigsen says

      Hi Lucas!

      I have reflux and a small sliding hiatus hernia.

      This works for me: I read this site six months ago and started on a strick lowcarb diet. After 15 years on PPIs(losec, Nexium) I quit, and it worked. I have been of the pills since. Meat, fish and raw vegetables did the trick. My problems disapeared (and I lost weight very fast).Then I started adding things back in my diet and I discovered that bread is the stuff that creates trouble for me. Particularly wheat, I think. Maybe yeast to. So now I am testing all the different grains to see what works. It might be other foods for different people. I tried Betaine HCL too, but did not need it.

      I live in Norway as well, a diet without bread here is a bit difficult, but possible. For breakfast I have made my own mix of nuts, seeds, yogurt and Biola (sweetened drinking yogurt). But you do get kefir as well, it´s called kulturmelk (culturemilk, but old people know it as kefir).

      Good luck!
      Frank

  122. Jennifer says

    You noted in your article not to take HCL if you’ve been taking NSAIDS. Unfortunately, I take Excederin a few times a week- something I hope to eliminate when I get my digestion in check. I assume you mean not to take NSAIDS while you are taking HCL, right? Should I avoid HCL and just go with Bitters?

    Thank you for this, Chris. I’m excited to try this Protocol. Ive had burning in my stomach off and on for over a year and the side effects from Prilosec were just unacceptable to me. But so is constant stomach pain. So, I’m going for it!

  123. Elizabeth says

    Hi, Dr. Kresser.

    I stumbled upon your website today while researching what more I can do to cure my gastritis. (Background: I never had problems in my life until my OB/GYN put me on 800mg of Ibuprofin every 6 hours for two weeks following a c-section, which subsequently destroyed my stomach.) I started the GAPS diet 4 months ago (LOTS of bone brtoh soups!) and have had incredible relief. I have also been taking Bitters and DGL for several months. I still suffer, however, from gastritis and esophagitis; I am hopeful that with my diet I will reverse these conditions.

    My question for you now is regarding the HCl. I’ll follow the protocol that you lay out for TAKING the HCl, but, eventually, I am hopeful that my conditions will resolve, and I’d like to get off the HCl. How will I know that I’m ready to get off the HCl? Do we get off the HCl slowly? What’s the protocol for getting off HCl?

  124. Jean says

    Dr. Kresser,
    My son has been diagnosed with Silent Reflux. It’s mostly just the voice problem that he is experiencing (hoarse and gravelly for 1 year and 2months). I understand GERD is different that Silent Reflux/LPR, but do the same priciples of your research hold true? The ENT prescribed a PPI (took generic, only ones we could afford), elevated the bed, try not to ear prior to sleep, also speech therapy. He’s done it all for 2 months and he’s the same if not worse. He is a swimmer and he was eating dinner and then off to swimming, I’m learning that wasn’t good either. Sorry to ramble on…. My son and husband are skeptics and I will need to convince them of Kevin doing the Paleo diet. Do you think it may work for his LPR? Also, he was very lactose intolerant as an infant, I went dairy free and when formula fed, I gave him Lacto-free Infamil. He seemed to grow out of it around 1 1/2 or 2 years old. Thank you for so much great information.

  125. Sarah says

    Hello Chris! I have dabbled in the past with the GAPS diet with much success with my husband who suffers from numerous “symptoms” from autoimmunity as well as psychiatric disorders… Sadly, life took over and we did not accomplish a total transformation of our diets, and gradually went back to eating the “regular” american diet. Well, it’s funny when you’re not strong enough to make a healhty change for YOURSELF, see what happens when your CHILD comes up with the same symptoms and worse! …We’re going to get back on that diet one way or another!

    Right now, I am exclusively breastfeeding a 15 month old boy with severe food allergies. He’s got the top five usual; milk, soy, nuts, eggs and wheat, but in addition to that, beef, chickent, oats, rice…basically of the 24 they tested him for, he’s positive for 22, and we’re just getting started! (He was cleared on turkey…) We are looking at a possible Eosinophillic Disorder (which his father also has), which he’s being tested for at Children’s Hospital in two weeks. It’s hard (almost impossible) to find an MD who is willing to look at *holding back* on medication and trying diet first…so I’m sure I will be fighting them off to try him on infant prevacid or worse steriods for the EO! At any rate…I am starting the diet again this week – this time NO TURNING BACK! Naturally, since I’m the one nursing him, he’s obviously getting improper proteins from me. So I am going to cut that possibility out. (He’s thriving btw, 24 pounds) and we recently had labs done on him, and everything came up normal.

    SO. My question is this, over the last month, he seems to have developed GERD type symptoms. Night waking, arching, chronic cough w/o illness, and vomitting 1/2 hour after a feeding for 4 nights in a row. For several days, he ate very little actually. For 2 days now, he’s held down feedings during the day, but still at night, he wakes up from a deep sleep, and out of NOWHERE, gags, coughs and vomits, in that order…. We sleep with him. I’ve got him as propped up as he can be, and I’ve been trying to get him not to do much night nursing with the help of a pacifier :( I just need something to relieve him of these acidy-cough-burps ending in vomitting, while we work toward arriving at the antiinflammatory benefits fo the diet. I’m entertaining the possibility of an NSAID at night for a couple of days…or maybe doing a patch test for ACVinegar and trying that to relieve the acid? ANY thoughts would be appreciated! It’s just so hard since he’s so hypersensitive and can have no other food that could heal him at this point… except for turkey broth….hmmmmm.

  126. Ahmed says

    Chris, the reduced carb aspect made me lose 4kg in a month! I am taking Manuka Honey for the pylori. But on the food side of things, I stand in the kitchen and don’t find much option, since even brown bread, etc. should be eliminated! What about eggs, for example? Vegetable pies? Meats?
    Thanks!!

    • Ahmed says

      May I add I’ve always been skinny (72kg lately, before I lost 4kg due to eliminating rice, a major part of my diet) but used to eat very well and never showed in my weight! I hope the acid level issue, while solving the GERD issue (which I have been diagnosed with after an endoscopy 30 days ago) I hope I could solve the nutrients absorption into my body.
      Thanks a million!

  127. Jeffery A. Arnson, Certified Nutritional Microscopist says

    Dear Sarah,
    You need to make some changes. I’m not a fan of acid, in fact, I believe it is the cause of all illness and disease, including the HCL acid in your stomach, apple cider vinegar poison, and, most medicines are also acidic. Read “The pH Miracle.” Start alkalizing the blood and tissues of the body and work in consort with the amazing human organism. The apple doesn’t fall far from the tree, does it. Don’t expect any changes when doing the same old – same old. Get your blood tested by a certified nutritional microscopist and see for yourself, how your every day lifestyle choices are causing the imbalances you’re describing. Stomach acidity is a result of digestion and not necessary for digestion. Your teeth digest your food. Chew your liquids and drink your solids. They’ve got it all backwards! Alkalize the gut and return to an alkaline balance (blood pH of 7.365), with urine and saliva pH of 7.2 or better. The old science (if you can call it that) of apple cider vinegar robs Peter to pay Paul. Stomach acid causes illness and disease, it doesn’t help your amazing  human organism. Do your son a favor and break the cycle of imbalance. Make informed and intelligent lifestyle choices. Get the information you need to rid yourself, your son, and your husband of the poor quality of life you are experiencing. OR, continue on with these outdated thoughts and treatments that are just making you sicker and sicker and sicker… Your choice. Your health. Do something dramatic or be victim. Which do you choose?
    Jeffery A. Arnson,
    Certified Nutritional Microscopist
    GreenSquare Center for the Healing Arts
    6789 N. Green Bay Road
    Glendale, WI 53209
    jarnson@centurytel.net

  128. Maryanne says

    My own severe GERD issues have been due to Candida overgrowth. I’ve been battling this for 12 years now (I’m 36). I’ve cut out sweets and flour and eat mostly brown rice, meat, egg yolks (not the whites), green apples, and berries. I am now 80% better but not there yet. Candida sinks itself into your gut and creates “leaky gut syndrome” where you’re not able to digest your food. This creates severe deficiencies. There are some tools to help battle Candida, such as Olive Leaf, Oregano, and Caprylic Acid. Lots of probiotics and the right diet. Believe it or not, colonics have helped tremendously as well, particularly if you find a practitioner who will instill probiotics into your colon.

    • Colin says

      Maryanne,

      Wondering how your battle with Candida and Heartburn is going. I’ve had severe heartburn for years and had an upper endoscopy done where they found an overgrowth of Candida. GI doc didn’t think there was any connection to heartburn and candida, but after research I became convinced that my heartburn was due to candida. I’ve had about an 80% reduction in symptoms as well. Have cut out all sugars, processed foods, and sweets. My ‘grey area foods’ are greek yogurt, kefir, brown rice, quinoa, strawberries and other berries. Occasionally, i’ll use 1/4 banana in my smoothie…I miss bananas so much. Anyhow, what is your protocol? I feel like i’m so close, but just can’t seem to completely shake it. I still feel like my esophagus is inflamed too. Other symptoms, which are probably all related to candida include pain in left side of stomach – dull pain below ribs; burping after eating; and muscle cramps in legs. Look forward to hearing your reply, or anyone else’s that might be able to shed some additional light. I take oil of oregano, grapefruit seed extract, and kyolic garlic on rotation as well as take B vitamins, Vitamin C, L-glutamine, and probiotics.

  129. Michelle says

    Terrific info on GERD. Having taken Prilosec for years, i’m now 9 weeks pregnant and ran across your articles as a possible solution. i’ve eaten paleo (mostly) for 6 months now, but still have terrible heartburn. Is any of your advice (very low carbs, HCL tablets, etc.) contraindicated during pregnancy?

  130. Michael A says

    Great info. Thanks, Chris. I’ve been on either protonix, nexium, or prilosec supplementing with Znatac/antacids for about 15 years (im now 35). This week i dropped my PPIs to try HCL/Pepsin, GDL, Mastic. I’ve been pretty strict paleo VLC for 6months and have given up drinking coffee and alcohol and eating sugary fruit to improve my chances of success.

    a couple questions for you or the community at large:
    *Does long-term PPI use effect acid production after PPI use has stopped? will my stomach eventually catch-up on acid production?
    *how long should i have to take the HCL/pepsin to see improvement? i.e. am i trading one pill regimen for another?
    *will this help if i have a hiatal hernia? I was diagnosed with one 15yrs ago, but may have healed.
    *when you say increase dosage until you feel a “mild burning”, where is the burning felt, in the abdomen, or burning as heartburn?

    I’ve been following the suggestions of the above article for about a week now and have seen an improvement from quitting PPis cold-turkey in the past. however, I do have some substantial reflux and discomfort after meals and at bedtime and gnosh GDL to soothe, with some relief, but not the kind of improvement i was hoping for.

    Any suggestions or advice would be very helpful.

    Thanks-
    Michael

    • Chris Kresser says

      - In my experience, most people are able to re-start stomach acid production, but the longer you’ve been on the drugs the more likely it is you’ll require supplemental HCL indefinitely.
      - See above, but if you have to choose between taking HCL indefinitely (which is harmless) or PPIs (which are harmful), it’s a no-brainer.
      - Not directly, but may help with associated symptoms.
      - As heartburn, usually.

      • Michael A says

        Thanks for the reply, Chris. I just upped my dosage of HCL with some improvement. I may just not be producing much acid. I am afraid that I’ll probably need to see a GI to rule out a hiatal hernia and/or discuss possible gastroplication (my grandfather and great grandfather were lost to esophageal and stomach cancers). Do you know of side effects/issues associated with the procedure? It wont cure my acid production or digestion issues, but merely mask the most prominent symptom.

        I trust your advice and anything you could add to the conversation is greatly appreciated.

        Thanks-
        Michael

  131. Ahmed says

    Dear Chris, reference to Michael’s comment, I have a “small hiatal hernia” which doesn’t really bother me as I do stick to having small meals, fruits & vegetables, etc. In this case, can things in any way develop into a scenario similar to Michael’s grandfather??
    Thanks
    Ahmed

  132. Tanya says

    Chris:

    You provided this as an answer to an earlier comment in response to what is the problem one would notice after taking the HCL (Answer: Problems would be mild burning sensation. Would occur 30-90 minutes after meal.)

    My question is what does that “mild burning sensation 30-90 minutes after the meal” indicate ? Does it mean you have plenty of the stomach acid ?

  133. Greg W says

    Hi Chris.

    I have been battling ongoing reflux and asthma/allergies for well over a year. Tried PPI’s, they do not work. Initially gave up wheat to help w/allergies and asthma with dramatic improvement. I am 47,otherwise very healthy, seldom get sick, not overweight and have just recently had a good physical. I do believe that the low carb approach will eventually help me with reflux. However, I have had no luck with either ACV or in the last 3 days the HCL/Pepsin. After 6 attempts of one capsule with start of meal I have had worse heart burn than usual approximately 45 minutes to 1 hr later. Do you think this means my stomach acid production is fine, and should I be patient with low-carb eating on it’s own to see some results and if so how long might this approach take. Most of my carb intake has come in the form of fruits(mostly apples) and small amounts gluten/wheat free bread and sweet potatoes. Should my low carb intake be limited to vegetables, and where do foods like chick peas, hummus and endamame beans fall in the low carb diet. Thanks Chris !

  134. Marcel says

    Hi Chris
    You may have answered this already but…
    Are you aware of any research to validate the HCl challenge test? I have heard the results may be inverted ie. taking one capsule and getting “burning” indicates a poor mucosal barrier and therefore poor HCl, and likewise taking alot of capsule and not getting any sensations indicates a good mucosal barrier. Any thoughts?
    Thanks, Marcel

  135. Ahmed says

    Hi Chris, I don’t get heartburn and actually feel digestion is smooth when I take tea with mint after a heavy meal. Does that mean I am hypo rather than hyper acidic?
    Thanks

      • Ahmed says

        Thx Chris! Although without it, it takes me four hours to digest some rice with vegetables and a quarter of boiled chicken, if no salad included for example! Could THAT mean hypo?
        Thx!!
        Ahmed

  136. Susan says

    Dear Chris,
    I am a desperate woman. I have been having major health problems for 2 years now. I am going to make this short so that you can have an idea.
    In Jan 2009 I started taking without doctor’s advice a slimming pill. It was supposed to be natural as a friend was talking as well. I was taking 1 pill on empty stomach. After 5 days I started to feel symptoms, asked my friend, said it was normal. I was having little acid reflux, dry mouth, and felt something stuck in my throat. I continued thinking maybe symptoms will subside, but at the 2 weeks mark I was miserable. My mouth was so dry I couldnt find saliva. I had insomnia, my tongue had fissures and it was burning! Then we discovered that the pills had sibutramine. I dont know what happened!
    I have done 2 endoscopy, and I have done 2-3 antiacid treatments with Pariet and Nexium. Nothing has helped me. Everything that the doctors tell me is that everything is fine, I just have little more acid than usual in stomach and a very small hiatal hernia. I dont know what is happening to me.
    As of today, I feel my tongue burns, still has fissures.. sometimes my tongue bleeds, not much but feels like a pinch and I see blood. My palate is so sensitive, my throats are burning and are red. I feel burning sensation in my stomach, I feel like a dragon. I also mostly everyday feel like phlegm is stuck in my throat.
    I tried ACV with baking soda for a week, got demotivated and stopped. I bought Betain HCL with pepsin and have DGL, and NAC (Read is good for phlegm in throat). I tried HCL but feel a lot of warmth. I do have to say I went to the toilet like 10min after the HCL. but felt burning in my stomach.
    I really dont know what to do. I dont know how to use these. Do you think they can help me heal? I watch what I eat, and even if I dont eat bad food I still get the GERD.
    Now, should I take DGL 20min before meal and during meal take HCL? I also read about Zinc Carnosine and Calcium citrate powder that they can help with this. I just need guidance. I am desperate I can even kill myself and not live like this. I am 29, married, have a 3 year old son, and Im dying to try for my second baby but feeling like this is impossible :( Please help!

    • Mia says

      I am in the same boat exactly
      Hcl made me worse but i was show to have low hcl
      Small hiatal hernia just like you and burning in my throat too
      I am desperate

  137. Elaine Clickner says

    Hello Chris,

    Great information and much appreciated by my husband and I. We are currently withdrawing slowly from Nexium which we have been on for at least 10 yrs. The withdrawal is difficult and we are happy to know about HLC and have some on order. I am 65 and my husband is 64. We had no tests, but were just given various PPI’s and ended up on Nexium. Now that we have more facts about this medication (since we were not told it was going to hurt us ) we want to be off of it and are steadily working toward that goal. I withdrew from antidepressants in 2008 and from benzodiazapenes in 2010. Neither of those were as hard as getting off PPI’s. I am angered and upset by the manner in which the population of this country is manipulated by Big Pharma. But I’ll save that rant for another time and place.

    I was most interested in being able to follow the physiological processes described in your article. Once I can see and understand the process I am better armed to take the right steps to get my body/mind back in balance. The mind/body connection cannot be ignored and until allopathic medicine stops just treating our symptoms lot of folks are just going to keep getting sicker and sicker.

    So, enough said. I am excited to get going on the HLC and one of these days I’m going to be able to say goodbye to “The Little Purple Pill”

    namaste`

  138. says

    Hello Chris,
    I have a question or would like to discuss the subject you spoke on about testosterone and other hormone replacement creams (Episode 12 ) I was frustrated after hearing your comments. I was going to start taking (HRT) hormone replacement therapy (Crème) because my testosterone has dropped considerably 239 ng/dl My doctor wanted to give me the real thing ( steroids) but I
    told him NO thanks due to the side effects. Therefore, I would like to see what your suggestions are? or alternatives.? Lets talk please! This is the compnay i was going to purhase the naltual (HRT) sabresciences.com )
    Thank you very much for your reply and help!
    Sincerely,
    -Anthony (NJ) Age: Just turned 53
    PS. Side notes: Athletic, I’ve been training and eating healthy for
    the past 28 years, don’t smoke, don’t drink, All vitals are in great
    shape, heart, liver, all organs, etc, etc,
    Regular yearly Dr. check ups good, blood work, endocrinologist visit
    good, urologist visit good, prostate good,
    just my T has gone down. Go figure! I’ve just been dealing with a lot
    of stress though over the past 3 years.

  139. Kira says

    Thank you so much for this series. I have an interest in low stomach acid levels because of some health concerns in my family. If you ever add to this series, I would appreciate an expanded discussion about why stomach acid level might be low (other than aging). I have read that iodine is essential for stomach acid production (one of Dr. Nan Fuchs books) and most people do not include enough seaweed and fish in their diets. I wonder if the root cause might be gut issues that prevent nutrient absorption, affecting stomach acid production and starting a downward spiral. I don’t know – just wondering how it all starts with younger people (and possibly older ones too).

    Both my teenagers have this problem (from stool testing) despite what I thought was the healthiest diet possible (rich in whole grains – lots of home-made bread, lots of vegetables and no junk). One was quite malnourished and had food allergies and adrenal problems by the time we started testing – both possibly contributing to bipolar disorder. The other has a leaky gut, adrenal problems and liver detoxification problems along with depression and anxiety. I am not looking for medical advice but am hoping that by drawing connections other people can be helped.

    • Chris Kresser says

      I believe I mentioned a few potential causes in the sereis: H. pylori infection (probably most common), certain drugs, micronutrient deficiencies, chronic stress.

  140. Zannix says

    Hi Chris,

    I just wanted to ask you… I’m doing all of the above suggested, but I don’t really know how to cut down on carbs so much, yet maintain the energy needed to go normally through the day.

    I’m eating rice and potatoes as my source of carbs, as they’re gentle on the stomach and don’t cause a big reflux for me (and yes I’m using probiotics and HCL and it seems to be helping).

    Should I substitute that with some other carb form (like pulses or…?)

    Help appreciated,
    Zannix

  141. John says

    I have been trying to eliminate overgrowth for a while with my wholistic md for a while. We have tried various herbs, different diet approaches (many of the ones you have recommended), and other things but no dice. She is saying it may be time to try Some of the antibiotic protocols. Most likely it would be the non systemic drug rifaximin to reduce any side effects, most likely a 14 day course, along with continued low dose erythromycin to act as a pro kinetic (stimulate the migrating motor complex and essentially clean house in the small intestine to prevent overgrowth). It is one of the protocols used by pimentel, dr siebecker, etc. what do you think?

    Also, what amount of carbs domyounfind most people seem to be able to settle back to. I used to eat large amounts of carbs before all this started years back and now do around 200-300 grams a day due to my high activity. I know it is probably too high to get rid of the silo but I will reduce it to help in clearing things, but do you think I could ever go back to that level. High fat also would not help due to the nature of my work, it is very high intensity and glycogen driven. My adrenals would crash without the carbs. What’s funny is my thyroid numbers are also spectacular on higher carb, and my only symptoms right now are the bloating and gas. No gerd, adrenal, or thyroid problems.

  142. Yvonne says

    Hi Chris,
    I am breastfeeding and have gotten off Zantac. I was on it for 5 weeks. I find it challenging to go on the SCD diet while breastfeeding b/c I get die off symptoms due to too low carb intake and cannot sleep. Is it safe to take HCL when nursing. All the literature seems to say avoid DGL, Mastica Chios and HCL when breastfeeding. If my daugheter took the bottle, I would have given up breastfeeding by now to treat my heartburn more aggressively. I am on my 9 th day without Zantac but I’m starting to feeling slight reflux coming back again. What should I do??

  143. says

    I don’t get the classic gerd symtoms often even though I have a hiatal hernia, just heartburn occasionally. What I have had however is a ‘lump in throat’ sensation for the past year that I’ve been unable to get rid of with all the medication I have been given. The doctor diagnosed me with globus hystericus of which there is no treatment. The sensation has been driving me mad and I’ve been searching for ages for a way to get rid of the symptoms.

    I have never been able to stick to a low carb diet for longer than 1 meal so Chris’ suggestions were out of the question for me but for the past few weeks I eliminated wheat from my diet. The result has been pure bliss with the sensation first diminishing then disappearing altogether in a few weeks!

    Just to prove to myself that it was in fact the wheat causing the problem, I ate a slice of toast a few days ago and the sensation was back that very day! I’ve never had a sensitivity to wheat even though I have tested negative for antibodies in the past but clearly there’s something about wheat that is causing an issue with me now.

    I now eat plenty of carbs in the form of potatoes & rice with reasonable portions of chicken, fish or beef plus veg without any heartburn (lamb causes me heartburn no matter what!). I Just thought I should share in case this helps somebody with globus hystericus symptoms.

  144. Janel Miller says

    Hi Chris, thanks for all your helpful advise and careful explanations. We just had it confirmed thru two endoscopies and a higher dose of prevacid that our two-year-old daughters vomiting since birth is caused by acid reflux. I’d love to get her off the prevacid entirely, esp now that we know the cause (and that it’s not anatomical, allergies, etc). What natural remedies would you recommend? I have just started making kefir again, which she likes, and will also start probiotics with her soon. Would you give her the DGL (at age 2)? I have also heard that cranberry concentrate can help, and also apple cider vinegar (though I’m not sure I can get her to take that). Thanks so much! janel

  145. Blair Pringle says

    Hi Chris,

    I’m a bit of a late bloomer to this article. I’m a 23 year old male, I am not overweight, but have an extremely high carbohydrate and high protein diet due to my sporting commitments. I have had reflux and Oesophagitis for about a year now, I did the usual thing and took Nexium for 6 weeks and it made me feel horrific, I have now been taking Poliquins HCL 4.0 supplement for a week and was having great results, until suddenly, I am getting the same symptoms as if I was still on Nexium.

    Do you suggest even though im not overweight to try a LC diet? or what do you suggest, I loved your article but I just find it so hard to believe at 23, I have low stomach acid?

    Please HELP!!!

  146. Greg W says

    Blair-I have posted here before. At your age it is quite possible that a week of HCL supplementation set your body back to normal production on it’s own and now the supplements are causing the problem.

    I am in the midst of recovery from a long battle with reflux. HCL proved to not be my problem. I believe LC helped me to kick start the recovery, but eventually I found my weight falling below what I am comfortable with. I am 47, 5′ 9″ and did not want to fall much below 160. I was having trouble maintaining that. I have added more fruit and brown rice bread back into my diet and good fats specifically almond butter, coconut oil, and more avocados. I have found healing the damage done to my esophagus the real challenge. What has helped me more that anything is making a real conscious change to not so much what I eat but as to how. I am re-teaching myself to chew my food thoroughly and to devote a good 1/2 hour to each meal. Of all the supplements I have tried to help me which includes, d’limonene, calcium citrate, mastic gum, HCL as well as previous use of useless PPIs and H2 Blockers, the only one I can say for sure has helped that I still take is DGL Licorice 20 minutes before eating 3 time a day and before bed. I allow myself one cup of low-acid coffee a day, I am trying to follow a 60/40 alkaline to acid ratio in the foods I eat. I have stopped consuming beer, wine and any liquor excluding my Titos 5 times distilled vodka and soda with lime and never more than 2 of those which you can try and pry out of my cold dead hands. After close to 2 years of misery I think I am finally starting to heal.

  147. MDC says

    Chris,
    This is great information, Thank you! I have had Gerd for 18 years. The past 8 months I have heartburn, stomach rumbling, and major stomach gas. I had a colonoscopy which was fine. My upper GI endoscopy showed inflammation. I was perscribed an acid blocker which made things worse. I have taken myself off of the blocker and adjusted my diet. My heartburn has decresed to not very often, however, I still have a great deal of stomach gas with some nausea. What do you recommend?

  148. Mary Condon says

    My son had ACL surgery when he wa 15. Following the surgery he was vomitting from the anesthesia and then two days later he got a stomach bug, or a reaction to the antibiotics and pain relievers and was vomitting again…..Two days after that he came into our room at about 1:00 in the morning and said, “Mom it hurts right here” pointing to his chest. He has had chronic heartburn ever since (and never had a problem with it previously. He is 21 now. He is the same weight, 130 pounds, that he was at ge 15. The doctors put him on Nexium, which helped with the symptoms, but he never felt well. About 9 months ago, he stopped the Nexium…I just couldn’t see him on this for the rest of his life and knew that nothing was healing. He tried the AC vinegar and it helped a bit, but symptoms came back. He tried gluten free and again symptoms improved, but he was never normal. He is now trying the Specific Carb. Diet along with taking Aloe and this seems to be working!!! Your articles here convince me that we just have not put all the pieces together yet!!! Thank you so much for this information. What a Godsend for us!

  149. Terry says

    Hello Chris,

    I underwent a surgery in November 2011 and life changed since then. I had an episode of UTI and had to take strong doses of broad spectrum antibiotics (includeing IV doses), a week post surgery I felt if I have a heavy stomach made it harder for me to breath, lots of sputum coming out of mouth, black fluid coming out when I try to cough. I went to Gastro and endoscopy concluded into GERD and Antral Gastritis, somce inflamation of LES. I am on Nexium 40 mg twice a day, smelly breath and pain in my throat at times. I have an inclined bed, occasionally I hav sticky stools with foul smell. Please suggest, I am a Vegetarian by diet.

    Many thanks for an excellent content on your site!!

    Regards
    Terry

  150. Brian says

    Hi Chris,

    Is there cause for concern that supplemental HCL will lead to a dependency? Would the brain/stomach get the message that there is enough stomach acid, and become less efficient at producing it naturally?

    Thanks!

  151. Tracy says

    Chris,

    Took your advice with low carb diet and HCL with pepsin. This greatly decreased my stomach gurgling but made me constipated with nausea. I have been taking only one 650 mg tablet with meals. What do you think?

  152. Ceejay says

    I don’t suffer with heartburn very often but more frequently gas and bloating. I’m currently on the GAPS diet, but I also wanted to try HCL. The first time I tried it, I took a total of about 5 650mg pills in one day (1 at breakfast, 2 at lunch and dinner). I started to feel a little pain after dinner, and then it got worse and worse until I was in a lot of pain and vomiting around midnight or 1 am. After waiting about a month, I decided to try a lower dose just to see, so I took one 650mg pill at dinner. Again, I felt some mild discomfort through the night, and then I had diarrhea the next evening, which is very rare for me. I was assuming that this meant I didn’t need the HCL, but then I read somewhere else that sometimes people experience discomfort when first starting to take HCL and really need to keep taking it and let their body adjust. Can you clarify this for me?

    • Mark says

      Hi Ceejay, I also had diarrhea after taking two HCL and pepsin pills. I had really high hopes for this as a treatment so don’t want to give up on it. Now I don’t know what to do.

      I was wondering if you had any success after your diarrhea?

      Thanks

      Mark

  153. Morgan says

    Hey, I am only 12 years of age and I have heartburn’s and aches sometimes, can you tell me if it’s okay that people ,like, 12 should get heartburn…..or is it serious!?!?! I can’t take any tums or anything cuz u got 2 b 16 or over…PLEASE HELP ME!!!!!!! :) REPLY A.S.A.P!!!! Thank you! :o

  154. says

    I’ve suffered from throat mucus for some years now and havn’t get remedyI’ve experience so much pain chestburns,headach,and weakness.I’ve many medication but doesn’t heal please help

  155. Stefanie says

    I’ve been reading a lot lately about low stomach acid and GERD, but my doctor basically refuses to even discuss it with me. He blames it all on my small hiatal hernia. I’ve read Dr. Wright’s book, but I noticed that he continually mentions stomach acid decreasing as we grow older. Is it possible to have a low stomach acid issue in your mid-twenties?

  156. georgie says

    Hi ,
    Sir I am having slight form gerd they have put Me on nexium 40 and I am not having much relief the most painful is pricking sensation at left chest bone andgave way to anxiety .please do help

  157. Mia says

    Hi Chris
    I took hcl for 3 weeks and i felt better until all of a sudden after 3 weeks i noticed heartburn worsening. Could this be that i no longer need it after only 3 weeks?

  158. Mia says

    Hi Chris
    I took hcl for 3 weeks and i felt better until all of a sudden after 3 weeks i noticed heartburn worsening. Could it be that i no longer need it after only 3 weeks?

  159. Pappy says

    I was recently diagnosed with Barrett’s esophagus, including the presence of two “changes.” I am willing to try the dietary changes you have recommended, but wonder about your statement at the end of the final article concerning gastroplication. Also, I assume that if I want to try the HCL test, I should stop taking the omenprazole a couple of days prior to beginning?

  160. Kim says

    Dear Chris
    Thank you so much for your so helpfull research!

    It looks like in continental europe where I live, those hypothetis havent arrived yet.
    I cant find anyone to help me with the therapy of my stomachal issues which have become so bad after a antibiotical therapy at seem to get worse. I have startet Betain-HCL , and happily experienced less bloating in the stomach and more energy after eating. But I have developed a heartburn, which I never ever had before. I stopped the HCL then introduced it again. Still the heartburn has become worse. So what shall I do?`Withoout Betaine-HCL there’s almost no digestion and with I get heartburn.
    At night there seems some foodliquids coming up my throught, as I find my mouth with a (food-)layer in the mornings.

    So shouldnt I take the Betaine-HCL as though i benefit from it or more – I need it?

  161. Debbie says

    Chris,

    I was recently diagnosed with gastroparesis (which I think has been caused by my Prilosec) being I’ve been on it for 10 years and it slows digestion. By changing to a Paleo type diet, could the effects of the gastroparesis possibly change once I go off the Prilosec and the acids/digestion starts coming back?

  162. Barbie says

    Hello,
    Your article is quite informative. Many of the suggestions I have already tried. However, in my case I have both GERD & collagenous colitis, which obviously creates the ideal treatment described next to impossible.
    Do you have any alternatives to use in my case? The CC is pretty much under control (after one year of brutal reactions) though dietary changes. Gluten, dairy & wheat. WHEAT is not mentioned often enough, & in its present form is good for no one. Lose it. Dairy, even gluten are good for causing a plethora of problems.

    Thanks,
    Barbie

  163. T Consuelo says

    Hi Chris,

    Thanks for the information. Very very helpful indeed.

    I do have some questions for you. I am experiencing voice hoarseness in the last 2 weeks. And I suspect that GERD has something to do with it. I have taken medium during this time. And I feel sorry about it after reading your article.

    I am great believer of natural healing. I have been taking my digestive enzymes, and vitamin c supplements, and eating healthy. Until I went on a holiday out of the country, and guiltily indulged in unhealthy diet of high carbs, sugars, and caffeine. Not too mention missing some meals while on the go. I thought that this triggered the acid reflux. I occasionally experience ‘choking’ when drinking liquids. Notably, I did not experience heartburns until I started with Nexium.

    After reading your articles, I am more convinced that I should get off Nexium. And start on low carb diet, pancreatic, and probiotics.

    My questions:
    -could you let me know of your assessment of my situation as laid out above?
    -do antibiotics help with gerd? Should this be taken at the onset when getting of Nexium?
    -I am really getting stressed nd worried about my voice. Will I get it back once acidity balance is achieved? How long does treatment normally go?

    Thank you in advance. And more power to you.

    Regards
    Consuelo

  164. T Consuelo says

    Hi Chris,

    Thanks for the information. Very very helpful indeed.

    I do have some questions for you. I am experiencing voice hoarseness in the last 2 weeks. And I suspect that GERD has something to do with it. I have taken medium during this time. And I feel sorry about it after reading your article.

    I am great believer of natural healing. I have been taking my digestive enzymes, and vitamin c supplements, and eating healthy. Until I went on a holiday out of the country, and guiltily indulged in unhealthy diet of high carbs, sugars, and caffeine. Not too mention missing some meals while on the go. I thought that this triggered the acid reflux. I occasionally experience ‘choking’ when drinking liquids. Notably, I did not experience heartburns until I started with Nexium.

    After reading your articles, I am more convinced that I should get off Nexium. And start on low carb diet, pancreatic, and probiotics.

    My questions:
    -could you let me know of your assessment of my situation as laid out above?
    -do antibiotics help with gerd? Should this be taken at the onset when getting of Nexium?
    -I am really getting stressed nd worried about my voice. Will I get it back once acidity balance is achieved? How long does treatment normally go?

    Thank you in advance. And more power to you.

    Regards
    Consuelo

  165. Ellie says

    I’ve been following up various aspects of GERD for a few months now and doing well with Betaine HCl. I always used to eat lots of yoghurt and kefir, but food allergy testing tells me I need to avoid milk. Also, yeasts are on my ‘avoid’ list, which seems to cut out water kefir, apple cider vinegar, sauerkraut etc, all of which I enjoy and would otherwise be eating on a daily basis – and all of which are highly recommended for treating GERD.

    Do you feel that with the yeast intolerance, I am right to avoid these products and stick to probiotic capsules? Or might the benefits possibly outweigh the negatives? I have tested negative for candida, but may still have H Pylori (following herbal treatment a few months back, not re-tested since).

    • Chris Kresser says

      I think kefir can be very helpful for resolving yeast intolerance (esp. when d/t h. pylori), but opinions on this vary.

  166. Shawn J says

    Hi Chris,

    Ive read all of your articles and right now I am seeing a Naturopathic doctor and she has started me on Probiotics Acidophilus. Im still experiencing some weary days, burning throat, hot breath, and chest pain. Ive have been suffering with GERD since July 2011, (I was misdiagnosed and have been on everything from antibiotics, steroids to antacid) and was just diagnosed with it back in December 2011. I need to know, if possible, how long does it that probiotics to heal a person with GERD? I want to try HCL & DGL, but Im being patient to work with this doctor. I’ve told her on my on and off symptoms but she’s telling me to continue taking it. I’ve only been taking it for almost two weeks. (…I know) :)

  167. Kim says

    Hi
    Why does Betaine-HCL help me so astonishingly with all my symptoms, but on the meantime after 2-3 days slowly slowly my stomach gets inflammated (Gastritis) that I have to completely stop taking it?

    I do never experience heartburn after taking HCL.

  168. lenny says

    Chris, how do you make light of Art Ayers’ comment regarding the inadequacy of betaine-hcl to increase stomach acid? His comment reads as: At the link that you cite, they were advocating adding a salt, betaine-HCl, to increase stomach acid. This is silly. The betaine is a weak base and when it is neutralized with HCl, you get the salt. That just means that it acts like a buffer to maintain a particular pH, it is not going to acidify any more than adding NaCl. Betaine is, however, an interesting compound that may interfere with heparin-based signaling.

    The point here is that alteration of stomach acid levels is not caused by the contents of a single meal and indicates more profound problems, such as the most likely, Hp infection.

    I don’t buy the impact of stomach acid levels on protein digestion and some consequence of proteins slipping through. That isn’t consistent with how digestion works. The peptic enzyme hydrolyze proteins differently than the subsequent pancreatic proteases. This is interesting with respect to antimicrobial peptide production, but I don’t think that there is going to be a systematic impact on immunity. Those proteins and large peptides do not get across an intact intestine. Leaky gut is required. COX inhibitors would be more likely problems.

    Vinegar and lemon juice are not going to acidify the stomach. They contain weak acids, acetic and citric acids, that will actually act as buffers and neutralize stomach acid. That doesn’t mean that they are not useful, because they are very helpful in dissolving biofilms.

    • Kim says

      Hi lenny
      Are you someone who knows some answers about the topic ?
      your words spread some knowing and understanding?

      I cant find anyone to answer my questions about Betain-HCL as there thousands of people seeking answers and quite nobody to have time or beeing competent about it.

      regards
      Kim

      • lenny says

        The problem lies in the fact that no studies, or none that i’m aware of, have tested the claim that betaine-hcl increases stomach acid. If you look at the chemistry of reaction between betaine and hcl, you notice that hcl is not actually available to the person ingesting it. I’ll explain it like this, betaine is regarded as a zwitterion, a neutral molecule with both positive and negative charge. I know it sounds counter indicated, but it’s not. Betaine, like every amino acid, has a carboxylic group and an amine group. The amine group attracts the hydrogen from the carboxylic group (known as deprotonation), causing the carboxylic acid region to be negatively charged and the amine side to be positively charged (hydrogen is a positive ion as you know). What happens next is that when betaine reacts with HCl, the carboxyl part of betaine (the one that lost a hydrogen ion) attracts the Hydrogen (from the HCl). This causes the net charge of the betaine to become positive (remember the amine side had a positive charge due to the initial attraction of the hydrogen ion from the carboxyl?), which attracts to the negatively charged Cl leftover from the HCl. The resulting molecule, when exposed to water will dissociate (separate) into the positively charged betaine and chloride, not betaine and hydrogen chloride (HCl). It is possible that the positively charged betaine may release the hydrogen which it took previously from the HCl and make the solution acidic, but like i said earlier, there haven’t been any studies confirming or denying this. Hope this helps a bit =)

  169. Justin says

    ” Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation.”

    I’m a bit confused about this. This sounds like the same “mild burning sensation” that is the original heartburn. How do I tell the difference?

  170. Mike says

    Hey Chris, I’ve read from a few sources that it’s best to avoid HCL that comes with pepsin because pepsin is derived from animal intestines. Do you know anything regarding this?

    Thanks so much. Been on this regimen for a few months and it is slowly aiding my GERD. This is coming from a young, athletic, generally healthy 20 year old.

    • Dana says

      If you’re a vegetarian, that might be of concern. If you’re not, don’t worry about it. People have been eating animal intestine for a very long time now, with no adverse effects on health.

  171. Christine says

    I have always had bad heartburn/GERD off and on for many years. About 4 years ago it was so bad that my doctor gave me Metoclopram. It did wonders. But I don’t like to take it very oftern as I am wary of the symptoms I have read about. However in the past few weeks I started a low carb diet and my heartburn is horrific. Even with taking the Metoclopram I am not seeing any real relief. I am contemplating going off this diet, though I hate doing so as 10 more pounds is my goal weight. I am only around 15 pounds to what is considered overweight for my height. Any suggestions as I am leaving for vacation in a few days and I do not want to suffer the entire time.

  172. Kathy says

    Chris;
    First, was does the L.A.c stand for?

    I first got bad heartburn about 30 years ago when I was pregnant. Was on Prilosec up until about 3 years ago when I was diagnosed with Ulcerative Colitis. Celiac Disease is in my immediate family although I tested negative for it. Despite the “specialist” saying that diet wouldn’t matter, I stopped eating gluten. I very rarely get heartburn anymore. I do have BE and have gotten letters lately about needing to do the upper GI again. I wasn’t really worried about the BE since I rarely have symptoms, but I thought I read that you advise people in my situation to continue with medical help. Understand, I also don’t have insurance, so not likely I can afford an upper GI. By the way, the Colitis symptoms are also gone. I am going to try the Paleo Diet since I do have inflammation in my upper back from whiplash and excema. (The excema has improved with the Celiac Diet)

  173. Alex says

    Hello Chris,

    thank you for putting forward a pathway to good health that doesn’t involve a
    lifetime of drugs. I started getting serious reflux 6 years ago and have been taking PIPs since then. Recently I have been noticing other health effects, seemingly unrelated, that may well be associated (for example my wife complains about my awful breath, which I can not smell, but I am assured others around me can). I was surprised that various doctors I have seen have had no explanation for the root cause or prevention of GERD, a disease that started seemingly for no reason and affects a huge number of people, other than “take drugs for the rest of your life”. Your article struck an immediate chord for me because I recently was taking some very bitter Chinese traditional medicine for another complaint and my reflux substantially cleared up while I took the medicine, anecdotally supporting your theory.

    Do you recommend stopping PIPs abruptly, or phasing them out over time?

    • aisha says

      hello alex.

      how are you now?we have same problem about gerd..and unfortunately the doctors are not aware of bad breath in gerd.when i opened that topic to my doctor..he taught me how to brush my teeth..hahahah :D

      can u give me tips to ged rid from gerd..wait ur reply…

  174. Richard says

    Hi chris, i was diagnosed of gastritis some years back. My symptoms are very severe which are stomach pain, diarrheoa, flatulence, fever, dizziness, anal pain, headache, fatigue and even more. I have tried most treatments all prove futile. It is not cause by pylori, what shoul i do?

  175. Johanna says

    Hi Chris,

    I am a yound and healthy 31 year old woman. I went through a gastric sleeve procedure in November of 2010, and have been on PPI’s since then. Previously I never suffered from acid reflux. I had no complaints until recently, when I became allergic to both PPI’s and H2 Blockers. I break out in hives. I tried stopping the PPI’s but cannot stand the acid reflux, nothing seams to work. Could I also benefit from your recommendations? At this point I am willing to try anything. What is your opinion? Can I also be suffering from low acid and overgrowth of bacteria? Starting tomorrow I am going to start a very low carb diet and hopefully that will help.

    Thank you in advance =)

  176. Monica Tedford says

    I have been diagnosed with Barretts Esophagus about 3 weeks ago and have been research ever since changed my diet entire plus cant eat much because my throat is always sore but it seems it kept sore being on the PPI’s so I went off them doing baking soda and ACV once in the morning and once at night plus 2 oz of aloe plus unflavored gelatin once in the morning and once at night was this stupid of .. I really can’t afford to make mistakes I have two toddlers that I want so badly to stay alive … please inform me

  177. Laura says

    Your articles are making a lot of sense to me; my doctor seems to throw prescriptions at me for every problem and I’m not at all convinced that he actually knows what’s wrong with me… I was prescribed two rounds of Cipro a few months ago–and almost immediately, I began a lot of wheezing, belching, and heart palpitations, but no heartburn. (Belching and palpitations is a connection that I don’t entirely understand, but I DO feel strongly that there IS a connection.) My doctor has now prescribed 3 different PPIs. No improvement. I’m just wondering how a strong antibiotic could affect my gut flora in a way that would CAUSE gas. It seems that it would knock down the numbers, which according to your theory, would DECREASE gas-causing bacteria. Does your GERD advice apply to me, or am I different case?

  178. Dayle says

    Chris,
    3 weeks ago I woke up in the middle of the night with this horrible pain in my throat and chest that felt like I had swallowed something large and it got stuck. Since then the pain has subsided some, but it never went away. I went to the dr and I am scheduled for an endoscopy next month. The dr thinks I have GERD and wants to start me on medication for 2 months. I don’t like to take medication unless it is absolutely necessary. I am overall a very healthy person. I don’t drink or smoke and I am not overweight. What would you recommend? I just started taking enzymes and Culterelle. I haven’t noticed a difference yet, but should I continue, or try something else? Oh, and I have never had heartburn in my life.

  179. Jennifer says

    Chris,
    I have had acid reflux for almost 20 years (I’m only 35 now). I am not overweight and eat quite healthy. I cut out preservatives and white flour/sugar years ago yet still have acid reflux. I have been on antacids for years and have had the suspicion that the medicine was making my condition worse instead of better. It seems as though the more healthy I got the more food sensitivities I developed. One food intolerance I have is garlic. I can not even eat small amounts without having acid reflux for days. Also cloves cause me to have acid reflux too. I am really trying to get my head around the concept that acid reflux is caused by too little acid. I just don’t understand this, because it seems that the more acidic the food is, then the worse my acid reflux gets. For example I cannot eat oranges, spices, and high fat food without having reflux. My reflux is always bad at night. Almost every morning and naps during the day I wake up with a n acidic taste in my mouth. The other concerns I have is about the Paleoithic diet. I think it is impossible to eat like they did back then, because of all the pollution. Also what they feed cattle these days is completely different then back then. The only way this would work is if we lived on a farm and raised the cattle and animals ourselves. Also what about all of the toxins and antibiotics that are in our meat supply these days? I also wonder what your thoughts are on the acid/alkaline balance diet. Furthermore I wonder what your thoughts are on things that can heal the esophagus. Do you think taking aloe is beneficial? Furthermore what about things that can tighten the LES? I saw a couple of questions on this, but no answers. I have been taking probiotics and they have helped, but definitely not cured, and I am fearful to taking the HCL, because everything that makes my body produce more acid has made it worse (including apple cider vinegar). I am not overweight, and am in great shape, and do not have gas problems. Also I do not have health insurance, so I have been trying to fix this problem for years. Just wondering what your thoughts are on this.
    Thanks

    • Jennifer says

      forgot to mention was tested for H pylori years ago when I first developed the problem and was negative.

  180. Jennifer says

    Also,

    I have been really trying lately to do the low carb thing, and the more protein I eat the hungrier I get and then end up eating carbs to fill me up and then I start to feel over full and sick. What I should do? Why do I get so hungry eating protein? What can I eat to fill me up that’s not going to make me over full?

  181. Leah says

    Hello
    I am at my wits end and I am wondering if my initial gut feeling of having low HCL, is causing my symptoms…. Which all started with my tongue turning white with very bad breath and also include intense upper stomach noise( not associated with meals ), pain in my upper abdominal area, terrible nausea and fatigue.
    Endoscopy shows delayed gastric emptying , nothing else. No pylori or ulcers. Blood tests, normal. More tests ordered, continuously. Currently on an antibiotic for SIBO. Dr suggested Prilosec. My
    intuition says “no”. Now I am stuck, not knowing which way to turn.

  182. Barbie says

    I’m 58 years old and have had chronic constipation for 30 some years. Up until recently I was taking 3 capsules of psyllum husk, 4 large teaspoons of Flax seed meal and 2 stool softners (not with laxative but plain stool softners) and prunes every day to be able to go. Well that worked until a month ago and I developed immense gas pains. I went to my primary care and they gave me amitiza 2 xs per day. It helps with the gas just a little but every night I am up walking the floor trying to move gas around in my intestines. I began taking a probiotic supplement at the same time. The probiotic gives me terrible heartburn and it feels like I have a lump in my throat. I’ve had mild heartburn on and off for years. I was on nexium years ago but got off it myself. So really I feel like a mess. I struggle with constipation, terrible gas pains and now the heartburn. If I don’t take the fiber, I’d never go to the bathroom. I feel like a walking medicine cabinet. Any suggestions out there?

  183. Sylvia says

    Hi Chris,

    Thanks so much for all the information! I have been diagnosed with silent reflux and so tried to go on the Paleo diet but it has been really difficult. It seems that I cannot digest fat or oils very well. A steak with salad causes me no problems whatsoever but olive oil ( I took a couple of tablespoons at once because I was really worried about not getting enough calories) made me feel sick for a whole day and gave me terrible reflux in my throat and mouth. I am considering trying mastic gum (I used to have H. pylori but recently did another breath test which is apparently negative) and also HCL/pepsin and an ox bile supplement. (I have a huge amount of bloating even when I don’t eat much at all and candida problems. I need to burp a lot but never, ever fart so it seems that the food I eat is just not moving through the system…..) What do you think of this approach and how can I do a low carb diet and take in enough calories when there seems to be something wrong with my fat digestion…..? Thank you.

  184. Stephan says

    Hi Chris – not sure if you’re still monitoring this thread, but I was wondering if having a hiatus hernia affect the guidelines presented above? I never had any issues with heatburn until I was diagnosed with a hernia one month ago. Would the hernia affect the functioning of the LES? If so, then how can diet fix that? Thank you.

    Stephan

  185. says

    Hi Chris – stumbled across this article and you site today. I have a site about GERD diet and thought that I had researched this area quite thoroughly, but have learnt a lot today. Lots of think about. I need to study your site and the responses in detail. Can I put a link to my site here? Many thanks – will return soon.

  186. B. Marie says

    I have burning pain under both ribs and doctors can’t figure out what is wrong. This all started after a digestive illness a few months ago. I also have itching and tingling sometimes after I eat, my eyes are red, and nose burns. I am on Librax and probiotics, but my problem is not solved. Any suggestions?

  187. Dana says

    FYI, I think the amount of carbohydrate in fermented dairy foods is overstated. The carbohydrate number they put on nutritional labels is “by difference,” meaning that after they assay proteins, fats, and minerals, “carbohydrate” is anything left over. So typically, they will count lactic acid as carbohydrate even if it doesn’t have the same effect on the body.

    Especially if you are fermenting it at home and you give it long enough to get good and sour, you should be fine. I’ve certainly had no problems with it when I’ve fermented kefir in the past. At some point I want to make myself into a guinea pig and test my blood sugar after consuming homemade kefir just to make absolutely sure–but often I can tell just by how I feel afterward.

  188. Steve says

    Hi Chris. Love this series of articles. Even though it hasn’t helped me unfortunately. Im interested in why you specifically suggest Pepsin should be taken. There seems to be evidence that pepsin should especially be avoided. acid-reflux-relief.blogspot.co.uk
    PS raising the head I the bed by a foot and propping myself up a lot with pillows seems to work wonders for me. I’ve tried everything else believe me :) of course, it’s not a cure and the wife is bored of slipping off the bottom an wakin up on the bedroom floor :)
    Thanks
    Steve

  189. Iain UK says

    Doctor Chris..
    Brilliant articles…my wife has hypothyroidism..I have been diagnosed with Heliobacter Pylori…and your pieces have been totally way and beyond those of our indifferent NHS GPs!
    Though I am not a Doctor…I have been interested in medical matters since a child..this being due to being a direct descendant of JAMES YOUNG SIMPSON.
    I was prescribed triple therapy..but have not begun..as I am concerned with overgrowth leading to possibly CANDID ALBICANS.
    I am therefore ‘prepping’ my tum…with enzymes..pro and pre biotics…and taking substances that HELPYRON loathes..ie turmeric…garlic which Dutch MSs prescribe with OMEPRAZOLE, Licorice to heal existing damage………Mamkuna Honey..Pepto Bismol as it has anti microbacterial properties…etc.
    My question is..I shall add your suggested supplements to the intake..with virgin coconut milk…but if my natural regim does not rid me of this intruder…and I have to pursue triple therapy…am I right in saying that continuing the natural path ‘in tandem’ will help the process…especially replacement of beneficial bacteria which has been destroyed by the amoxycillin?
    Many thanks again..and in conclusion…my wife wonders what your view is on ARMOUR for hypothyroidism?
    Best wishes from the UK-Iain and Chris.

  190. Maria says

    Hi-
    I have been dealing w/ GERD and Gastritis for 3 yrs now. It started after a stressful time during my life. A year after my symtoms came on I took a total change in diet/lifstyle and my GERD was 95% better, however my gastritis was still there so, I went to my local health food store and took Betaine HCL (one tablet) however the person that told me to take it failed to mention to keep the powder in the capsule. It was my first time taking anykind of supplement and I failed to ask exactly what I was taking. I was desperate and took the first thing the health food store attendant gave me. I opened up the capsule and mixed it with a cup of water becasue he told me to start of by taking a little at a time so I thought that that is what I was supposed to do. So, ever since then my chest has been ON FIRE! I have seen a doctor and there is moderate irritation in my esophagus. No ulcers and no hernia. When I told my doctor what I did he looked at me like I had two heads and prescribed a high dose of nexium. I havent taken any PPI’s because I know that they only will only bring on more problems. Could I have really damaged my esophagus that bad from taking HCL powder the way I did and what can I do now to heal it??

  191. says

    Hi Chris. Love this series of articles. Even though it hasn’t helped me unfortunately. Im interested in why you specifically suggest Pepsin should be taken. There seems to be evidence that pepsin should especially be avoided. See the website provided (it’s not my site of course)
    PS raising the head I the bed by a foot and propping myself up a lot with pillows seems to work wonders for me. I’ve tried everything else believe me :) of course, it’s not a cure and the wife is bored of slipping off the bottom an wakin up on the bedroom floor :)
    Thanks
    Steve

  192. Kay says

    Chris Please help
    IN 2009 I had an endoscopy for heartburn problems and the diagnosis was hiatus hernia and esophagitis. I was prescribed 40mg of Nexium daily. I knew they were playing havoc with my health, wheezing after the slightest effort and unable to walk any distance. Bloating, weight gain, dermatitis to name a few. I thought I had struck gold when I found your site about stopping PPI drugs and when I read the info about side effects I realized that I had been taking them for 3 years and they had in fact been making me ill. I found several other sites, all English speaking, asserting that too little acid – Hypochlorhydria – had similar symptoms to too much acid but I live in France and could find none in French. Without exception the advice here is to take PPI’s for the rest of your life.
    I decided to cut down and almost immediately my breathing returned to normal and I had no pain, no GERD and when I stopped altogether I began to feel well again When I told my doctor he was horrified and sent me for another endoscopy and to my horror the diagnosis was the same as before so obviously the PPIs had not cured the esophagus. Neither he nor the gastro specialist were interested in the possibility of low stomach acid and have told me I must go back on Nexium. I have done the simple baking soda test several times and don’t belch and I have no GERD or heartburn. I sleep well with my upper body supported and cannot bear the thought of going back on Nexium. For about 2 months I have been taking Mastic Gum, ACV with Manuka Honey, yoghurt and supplements to replace lost minerals. I have asked for a test for B12 (apparently not absorbed if you have Hypochlorhydria) but my doctor says I don’t need it.
    To my dismay I see in your final article you say that people with Hiatal hernia and Esophagitis probably do have to take IPPs and I don’t know what to do. Is there any alternative? Is there something I can do to reduce the damage to my esophagus because I don’t think Nexium has worked in the past.
    Kay

  193. says

    translation with google: Already with cladodes, good results are obtained on gastritis, esophageal reflux, hiatal hernia, and all, synergy, combined with biodynamic olive oil, ripe olives with mini-dose of olive green leaves, ie inner pulp purple dense and alive!, berries, rich in polyphenols, anthocyanins, oliflavonoidi, flaxseed, omega3, pearly white powder made ​​from mother of pearl shells or valves of oyster shells, containing all the trace elements, which function as catalysts and natural chelation therapy, amino acids, vitamins and minerals and, from seeds of wild fennel, as fermentative and intestinal rich in polyphenols, particularly EGCG, aS tO tHE DISCOVERY RESEARCH CENTER “CAREGGI” FLORENCE, ITALY, YEAR 2011, which combined with tURMERIC, rise SIGNIFICANTLY. So there I was. Regards, Francis Paul Ruggieri, Italy, phone +39-366-1493767; E_Mail ruggierifp@alice.it

  194. Tom says

    Chris,

    Do you happen to know of any doctors in the Atlanta area that see eye-to-eye with you?

    I can’t seem to find one who isn’t on the Big Pharma bandwagon. I’ve got Barretts esophagus and am convinced that there must be a way to reverse this that doesn’t involve a lifetime of PPI usage.

  195. John says

    Hi Chris. I came across your posts via a friend who has been using the HCl and swears by it now, so I am going to give it a try.

    The problem with my GERD is that I’ve never had traditional heart burn like symptoms. I’ve always been diagnosed due to either: a persistent cough, frequent burping in conjunction with a loss of voice (not great when you make your living as a singer :/ ) While on OTC Omeprezole, Zantac and the like, the symptoms subside but I realize after reading the above that the underlying problem is much bigger.

    Since I don’t usually get ‘a burning feeling’ in the chest (and my other symptoms have subsided for the moment) how will I know how long to take the HCl for and when I am ‘cured’?

    Also I’ve read up on foods and drinks that cause the LES to ‘relax’ and thereby causing reflux and the list always includes peppermint but you included it in you list of bitters. Can you demystify this contradiction?

    Thanks again for all of the great info!

  196. kim says

    Its not nice letting all this hopefull people let describe their problems and let them hope they will find an answer. As you wont answer or even give the feedback that you dont have the time or capacity and letting this list grow and grow and grow. :(((

    • barb says

      Kim, that is not fair and not all correct. There are MANY posts that Chris has made concerning a variety of MANY issues and what can be done to help eliminate them. He is ONE PERSON with just so much time! Give a guy a break :-) For there are many, many people asking many questions and NOT READING his valuable information.
      Some times you just have to look, read and do research. He gives suggestions over and over. How can he possibly answer EACH and EVERY question ON EVERY SUBJECT and still live his life or deal with REAL HUMAN patients??!!
      This isn’t exactly “GET FREE ADVICE” It is for informational purposes only. Let’s just hope he doesn’t stop the questions due to time restraints.

      • kim says

        Yes, of course he is a human beeing- even a committed nice one.
        But this isnt the point. Its just not fair, letting people write and loose time and especially abusing their hopes by letting fill them in this forum and then getting NO answer. Please read all this letters full of hope and despair!!!!!!!! If Chris has no time for it, then he should close this forum. Otherwise its just one new lottery – if you have chance one out of thousend you might get a short answer. This is spoiling peoples energy and hope. Of course maybe his site will be found by google more often the more people share their questions.

        • Priscilla says

          Kim, Chris has specific suggestions/directives. You need to follow them and give yourself some time. I was diagnosed with GERD 3 years ago and never given any nutritional advice or direction by an MD. My questions were never answered by any physician as to the conditions present that resulted in my GERD. After conducting my own research and really abiding to the advice of Paleo experts, I feel amazing. Believe me -I did not WANT to 100% commit in the beginning. My mind made the transition difficult. It was too hard, too expensive-everybody eats a crappy diet and they are fine. Or so I thought. A year later, a macro nutrient dense diet is just my norm. I am still taking HCL and enzymes. Drink homemade bone broth and eat homemade sauerkraut and/or water kefir). I put sleep and happiness first, stress manage, walk everyday….Just commit to what you need to correct and you will be fine. You sound desparate and worried-and blaming Chris? This is a stressful state that will not help you meet your heatlh goals.

  197. Laurie says

    Chris, I have taken 40mg Nexium daily for over 10 years with GERD! I am active and play tennis regularly and must tell you that I get injured ALL THE TIME and have been a house painter and got injured doing that too! I am always tearing a ligament or tendons and have had numerous surgeries! I have had surgery on both the inner and outer elbow, ACL surgery, sprained ankles and now need wrist surgery from a tendon tear again!! I have had gallbladder removed, hypothyroid with half of the thyroid taken out, and my blood work has shown low magnesium, potassium and iron which the Doctors could not understand why. Clearly there is little knowledge of how to treat GERD in a healthy way and three separate Doctors have told me that there is no long term bad effects associated with NEXIUM and it is perfectly fine to stay on them long term.
    I recently have contemplated how uncanny it has been on how many times I have gotten injured and am in not in such great health – even though I do not smoke and eat relatively healthy. I am 50 now and do not want to start breaking bones now that it has been clinically proven that NEXIUM causes bone weakness.
    I am now figuring that maybe somehow, NEXIUM might be a culprit to my chronic injury history. I have been wanting off this drug for awhile now but knew of no alternative and have tried a few things to avail. I have been off of the drug for a whole week now and am dying of heartburn and pain so after reading this – I am off to get HCL, DCL, Genetian root, and glutamine today as well as will be doing the low-carb diet. Hoping it will all work. Thanks for the info!
    Just curious Chris, have you ever heard of chronic injuries of ligament and tendon tears or a link of this kind to long term PPIs??

    Just wondering,
    Laurie

  198. Kelli Doan says

    Hi Chris,
    I have read all of your articles and I am fascinated and intrigued by the information. I have taken 40 mg. of Omeprazole daily for the the last 7 years and my reflux is getting worse. It has started to go into my lungs and I experience heaviness in my chest, shortness of breath, and coughing all night long. My Doctor said I have walking pneumonia and put me on two rounds of antibiotics. I am desperate to find relief and very confused as to the conflicting information on the cause of reflux. The one thing I am convinced of is that the medication I take for reflux is not good for me and making it worse!
    Are you familiar with Dr. Ronald Drucker and his product, DigestaCure? He, like you, says that acid reflux is caused by autoimmunity and Digestive Dysfunction that leads to undigested food matter in the colon, but unlike you, he says this produces EXCESS stomach acid which leads to reflux! His product contains “plant healing compounds” and I’m wondering if this is similar to the enzymes and things that you recommend? I have not tried his product as it is quite expensive. I don’t know if it’s a scam or what to believe! All I know is that I have to get off of this medication (omeprazole). Thanks for any insight.
    Kelli

  199. Kelly says

    Maybe my experience can be of help. I left Chris a message a while back and have since gotten a good handle on my prior GERD situation.
    The first thing is that I weaned myself down to a low dose of Prilosec, then quit it completely, then used an acid reducer like Tagamet once daily to help me for a period of a few months. I quickly weaned off the acid reducer first using it every other day or so, then committing to not at all (no matter what).
    I then had to try a lot of different approaches, including trying the HCL several times (the first time, one pill just created more burning so I tried a different brand and gave it a chance and it really worked for me). What worked for me is the Now Foods Super Enzymes brand. It has digestive enzymes as well (this is an area that I have had issues with in the past, documented by blood tests, so I feel the addition of some digestive help was key). Please note, I do not have a gall bladder. I did have GERD before the surgery however, so I’m not sure that it’s lack of presence in my body makes a difference.
    I continued to use the HCL supplement until I felt that I had all my digestive processes in order, including elimination (also an area that I had prior problems). Some things that have helped me in that arena (as well as with GERD issues) are drinking about 4 ounces of Kombucha daily, taking a probiotic that works for me, eating a strict Paleo diet that is lower in carbs, but still includes some starchy vegetables, drinking a little bone broth daily, getting good sleep, try to avoid stressors (including eliminating the super high-intensity Crossfit metcons and focusing my fitness elsewhere).
    Then I made a leap and went without the HCL supplement. For a while I relied on a shot of apple cider vinegar or fresh ginger for relief, but still had some reflux problems. Part of this may have been to a trauma that my body went through that caused some physical stress and unfortunately required a short course of steroids for healing. It’s important to note that I did NOT let myself touch any GERD medication (Prilosec, acid reducer, etc). Instead, I listened to what my body needed – extra rest, trying to keep a positive mental attitude despite the injury, and an extra tight anti-inflammatory diet. I really focused on what I could do, outside of the injury I suffered, to get rid of reflux once and for all. After several months of paying really close attention to when I would get GERD (which was no longer daily, but still several times a week), I learned what was still causing the occasional problem: drinking water. I have a habit of sucking down a lot of water…all day long after my cup of coffee in the AM (interesting to note that the coffee has never given me reflux, but I would often get reflux after switching over to water). So, I cut back and tried drinking less…only when I was thirsty and little sips. Even fewer instances of reflux. I started adding lots of lemon, or crushed ginger or a couple shots of apple cider vinegar to my water. As long as I do that and don’t suck a lot of water down at once, I don’t have reflux. I also try to avoid water or liquids with food. And I don’t drink water during a workout, unless it’s just sips during an endurance workout. I’ve since been able to add back in the high intensity, Crossfit metcon-style workouts.
    Overall, I drink less total water in the day. Some days I take an extra shot of apple cider vinegar, depending on how I feel. If I go on a trip, where I can’t have my daily digestive aids like Kombucha and may be eating less than optimal foods, I be sure to have my HCL supplement around. I typically do need it under those circumstances.

  200. KL says

    I’m wondering if you think HCl supplementation is safe in pregnancy? I’m an acupuncture student and want to recommend it to a patient. I’ve gotten mixed opinions from several practitioners about the safety.

  201. Antony Wahba says

    Thank you. Very much. Even if your logic and list of studies with poor statistical significance are all – forgive me for being skeptical – bullshit, you’ve given me hope. I’m a 24 year old pharmacist who’ve been living with PPIs for the last 5 years of my life, and with my medical background the horrors of side effects have been haunting me increasingly. From liver damage to impotence in males it was very hard to acknowledge that this is the path I’m doomed to walk. After reading your enlightening post and many other resources online I now believe that even if I failed to get off PPIs completely, at least I can try. Thanks again.

  202. Joe Bernard says

    Thanks for the articles Chris, great info. I’ve tried everything and still do not get relief, what do you recommend? I was diagnosed in May with an inflammed small intestine, H. pylori infection, and gastroparesis (45% emptying rate). I took a 14 day antibiotic treatment for the H. pylori (this was before I read your articles), so hopefully it is gone, but so is a bunch of beneficial bacteria. I keep losing weight and it’s very frustrating. I am 23yrs old, 5’10, and on January 8th I was 144lbs but as of this morning I was 122.8lbs; add in the fact that my stomach pains caused me to not eat all day today and I’m down more weight. This gain and loss cycle has happend three times in the past in the past four years, resulting in similar losses of 20-25lbs within the same range (150-145 >>> 125-130). I’m trying to gain again but it’s ridiculously hard. I KNOW that carbs are fermenting in my gut, I can feel it. My stomach gets distended, I’m bloated and constipated ALOT, and get stomach pains. This prevents me from getting a good amount of sleep each night and as a result, I am a zombie everyday at work, trying to survive until the weekends so I can hopefully make up some sleep.

    I’ve been paleo since the fall of 2007, and recently tried low carb as per your recommendation but it did not work. No matter what macronutrient ratio I eat while staying paleo, I am able to eat well for 3-5 days but then I tank and can barely eat anything for the next couple days. I’ve had a colonoscopy, upper endoscopy, allergy test, and gastric emptying study. I was thinking that it might be SIBO and want to get a test done for it, but I’m not sure. If you have any other recommendations besides the ones in the articles I would greatly appreciate it; I’m at my wits end and do not know what to do. I just want to be healthy, be able to workout, gain weight, and be strong, and just enjoy life….but this has been holding me back for four years.

  203. Caleb Pleasants says

    Does anyone know more about the burning sensation spoken of when taking HCL. I have severe Acid Reflux and have been on PPI for over 5 years. I decided to ween myself off of them and have since started on HCL and Pepsin. Sometimes it seems like I have the right balance in the number of HCL pills I take. Usually about 4 depending on if what I am eating is high in protien or not. However I have never expirienced any burning in my stoach. The burning I feel is the normal acid reflux burning. Is this the burning spoken of, or should I be taking more HCL and feel a slight burning in my stomach? Thanks

  204. Gurps says

    Doctor, I need your urgent help here, I think I have silent reflux, I have post nasal drip and burp a lot after drinking water. I had acid reflux 6 months ago, I had heartburn, feeling of acid coming up etc, I was tested negative helicobacter plyori.
    Yesterday, after cutting the grass and gurgling with salt water I started to produce excess salavia in my mouth. Bearing in mind, I do have allergies and its still allergy season, and it maybe wasn’t prudent of me to cut the grass although I did use a protective mask.

    What do you think it is? Any suggestions, please help.

  205. Crystal says

    Thanks for this amazing series of articles. I have been taking Prilosec for over 5 years and I’m only 24. My Natropathic DR said it was due to stress but I never tried HCL. I am going to try it ASAP. I am just curious if it is necessary to continue taking the Prilosec when starting this regimen or should I completely stop taking it when trying the HCL with Pepsin?

    • Chris Kresser says

      I can’t offer advice about drugs; that’s something you need to discuss with your doctor. I can tell you that many of my patients are able to stop their PPIs after starting the HCL protocol.

    • Glynis says

      Elisabeth,
      Thank you so much for your story. I agree, Dr. Campbell-McBride’s book on GAP Symdrome is excellent, as is her dietery guidance. I have just stoppped Nexium two months ago, and a GAPS-based diet for the last two weeks. No-one should be put off by the title of the book. This research, recommendations, and dietery advice for “healing and sealing” the gut is a must for anyone with gut problems. I too have a hernia and a stricture in my oesophagus, and this latter issue will not easily be resolved. But setting the gut straight is the primary advance in health improvemnt. Did your chiropractor say that the reduction of the haital hernia is permanent? There seems to be some comfusion about that outcome.

    • Glynis says

      Elisabeth,
      Thank you so much for your story. I agree, Dr. Campbell-McBride’s book on GAP Symdrome is excellent, as is her dietery guidance. I have just stoppped Nexium two months ago, and a GAPS-based diet for the last two weeks. No-one should be put off by the title of the book. This research, recommendations, and dietery advice for “healing and sealing” the gut is a must for anyone with gut problems. I too have a hernia and a stricture in my oesophagus, and this latter issue will not easily be resolved. But setting the gut straight is the primary advance in health improvemnt. You can have the stricture stretched, and as long as there is no acid reflux into the gullet the stretch can last several years. Reducing the hernia is a great help, and I need to find a chiropractor to reduce mine. Did your chiropractor say that the reduction of the haital hernia is permanent? There seems to be some comfusion about that outcome.
      The GAPS book is a great gift to the world, and I highly recommend it.

      • Elaine says

        Glynis, I am wondering how you stopped taking the nexium. I have been taking it for longer than I can remember and even though have gotten my dosage down to half (20 mg) every time I try to stop the pain is unbearable. Thanks for all the information you have supplied.

        • Glynis says

          Hi Elaine,
          I tried to come off Nexium a couple of times but the pain was excruciating. This time has not been without its issues, but I feel as if I have succeeded and faster than I ever imagined.
          First, I would advise you not to make it all too complex as you can get confused about what is working and what is not. I decided to transition to Zantac, because at least you can control it. I bought the lowest does pill, Z75. Have a pill cutter to hand. This way you can tweak your dose to suit your needs. I chose Zantac because it works differently from Nexium and other PPIs. Zantac at least lets you have some acid production. This is important. Do your research and even consult your PCP, but remember they will prescribe much highr dosage than you might care to take, but you will find out how high you can safely go. Then, if you get the rebound under control, you can gradually reduce the Zantac. (I found at first that the Z150 minty did not work for me, although I do not know why. Fortunately that led me to the Z75s, which is much better.) You will find that you will alter your dosage of Z up and down a bit before you know what will help you. If the night time is particularly bad, then you can plan your highest dosage accordingly. Sleeping propped up also helps for the bad times. Based on a reversal Chris’s advice not to dilute stomach acid by drinking at mealtimes, I sipped water when I got the burn to dilute the acid and often that was all that was needed. Ocassionally, I took a slug of heavy cream, which seemed to sooth my oesophagus. I am sure that the Kefir would be very good, too. You just have to figure out what works for you. Be patient and flexible. What works one day, especially in relation to drug dosage, may not work the next.

          Luckily, I had oral surgery and had to take a broad spectrum antibiotc, so I started Kefir to offset the destruction of and augment the colonization of my good gut bacteria. Understanding the connection between flourishing bad bacteria etc. and carbs was extremely helpful. So, I started reducing my carbs significantly. Then I found the GAP Syndrome website. Dr. Natasha Campbell-McBride has posted the initiation diet, so you can get started with that aspect of your recovery. I received her book yesterday amd it is fascinating. I do not fit into her targeted population, but I fully believe that gut health is a core issue for everyone, especially we who have basically circumvented our natural gut activity and have paid the price.

          Keep in mind that your goal is to heal the inflammation, correct the gut flora, and get back to normal acid and enzyme production and activity. Listen to your gut, your appetite, and your inner wisdom……and be patient. :-)

  206. Rob says

    Chris, thanks for the wealth of advice you provide to the community. My coach and I are trying to navigate an HCl protocol where I was taking 5 Poliquin brand capsules with every meal for some time and would never get the requisite “warm sensation.” In your article, you mention a “mild burning.” Is it possible that I am just not attuned to feeling a sensation whatsoever? My family has a history of low stomach acid. Is there another gauge that I can use apart from the radio sensor with my doc? (He hasn’t been particularly helpful through my paleo journey.) I don’t get bloating after meals but have rare, occasional gas depending on the content of the meal.

  207. Julie says

    Wow, nice to see Chris is still actively contributing feedback. I was dx with GERD in ’05 but refused to take any acid suppressing pills, but got to the point where I couldn’t stand the discomfort so I started popping them here and there. In ’06 I was dx with Ulcerative Colitis. Started SCD, stopped all acid pills, but determined even SCD was too many carbs for me (still can’t have fructose of any kind), so I went down to VLC for 2-3 years. Living on less than 20 grams of cabs became my normal, but I also learned it can be a very alienating to the outside world. I am totally drug free for years, have had slight UC flares here and there, and have been educating myself on what and I can and cannot eat.

    Here’s my problem/question…I cannot have even the slightest bit of fat, acid foods like tomatoes or mint and so forth… or I get horrible acid reflux, it burns all the way up my throat. This has been increasing the past few months. I do currently eat about 60-90 grams of carbs a day, but they come from veggies, gluten free oatmeal, sweet potatoes, winter squash… I eat no grains, no sugar, only stevia. Okay, that’s a lie, I will now allow myself to eat “like normal people” maybe 2-3 times a month at social functions and such, but 95% of the time it is whole foods prepared at home. I have been eating like this for years (oddly enough even before being dx with GERD and UC). So I am already eating a ‘paleo’ style for years, so why am I having so much reflux and constant burning in my throat and esophagus and how do I know if it is low acid, or if I am one of the only 10% that actually have high acid?
    I live on baking soda, acv, glutamine, mastic gum…just nothing seems to be working…

  208. Jennifer says

    Dear Julie,
    I have exactly the same problem. I have acid reflux all the time from the slightest thing like mint, spices, garlic, high fat, tomatoes, chocolate, and peppers. I have been eating low carb for years and hasn’t seemed to make a difference. I take probiotics every day which does help some. Also I chew papaya enzymes sometimes which help.

    • Julie says

      Dear Jennifer…I finally found RELIEF!

      Since your symptoms sound so similar to mine (reflux from EVERYTHING, and pretty much 24/7), and a dull ‘pain’ under my sternum, that I wanted to share how I’ve experienced relief these past few days. My reflux was so bad these past few weeks – always getting worse as the day went on, that I had to sit straight up instead of being able to lay of the sofa to watch tv. At night I had so many pillows under me trying to prop me up, it was ridiculous…and didn’t help, anyways. I was also burping like a sailor!

      Out of the blue it hit me, “I think I have a hiatal hernia”! So I researched on-line how to ‘cure’ it, and was chocked to learn how common it is, and how VERY easy to manually manipulate the stomach back down where it belongs. I thought, “what the heck, what do I have to lose”. It only took a few minutes…but when I got up off the floor the pain was GONE! Now I feel like an idiot for not thinking of this sooner.

      From what I’ve learned, a hiatal hernia is when a portion of the stomach slides up through the esophagus, so therefore the sphincter valve (which is only suppose to open when we swallow food or liquid), is ALWAYS open, which is why I was ALWAYS experiencing reflux. And burping. And pain. And a “fullness” even when only eating a very little bit.

      You can easily find many many websites, and YouTube video’s showing you what to do. I am still in amazement at how easy it was and how much better I feel. Obviously, I am still very careful with what I eat right now, but for the past 3-4 days, I have not pain, no burping, and very little reflux.

      I hope someone may find this helpful.

  209. Jennifer says

    Dear Julie,
    I have exactly the same problem. I have acid reflux all the time from the slightest thing like mint, spices, garlic, high fat, tomatoes, chocolate, and peppers. I have been eating low carb for years and it hasn’t seemed to make a difference. I take probiotics every day which does help some. Also I chew papaya enzymes sometimes which help but would really love to know why.

  210. Jared says

    I have been diagnosed with GERD by my gastroenterologist and I was tested negative for H. Plyori antibodies. I have been following the GAPS Diet for over a year and yet I still have a persistent burning/stabbing sensation under my sternum in my mid-upper abdominal area.

    When I take even one 500mg HCL capsule I end up burping up acid. Sometimes the pain feels worse, sometimes it stays the same, and sometimes it feels a bit better (although it’s so hard to evaluate it because it’s constantly changing throughout the day). What do you recommend I do to treat this pain?

    • Jared says

      To be more specific as to where the pain is located, I would actually describe it as being under the xiphoid process. Thanks in advance.

  211. Jackie says

    I have GERD and esphogitis. I’m worried because I have moderate inflammation in my stomach lining. I have been taking 60 mg dexilant and still no help. Can I get off of the PPI’s even with esophagitis?

  212. theresa says

    I have GERD and apple cider vinegar, lemon juice make it worse. Does this mean I produce too much acid? Is HCL still and option for me?

    • Julie says

      Hmm, well I was hoping to hear from Chris, since obviously I am not alone here. To Jared…I too have tried HCI and get a burning sensation with one pill. It freaked me out, so I stopped…not sure if I should have hung with it for a few more days, or not. To Theresa….AVC and lemon juice makes it BETTER for me, but I also dilute them both – too afraid that it might burn my throat/esophagus to try them straight. What works the best in relieving the pain though, is baking soda…usually have to do it a few times though. I burp like a sailor, but it works.

      I guess my confusion is not how to put out the fire, but how to prevent it from happening in the first place. All the ‘typical’ foods on the “do not eat if you have acid reflux” list bother me immediately when I eat them. It used to be just coffee and alcohol that mildly bothered me, but as the years go on, everything bothers me. I eat plain lean meats and veggies, that’s about all I can handle if I want to be pain free. I know the importance of getting good fats in my diet, but can’t tolerate them. I used to eat coconut oil almost daily, now it gives me horrible reflux. What gives?

    • says

      If I understand the article correctly there is no such thing as a stomach acidity level that is too high. The REAL problem is a bacterial overgrowth preventing your stomach from functioning normally and possibly a stomach lining that may have grown too thin.

      As he said above, continue to increase the acidity of your stomach acids, avoid bread, pasta, rice and all other grains for at least a week, sugar and artificial sweeteners, eat soups made from bones and take tons of probiotics, If you don’t know what probiotics are then ask your chemist.

      I started doing this 2 about days ago and already I feel transformed.

      • Chris Kresser says

        There is such a thing as excess stomach acid production, but it is rare. Glad to hear you’ve had some success!

        • Anna P says

          Is the rare incidence of excess stomach acid production ever a factor in GERD? If yes, what’s the treatment? I would guess it’s no longer HCL.

          The reason I ask is that my dad is very hesitant about HCL. He’ll try it and claim it causes various pains. I’m trying to convince him to give it a real try before we give up. Some people here have said it takes a few tries, or that it might feel worse before it feels better. But I wonder if I am wrong to insist when there is that rare 10% out there who over-produce stomach acid.

          Thank you very much for your time. You’ve already helped me a lot through your work.

  213. lee says

    Hello, I have a friend that had most or all of his esophagus removed due to cancer caused by reflux. He has gone 4 years now (a miracle as most do not last long with this type of cancer) and he still has acid reflux and is on PPIs plus others to prevent the problem. I do not know all the details of his surgery but am told they rebuilt his esophagus with his stomach so he can’t eat much at one sitting and I don’t think he has a valve to prevent the acid from coming back up. My Q to you is this- Does he dare to try any of these suggestions with his “modified” digestive system. We live near Boston and any suggestions for doctors would be welcome. Thanks to all!

  214. Arjun says

    Hello Chris,

    i was diagnosed with ibs 2 years ago(though i strongly beleive i dont have it) after i went to testing after a food poisoning episode , in the first year the symptoms were intermittent like for one month too bad..and then gone…it is impossible for me to gain weight after the symptoms started..i have lost 12 kgs ..and from last 6 months it is really bad,,,,the weight loss accelerated..i have burning sensation in urinal tract area and behind ribs, my primary symptoms are gas (lots of it sometimes) ,headache due to it ,gerd like symptoms,,i am not sure what is it that is wrong,,, i really need to gain weight ..not sure what diet and approach to follow…pls help Chris!!!

  215. andrian says

    is there a research about connection GERD and heart rhythm, and how to get rid of it. It makes me like running a thousand mile ( neever did that ) and force breathing from mouth. sorry for bad english, don’t where to ask this

  216. Jen says

    Hey Chris,
    Thanks so much for presenting us with such useful information. I have been struggling with GERD since a round of oral steroids to treat poison ivy. Since then I have been suffering from severe dry cough and feeling like something is stuck in my throat – all of which have been relieved by zantac – although, as you mentioned previously not without tons of side effects. Would you still recommend HCI treatment if the GERD was caused by a steroid damage? Many thanks.

    • Shirley says

      Hi Jen….I too had those same symptoms as well, the cough (still have) and the feeling like something was in my throat….I am currently on Dexilant 60mg for the acid reflux and a presc. for allergies to clear up whatever was making my thoat tighten. While the throat has improved, the reflux medication is working less all the time. The cough I’m not sure where it is coming from. I was so excited to read Chris’ articles and have started making steps toward following his dietary plan and going off the meds totally. GAPS diet is right there with the same info and eating guidelines. There are enough testimonies out there from people who have been healed from the inside out, that I feel empowered to get started soon.

  217. Charlotte Hepburn says

    Hi, thanks so much for these articles on how to get rid of GERD. I first got the sensation of burning in my throat or as if a razor blade was stuck there when I gave up smoking 4 years ago. I saw a nutritionist who gave lots of the same advice as these articles and I started taking High Strength Betaine HCl with Pepsin which did really help. My nutritionist said I could take up to 8 a day. Each tablet contains 650mg of Betaine HCl and 45 mg of Pepsin. I always took 8 a day and I did follow the guidelines about increasing it gradually but have never got to the stage where it feels worse because of the tablets – although it’s hard to tell because my main symptom is burning in the throat. I did alot of the dietary changes and stayed not smoking for just over a year. The tablets helped a great deal but did not eradicate the problem. I went back to smoking (very foolishly) and no longer had the sensation in my throat. I have now quit smoking again (once and for all) about 2 months ago and the burning sensation came back. It was/is pretty much constantly unless I am actually eating. I’m taking the tablets again and since reading your article 2 weeks ago have cut out sugar completely (I’ve never used artificial sweetners – I think they are worse) and I have lowered my carb intake to 20 grams a day from vegetables for 9 days now. I’m drinking lots of filtered water, eating organic eggs and free range (organic where possible) chicken, pork, beef and vegetables. I have also been drinking one tablespoon of lemon juice mixed with 2 tablespoons of water 10 to 20 minutes before meals. I have felt an improvement in the pain but really want to get rid of it forever. I am yet to try the bitter herbs. My question is can I take more than 8 x HCl tablets a day? I can’t get back in touch with my nutritionalist – I think she’s left the country. I’m sure I’ve read that the stomach would naturally produce 14 times what one tablet provides somewhere.
    As I say I have felt improvement am I just being impatient for more improvement and my body will catch up in it’s own good time? I’m 32 years old (just turned) and I smoked from the age of 14 to 28 and then again from 29 – 31. I used to drink two litres of coke a day (UK coke that has sugar in it rather than listed as fructose) from the age of 19. I have obviously stopped that as I did for a year before – when I don’t smoke I don’t need something sweet to take the taste away – how ridiculous that is. I am losing weight which I understand will help as my fat is all stored round my stomach. I’m thinking about asking my doctor to test for H. pylori – I understand it’s naturally present in some places in the body but if there is too much could I need something else like antibiotics to kill it before I would really feel the benefit? Your article helped explain all the health problems I’ve had for the last 8 years. I had giardia, Clostridium Difficile and Compilabactor. None of which the Dr’s could explain – they just said I should not be getting it at my age. I was diagnosed with IBS which seems to be a catch all for ‘we don’t know’ but since I’ve been back on the acid tablets and the diet I haven’t had any diarrhea at all!
    Why does drinking sips of wine with a meal help – it sure feels like it does. In fact if i drink alcohol the pain goes away is that just a relaxing effect which unfortunately probably makes it worse the next day?
    I can’t thank you enough for the information you provided. But would really appreciate any advice on my questions if possible

    • Someone says

      Charlotte, I too have (had) constant burning in my throat, and quit smoking about 5-6 years ago, mainly because I had such a severe sore throat I couldn’t smoke! I also have inflammatory bowel disease. What gave me relief (temporarily) was baking soda in water and Colloidal Silver-500 ppm – anything less than that really didn’t help much.

      But I found out what the problem was and now have no pain in my throat and hardly any reflux at all. When I gave up the cig’s, I traded them for nicotine gum. Mint, no less. I chewed nicotine gum ever since I quit smoking, but after a few years the throat burning started. So I slowly weened myself off the nicotine with just mint gum. It worked for a while, but slowly the burning in the back of my throat came back with any sort of mint gum. Once I stopped that, the burning in the back of my throat stopped immediately.

      So, I don’t know if you ‘chew’ your nicotine now, or not, but I have read elsewhere where mint can cause burning in the throat.

  218. Charlotte Hepburn says

    Hi Someone
    Thanks for your reply. I don’t chew nicotine or any type of gum but I have noticed that brushing my teeth (with mint toothpaste) often makes the burning sensation worse so that’s helpful to know about mint. I will try some alternative toothpaste.

  219. S. Beem says

    I have spent all afternoon reading your articles about salt and GERD and other than this disappointment in finding a Prilosec ad in the body of one of the GERD articles (?!), I am very grateful for all of this well-informed, easy to read and understand, information. Thank you so very much for taking the time to write it. I have only one question: Having had my gallbladder removed, is there anything I need to do differently when trying to go off of my Pantoprazole? I am thinking of implementing your dietary suggestions to help with excessive gas issues, but I have no idea what a higher in fat diet will do.

  220. Lisa Hassan says

    Hi. I started having heart burn seven years ago while pregnant with my daughter. When she was born, the heart burn never left. I have been to a gastroenterologist and I have had an endoscopy done recently, as well as a manometry. I have trouble swallowing often. It feels as if food does not go down completely, even when I chew for a long time. I just feel like food is almost stuck at times. The manometry came back normal. Both the endoscopy and manometry showed that I have a small hiatal hernia, and that I have some signs of damage from the acid reflux, but the doc said not a great deal of damage. I have been taking the generic version of nexium for about a year, and prior to that I have been taking nexium on and off sine the birth of my daughter seven years ago. Being some what more of a naturalist, I have taken Papaya enzymes more than the nexium. The papaya relieves my heart burn symptoms instantly. My problem is that the heart burn does not seem to cease. I asked the gastro about a month ago if I have to continue to take the nexium and she said yes, due to the hiatal hernia. I just feel that tis can’t be good, to take an antacid like this indefinitely. I just started today a probiotic multi vitamin for digestive balance. I am out of the antacid pills. I am tempted to re-fill them because the heart burn symptoms today are terrible. I am on day two of not taking the nexium. I also have tried to change my diet. I am 35, 5’7 and weigh 150 pounds. I am average and moderatley active. I also watch what I eat and believe in natural organic foods as much as possible. I do not drink soda at all and avoid HFCS, and artificial sweetners of all kinds, I just think they are gross. I have a cup of tea or coffee daily, but no more than a cup. I have reduced the amount of carbs, mostly breads from my diet. someone else on this forum said they get a feeling liek they have to belch but can’t. I have had this feeling since I was a kid. It occurs after certain food( think carbs-gluten now). I get a tightness in my chest, not like a chest pain…but almost like pressure, full feeling…like you have to burp but can’t. It is very uncomfortable. I notice it mostly after I eat my mother in laws home made bread- Roti, and Indian bread. It’s horrible after I eat that bread, and I’ve noticed with other wheat products or pasta products. I have looked into gluten free sensitivity because the gastro ruled out gluten allergy after the endoscopy. I have every symptom listed for Gluten insensitivity. So I am doing my best to have a gluten free diet. Gluten free products are extremely expensive, so I do what I can, but for a more cost affective way I am avoiding breads as much as possible. which I don’t eat a lot of anyway, but I like to have a whole wheat sandwich for lunch, which I have stopped. I buy GF pasta now, but am worried also with the arsenic issues now found in brown rice. I do notice an amazing difference when I eat the GF pasta. I also get this burp type feeling if I have a beer. My question is, in my case with the hiatal hernia, what is the best product to use for digestive health? I am highly concerned about Barretts Syndrome. My mother passed from cancer, my grandpa was just diagnosed with throat cancer, and my father suffers from hiatal hernia as well, although in excellent health. I am worried the acid buildup will cause esopohogeal cancer. I just want to naturally, and on my own if possible, lessen the acid build up in my system, and have overall a healthy digestive system. right now it’s a mess! Thank you for taking the time to read this long post, much appreciated.

    • Julie says

      Lisa, please read my post from October 10th about my hiatal hernia that I experienced on and off for years and became unbearable. I did quite a bit of on-line research and found tons of sites and YouTube videos of how to fix this naturally, by yourself. I was totally shocked to learn that one can get on the floor and manually manipulate your stomach and ‘move’ your hernia. It worked! It took some practice. I also now do ‘breathing exercises’ which also work. Who knew?! I used to also have the feeling of needing to burp and found apple cider vinegar and/or baking soda worked immediately. If you do these things and continue on your diet I’ll bet you’ll find relief.

    • Elizabeth says

      Lisa, your story is very similar to mine. I never had heartburn in my life until I became pregnant with my son 4.5 years ago. After I was done being pregnant, the heartburn did not go away. I also experienced swallowing problems. A gastroenterologist put me on the drug Omeprazole. For the short term, the Omeprazole was beneficial in that it gave quick, immediate healing to my stomach. However, the Omeprazole did not resolve my swallowing issues, so my gastroenterologist left me on the Omeprazole for the long term. In time, long-term use of Omeprazole resulted in gall bladder pain (stones), deteriorated bowel movements, and my immune system suffered. I truly believe that it caused me to have increased gastritis. AND the Omeprazole never did cure my swallowing issues.

      In July 2011, after doing quite a bit of my own research, I quit the Omeprazole cold turkey. After following a very specific diet and supplement plan, I can now say that I no longer have heartburn. (Knock on wood.) It has been about 5 months since I last had heartburn. This is noteworthy, considering the excruciating heartburn that I had experienced — heartburn so bad that it caused damage to my esophagus. This is what I did: I went on the GAPS diet, and I followed it very strictly. (You need to read the book.) In conjunction with this, I also went through a series of supplements — ReNew Life’s First Cleanse, Enzymedica’s Candidase, and Enzymedica’s Digest Gold. (This was QUITE a lot of detoxing at once, but I’m glad I did it.) For my gallbladder issues, I used Pulverexx which resulted in me flushing out hundreds of gall stones, and I no longer have gallbladder pain. Also, I followed everything at Todd Caldecott’s website for GERD — just type GERD in the search box at the lower right margin from his home page. Also, I went to a chiropractor, and he adjusted my hiatal hernia downward — this brought me tremendous healing. I required two chiropractor visits to get that hiatal hernia to stay permanently down. Finally, I eat by following the principles of the Weston A Price Foundation, which has benefited me greatly — I love these principles so much that I plan to eat via WAPF principles the rest of my life. (I highly suggest you find or make some real kefir — this is highly beneficial in replenishing gut flora.) Go to the WAPF website and find the article entitled “Acid Reflux: A Red Flag” — very helpful.

      My recovery has been incredible. No heartburn in 5 months now. I even “tease” it by eating foods that were forbidden to me. All bowel issues are resolved. I still have terrible swallowing problems, however. The food gets stuck in my esophagus. I believe that I have permanent damage in my esophagus. I have an appointment scheduled with my gastroenterologist for next week to further check this out — I may need to undergo a procedure to push back probable scar tissue in my esophagus. I have a miserable time eating and oftentimes have to expel the food if I have not chewed it finely enough. I’ve healed the rest of me. Now I need to do something about this esophagus.

      • Glynis says

        Elizabeth,
        I did leave a comment with a question or two for you but it ended up misplaced.
        so, thank you dor your post. The GAPS book by Dr. Campbell-McBride is wonderful for everyone in my opinion. Your oesophageal stricture can be successfully stretched. If your hernia has been reduced and you are not experiencing acid reflux, the stretch can last for years.
        Did your chiropractor say that the reduction of your haital hernia is permamemt? There seems to ne some comflicting opinion on this topic.
        Also, once the hernia is reduced will the LES gain tone again and so keep the hernia in place and stomach contents where they should be?

        • Elizabeth says

          Hi, Glynis. As you have pointed out, I believe that what I have is an esophageal stricture, and, at my appointment with my gastroenterologist next week, I am going to ask him about the procedure to have my esophageal stretched.

          My chiropractor did not say that my hiatal hernia being pushed downwards is permanent. I can only tell you of my own experience with this. As I stated in my first post above, it took two chiropractor visits to get that hiatal hernia to stay down. After the first time I went, the hiatal hernia drifted upwards within two weeks. I then returned to my chiropractor a second time, he pushed it back down, and the hiatal hernia stayed permanently down this time. I say permanently, because that second chiropractor visit for this issue was about a year ago already. About six months ago, I went to the chiropractor for an unrelated neck issue, he checked the area where my hiatal hernia had been, and he confirmed it had not popped back up. As I type to you now, I can feel that the hiatal hernai has not slipped back up. I believe that as long as I continue to eat well via WAPF principles, that the hiatal hernia will not reoccur. I don’t know the answer to your question about LES tone; I can only tell you my experience that I no longer have heartburn and the hiatal hernia has not drifted upwards so it’s likely that my LES regained its tone.

          • Glynis says

            Hi Elizabeth,
            Thank you so much for your detailed reply. I know exactly how things are with that stricture, but you will get relief when it is stretched.
            I came off Nexium about two months ago, after eight yearsof treatment. I transitioned to Zantac, and now I am taking GDL instead. Fingers crossed! I b elieve that until I get the mechanical issue of the hernia corrected, I will not be sure that the GERD is going away. I feel very much better, despite rebound etc. I started Kefir and found Dr. Natasha Campbell-McBride and GAPS diet. The changes I have made in the past two weeks have been very encouraging. I still get episoded of burn, and these have revived the stricture which is, of course, expected. But if I can get the hernia tucked away in its correct place I believe things will move along apace.
            Your story was so very similar to my own. You have been a hteat help and encouragement.
            Cheers,
            Glynis

          • Glynis Mitchell says

            Hi Elizabeth,
            I have been treated by the chiropractor, both soft tissue and spinal manipulation, and I feel very much better. Thanks to you, I found a simpler solution to the hernia issue.
            I transitioned from nexium to zantac to GDL to tums to nothing. Very, vey occasionally I take tums.
            I am following a regimen based on the GAPS protocol, using kefir, probiotics, and just recently introducing Betaine hcl with pepsin, as per Dr. Natasha Campbell-McBride’s recommemdations. I could not–would not–have chanced taking the hcl if I had not been treated for the hernia. I have Barretts and must keep acid from my oesophagus!

            Having read many of the posts on this website, hiatal hernia seems to be a recurring theme.
            I would love if Chris Kresser dedicated some time to this issue in relation to GERD.

            Anyway,
            Thank you so much for your support, Elizabeth.
            Happy holidays,
            Glynis

            • Elizabeth says

              Hi, Glynis. I’m glad that my story was of help to you. As for me, I’ve continued to heal. I’ve not had heartburn in about 6 months now. I feel that my stomach still needs a little bit more healing; I’m eating a chicken bone broth soup as i type this. :) My esophagus conotinues to trouble me; I did see the gastroenterologist about it, but he’d like to delay seeing me until February. He doesn’t believe I have a stricture, but we’ll see. In the meantime, I’m hopeful that continued healing *may* heal something about my esophgus.

              • Glynis Mitchell says

                Elizabeth,
                Dr. Narasha wrote that in GERD the LES may also be colonized by unfriendly bacteria/yeasts. I have started opening my probiotic capsules and taking the powder with a thickish kefir. My thinking is that the good bacteria will coat the mouth and the oesophagus–at least for a wee while-and get a chance to do their work. I also put a capsules worth of probiotic powder into my mouth after brushing my teeth, in order to promote oral bacterial health.
                I will let you know if these strategies make a difference regarding my stricture and the occasional acid reflux that I still experience at night time.
                I sincerely hope that you do not have a stricture.
                I am making bone broth chicken soup as we speak!
                Cheers,
                Glynis

  221. Steve says

    Hi All
    Worth sharing my story. I took ppis for many years until I had to keep increasing the dose but with no releif.
    I followed the GAPS diet and hcl, b vitamins etc etc.
    My problem is at night. At least that’s when the damage is done. Finally in desperation I propped my bed up and with pillows never let my upper body go prone/horizontal. The effect was miraculous.
    If I ever slip down the pillows in my sleep I wake in pain. I then sit up and swally and I can here gurgling as the acid drains from the oesophagus through the lower oesophageal sphincter and back where it belongs in the stomach. Followed by pain releif after a few minutes.
    Tool a year of keeping food diaries and trying lacto b amongst other supplements and melatonin before I finally tried it.
    I was extremely disciplined over a year long period with my nutrition and I’m afraid I got no where.
    I personally don’t think it will ever be cured. Surgery for a weak LES exists but is about as successful as PPIs and has complications with swallowing issues. There is little to know medical research for the route cause since pharmaceutical companies have the big budgets and they are happily taking money for PPI drugs like nexium or omeprazol which as we all know only mask the problem, perhaps even allowing some healing but the symptoms return once the patient stops the drugs. And of course they also have side effects.
    So there you go. Ill be sleeping almost sitting up for the rest of my life. Nice to be pain free as it was getting a bit scary. Shame there’s no cure though.
    If you suffer from gastritis try it for a week. It worked for me.
    Oh I should say. I ate low carb before I even had a problem. I eat mostly paleo now. I expect things would be much worse with pressure causing acid reflux during the day if I didn’t eat this way. So nutrition is definately an important part of controlling this but not the cure in my case.
    Best of luck
    Steve

  222. Steve says

    Hi AllWorth sharing my story. I took ppis for many years until I had to keep increasing the dose but with no releif. I believe the cause was alcohol and NSAIDs for the hang over over a fun Christmas period with quite a few work Xmas bashes. Should have stuck to paracetamol. I followed the GAPS diet and hcl, b vitamins etc etc. My problem is at night. At least that’s when the damage is done. Finally in desperation I propped my bed up and with pillows never let my upper body go prone/horizontal. The effect was miraculous. If I ever slip down the pillows in my sleep I wake in pain. I then sit up and swallow and I can here gurgling as the acid drains from the oesophagus through the lower oesophageal sphincter and back where it belongs in the stomach. Followed by pain releif after a few minutes. Tool a year of keeping food diaries and trying lacto b amongst other supplements and melatonin before I finally tried it. Wish I had done it earlier!I was extremely disciplined over a year long period with my nutrition and I’m afraid I got no where with regard to a cure. I personally don’t think it will ever be cured. Surgery for a weak LES exists but is about as successful as PPIs and has complications with swallowing issues. There is little to know medical research for the route cause since pharmaceutical companies have the big budgets for research and they are happily taking money for PPI drugs like nexium or omeprazol which as we all know only mask the problem, perhaps even allowing some healing but the symptoms return once the patient stops the drugs. And of course they also have side effects. So there you go. Ill be sleeping almost sitting up for the rest of my life. Nice to be pain free as it was getting a bit scary. Shame there’s no cure though. If you suffer from gastritis try it for a week. It worked for me. Oh I should say. I ate low carb before I even had a problem. I eat mostly paleo now and I barely drink alcohol. I expect things would be much worse with pressure causing acid reflux during the day if I didn’t eat this way. So nutrition is definately an important part of controlling this but not the cure in my case. That said; When I do break the paleo rules or have a couple of beers there is no deleterious effect since I’m sitting up and so gravity does its thing whether my pathetic weak and floppy LES is on holiday from its job or not :)
    Best of luck
    Steve
    PS This site is broken if you attempt to add a comment via an Iphone. The comment update fails :)

    • Glynis says

      Hi Steve,
      You do not mention if you have had an evaluation by endoscopy or even by a chiropractor. The reason I ask is that I am becoming suspicious that we who have a hiatal hernia may find it difficult to move forward and will continue to suffer, unless the hernia is corrected. If you scroll up, you may find Elizabeth’s posts on the issue of hernia and stricture very helpful. Just a thought.
      Best,
      Glynis

      • Steve says

        Hi Glynis,

        Yes sorry I should have mentioned. I’ve had an endoscopy – worst experience of my life – and no hernia was found in my case.
        I was at a party at the weekend, alcohol was consumed! No issue at night due to sitting up. I should also mention I’ve taken HCL in the past and apart from appetite abatement I found no relief.

        Best regards all
        Steve

  223. Jennifer says

    Maybe someone on here can help me: I have had acid reflux for years. Everything acidic gives me acid reflux from mint, peppers, tomatoes, anything citrus, most spices, and I have a crazy intolerance to garlic. If I just eat something that touched something with garlic I will have burning in my throat and acid reflux for two days. I eat mostly gaps diet. I do however eat sweet potatoes, organic rice, and small amounts of wheat. I have tried to go grain free but high fat and low carbs make my acid reflux worse, and I am hungry all the time. There is a possibility that I didn’t try it long enough maybe? Also my acid reflux is really bad at night. Every single time I lie down and go to sleep I wake up with acid taste in my mouth and if I eat any of my triggers I will wake up in the middle of the night with bad reflux and coughing. I am wondering if I have a hiatal hernia, but I don’t have health insurance. I read previous comments that people have gone to chiropractors to put there stomach back in its place and was wondering how I go about finding a reliable one that can do that. I was also wondering about doing the gaps introduction diet, but I am confused about how to do that. Am I supposed to boil a whole chicken to make stock or just the bones with some meat on it? Any advice would be greatly appreciated!

    • Julie says

      Jennifer, I responded to a “Jennifer” back on Sept 25 & October 10 – I don’t know if it was you or another Jennifer. Anyways, if you scroll up to that post I explained how I ‘fixed’ or ‘manipulated’ my own hiatal hernia by myself – at home, on the floor. I did that after being in so much pain and doing some on-line research. I was surprised to find so much info on it and tons of YouTube videos demonstrating how to do this. It actually worked! It took some practicing, but once I got the hang of it, I felt relief right away. I’ve felt the need to do it again only a few times since then.

      So, I’d say give it a try instead of going to a Chiropractor. I also now do deep breathing exercises daily, which is suppose to strengthen you diaphragm muscle and help keep the stomach down where it belongs. (well, I forget the exact reason this is suppose to help, all I know is that it works).

      I still have mild acid reflux, but not that constant pain, and baking soda in a little water always did, and still does, relieves the reflux immediately.

      I can’t comment about the Gaps diet, I have been eating a paleo diet for years, but I am assuming it is a similar principal. Bone broth is excellent for our digestive tract and healing to the lining of our colon. I do it every week or so. You drink the broth, and I break up the chicken or turkey and make a soup. Strain all the fat and you are left with a thick ‘gel’ like broth. Yum!

      After you manipulate the stomach down where it belongs, the LES valve (sphincter valve) should now stay closed, because it is now not constantly being propped open by the hernia, and your reflux symptoms should begin to subside – provided you continue to not eat foods you know give you reflux and eat foods that heal the lining of your stomach and esophagus.

      I wish you luck on your journey.

  224. Kevin says

    Two points:

    1. For those of us who have both GERD and diverticular disease, eliminating probiotics is not an option. I have little doubt that probiotics inhibit outbreaks of diverticulitis.

    2. As I know from personal experience, low-carbohydrate diets will not eliminate, or even reduce, cravings for sweets in all, or perhaps even most, individuals. If it does help most, then that is marvelous; I wish I were one of you.

  225. colin says

    You say that heartburn is not caused by too much stomach acid, but rather by too little or by bacterial overgrowth (H. Pylori I presume) but I tested negative for H.P. and ulcers and everything else and my GI threw up his hands saying he didn’t know what was causing the chronic heartburn and reflux. So either the test was wrong or your statement is. There clearly are other causes of heartburn and you should not omit the fact. Gall stones, for example, can cause heartburn, can they not? Or even pregnancy, temporary or not. Everything else sounds well and good, just wish I had read this 5 years ago when I first began taking PPIs, before I further destroyed my already broken digestive system and developed all these consequent and complicating problems. Now I don’t know if I’ll ever be able to return to normal functioning. Too bad I can’t afford insurance.

  226. Jeff says

    My comment is more of a question. I have been pale for about two years now. About a month or so ago I started getting the feeling that food was stuck in my throat. It’s not constant, but comes and goes at times, although recently it has been more constant. I can’t say that I have experienced acid reflux — I have very infrequently experienced heartburn type symptoms in the past (very, very infrequently) and my current symptoms have none of that burning type sensation — just more like something is constantly stuck in my throat. Haven’t been to Dr. yet, but can or does this sound like GERD? And if I do visit a DR. do I see my regular GP or an endocrinologist??

    Anyway, I eat no wheat, am generally pretty low carb (do eat potatoes and rice), a good amount of meats (almost all grassed), fish, poultry and lots of veggies (mostly salads, greens, broccoli, cauliflower, squash, etc). Also eat yogurt and fruit (berries mostly), maybe every other day and dark chocolate (maybe every other day as well).

  227. Tam says

    Dear chris,
    Wonderful article, thank you.
    1 question, I have reflux and biopsy from lower oesophagus shows (apparently) “mild chronic inactive gastritis”. Is it too dangerous to try Betaine HCL/pepsin & Gentian Bitters method?
    Right now trying low carb diet, working wonderfully (but I miss carb….)
    Thank you again for this website.

    • Glynis Mitchell says

      Tam,
      You pose a great question. There are probably many folks who feel scared about introducing hcl/pepsin while they have GI inflammation with or without hiatal hernia. I know that I am one of them.
      I hope that Chris Kresser responds to your question, as he would be serving this community well if he did. Meanwhile, I can only tell you my approach.
      I started by getting off all acid suppressors–quite challenging. (You do not mention if you are taking acid suppressors).
      I started Dr. Campbell-McBride’s protocol for healing amd sealing the gut, as laid put in her GAPS book. To be fair, I describe my aproach as a GAPS-like approach. I started with the healing foods, introduced kefir, and then introduced a probiotic. I had a hiatal hernia and Barrets so I was scared to start the hcl/pepsin regime. I read Elizabeth’s post on chiropracty and the repair of the hernia, so I went for treatment to a chiropractor. Only in the last week have I felt confident to start the Betaine hcl with pepsin. I am following Dr. Natasha’s recommendations rather than the higher doasages suggested bu other experts. I can go higher if needed, but perhaps it is better to start low and see how the body reacts. I have BE and a stricture, which means I may throw up if something gets stuck, and I did not want to risk throwing up high of hcl. So far, so good.

      Anyway, strategies for healing the imflammation and sealing the gut would be a great starting point, rather than diving in with high doses of HCL. I may be too cautious on this issue. That is why I would just love Dr. Chris to comment.

      Best wishes,
      Glynis

      • tam says

        Hi Glynis
        thank you for your reply (first time i ever write anything on board like this!).
        One morning in September this year, i had a stomachache then felt sick, then I was on Omeprazole (after my doctor told me i have acute gastritis) for 6 weeks (10mg for 2 weeks, 20mg for 2 weeks, 10mg for 2 weeks). Then felt better, so went completely off for 3 weeks, then started feeling sick again (I never felt “burning sensation”, just feeling wanting to be sick) so started 10mg again for 10days.

        Then 12 days ago i had (my first) endoscope, the findings were small hiatus hernia and reflux (till 2cm above LES ?), no Barrett, “stomach+duodenum appears normal”. Biopsy from bottom of oesophagus (not from the stomach). Lab report was no Barrett, “mild chronic inactive gastritis”. My doctor told me “mild chronic inactive gastritis” is a description, not diagnosis, “not much to worry”.

        After this (i never had chronic illness, so i am still in shock), i read lots about GERD, then i arrived this wonderful site. i read “heartburn, cured” and “Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and Gerd”.
        I started low-carb diet since 10 days ago, i am off medicine now, i don’t feel sick at all, only some strange sensation in my throat continues (i recently went to ENT to check my throat with camera from nose, was nothing there), but doesn’t bother me too much.

        I am in my mid 30s, medium built (?) 172cm, 69kg, i don’t want to be on meds (especially after reading this!), so i would like to try supplement or/and herb etc.
        just today i booked my first chiropractic session (for next week) after chiropractician told me she treats Hiatus Hernia.

        I am sure this does not interest anyone (but please allow me), my additional concern about starting HCL is that I live in EU since childhood, but originally from far east asia. i know that asian stomach is much weaker than westerners’. Since i am already feeling better with my low-carb diet, i don’t want to create a “new” problem.

        Hence i asked here, can I take HCL even with “mild chronic inactive gastritis” (apparently “not much to worry” from doctor + “stomach appears normal” from endoscopist)?
        I have “Betaine HCL/pepsin & Gentian Bitters (HCl 650mg, Pepsin 25mg, Gentian root 20mg in 1 capsule)” with me. i took 1 a few days ago, i felt nothing, a bit warm stomach perhaps….(though shall i continue….?)
        thank you.
        tam

        • Glynis Mitchell says

          Tam,
          I cannot realy amswer for you other than to say to follow your instincts regarding the hcl. It sounds like you are not convinced that hcl is appropriate for you, and you did get a heat reaction on staring it. Do you really need it? Also, gastritis is inflammation. Perhaps treating that first. is wise.

          I had an acquaintance who went to a Chinese herbal practitioner because of very strong acid reflux. She was delighted by her results. I wonder if, since you come from such a culture and you have some anxieties about Western diseases and solutions, you might be wise to go your more traditional routes. Having the hiatal hernia treated should help. As I said, I did not feel comfortable about taking hcl until I let the chiropractor treat my hernia.

          Remember, I can only share my experience and my logic of approach. I am not a doctor and I find myself making decisions without much input from those who claim expertise, due to their silence on these topics. Everyone is different, but I believe caution is always good until you can figure out the order of the steps you will take.

          Best wishes,
          Glynis

          • tam says

            Dear Glynis
            thank you for your reply.
            i got all the supplements mentioned in the book (quite a lot of them!), booked chiropractice, and acupuncturist, i will try to see a Chinese herbal practitioner too. Thank you.

            I agree with your treating gastritis first, but because it is “inactive” so there is nothing to heal (by the sound of my doc), that confuses me re: HCl. Would love to hear a suggestion from Chris on this matter, if possible.
            yours,
            tam

            • Elizabeth says

              Hi, Tam. I want to share my personal experience with you regarding the HCL. I agree with Glynis that gastritis is inflammation and treating that first is wise. When I first tried HCL over a year ago, I had a dreadful time; I felt AWFUL. I believe that my stomach was not healed enough for it. I tried again the next day, and I felt so horrible and sick. That was all a year ago. I’ve healed a lot since then. About two months ago, I decided to try the HCl again, and I had NO issues! My stomach was fine! So, give it a try and if you feel horrible, put it on the shelf (like I did), and try it again in 6 months. You may very well have to heal first like I did.

            • Glynis Mitchell says

              Hi Tam,
              I think that being told you have an “inactive” inflammatory condition is very confusing, and until you het some clarity on this issue I urge caution regarding HCL.
              I just started a very low dose of Betaine HCL with pepsin about a week ago, 200mg of HCL with 4mg of Pepsin. I started with 1capsule, twice daily, and after two days upped it to 2capsules twice dailly. Dr. Natasha suggests that you can try 3capsules, but she indicates that 3 might be an excess. I tried 3 (that eqtes to 600mg HCL and 12mg Pepsin, which is still lower than one of the capsules recommended by this and other sites). I did not take this higher dose twice, as my instincts told me to be cautious. Fourten hours after taking the higher dose, I awoke with that generalized burning sensation in my stomach, of which we are warned. Indid not have reflux, but the burning sensation took over an hour to pass.
              So, all I am saying is please be very cautious with HCL, because your gastritis may make you vulnerable to a damaging reaction, and if you do devide to try it go for the lowest possible dose amd work from there.
              I will be very interested to hear what your Chinese herbalist suggests.
              Best wishes dor the chiropractic and the herbalist consultations.
              Glynis

              • Tam says

                Dear Elizabeth and Glynis
                Thank you both for your reply.
                My HCl + pepsin is 650mg a cupsul, so I guess I can’t go lower dosage than this at one, however, I tried yesterday 1 cupsul after lunch and 1 after dinner, I felt pretty good.
                I might try today too 2 cupsule a day, maybe.
                I am switching Very low carb diet to SCD this week. Still no feeling of wanting to be sick (which was my main issue), no PPI medicine. That’s a good news, just a strange throat sensations.
                My first Chiropractice session is this week, will report then.

                Re: HCl, I asked my doctor about it, he told me he thinks I can take it (admitting he doesn’t have much experience on using HCl). Yes “inactive” gastritis FROM oesophagus biopsy (not from stomach) + endoscopist’s comment on “stomach appears normal” confuses me, on HCl. But I might try 1 more day, to see.
                Thank you,for your caution!
                Yours
                Tam

  228. Sami says

    I just want to thank you for posting this series of articles. I’m in my mid-30s and have been on Prevacid daily for the last four and a half years, although I had stomach issues for a good 10 years before that. Whenever I spoke to my doctors (a few different ones over the years), I would always describe the pain as feeling like there was gas in my stomach trying to expand in too small a space. Most of them didn’t like or didn’t understand that description, and would question me until they could put it into the more standard terms of heartburn and acid reflux. I was eventually put on Prevacid, which helped treat the symptom, but I understood it was only treating the symptom and not the cause, and I could never get a satisfactory answer on how to tackle the cause of my stomach pain.

    So much of what you talked about in your articles rang so true for me. It was very refreshing! I decided to try out your three-step process, although I was not sure what to expect. I was unable to find HCl in any local stores, so I ordered it online. In the meantime, I started step 1 – reducing my carb intake and cutting back on artificial sweeteners (I have tested negative for H. pylori). The difference has been astounding! Prior to this, if I didn’t take Prevacid for more than two days, I definitely felt it. I have now been off Prevacid for two weeks with no pain or reflux whatsoever. I haven’t even started taking the HCl yet (just got it in the mail)! I’m not sure what results I was expecting, but I certainly wasn’t expecting such a drastic difference in how I felt this fast.

    Thank you again for making this information available to us. It has been an empowering couple of weeks!!

  229. Kate says

    Hi Chris,

    Thank you for your article. I am about to head to the shops to buy some HCL!

    I have suffered from GERD periodically over the last 6 years, and I always start getting symptoms in summer. The symptoms last around 3months and then disappear. Have you seen this before and do you have any idea why I would only get this condition in the warmer months?

    Thanks in advance.

    Kate

  230. Mindy jones says

    Thank you for posting these articles!! I appreciated the thorough documentation. My 8-yr old daughter has been so sick (vomiting, fatigue, nausea) for a year. The specialist after many tests has determined nothing, but from my own research I was sure it is reflux. I found your arcticles looking for some other answer than Prilosec. So I put her on the scd diet with me (I have celiac disease) and gave her minced ginger root and homemade yogurt. She has been well from the start! It is such a wonderful blessing to see her play again!

    Mindy

  231. Melanie says

    After being on HCl for 3 weeks, I developed a duodenal ulcer that I have had for almost 2 years. Is it ok to go on acid blockers for a short time to heal the ulcer? What is the best way to heal it?

  232. Daniel Butler says

    I am a 23 year old GERD sufferer…
    I have had what feels like heartburn for years…(oddly enough I dont really get reflux that comes into my mouth or throat I dont think)
    Mine was not gradual…It literally came out of nowhere.
    One day I was fine (Never had heartburn prior)
    The next…CONSTANT heartburn/bloating/Palpitations…
    They found a small hiatal hernia…
    I had a nissen fundoplication (Which seemed to help like 50% for a little while then stopped working)

    So my question is…
    Could this stuff still work for me?
    I am young…so is my problem still too little acid?
    How could my symptoms of started so suddenly?
    Will the Nissen operation impair the effectiveness of this treatment?

    Thanks…
    I am at my wits end with this…
    I dont smoke or drink…I just want to feel like a normal 23 year old…
    I even had to give up skateboarding (My symptoms flare up when I jump)
    It was one of my biggest passions…

  233. Tim Spanoudakis says

    Chris

    Amazing article found it after having to come of PPIs ready for a Manometry study. I have been on Omaprazole for 13 years and they started to fail last year. I had an endoscope last May and had polyps removed. It was only recently that I started to wonder if there was a link. It turns out that PPIs are really bad for you so then came across your site while investigating more. I I have felt ill for years and now attribute this to malnutrition caused by the use of these awful pills. My doc suggested doubling the dose… They just dont understand this stuff. Was even considering Nissan F or Lynx bracelet surgery. I am now going to tae HSL, DGL and iberogast and probiotics. I have been on LC diet for 3 weeks as I need to lose 25+ pounds. I read the excellent book by Gary Taubes (why we get fat)

    I have a question. I totally buy into the low acid explanation, but is there any theory on why certain trigger foods can make heartburn worse? (coffee, tea cooked tomatoes, etc)

    Appreciate anyone’s thoughts on this and thanks once again for the most insightful article, I can see it changing my life!

  234. Roger conner says

    Are body ph and stomach ph connected? Here is why I ask. My wife has “orange tongue.” Doc’s have no idea, and the most frequently cause is a body ph that is too acid. She also has Gerd, taking Prilosec. Is it possible to have a mouth ph that is too acid and a stomach ph that is too alkaline? Would hcl also make her mouth more acid?

  235. Mari1985 says

    Hi!

    I recently started the low carb diet and betaine supplement. I found a pancake recipe that calls for whey protein, is there any issue with this protein and the betaine supplement? or is it safe to eat it?

    I hope someone can help me with this. I’m struggling to find breakfast ideas.

  236. Tim Spanoudakis says

    I found the same problem with breakfasts. I use a couple of eggs with yolks and half a cup of ground almonds for pancakes. Used with Truvia as a sugar substitute they are pretty good but a little fragile to cook. Give it a try they are very low if not nil net carbs

  237. Roger says

    I think I’m probably suffering from age-related low acid production since I’m having problems with heartburn and occasional reflux. I would like to supplement with Betaine Hydrochloride (HCL) but given the warnings about pain relievers which seems to cover about all of them, what can be taken for headaches and the usual aches and pains of aging? Does the warning mean regular use or no use period? Thanks.

  238. Tim Spanoudakis says

    Hi Mari1985, in the UK, all supermarkets sell them in the nuts or baking aisle . Sure it’s the same in other countries too. Go to http://www.apinchofhealth.com and try out the buttery almond cake it’s awesome and virtually carb free. I use Truvia (from the stevia leaf – that might be a UK brand) instead of Splenda as we are trying to beat SIBO and apparently Splenda is not absorbed so is freely available for all those bad bacteria.Truvia is just like granulated sugar. I also make awesome NY cheesecakes replacing sugar in the top with Truvia (or splenda) and using ground almonds and crushed hazelnuts (to give it crunch) for the base. If you are on a low carb diet and like baked cheesecakes then this is a real treat and makes it all quite enjoyable!

  239. Brown R says

    Can someone help me?

    My doctors found a stomach tumour. And high mercury toxicity. I had some sushi last year, and ended up in the hospital for a ‘stomach bug’… and shortly after, I began to have heartburn, silent heart burn, and gastro issues. I tried conventional medicine (it didn’t work.)

    Now, I can’t eat brown rice and most grains without heartburn, sauerkraut and cabbage and yogurt makes me extremely tired, high sulphur foods (broccoli, onions, garlic, etc), (most mercury toxic people have this), and I’m now allergic to nightshades and citrus foods.

    I NEED HELP TO KNOW WHAT TO EAT!

    1. What can I replace grains with? (I eat spelt and barley bread for breakfast, lunch and dinner.)

    2. And what can I take right now to provide relief for that burning sensation and heal my throat from acid damage? I have tried apple cider in the past and it was helpful, but I’m concerned about damaging my throat with more acid!

    Anyone have any ideas?

  240. Yusra says

    Hi Chris,

    I just found your article and it reaffirmed so much of what I thought about GERD. I was diagnosed with GERD one year ago and then candida 6 months later. I read an article recently that outlined research conducted on GERD patients taking omeprazole (which I was on for 6 months) and the development of candida. I am convinced my candida was a side effect of medication. I believe I may also have IBS (very mild form though). I am 26, healthy and fit. I found that carbs, proteins, and various spices really upset my GERD. I want to change to a low carb diet and try increasing my stomach acid. What would you suggest? It’s hard to know where to even begin.

    • CT says

      Yusra,

      Your situation sounds very similar to mine. I am overall very healthy, fit, eat a low-carb diet, with no bread, pasta, etc. I have been battling candida (diagnosed with upper GI) for over a year. Main symptoms for me have been heartburn, reflux, and stomach pain, all of which i’ve had for 4-5+ years. Eating low carb seems to help with about 60-70% of my symptoms. I have just started adding HCL pills and take anywhere from 3-4 pills per meal. I haven’t noticed any difference in my symptoms though since starting HCL. How many pills do some of you take per meal? I worry that more than 4 is too much. Is it not beneficial to take a lesser amount? Good luck and thanks for any other help.

      • Ol says

        I found that Norm Robillard’s book Fast Tract Digestion Heartburn gave the missing link to get heartburn success the rest of the way to 100% –> resistant starch foods. The lower the GI impact of a carby food, the longer it’s fermenting in the gut, thus fueling the SIBO. Jasmine and sushi rice spike the blood sugar but it means no heartburn (portion control and some of Jaminet’s techniques for limited glucose impact by starches means that’s a dietary option) as opposed to basmati rice which is mostly resistant starch. Other good tips are to eat the starches warm and not cold to increase digestibility. Unfortunately sweet potatoes and bananas are very fermentable but he has a technique for calculating how much fermentation potential a serving will have in order to not exceed a threshold. I’ve had good success with using the home anti fungal herbals for candida. I’ve even taken them and found intense sugar cravings subside.

  241. says

    Hi Chris
    I came across your site while researching stomach acidity for a book I’m writing on Chinese health preservation. Congratulations on a lot of interesting well-sourced material.
    A question though? If normal stomach acidity kills all bacteria in the stomach how would the supposed benefits of naturally fermented foods (miso, sauerkraut, yoghurt etc.) work/.
    with thanks
    Peter

    • Glynis says

      Dr. Natasha Campbell-McBride (Gut and Psychology Syndrome) advises routinely adding fermented foods and kefir etc. to soups, stews etc. when they are coolish, so that the bacteria multiply and also they have a good chance of getting into the gut. If you add to very hot foods they will be killed.
      However, taking a supplement form in the beginning even alongside other fermented foods may be a good way to go, as the capsule ensures the bacteria can get to the gut. I will reread her instructions and let you know if there is other information.

    • Glynis says

      GAPS (pp. 245-253) Dr. Natasha explores historical and current research and practices with regard to probiotics–supplements and foods. She does not advocate enteric coated probiotics because she suggests that the coating may not be broken down at all, especially if the person has low stomach acid. She says that even if the probiotic gets killed in the stomach acid, the dead bacteria continue to have a therapeutic effect in that they carry toxins out of the system. If you take the probiotic supplement with food or after food, she says, it is more likely that some of the good bacteria will get into the gut. This is because food particles get linked to stomach juices and therefore the bacteria can survive.
      I recommend reading her book for your own edification. She gives wonderful research-based practical advice, and her book is not exclusively for GAPS patients. It has great recommendations for everyone interested in a healthy gut and a healthy life.

  242. Josefa Nunes says

    Thanks Peter for your question. I wonder that too. In this case, are probiotics supplements more beneficial than the fermented foods?
    Josefa

  243. Marcus says

    Hi

    Does this sound like low stomach acid/gerd to you guys ?

    1. I’ve been getting pretty severe stomach aches (starting around 5 months ago) only before meals, it’s definitely not just normal hunger as I’m eating the same amount/stuff I’ve always had. The pain had been just below the belly button but lately its near my lower right abdominal. Even after I’ve eaten I get a acidic feeling in my lower throat maybe 30-90 mins post meal. Around the evening onwards I start to feel very bloated and have the need to burp/belch alot and it makes my stomach feel a little better. I’ve been taking Lansoprazole (Proton Pump Inhibitor) for about 2 weeks and the symptoms are only slightly better but no way near gone.

    2. The same time the stomach issues started I’ve developed an intolerance to nuts (very painful stomach aches & an itchy bum lol), I found it pretty strange as I’d pretty much been eating nuts nearly everyday for as long as I can remember.

    3. Lastly I’ve had a scaly itchy skin issue that has been present for at least 10+ years, for the most part they appear on my legs or hands but very recently it has gotten much worse as I have a big rash on my left leg and one on my hand. Before I’d only have a single rash about the size of a penny but this one on my leg is much bigger. Some pictures are below, sorry about my hairy legs :-)

    http://imgur.com/vGqu5I0
    http://imgur.com/VE9NCVu
    http://imgur.com/iGWtl0h

    Sorry for such a long message

    Thanks,
    Marcus

    • Marcus says

      Update:

      I’ve been eating paleo-ish (minimal sugar, no grain, wheat and gluten) for the last 5 days and my my stomach pains are currently non-existent. Maybe I’m just allergic to one of things I’ve cut out ?, surely my stomach acid couldn’t changed in a good way that quickly. I’m taking a Betaine HCL supplement once with every meal.

  244. says

    Hi Chris,

    Thank you so much for these series of articles, it has helped me so much, and really enlightened me about the causes of GERD and how to treat it. I referenced your articles on a post I did on my blog fitchocolatelover.blogspot.com.

    Since I stopped eating bread, my heartburn has really been drastically reduced, and I’ve been avoiding other non starchy carbs too. I’m going to try the HCL and DGL supplements as well.

    Thanks again

    • nada says

      Hi,
      I am literally crying right now because I will hopefully finally cure myself. I just wanted to know, which of the diets that chris talked about did you follow? VLC, GAPS, or SCD??? I dont know which one to follow!

  245. Jeff S says

    So I’ve been Paleo for over two years and a few months ago started experiencing a lump type feeling in my throat (as if food were stuck). My neck around adams apple was also a bit tender. Saw my Dr. who did a thyroid test and I did have somewhat high thyroid antibodies. Then saw an endocrinologist who thought the numbers were necessarily of concern (besides the slightly high antibodies everything else was ok. He suggested seeing an ENT — which I did today.

    The ENT diagnosed me with silent (Laryngopharngeal) reflux. She wants to put me on Omeprazole (40mg). She also said I should avoid chocolate, food high in fat content and tomato-based products. The chocolate and the tomato products are no problem, but how do I maintain my Paleo diet and avoid high fat foods? Can I still cook with coconut oil and butter/ghee? Do I need to avoid bacon and other fatty cuts (have some frozen grassfed pork belly in the freezer)? Should I take the medicine prescribed?

    I used to eat more yogurt and store bought kefir than I have recently (when the symptoms first started), but not sure if it had made any difference. Should I try both again? What about Kombucha (store bought?) and things like sauerkraut?

    I mentioned Chris’s suggestion of HCL and the ENT thought that made no sense since it is acid and I should be reducing acid.

    Any suggestions welcome

    • jeff S says

      So I’ve tried HCL for about 3 days, taking 1 650mg capsule with each meal. What I have noticed so far, is that the next morning a feel a soreness in/around my belly button. Is this a symptom of the distress I would feel if I’m taking too much and would this then suggest I have too much acid and thus maybe should be taking the Omeprazole that was prescribed?

      Anyone??

      • Glynis says

        Hi Jeff,
        First, if you start on a PPI (even for a short time) you will have trouble getting off it.
        Second, traditional medics assume excess stomach acid is the cause of all reflux, silent ot otherwise, and alternative medics assume that the real problem is low stomach acid. Both assumptions should be approached with some caution.
        Third, adding HCL is not as harmless as is purported, and I would approach such supplementation with caution. The fact that you are experiencing peri-umbilical pain suggests that the HCL may not be the thing for you right now. Put it aside , until you have made some less radical changes and listened to your body.

        I tried a very low dose of HCL with Pepsin amd the pain was excruciating, many hours after its ingestion. I then assumed that my acid levels might just be normal rather than abnormal. Since then, I have learned that my stomach was not emptying efficiently. Once I reduced the volume of my evening meal and ensured that I did not eat for some three hours prior to bedtime, my gatric emptying improved.
        One of the main reasons for acid reflux is back pressure, and it appears that this pressure (at least for me) relates to slow hastric emptying, food volume and timing of meals. This finding supports my hypothesis that my reflux problem is not necessarliy a function of low or excess acid.

        All I am saying is, be wary of acid suppressing drugs amd be cautious about assumptions about your gastric acid status.

        • jeff S says

          Hi Glynis

          It’s hard to figure out what has been going on. I’ve had this constricted feeling in my throat for a couple months now. Initially went in to my Dr. to have it checked out and it seemed as if my thyroid was sore. Had some blood work done for thyroid and the test showed I had elevated thyroid antibodies. Then saw an Endocrinologist who didn’t think the elevated antibodies were of concern, but he thought I should see an ENT. She did an endoscopy and said my throat/larynx was inflamed and that I should take the PPI and watch what I eat. (I told her I was Paleo but she was unfamiliar with the diet.) I have another regular Dr who is a Paleo practitioner. She thought it might be worth trying the HCL. I have been Paleo for more than 2 years. Don’t eat any grains or sugars and eat what I believe is a pretty healthy diet (veggies, lean meats (mostly grassed), and recently more safe carbs such as sweet potatoes and rice–and sometimes yogurt and some store bought (non-sweetened) kefir. So except for the fats in my diet, not sure what I would cut-out. I never had any stomach issues in the past. (I used to ingest lots of advil in the past due to a herniated disk, but haven’t really had to since going Paleo and maybe a year or more before that.) Am supposed to have another thyroid test as well.

          • Glynis says

            Jeff,
            That constricted feeling in the throat is something I experienced for the first time when I came off Nexium, after several years of treatment. Here’s the issue as I see it. When you come off Nexium rebound acid secretion occurs. I felt like there was a wee devil with a squeezy bottle of acid in my stomach, squirting, squirting the acid–far worse than anything I had expeienced prior to starting the Nexium. There is a study that demontsrates that even a short term treatment with a PPI will result in rebound acidity when you stop it. You will have overt reflux pain rather than silent reflux. Study subjects confirm this.
            In addition, this experience of rebound (that is ansolutely an excess of acid) raises the question of an association between that choking reflux feeling and an excess of acid. So, measures to stop the excess are appropriate. And using HCL too soon may not be wise, until you explore other options amd become convinced of your normal acid status.
            I am absolutely sure that taking Nexium or Omeprazole will give tou great relief, but that path may trap you in the end because stopping is a painful amd lenghty process. I have had to try Zantac in the interim. Zantac is in tab let form and far easier to control amd to tweak. I am currently coming off a single nightly dose of Zantac 75, and although I am not free and clear the difficulties are nothing like the rebound from PPIs.
            You do need to concentrate on healing your oesophagus, right now. When I took the low dose of HCL with Pepsin, I was very worried anout highly acidic gastric contents refluxing into my gullet and perhaps making their way into my small intestine with further damage to otherwise healthy gut mucosa.
            This issue is not as simple in practice as some sites might suggest, so take your time amd do not change too many things at one time. Heal first with your high proetin foods and foods rich in antioxidants. If you decide on an acid blocker, comsider possible future issues.
            I have decided (reluctantly) to take the Zantac again if my current strategy does not work out. Sometimes life is about compromise. :-)

  246. Jennifer says

    I have had acid reflux for years. I’ve changed my diet over the years and weaned myself off of acid reflux medicine over the past year. I did the paleo for a few months and lost a lot of weight; however I was normal weight when I began to eat very low carbs. I ended up losing too much weight and had very low energy. For the past five years I have had low energy and always cold and lose my hair a lot. I recently got health insurance and went to get my blood checked, because I thought I may have a thyroid problem. It turns out I am pretty anemic. I read somewhere online that taking acid reflux medicine can interfere with your stomac’s ability to absorb iron. I am wondering if anyone else on here has had problems with this. I wonder if my anemia is due to the medicine or the acid reflux itself, or the paleo diet itself. Has anyone else on here had problems with anemia?

  247. Teresa says

    Hi,
    I’m following the GAPS diet, and am still in the introductory phase. Can aloe vera juice also help with the healing of the gut?

  248. Scotia says

    Hi Chris,

    I’ve been reading your articles with great hope and I’m hoping you can help me a little. My son is 3 years old and from 3 months – 1.5 years was on a PPI for GERD. He still sometimes has ‘flare ups’ when I know he is burning but on top of that he is always gassy and bloated, has a lot of undigested food in his stools, has mood swings, dark circles under his eyes, is tired a lot, always coming down with viral infections that he cant shake, clingy… unfortunately the list goes on :(

    He’s always followed a dairy free diet and we are seeing an allergist in the next few weeks to see about any other allergy issues, but I wonder if he just has some serious issues with his gut balance.

    If that’s the case, what can I do for a person so young? We give him probiotics daily (although the do have FOS so that might make things worse?)

    My younger son (7 months) also has reflux, but he mainly spits up all day and we have managed to avoid any medicine. He also follows a dairy free diet and is on Neocate formula since weaning. Is there anything I can do to help him?

    Thanks.

  249. Glynis says

    Hi Scotia,
    I feel for you and especially your children. I do not know if Dr. Kresser wil respond to you. There are fewer and fewer responses on this site. May I suggest that you and your wife read the Gut and Psychology Symdrome Diet, by Dr. Natasha Campbell-McBride. Do not be put off by it relating to childhood autism; it is for everyone. But I think you may find it very useful and it may point you in a direction to get some practical help, though I do not know the financial cost of having a consultation with an expert. The book is great amd has practical advice, recipes etc. there is a lot of information in the book, but please try and get consultation help and support too. I am assuming that you are in the US, but if by chance you are in the UK! Scotland even, investigate if you can see Dr. Natasha on the NHS.
    Anyway,
    Kindest thoughts and best wishes to you all.

  250. Yvonne says

    Hi Scotia,
    I agree with Glynis’ great suggestions. After my daughter’s birth, I came down with GERD and so did she. I put her on the GAPS diet around 8 months (the book has a section for babies as well) and she has been steadily improving since following the protocol. I also used a GAPS practictioner as my holistic nutritionist to guide me, cheer me on, and inspire me because there will be setbacks that make you wonder if you are on the right track. We are both doing much better these days. It has been a year on the diet so far. Our babies need real food and real nutrition to heal. Good luck. You will be amazed with the results.

    • Scotia says

      Thanks Glynis and Scotia for replying.

      I had looked into the GAPS thing before but it is just so daunting, I would have a really hard time convincing my OH about the benefits, he’s very much a mainstream medicine kinda guy.

      We are based in the UK, Scotland in fact but doubt we would get to see anyone even close to Dr natasha on NHS.

      Hopefully we can work something out… Are there any supplements that are safe for children to take?

      • Glynis says

        Hi Scotia,
        I am also from Scotlamd. i was a midwife and health visitor before moving to the US. I also have an MS in epidemiology.Please invest in and read Dr. Natasha. Campbell-McBride’s book. It has a huge amount of information and very practical advice. And, yes, it is daunting.. Investigate possible consultation with her or with her nutritionists. You do need support because you are dealing with children who have reflux. God knows how hard it is for an adult to get off acid supressors, so children are more challenging. But i am fully comvinced that there is a solution for your children.
        All the bery best.
        Glynis

  251. Jessica says

    I have had issues with heartburn for quite some time. After reading about HCL and digestive enzymes, I decided to give them a try. My bowels were regular if a bit loose, but as soon as I started taking the HCL and digestive enzymes I’ve become very constipated and I have no idea why. I eat a low carb diet, no grains, and eat fresh fruit and vegetables daily. I drink lots of water and am quite active. I don’t see how the supplements would be causing the constipation unless I am just creating too much dead bacteria to pass. I don’t know if this is normal or if I should just stop the supplements. My heartburn is thankfully gone, but I don’t want to be constipated!

  252. Yvonne says

    Hi Scotia,

    WHen my baby was 10 months old, I put her on zinc (1/3 capsule) and 1 capsule of digestive enzyme by Enzymedica to help her digestive system. I did not try HCL on her as it is quite caustic opened. I opened the zinc and enzymes and put them into her solid foods. Bio Gai probiotics are very safe for babies but is pricey. I had lots of disputes over the alternative route with my husband unfortunately but now he is happy with the results. I worked with a naturopath and holistic nutritionist to help my daughter because I was going into “unchartered water”. However, in the end, I basically put her on my diet and that was what helped her the most. It is very daunting to do this diet long term especially if you do not have support. We both still have digestive issues that we are working on but I would say we are 80% better after being on the diet for a year. That is something to celebrate!
    Yvonne

  253. Yvonne says

    Yes, I’m on the GAPS diet. There is a section for Babies and Solid foods intro in the book, Gut and Pyschology Syndrome. I basically followed that for my baby but added the supplements, zinc and digestive enzymes–without hcl and pepsin.

    Yvonne

  254. Maria says

    Hi Chris,
    I’ve never had issues with GERD until I took some “strong” antibiotics for a throat infection 8 months ago. They made me feel sick instantly and I kept telling my doctor that they are making me feel exceptionally bad (nausea and burning) but they insisted that was normal. Well it wasn’t and I’ve had GERD issues ever since.

    My issue is that I’m trying to get pregnant and I noticed that hcl has a pregnancy warning on it. Is there a safe alternative for me? I was taking dgl until I realized that it could effect your estrogen and prolactin levels. I learned that the hard way when I got a blood test and realized my prolactin levels were high. Do you have any suggestions for me?

  255. Tami says

    “. Since it is the mucosal lining of the stomach that protects it from its own acid, a damaged stomach lining can cause irritation, pain and ultimately, ulcers.”

    When a lot of mucous accompanies stool in bowel evacuation, is that a result of acid irritation? Does acid enter into the intestines from the stomach? I ask because when I’m stressed or bloated, my bowel movements end with lots of mucous and I suffer from burning cramps that feel like acid burn.

    As a side, a dog handler states that she knows when her show dogs are stressed because they have mucousy stools.

  256. Erica says

    I just read all the articles on GERD. I am going to try all the recommendations and am hoping to find some relief. I lose my voice every 4 or 5 days when I stop taking my 40mg Nexium/day. This greatly strains my day as I am a counsellor who needs her voice! I hate taking Nexium and now after a year my blood work now shows me deficient in many areas. Even though my throat is burning now, I am sticking it through to try your suggestions. One question as I may be an exception….I had an eating disorder for over 15 years (bulimia) which meant vomiting regularly which means my esophagus has been exposed to a lot of stomach acid. My digestion as a result has been horrible even though I am recovered from the bulimia. I am wondering if there are any exceptions to your recommendations in a case like this where the body did not process food in a ‘regular’ manner for years and now is sluggish in all sorts of ways? I am afraid of Barrett’s syndrome and recently had a scope done that was “normal” to my doctor but still his solution is the Nexium daily! Any further considerations would be so helpful! great website — thanks so much :)

  257. Ashley says

    If I made coconut yogurt at home, would it have the same benefits as the milk yogurt without the carbs? Thanks!

  258. Gergely says

    I’m 21 years old. I have Gerd symptoms for 4 years. I was on PPIs, they didn’t help, Then after 2 years I started to have LPR symptoms(sore throat, excessive burping), I went off the PPIs, and tried to live healthy, but my symptoms became worse and worse. The PH test, which was really expensive, showed that I have severe acid reflux. So I had the NIssen Fundoplication last month. Now my symptoms much worse, I have more heartburn and more sore throat, I’m bloated and constipated, I feel that this operation was a huge mistake. Now that I can’t burp it just makes things bad. I’ve lost 28 pounds, can’t gain weight, and I tried a lot of things. , tried HCL supplement and Enzymes but nothing helps. I live in a little country, Hungary. I need to wait a month to get to a gastroenterologist, because healtcare is so bad here,my parents payed a lot of money for the nissen fundo, the procedure, which made my life a real misery, Now they are not willing to pay a private doctor, I can’t sleep, I can’t live, I need help! There’s noone I can turn to, I wanna die!

    • Glynis says

      Hi,
      I feel for you, but you may have to compromise and give yourself some time to rest and get sleep. Sleeping propped up, as suggested, does help. However the quality of sleep is not so good. If your test says that you have an excess of acid then you do not need to take HCL. In fact, taking HCL will cause you excessive pain. HCL is not harmless.
      Have you considered a transitional plan. PPIs are horrid drugs, so perhaps something like Zantac in the evening might alleviate your acid symptoms and allow you to get some quality sleep. Zantac comes in tablet form, so as you make progress with your diet and healing you can then tweak the dosage and gradually try to reduce the drug or get off it. But, if you truly have excess acid you may need some help with acid suppression long term.
      My suggestions are based only on my personal experience. However, I have not had the tests or surgery that you have experienced, so my situation may not equate with yours.
      Getting off your acid blockers and putting your GI system right is not simple, and it can take a long time.
      HCL is not “harmless”. The three steps suggested by this sire are absolutely sensible, but the reality is neither simple nor pain free. Listen to your body; be patient. I wish you best of luck.

      • Gergely says

        Thank you for your reply, they didn’t tested my acid level, it was esophageal ph monitoring, and I sleep popped up. I think I also have low stomach acid, should I try HCL for a longer period? Can it be that it gets worse before it gets better with the HCL supplement?

        • Glynis says

          Hi, you said that your ” PH test showed severe acid reflux.” Ph is a measure of acidity/alkilinity. You would be wise to clarify the numbers and their meaning before embarking on taking HCL .

  259. Steve says

    That’s sounds terrible. If you can’t sleep it may help to sleep sitting up. Sounds extreme but it works for me. It’s the only thing that does. I’ve everything. Same as you barring the operation. I sleep propped up to about 50 degrees and use a travel pillow that goes around the neck to keep my head comfortable.
    Hope this helps you.
    Out of interest did you take ibuprofen. I wonder if it might have been the cause.
    Good luck to you Gergely.

    • Gergely says

      I often sleep sitting up, because I can’t take this throat burning. I would choose more heartburn instead. Unfortunately the success for LPR sufferers with Nissen Fundo is much lower than for GERD sufferers. I think it’s because of the bloating, I had excessive burping before my surgery, and now it’s hard to burp, and somehow I feel it makes more acid come up. I should have try HCl before my surgery, maybe it would have helped me. Now I may have too much pain to use it. Anyway, best wishes! I hope that the science will improve and poeple like Dr. Kresser will change this outdated healthcare.

  260. Steve says

    I agree with Glynes. The quality of sleep is very important.
    For me the quality improved when propped up as the only time I had symptoms was when laying flat.
    So it worked for me but may not work for everyone.
    I also tried a strong dose of melatonin as a paper I read showed good results correlating deep sleep with the healing of gastritis. Didn’t help me though.
    Best of luck.
    Steve

  261. Wendy says

    This is great and I plan to follow up in the hopes of relieving my gerd symptoms. I hope this will also relieve my asthma as well. Have you done anything on copd? I can’t find any if you have. I would love to know what you have to say about Chronic Obstructive Pulmonary Disease.

    Thanks for all your good work, I feel fortunate to have found you.
    Wendy

  262. Jessie says

    Thank you for this great article! How long do you suggest cutting out carbs, starches, and legumes before I can incorporate them back into my diet?

  263. Angelica says

    I am so happy to have found your articles. I am 33 years old and 3 years ago I had an upper G.I done and was diagnosed with GERD. I also experience chronic constipation. I was started on omeprazole, I am currently having a bad flare up which led me to research on a cure and that is how I stumbled onto your site. I am so happy I did. I recently started the red apple cider vinegar before each meal and this does alleviate my symptoms. I have not started anything else but your site has led me to look for a N.D in my area and I have an appointment coming up. I plan on sharing this info with her to see where I should start and to make sure I do it right. Your site has been so helpful and I am so grateful you shared it. I am so tired of living like this, I thought I was going crazy with all these weird symptoms but after reading some comments its nice to know I am not alone. Im pretty sure my doctor has me tagged as a hypochondriac, but all she would do is up my dosage or add Prevacid along with the omeprazole. She never once addressed how to increase or able my body to produce the acid I need or how to get rid of this condition, To think I had to live with this forever was depressing. Again thank you and your information has made me optimistic to my road of recovery!

  264. Jennifer says

    I really need help right now. I’ve had acid reflux for years and was on different antacids for years of course non of them have worked. Anyways in the past year I have weaned myself off of antacids and really watched what I ate. For the most part it is manageable. However over the weekend I ate at a Chinese food buffet and have had the worst acid reflux in a long time. I’ve had sores in my mouth and now the back of my throat hurts especially when I swallow, and I don’t know what to do. I took Prilosec yesterday and use Prilosec when I have a flare up occasionally, but it has not helped much. Does anyone have any ideas on how to heal the back of my throat without medicine. I am a single mom on a fixed income and am really struggling right now and can not even afford to go to a Doctor.

    • Scott says

      Hi Jen, You might want to look at magnesium supplements. My mother told me her aunt suffered from “burning tounge” and her Dr. had told her that Mg will alleviate this. When i started taking omeprozole, i also experienced a burning tounge. Turns out that Omeprozole affects magnesium levels and this is what caused mine. so every morning along with my breakfsast i pop a mag pil and voila…no more burning tounge.

  265. Bill says

    Hello,
    First of all, thank you for the information you have posted here. It’s so nice to find someone who actually has the interest of CURING the patient. Anyways, I have very atypical acid reflux. I rarely FEEL heartburn, but rather I slowly aspirate it. This causes asthma like symptoms and excess mucus to be produced in my lungs, which takes about an hour of coughing to clear up. Following your advice listed here, I was able to completely rid myself of reflux and breathing problems. After being reflux free for about a month or two, I decided to come off the medications I was using (enteric coated peppermint oil, 1 pill TID, and Betaine HCl, 1 pill per meal), and try to see if drinking kefir alone would be sufficient maintenance therapy. Unfortunately, the reflux, bloating, and breathing problems returned. At that point, I tried going back to the HCl / Peppermint / Kefir combination (I had started at 8 HCl pills per meal, and eventually was able to get down to 1 pill, the first time around, currently I am at 2 pills per meal. I also take 2 enteric peppermint TID now), but the problem won’t clear up this time around. Do you have any advice? Anything else I can try? That month of being reflux free was the greatest I have felt in a very long time, and I was actually getting restful sleep. I really hope to get that back. Any help is appreciated!

  266. Laura says

    Chris,
    Thank you for this information. I have been on a very low carb diet (anti candida) for a very long time. About a year ago I started to move to a Palio style diet and have been pleased but still have the following issues. Constipation has plagued me since childhood and i have never had normal digestion: very slow transit time and acid reflux/GERD. Also a hiatal hernia that my AK chiropractor keeps adjusting but it doesn’t stay down. I have used HCL w/pepsin and i think it helped but not sure. also use DGL, raw homemade kefir & yogart and so meny othes …You did not specifically mention candida in your article. Could you tell me what your thoughts are on this. Thanks again, L

  267. Mélanie Goulet says

    Hi,

    I think I’m suffering from low stomach acidity. I was a vegetarain for years and I am now on the paleo diet. I’m doing a very strict paleo diet and I still have a bit of bloating and burping after meals. Also, I do not break down well my food (undigested pieces in BM). I started suplementing on HCL a month ago and as soon as go take more then 600mg per meal, I start to feel heart burn and gastric reflux. So I stay on 600mg per meal, but I see no change in my symptoms. Is that normal?

    thanks

    Mélanie

  268. Gary says

    Chris,
    I have suffered from GERD for years & fought it in so many ways; most without success. I have now had an endoscopy, and it shows that I have stenosis/stricture in the lower third of my esophagus accompanied by Barrett’s Esophagus.
    At this point, is there anything I can do except take PPI’s? My gastroenterologist says with all the scarring (probably caused by “toughing it out” without doing much to alleviate my symptoms of “heart burn”), that is my choice, or this could lead to much more serious complications.
    I appreciate so much your advice and insight. Looking forward to it on this question.
    Thanks so much,
    Gary

  269. Michelle says

    I was diagnosed with acid reflux/GERD 8 months ago, after having my second child. I have tried different diets (low acid, gluten free – not longer than 2 weeks long, though). I finally went back to the doctor because it wasn’t getting better, and he prescribed me Famotidine. I took it for about 6 weeks, and stopped because it stopped being effective. I am not on any medication now.
    I am so thankful that I came across this website!! And I am on day 1 of the GAPS diet. I have one QUESTION though – how long until symptoms actually start improving? Symptoms of acid reflux/heartburn. I also have issues with gas and bloating, and I’m hoping this diet solves that problems, as well. I was just wondering what is the normal time it takes for acid reflux to go down after one begins the low-carb diet. Thank you SO much!!!

  270. Elizabeth says

    Michelle, I had severe acid reflux/GERD after having my 1st child. I did 9 months solid of the GAPS diet, I then reintroduced grains (from traditional sourdough only) and it took about one year for the acid reflux to leave me. This isn’t a quick fix. You have to reflect upon improvement in terms of months at a time (not from one day to the next). I’m not done healing yet, as I’m still trying to resolve bile reflux, esophagitis, and I’m taking HCl now so that I can get my stomach acid back where it should be! It’s been a long process for me. After taking a break from the GAPS diet (during which time I’ve been eating via WAPF principles), I started the GAPS diet again this weekend and plan to stay on it until Thanksgiving. ALSO: I consulted Eastern Medicine recently and they confirmed everything Dr. Kresser writes; the acupuncture was very helpful and the herbal remedies are further healing me. I’m two years into this process, and I think I have 1-2 years left to go. I hope this doesn’t discourage you; rather, I hope it gives you a point of reference. You can do this or be on drugs and feel miserable the rest of your life. I plan on healing and living my 40s and beyond healthy and pain free.

    Here are my earlier posts which you may find helpful:
    January 23, 2012 at 11:32 am
    November 5, 2012 at 8:48 pm

    • Michelle says

      Thank you SO much, Elizabeth!! I really appreciate you taking the time to reply. One more question for you – I’m om day 2 of GAPS, now, and am eating some foods that earlier I wouldn’t eat because it’d give me heartburn (berries, apple cider vinegar in water, etc.). Now, that heartburn that I’m REALLY feeling now (not so much the actually acid reflux) – will that go away eventually after my stomach levels out? I feel like I’ve had more heartburn since starting the GAPS diet, but less acid reflux. Does this level out at all? Thank you!!

      • Elizabeth says

        Hmmm… That did not happen to me. I’m not an expert, but if those foods are giving you trouble, it may be best to abstain from them until your system grows stronger.

  271. Matt says

    I’m so glad you wrote these articles. I’ve been suffering with GERD/IBS symptoms for almost 3 years now. The only time I’ve experienced complete relief was on a low carb diet. Once I got sick of it and went back to a “normal” diet low and behind the symptoms came right back. I’ve seen 3 different GI specialists and they all insist PPIs and H2 blockers are the way to go. I’ve finally been tested for H pylori so I’m waiting to see the results. I occasionally take DGL, Betaine HCl, and digestive enzymes with some success, but ultimately I think eradicating the bacterial overload works best and makes the most sense.

  272. Tim Spanoudakis says

    Matt. Really interested to read your post. I first went on this site 5 months ago. Had to come off PPIs (after 14 years) to have a manometry study. Decided to stay off them after reading such bad things about them. Since then I have tried so many things, DGL, Betain HCL, Enzymes but it’s only when I decided to do low carbs to lose some weight that I noticed a radical improvement. I have been experimenting since, trying to understand what it is that works and I have drawn the same conclusion as you. Low carbs means I take at most 1 antacid (Gaviscon) per day. Lots of bad carbs (sugars, white carbs starches etc) and my reflux is terrible. I need to try and stick with it now which is just so hard.

  273. Fabiola Gibson says

    Hello,
    I was hoping that you can shed some light on my 3 year stuggle with on going stomach and mid section pain. It does not feel like an acid burn nor does it irritate my esophagus. It is a deep sour ache in the center of my mid section between my rids. It aches internally around my stomach and liver area. I get very bloated and it gets worse when eating big meals or heavy foods. It hurts daily and I even wake up with feeling pain. I was tested for bacteria but it came back negative. I just had my stomach scoped but haven’t gotten the results. I have a feeling that it will be inconclusive because my doctor hasn’t contactede. I’m afraid to eat. Any guidance as to what may be the cause will be greatly appreciated.

  274. Roberta says

    Chris,
    Knowing all that you know and the importance of gut health, I have a question for you. After doing GI Pathogen tests and finding out that someone has a parasite which route do you go in to kill them? Antibiotic route or herbal route? I would really appreciate any input you have.

  275. Trudy says

    Thank you so much for all this great information! I’m sure someone else has already asked this question so I apologize for repeating. I live in Canada and do not have a family doctor so I go to a walk in clinic. The doctor was sure I had an ulcer caused by my excessive use of Advil so he gave me a PPI. My stomach is feeling better finally but the hot feeling right between my breast is constant when I sit down. I am also a bit dizzy through the day and it feels lile my esophagus is doing flip flops at times. Exercising makes me feel great!

    Question is, when my ulcer is healed, how should I increase my acid without HCL? I mentioned it to the doctor and he thought I was crazy! Thanks again.

    Trudy

    • Trudy says

      Thought I should leave an update on the change in my condition. I started taking Tecta to reduce my acid production to zero and changed my diet to select fruits, vegetables, chicken and fish. I would be in such pain when I tried to drink liquid but did okay if I stayed away from it. I have 2 days left of the PPI and the burning in my stomach is gone! I’ve tried eating a few carbs and sweets to see what would happen and I seem to be okay. EXCEPT now it feels like someone is trying to stretch my esophagus constantly when I sit or lay down. When I’m up moving or exercising, all is well. Some think I have a hiatal hernia, some think its a side effect of the Tecta. My doctor refuses to test me (that’s what happens with a free medical system!!) so I’m going to see a chiropractor to see if he can push it back in place.

  276. CJ says

    I found myself very sick at the beginning of this year. Ended up in the hospital twice in one week because I was so sick, could not eat, could not drink.

    I went to the GI and they did an Endoscopy but found only inflammation in the LES, no Pyloria and no ulcers. I was diagnosed with GERD, and the doctor put me on Nexium for 3 months. During those 3 months I didn’t feel 100% but I felt ok enough to continue my regular life.

    I just came off the meds about 3 weeks ago. I lost about 1lb a day. I couldn’t even go to work. I had a host of symptoms: weakness, head pressure, stomach pain all the time. I don’t even remember the last time I felt hungry because all I felt was pain. I had gas, bloating and pain, not to mention just wanted to get in bed, which is now super uncomfortable because I raised it 6 inches like they recommend. I tracked my calories and at some point I was eating less than 500calories because eating was so painful.

    What I’ve done to help me:
    1. Checked for Candida – according to saliva test I was positive: I bought probiotics and stomach enzymes. Not to mention started drinking Kefir and Kombucha.
    2. I started a paleo diet. This has been quite hard since I’m barely able to eat period, and restricting what I eat has made even finding what to eat quite hard. But I heard it was good, so I’ve done it. I eat veggies and meats/protein.
    3. I did the HCL test – both the 6oz of protein, and the baking soda test (2 days). It seemed positive, it took me well over 5 minutes to burp. So I started to supplement with HCL. I felt something after the first pill, but ok so continued. I still couldn’t eat really. On the 2nd day’s dinner I didn’t really feel great, but thought maybe I needed more HCL. I took 2 HCL pills on the 3rd day’s breakfast/lunch meal and felt so sick I had to drink a glass with a tsp of baking soda, this helped but I wasn’t feeling great. Obviously low stomach acid wasn’t my problem.
    4. Back to square 1. Most sites now, including this one only discuss the need for HCL supplementation. I felt very depressed, but during one small blog line somewhere mentioned that if the HCL test fails, then you should try taking: Alkabase, Gastric Complex-HP and/or Mastica.
    5. I bought Similase, which is suppose to be like Gastric Complex-HP, and some Mastica.
    6. I started taking DGL Licorice and Similase, along with the probiotics and the enzymes. This seemed to help but not that great.
    7. I was afraid of Alkabase because of the high sodium, so I looked for something else that could act like an “alkaline.” I then heard from a friend of the family that raw potato juice is good for stomach ulcers and GERD. I then read that the raw potato juice acts as an alkaline, so I figured this could work instead of the Alkabase. I just peel the potato, chop it, put it in the blender with some water, puree, then pour it into a strainer and get the juice. I drink that, keeping away from the potato bits because I read those are bad.

    For 3 days now I’m doing this: fresh raw potato juice 30 minutes before every meal (empty stomach), 2 DGL licorice chewables 10 minutes later, and 1 Similase and 1 probiotic just before I eat my meal.

    I have to tell you, it almost brings tears to my eyes to think of how much better I’ve been feeling. I finally stopped my weight loss, I was down 13 lbs in 20 days. Every day I feel stronger, and like I can eat. I read this potato juice thing should be done for about 10 days. I check in then. Good luck to you all.

  277. Emily says

    I just wanted to say thank you for this series of articles! I have been on and off, but mostly on, PPI’s for about 15 years and in the last 8 weeks the reflux has gotten worse. I started looking at the side effects of Reglan, because I thought I was headed there. That’s when I stumbled across your website by researching why reflux happens. I started one week ago on the Betaine HCL with melatonin (6mg’s) at night. It is working wonders! I am so happy. I think I have to back off the HCL a bit in the morning as I am feeling heartburn symptoms after breakfast, but after lunch and dinner and at night I feel great! I was so worried I was headed for B.E. or worse. I am getting a scope done in a couple weeks just to see what the years have done to my esophagus. I can’t believe more doctors aren’t prescribing this as a treatment. Shame on them! But kudos to you! I will start spreading the word to my friends and siblings on PPI’s.

    • Emily says

      Hey Everyone,

      I just wanted to follow-up. The HCL Betaine regimen did not work for me. Turns out my acid levels are just fine. I’ve had heartburn for 25 years and just want to be done with it already. I started reading about the Paleo Diet and begrudgingly decided to try it yesterday to see if anything changed. I usually have a large bowl of gluten-free oatmeal in the morning, but switched to an apple and some carrots. Guess what? No heatburn/reflux. Then I kept with it through the whole day, no grains and no dairy. I haven’t had heartburn for about 36 hours now. It was literally like turning off a switch. Just a suggestion for those who find other methods aren’t working for them. Some of us have trouble processing grains and dairy and we should eat caveman-style to help our tummies. I haven’t made the bone broth yet, but plan to this weekend as that is supposed to help heal the gut. I am so excited. 25 years people! Goodbye Tums, Pepcid, Prevacid, Protonix. BTW, I had a scope done on Monday and my esophagus was miraculously erosion-free so thank God for that. I plan to keep it that way.

      • says

        Hi Emily,

        I have a similar situation to yours and the HCL did not work for me as i have mild esophagitis and have been on ppi’s for the 15 years.Tried getting off them over 1.5 months this summer and ended up with LPR so went back to them.So was curious how you weened yourself out of the ppi’s even if it may be easier for you as your esophagus is not eroded.Curious to see how you did it.

  278. Mari says

    I just wanted to share woth everyone the diet my Dr. Told me abput. It is called low FODMAP.. same basis as very low carb, but restricting selective carbs. Good luck!

  279. Tim Spanoudakis says

    Emily, what a great post. We are almost in the same position. I was on PPIs until this year for 14 years and came off after they stopped working and finding polyps under endoscope. I had not heard of using Melatonin before and have ordered some to see. The research on this area seems very interesting. The -only sure fire way to cut my heartburn is to drastically reduce my carb intake. It sees as simple as that for me, though not 100%.

    • Emily says

      Hi Tim,

      Yes, kicking the carbs is a great way to reduce the burn. Grain-free, dairy-free seems to work extremely well for me. The HCL Betaine didn’t work form after all. Good luck in your efforts towards better health!

  280. Valerie says

    “HCL should never be taken …by anyone who is also using any kind of anti-inflammatory medication such as corticosteroids (e.g. prednisone), aspirin, Indocin, ibuprofen (e.g. Motrin, Advil, etc.) or other NSAIDS. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer.”

    I started taking Betaine HCl tablets about ten years ago. (My hypochlorhydria is possibly related to hypothyroidism — Hashimoto’s.) Each tablet contains 650 mg betaine hydrochloride, 31.5 mg pepsin and 20 mg gentian root powder. A few years after that I began taking a physiologic dose of cortisol, a corticosteroid, for low adrenal reserve. No doctor has ever told me that these two were incompatible. The cortisol information sheet does not mention Betaine HCl. The Betaine HCl label does not mention corticosteroids.

    Apparently I need both of these drugs. Have I been damaging my GI lining? What am I going to do?

  281. Ellie says

    Thank you for sharing this information.

    I wanted to share my experiences about listening to your body. Not everyone is the same so I feel it is not appropriate to say that everyone does well on a certain diet. I cannot digest animal protein or fats due to low acid production in the stomach. Paleo was a nightmare for me.

    I do so much better on a grain diet. I am blood type A which apparently does not digest fats or animal products well, and benefits from supplementing with HCL Betaine and Gentian. So the blood type diet worked for me, Paleo does not. You’ve got to go with what feels right to you.

  282. Gloria says

    Hi, about 3 months ago I started to have severe pain in my lower abdomen, in a matter of weeks the pain went in the sthomach and then esophagus. It was fast in severe. I have never before had anything like that. I have a healthy diet and never suffered of GERD. A few days after my pain started my husband started to experience the same simptoms. We finally went to the dr. and a blood test came out positive for H Pylori. After 2 weeks of antibiotics and prylosec, we felt as bad as before. We ended up with two more weeks of antibiotics and now, that we are done with it and stopped taking the prylosec we struggle with pain and heartburn. The doctor told us that H ;ylori is highly contagious and that is transmited through salive. So our case seems to be different since we naver had heartburn before and only occasionally took zantac, after a too big meal. So what category do we fall in? Since is not something cronic, what should we do next?

    Thanks.

  283. Amy says

    Hi Chris,

    Very glad I found your article.

    My story goes back to 2010. After my second child was born (he was about 9 weeks) I contracted a severe case of Coxsackie virus – it was the most excruciating pain of my life – my lips and inside my mouth were shredded with no skin – just a big open wound. I ended up in hospital with no diagnosis until months later from a new GP.

    So, anyway, as a terrible side effect of this virus, I continued to get mouth sores (not painful) but sometimes burning and I was sure it was a yeast thing as a consequence of the virus.

    The other side effect was GERD. I felt like I was having a heart attack, couldn’t talk sometimes and sometimes found it hard to breathe. As I was breastfeeding at the time I was told the standard stuff – don’t go to bed after eating etc but it was terrible. I stopped bfing my son at 9 months and started on Nexium 40mg. After 4 weeks I was great, no symptoms at all.

    I have carried on with the Nexium 20m for the last 2 years with no bad side effects and frankly, with 2 little kids just relieved to get on with my life. My stomach isn’t great but it never has been, so I just figured it was par for the course. Then a couple of weeks ago I didn’t take my Nexium for 2 days. Well, bloody hell – I knew all about it! Same panic attack feeling is back and even though I am back on the Nexium, I am battling the symptoms still.

    I am going to the GI next week and have an endoscopy scheduled for early next month but I just wanted some advice about the Nexium as my GP has suggested staying on it until I see the GI. Should I stay on the Nexium, go cold turkey or try and wean myself off it. I have been trying the ACV but thought it would have little effect while I’m still on the Nexium. And what if they tell me I should be on this stuff for the rest of my life. I’m only 34. I never had symptoms like this until this virus. I am an otherwise healthy active woman, not overweight – I exercise and eat well (although not yet a restricted diet.)

    Help!!

  284. Alexander Hamilton says