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. Erica says

    Does anyone know how I can obtain a copy of this article?

    Gastric acid secretion and the morphology of the gastric mucosa in patients with acne vulgaris.

    Authors
    Drunkenmölle R, Schulz U

    Source
    Dermatologische Monatschrift 157:9 1971 Sep pg 648-52

  2. Kyle says

    There are some contradictions but perhaps they’re only rooted in the terminology. It is said the paragraph for carbohydrates that ‘short chain’ carbs are not problematic, but further down when referring to the low FODMAP diet it’s said that FODMAPs are carbs that are poorly absorbed by those with bacterial overgrowth. Wikipedia defines FODMAPs as short chain carbohydrates. ????

  3. Srini says

    I am taking a omeprazole tab almost every morning –
    if i dont i get a burning in my throat every day starting 5 pm until mid night-I even have to vomit some food to get the throat cleared-

    I eat a lot of rice-can that be a problem?

    any advice will be appreciated!

  4. Terri B. says

    Oh Karina, I’m so sorry you are suffering so much from this condition. I to have had reflux for several years and have been on prilosec for 13 YEARS! Then when it started getting worse my doc put me on pantoprozole which I took for 1 year, but my condition still is bad. So 4 months ago I just quit taking the meds. The first thing I did 14 years ago, which made a significant difference was to elevate my bed. My bed is on wheels so I took the wheels off the foot end of the bed, then bought those plastic bed risers from Walmart, left the wheels on the head end of the bed and put the wheels onto the risers. This lifted the bed about 8″ which is the recommendation from my gastroenterologist. It didn’t take long to get used to the position, as after the first night or two I didn’t have the acid coming up into my throat. We bought 2 twin beds and put them together, using twin sheets and king top sheets and covers. Anyway, I am now taking DGL, one before each meal and one before bed, I also eat ginger. Dr. Oz said to take a one inch knob of ginger, peel it and and slice into 1/4″ pieces, then put in glass jar with fresh lemon juice. I’ve had severe heartburn and just take out one piece of ginger and chew it (now it is spicy or hot) and swallow it and had my heartburn disappear immediately. But from everything I read about reflux, its a symptom of some other problem, digestive. Either your stomach isn’t producing enough digestive enzymes or your liver isn’t. I also started taking Culturelle and eating yogurt. Thats another reason why I wanted to get off the proton pump inhibitors…they all say not to take them if you have liver problems….so I definately believe they are harmful to you liver. I’m betting this ranititide is also not good for your liver. I’m also taking milk thistle for my liver, which was recommended by Dr. Oz. Hope some of this helps.

  5. karina charles says

    oh my goodness….
    im in UK, am 36 and am suffering like hell.
    my tonsils are swollen, weep, and once bled (gps kept saying tonsillitis), my esophagus, throat and roof of mouth are burnt, tender, red raw.
    my liver function tests are showing problems although they are unsure why and what, my energy levels are so low that sometimes i have to nap morning and afternoon.
    i crave, what ive now discovered through this site are foods in zinc, b12, magnesium, iron, folic acid.
    i cannot have an empty stomach because of acid probs, and have to eat protein in every meal, or again major problems.
    chinese take away is the only thing things that i dont get acid reflux with, and have to take ranititide 75mg (zantac or its equivalent) every day, twice a day.
    i am going through hell. i cant exercise, i so im putting weight on. i cant go anywhere unless i have ranititide.
    i look pale, have sucken eyes, reacuring cold sores, ulcers, and have had enough.
    so ive done my research which has led me to here.
    i am going to do low carb diet now, and take multivitamin with probiotic in. multibionta i think its called here in UK.
    i know the esophageal sphincta has been stretched ( as it all started during pregancy (third trimester; he was extremely high and long lol). so not sure what i can do about that, but thank you all of you for you help. not just dr chris but all of you that have replied, responded, and given you story.
    i now know im not going mad, looking forward to being pain, and burnt free, and if this works, may not need a tonsillectomy op.

    THANK YOU AND GOOD LUCK EVERYONE XXXX

  6. lavi says

    i am suffering from reflux esophagitis of gr a severe erosive gastritis with h pylori…i was given antibiotics for 14 days,,,then i was put on pantocid 40 morning evening for 20 days…then 1 pantocid before breakfat for a month…i hae been on this medication since 2 months…my sympotms have improved but i still get a reflux twice in a week..i am on a restricted diet …plzzz advise how much time will it take for me to get completely ok…i am so anxious on this which gets me so stressed…what can i add to my treatment…i have lost sooo much weight…feel giddy and nauseatic all the time….dont feel like going out…

  7. says

    How is reflux investigated?

    Normally the diagnosis is very clear from the symptoms and no tests are needed. If you are older than 40 and the symptoms are new and do not respond quickly to treatment a consultation with your doctor may be needed. If the diagnosis is unclear, then tests may be required including
    gastroscopy
    Oesophageal physiology – measurement of the oesophageal muscles and acid.
    Reasons for urgent investigation of reflux symptoms would include difficulty in swallowing, loss of appetite and weight loss.

  8. Lily says

    Supervised water fasting at places that the Natural Hygiene Society recommends like True North Health in Rosarita, CA or places that have raw food diet are amazingly healing. If you cannot afford it, eat alkaline foods for those wtih GERD or too much acid. Lemon juiced whole becomes alkaline in teh stomach. Manuka honey small amounts like 1 tsp. a day. Potatoe juice first thing in teh morning. raw washed potatoe unpeeled (red, organic) and all eyes, holes removed. Juice and filter. Wait 1 min until white starch stays on bottom of glass and drink only the juice. The best diet is dark leafy greens starting with plain romaine lettuce and adding other things taht are easy to digest. If you need carbs, a little white rice cooked well or chinese congee or fast cook to medium cook oatmeal only with boiled chicken no skin or plain red meat wtih a little oil in fry pain. But really no sugar, starch, spicies, alcohol, caffeeine etc. all the items you should not be eating wtih GERD. Basically dark leafy greens. Chinese herbal remedies also are the best aid but depend on diagnosis. Generally Wei Te Ling formula is a good generic one and Xiao Yao Wan. Take care. May God Bless Us All.

  9. Debbie says

    I have suffered from gerd for many years and enjoyed your information. I have been on Prevacid for many years, when I try to stop this drug I am thrown into extreme heartburn. I would like to start HCL, would I do this and continue my Prevacid? Any help would be greatly appreciated.

    • Deb says

      I too am having horrible, horrible pain when I stop the PPIs. It is now constant and I’m at a loss as to how to stay off the PPIs and fix the acidity of my stomach because I feel this information about low stomach acid is accurate but I am going to have to start taking the PPIs again to control the pain. I hope you get an answer, as it will serve us both well. Also, I would like to know why PPIs are initially effective for heartburn and GERD if the problem at the outset is low stomach acid. I hope Chris will have time to explain this to the two Debs. Thank you!

      • Maya says

        Once I started taking the Betaine HCL supplement with my emails I only had to take zantac one more time. It has now been over 1 month I have not had to take ANY form of antacid. I also sleep with my head slightly elevated which will help you in the early stages. It takes a few days for the Betaine to work.

  10. joe says

    Hi Chris and community,

    Need some help and your advice.

    I had severe upper middle stomach pain which almost made me fainted. Had rush to ER last Sunday. Then doctor said I had “Gastritis”. Gave me “pantoprazole”, which I assumed it is anti-acid drug.

    Before that episode and until now, I have been having chest pain(just around esophagus area from time to time.

    After I took the “pantoprazole”, stomach paid reduced tremendously, but chest pain seems to be there most of time. I don’t feel heartburn, but I DO feel chest discomfort a lot.

    Should I stop the medicine? Go ahead with the remedy you and the post suggest?

    Please help. Thanks

  11. Steve Evets says

    I was prescribed Prilosec in May of 2013 to treat dysphasia, painful swallowing. When I would eat an apple or rice or white chicken meat it would stick half way down until I coughed it up. I did not suffer from GERD but I would get heartburn that was usually stopped by taking a couple of Tums a day.

    I didn’t have my prescription for Prilosec filled for over a year and I just avoided eating the foods which caused me difficulty swallowing. Then about a month ago I had purchased some Rolaids instead of Tums and they didn’t work for my heartburn. So after about a week I decided to have my Prilosec prescription filled.

    I took my first Prilosec the Thursday afternoon I had it filled and it worked so I took one again the next morning with my other meds. It worked great and I could eat foods that would previously cause me heartburn, not GERD but simple heartburn. But I could also eat an apple without having it stick in my esophagus.

    My problem came that night when I experienced extreme bloating and then acid reflux when I laid down to sleep. I was so disappointed because the Prilosec had worked so well. So the next morning I did not take one but it still worked all day. So I decided that maybe the problem was that I took the first 2 Prilosec pills too close in time. Since then I have taken my pill every other day and it has worked fine with no negative side effects.

    My concern is for the long term effects of taking Prilosec since I have a prescription that will continue indefinitely. But so far it has changed my life for the better.

    • says

      Drugs such as Prilosec, or Nexium should be taken for a period of no longer than 8 weeks. Taken longer than that, they will actually stimulate your stomach to produce extra amounts of acid. Even long-term use of antacids will make acid reflux worse and could lead to dangerous complications.

      Also, if you take more than 1 medication, that can lead to serious reactions between all of the different drugs. One may enhance the effect of the other one and may lead to harmful consequences.

      I’m not a doctor. I used to suffer from heartburn for years and took Prilosec off and on. Then, I found a really good book which helped me so much. I don’t have to ever worry about heartburn or GERD again! I don’t have any other problems with them. The book talks about a holistic system to permanently cure yourself from heartburn and acid reflux. I highly recommend it.

  12. Michelle says

    Please help, anybody…

    What does it mean if someones ph levels were fluctuating at around a 6/7. But would drop at certain times?

    Anybody?????

  13. MIchelle says

    I have had four months of excruciating heart burn/ acid reflux. I’ve tried all the over the counter medications and all the acid blockers, none help my symptoms, at all. They only made things worse. I’ve also had a upper and lower endoscopy and a ph study. Which my GI doctor say’s I have acid reflux.
    Yesterday, I tried using ACV and it actually gave me relief. It’s the first time anything had an effect.
    I have know where to turn and Im really sick. Please could someone help me. I feel very alone in this situation and I don’t know where to go or who to turn to. This is literally, debilitating.
    Has anyone else not had “any” relief from heart burn medication?

  14. says

    I have been suffering from painful acid reflux symptoms that doctors found difficult to diagnose. Needless to say, pills and antacids didn’t cure me and the relief was temporary and sometimes insignificant.Until I tried the natural approach it helped me in ways that I still cannot comprehend. My acid reflux symptoms are a thing of the past. It’s like I have never suffered from heartburn.

  15. Cris says

    Hi Chris
    I am 35 years old and cant remember when was i first suffered from GERD but it keeps on happening for years until this day. Last year i undergone gastroscopy and doctor found out i have abnormal stomach function. My intestine movement is upward instead of downward and according to him its the cause of all my stomach issues and its lifetime case. He gave me prazole plus to treat heartburn and neutralized the stomach acid. But didnt work for me, been trying several alternatives and no good result. Everyday i suffering from bloating at around afternoon till nigth, heartburn, stomach spasm, flatulence, loss of appetite and weaknesses. Im so sick of being sick! It stops me from doing things i need to do. Please advise me on what i need to do, i want a healthy life and i dont know who else i ask for help and where to go. I will appreciate any help you can give. Thank you so much…by the way im from philippines. :-)

    • paula says

      Hi, I’m 34yo and from the Philippines as well.
      I’ve tried Nexium/zantac and every prescription drugs that my doctor gave, and was almost hospitalized.
      I googled home-remedies for GERD and was surprised with all the possible solutions!

      At 2am, I made ginger tea, and after 30minutes, I was very much fine.

      But I had to have something to treat me, and so I purchased Bragg’s Apple Cider Vinegar and honey.

      I was treated!

      I can now enjoy parties, and a few more drinks!

      Try Bragg’s, and hope it would work its miracles on you.
      Goodluck!

      • Emerson Paul Dizon Liwag says

        Hi paula, im also from the philippines. Can you tell me how to prepare the recipe & how often should i take this? I wish you could give me your number so I can directly consult to you.

  16. Janet Ohanis says

    Hello and thank you for all the helpful information. I have been treated for H-Pylori (antibiotics) in the past and was told that it would probably come back which it has, but they won’t treat again (twice, already) with antibiotics. About two months ago, I had to start taking 40mgs of OTC Nexium with 150 Zantac AM & PM for breakthrough symptoms. My question is this, I want to start taking Prescript-Assist Probiotic with Deglycyrrhizinated licorice before meals ASAP. Can I start the Probiotics and the licorice while I taper off of the Nexium and Zantac?
    Thanks again, Janet Ohanis

  17. Tony says

    Hi guys,

    Is it okay for GERD patients with esophagitis, or gastritis to have lemon or apple vinegar? Won’t it hurt inflamed area on stomach and esophagus?

    • Tina says

      Tony, I don’t know about other people but on me, anything sour will hurt my stomach ( having gastritis too) especially eating when my stomach empty. After taking L-Glutamine, Fish Oil, and bones both for about 3 months plus DGL daily my stomach is a bit stronger. I can now eat Fuji Apple or one mango AFTER lunch/dinner once or twice a week. Greek salad still gives me bloating and can only take a few bites.

  18. Carey says

    A couple of questions… after 25 years of gluten free life, and I gained some weight post-menopause, went on Natrurethroid for my thyroid, developed GERD and back pain…and, surprisingly, osteoporosis. My naturopathic doc had diagnosed the MTHFR gene mutation based on low folate and B12, and I’ve been taking oral Jigsaw B Complex with methylated forms of both (but perhaps not absorbing them?). I had occasional B12 shots but did not follow up on levels. I believe I have generally had a good diet for years, influenced by Weston A Price principles, so this was a shocker! Absorption is obviously an issue, and stress has definitely been an issue in the last few years. Gas had increased as well. I was generally eating low carb, high protein and fat, but perhaps too much? I noticed big dinners with friends going to 8pm with a little wine left me feeling terrible. I do not have any kind of history of constipation but have tended to diarrhea, if anything. I also noticed that taking a super powered probiotic seemed to aggravate, maybe even bring on, the whole thing, when I was trying GAPS… so I stopped it. I have had yogurt, kefir, good pickles and sauerkraut fairly regularly, but pulled back on all of them recently out of concern, after the SIBO dx.

    I have heard that stress at mealtimes can suppress stomach acid, even if your body has sufficient acid, because it puts you into a sympathetic nervous system response, yes? I am not seeing this factor mentioned, though, and believe it’s important. There were some stressful interactions at and after mealtimes coming into play, as well as rushing through meals, maybe not chewing enough? One doc suggested pausing and meditating a little before eating: that there is a biological, evolutionary basis to the practice of grace at mealtimes.

    More background: bio-identical estrogen patches and progesterone oil were added recently. A factor?

    Just before the hormones, I had a positive breath test for SIBO. Two antibiotics were recommended by my naturopath, as per the Cedars-Sinai protocol, but I resisted, reading that although this treatment protocol can temporarily control SIBO, the bacteria then rebounds a few months later. I had a colonoscopy/endoscopy. Colon was fine. My esophagus seemed un-damaged, thankfully, but there was gastritis/inflammation of my duodenum and one part of my stomach, as well as an adenomous polyp. They tested my stomach acid and said I had a good, normal amount, but that ‘it was apparently too much for me’ based on the inflammation…The GI doc suggested 4 to 6 weeks of taking pepsid, which he said would reduce acid but not suppress it and harm digestion (?) (to let the inflammation heal, I guess?). His dietician recommended the low FODMAPS diet, but the doc said not to do both at once, to try the drug first, to see what was working.

    I am resisting the pepsid so far. I have taken some of the general principles of all that I have read (Paleo, FODMAPS, Weston A Price, etc) and applied them, without going crazy. I think even the way I took my supps for years (minerals/D3 in the evening before bedtime) may have been an irritating factor. I have kept my cup of coffee in the morning with organic cream and palm (coconut) sugar but have eliminated all other sweets and most grains, with the exception of a gluten free burger bun now and then, or a wee bit of maple syrup.) I’ve added plantains cooked in coconut oil to my eggs in the morning, and they feel good…sometimes with naturally raised bacon. But I am trying to eat less at each meal, and eat earlier in the evening, with no food after 7 if I can manage it.

    Do you think a temporary course of Pepsid for a couple of weeks would be a good thing, and allow the gastritis to heal, or that it’s kind of off track, which I suspect?

    I think I’m making progress, judging by my reduced level of pain and other symptoms. Perhaps ‘cleaning out’ for the colonoscopy and endoscopy was a good thing (I used coconut water instead of gatoraid, approved by the doc, with the laxative). The size of the meal seems to make a big difference, and the timing. But will the gastritis heal on its own? I am having some bone broth soups, taking DGL (though it has dextrose, is that ok?) and taking Standard Process Labs Zypan, which has digestive enzymes and some HCl (but it doesn’t say how much) in it, one tab with meals. I also got a B12 shot and felt like a rock star after, so perhaps I need regular shots and/or sublinguals. I’ve had only small bits of yogurt, and some small amounts of Kevita probiotic drinks, which don’t have acidophilus in them, but several other cultures, and are stevia sweetened. I raised the head of my bed a bit. I noticed that in 5 days of staying at my parents’ elder care place, I had next to no symptoms: we ate dinner at 5:15 pm every night, no evening snacks. The one evening when I deviated for a party, symptoms flared. Also once when I forgot and bent over to pick up a heavy box, after lunch!

    That reminds me, doing dishes and stacking a dishwasher right after a meal can be deadly too. I have to wait a while. I used to have back spasms when washing pots, etc in the sink, and now realize those were referred digestive pains.

    I would love to get feedback about any of this, and particularly whether you think the SIBO, GERD, and gastritis in the stomach/duodenum can heal and re-balance themselves without drugs or other aggressive treatment. I do have some slippery elm and licorice powder, along with Glutagenics (DGL, aloe and l-glutamine) powder, and the DGL tabs with dextrose.

    I believe I have lost a few pounds and that’s helping too. The bloating is definitely decreasing.

    I should mention that for years I have had regular chiropractic care, and visceral manipulation, for my doc found that my pyloric valve and other sphincters/valves tended to go into spasm. (why, I am not sure). He recommended drinking warm water 15-20 minutes before each meal, which I sometimes remember to! And he prescribed the Zypan.

    I am wondering about how thyroid and other hormones relate to all of this as well. (I know, so many questions…) It seems that many post-menopausal women are getting this, but it may have more to do with other age-related factors– weight, lower stomach acid, etc, than with drop in hormone levels. (?)

    I am also hoping that one or another details in this epistle might help someone else have an aha! experience about some factor that might trigger them.

    • Carey says

      PS I forgot to mention that I tested negative for h. pylori both in lab tests and in the endoscopy. And that I used to keep baking soda by my bed and need to use some in the middle of the night with water, but am doing this way less now. Isn’t baking soda pretty much the same as taking Rolaids or Pepsid, though?

  19. Laurentiu says

    Hi,

    I don’t see anything mentioned about working out. I’ve noticed that when strength exercising, my acid reflux is activated. I tried finding specific exercises for GERD sufferers, but all i found was: biking, walking, yoga, pilates. This is not enough in my opinion and i really like to keep my body in great shape. Anyone who could provide a specific fitness program? thanks!

    Laurentiu

  20. michael s. says

    Another approach, which has worked for me, is to strengthen the sphincter. I find that swimming breast-stroke does this. Or, if you can’t swim, to mimic the breast-stroke movements in an exercise routine. I noticed that in the summer, when I swim regularly, I didn’t get heartburn. So in the winter, when I don’t swim, I did the exercises, and the result was the same.

  21. jay says

    hi Chris , i have bad psoriasis since childhood untreatable but by diet and was wondering do you have any protocol that you know works for clearing for this condition?? kinda desperate for more keys ..
    and ….. paleo itself can be very helpful but things like kefir/ ferments have any people cleared being able to eat those that you know of?

  22. Andre says

    Hi,

    Thanks for the informative article. I’m going to test the theory that the cause of my chronic daily GERD is low stomach acid. If this really does turn out to be the case, it will be a real revelation for me, as I’ve been battling this now for going on 8 years and I’m SICK TO DEATH OF BEING SICK!!!

    I’ve already started on a low card diet and I’ve been having some natural yoghurt with lots of probiotics but before I take the plunge and buy some HCL and Pepsin supplements, I would appreciate some advice on what to do about the Nexium I am currently on. I’m on 40mg daily and from what I read in this article, Nexium does the exact opposite of what the HCL will do, so the two would seem to be mutually exclusive approaches. However, I’m a bit concerned about what might happen if I just stop taking the Nexium cold turkey. Has anyone else faced the same issue before or know someone who has? If so, what did you (or they) do about it and how did you/they approach the change in treatments?

    Thanks!

    • Tania says

      hi, I’m not a doctor, but I have read various scientific reports that advise decreasing your medication dose slowly. I stopped cold turkey and experienced a terrible surge of increased acid for several weeks. When I tried 1 tab of HCL it burned my stomach. (Now it’s fine). The well known experiment with healthy individuals who were given PPI’s and then when they stopped, suddenly developed GERD for several weeks, proves that stopping the medication suddenly increases acid production for a short while. Therefore, some medical experts advise taking HCL supplements only after a few weeks of stopping, and doing it gradually, i.e. start with 1 HCL tablet and build up. The last thing you want to do is introduce acid onto a very acidic environment, caused by the body’s reaction to stopping meds. Hope this helps. It’s the only info missing from Chris’s informative site. I did a lot of research when I experienced problems after stopping my PPI.

  23. Avi says

    Hi Chris,

    I am not the kinds to read about medical problems online since going to Doctor in India is not expensive. I have chronic acidity and resultant coughing problems since I remember. I am 30 years old and I remember it is more than 15 years that I have had the same problem. Every time I visited a doctor, he would suggest me to cough syrup for my coughing and antacids for my acidity. That is not helping me. I am a vegetarian, Can you please suggest me some steps that I can take to reduce my worries. I am really troubled with my condition now.

    Thanks
    Avi

  24. says

    Would your diets & or suggestions work for dogs also. I raw feed my dachshunds & do at times have some upset bellies & gas. Stomach acid is extremely important for the digestive tract of dogs. Thank you.

  25. Simone says

    I have only taken Nexium http://onlinepharmacyreviews.org/drugs/nexium for 10 days and it was after the 5th day is when I started having severe diarrhea—-so weaned myself off that nasty med at once–then Dr. said try generic for Prilosec did that and within 6 days the same thing happened, personally I am having more problems since I have been taking this awful stuff and will be off as of today—- what is wrong with today’s medical profession, they hate to admit that some of the old fashion remedies are much better the high priced MEDS, well we know the answer to that, everyone gets a kick back, especially the pharmaceutical companies.

    I will never again take this type of medication and that goes for Cholesterol Medication, these meds ruin your daily living and life —-I will not let drugs take over my life and slowly take away my life—-Pills and more pills that;s all they know– I realize that there are people that need certain medications, however, I would make sure I need them before I put them in my body. ASK TONS OF QUESTIONS —-very important to your well being. When a Doctor wants to put me on a medication, first I ask why and second what is it going to do to help my issue and third I make a decision to say yes or no—have refused many meds and that is how I think we need to attack this stuff to get Dr’s to stop thinking everything is cured with a pill of some color or size.

    I wish we could get advertising of Medications off TV forever, its a bad thing–and its to sell these awful drugs. We need to start a crusade against advertising Medications of all kinds on TV–it should be banned like cigarettes and alcohol.

    Thanks for listening

    Does anyone out there have any idea where I can get some “good” information on Celiac Disease?

  26. Mswardy says

    I have started to suffered the signs and symptoms of the gerd since 2012 and it become worst last year 2013 until now.i feel something on my neck wich is very uncomfortable and it makes me suffered a lot,like the feeling of someone holding my neck very tight.when I eat or even just drinking of a small amount of water it just like the water stay on my throat and I burp.i am very afraid that it become worse and a serious health problem later on.any0one can help me here please?

  27. Kate Dixson says

    My last tsh was2.15, f4 8, f3 2.0, t3 72, thy anti <1, thyroglobulin <0.1, dhea 26, acth 38, after being in the ER twice for hyperthroid. All meds were stop for 4 to 5 days. After restarting on synthroid 125, still having some hot flashes fatigue in the middle of the day. It was a drug induced hyperthroidism of 125 of synthroid and 25mcg of cytomel and 60 of amrour stopped and started within a wk. Site very helpful.

  28. Peta says

    I have for two years suffered a rattling wheeze in my right lung and sore throat, lump in my throat, all right side. I was prescribed Omeprezole, and stayed on it a week. I hated it as it caused stomach cramping and flatulence. I also did not accept I had a stomach acid issue as I had never experienced any heartburn or sensation of acid. Although two times I woke in the night choking on what I think was acid, I still didnt accept it was an accurate diagnosis. The lump in my throat became worse and debilitating.

    I tested clear for H-pylori (when they thought I had ulcer). My gasteroscopy came back clear, no hernia no evidence of GERD. The Barium swallow told the ENT surgeon I had a contracted tight muscle in my throat, even at rest this muscle (forgot it’s name) is cramped and this is why I need a glass of water to washed food down with and can sometimes cough food up after a meal. He said, that one side of my larynx looked a ‘little’ red, and that most likely irritation from acid is what has caused the muscle to become cramped and also called in ‘Globus’. This he said, in his experience will settle down and go away on it’s own and then prescribed me Rantidine.

    I Ranitidine for 2 days and threw them away. They gave me a smacking headache. It’s official, drugs and me don’t like each other.

    So online to research a natural way out of this mess. I have to get my throat (and now ear) pain under control and get that muscle to relax. And if there is acid reflux going on it needs to be stopped and tummy healed.

    My lung is soooo much better. But it is a matter of time before I breathe a lung full of acid again.

    I am off to the chiropractor who understands muscles to see what i can do to get that lump in my throat to relax. I have booked to see a Naturopath to discuss ideas and I am prepared to undergo any form/style of eating to regain my life and if this needs to be life long.. so be it.

    My questions:
    If the goal is to increase/improve acid production, why then are lemon in water, and applecider vinegar recommended when these supposedly are alkalizing in the body?

    I was looking at the foods that become alkalizing in the body (endless websites that define things like coffee, sugar, red meat etc as acid forming) So.. am I understanding correctly it is not that some food are or are not acid forming.. it is whether or not they are a carbohydrate or protein that is the deal?

    I have been a week of:
    No alcohol
    No coffee/tea/milo
    No wheat or gluten
    No processed sugars (no junk food, baking goods, sauces, or hidden processed sugar)
    No commercially processed foods of any kind
    No dairy, at all – (no chocolate)

    Just to try and do something until I can get my head around all this information, and see the Naturopath and Chiropractor.

    Would the Atkins Diet be useful?
    Is low carb enough..? or is the ideal as close as possible to no carb?

    I thought straight vegetable green juicing might help heal the gut.. but I guess there would be way too much fibre and carbs in this?

    I like bone broth, I am brewing Kefir water as I type this and about to learn how to make home made sauerkraut.

    There is so much to think about and understand.

  29. mugwump says

    I saw a gastroenterologist this past spring for the specific purpose of getting tested to find out what my level of stomach acid was. The doctor told me (1) that the Heidelberg test is no longer available and (2) that there is no other test that will reveal how much acid my stomach is producing. I’m just sayin’ ….

  30. salina says

    I am so very glad I found this site. I’m so overwhelmed trying to take in everything I’m reading here but my head is spinning.
    My husband (37) has been suffering with Gerd and Acid Reflux for several years; His Dr had him on Dexilant at one point but his insurance wouldn’t cover it and it’s just to expensive so I have been switching out between Prevacid, Nexium & Prilosec out of fear his body might get use to one and not work. He suffers so bad with the harsh belching, burning, choking and nightly wakes ups running to the bathroom to throw up. I just went yesterday and got him a good brand of Enzyme and he started it last night, he took one just before dinner. Of course I don’t expect that it will heal him instantly but yea his symptoms woke him up out of his sleep. He took one again before breakfast this morning and called me and said it’s not working. Poor guy. He did say it eased slightly after a while but he was still belching. He also has what always looks like a full tummy. Not sure if that makes sense but the reason I wonder if it’s related is because my husband is a bit of a buff guy and I have had him eating very well on mainly meats and veggies for about 2 months and it almost seems to be growing? He also suffers from high blood pressure and migraines. We have decided to try a more holistic approach with wheat grass, fish oil, B2 & magnesium. Please help

  31. Dena Freeman says

    I was on Protonix for about 9 years, and just stopped taking it about a week ago. Before stopping, I started a melatonin supplement for about a week and have continued with that. I follow a Paleo diet. I am having heartburn now again, pretty much all day long, and wondering what to do. I’d like to try a very low carbohydrate diet but cannot find instructions on how to do this. I looked at the SCD diet page but it is very confusing. Is there another resource to help me follow a VLC diet?

  32. Gretchen says

    Hello Chris! This series of articles was fascinating! I do not suffer from GERD or heartburn, so I had never looked into any of this. I am a longtime sufferer of IBS and during a recent endoscopy looking for signs of celiac my doctor discovered that my stomach lining is all badly inflamed and my pyloric valve does not close. She then prescribed Prilosec 20mg to relieve the inflammation. I took my first dose today and BOOM, now I know what heartburn feels like. I’m scared to do the whole 2 weeks of PPI’s my doctor is asking for, and I can’t take HCL with my gastritis. I am waiting to see if my biopsy results indicate celiac or H. pylori. I am fairly tired of the whole business.

  33. Maria10 says

    I find the suggestion of HCL very promising. However, medical literature claims that stopping PPI’s, which cut stomach acid, leads to an initial rebound of high acid for a few weeks, should those of us coming off PPI’s take HCL right away? I ask because I’ve been trying HCL for the past few weeks immediately after coming off 4 weeks of PPI’s, and all my problems seem to be much so worse than ever before. I’m also taking digestive enzymes and DGL capsules. Now I can’t eat anything, not even fruit or salad, without feeling ill. I’ve had esophagitis and acid reflux for 6 weeks, previously managed the past 2 years by going Paleo. I can no longer sleep due to reflux, nothing seems to be working. My UK doctor just prescribed more PPI’s and Domperidone, which is banned in the USA for causing cardiac arrest.

  34. haila says

    can someone help me?i had undergone endoscopy and barrium swallow and its all normal,i am also negative in h pylori.only my gastro said that my stomach produces too much acid,i am experiencing a pain on my throat because of acid that makes my throat and mouth dry which result to bad breath but no heartburn or anything.i have tried ppi but not didnt work…i consulted and diagnosed my different gastro doctors but they were saying different opinions.i followed each but still didnt work…whats the best thing to do?i dont know any type of diet..?

  35. Bryant D says

    Can there be a correlation between low calcium and heartburn or duodenum inflammation? I had my calcium tested six months ago and it was above normal along with low vitamin d. I recently had it tested again and my vitamin d was normal and my calcium was on the low side. Taking calcium citrate seems to ease the duodenum discomfort that I have.

  36. says

    Hi Chris,
    I’m a naturopath in Australia and regularly read your blogs (they’re fantastic!).
    Do you have a tried and trusted protocol for weaning off PPI’s for your GERD patients?
    I have tricky patient with severe gastritis/reflux/GERD, (H-pylori negative), who wants to come off Nexium, but is still having trouble with her diet. She’s on a dairy-free, gluten-free diet and getting approx 60% relief from Slippery Elm, Glutamine, Zinc (PepsinGI), DGL, Curcumin, Gentian, Fennel.
    I want to get her off Nexium, but when she reduces her dose it gets worse…..would you use HCL and slowly increase?
    No lower GI symptoms
    I’m thinking she may need a Fodmaps diet.
    Appreciate any clinical gems or food for thought, you or your colleagues may have.

    • Maria10 says

      In anser to your question I found this on a UK consultants page http://www.gastrolondon.co.uk/

      In 2009 a report in the prestigious journal, Gastroenterology suggested that PPIs may cause a degree of dependence by increasing symptoms of indigestion if they are discontinued. (6)

      In 2010, the American Journal of Gastroenterology reported on healthy volunteers who were given pantoprazole or a dummy pill (placebo) for 4 weeks and then followed for another 6 weeks. One week after they stopped treatment, 44% of the people who had taken pantoprazole reported symptoms of dyspepsia, compared to 9% of the placebo recipients. By the third week, the difference had disappeared. (7)

      This suggests that there is rebound excess acid production when the medicines are stopped. It is thought that more of the hormone gastrin is secreted PPIs are stopped and this leads to worsening acid symptoms for a week or two after stopping these drugs.

      A case can therefore be made for decreasing the dose of these medicines slowly rather than suddenly discontinuing them. This might be a way to minimize omeprazole side effects and side effects from other proton pump inhibitors.

  37. Elizabeth Brown says

    I have GERD, mild IBS, and psoriasis. For 5 or 6 years my psoriasis and Psoriatic arthritis was treated with sulfasalazine and Enbrel. I stopped the Enbrel because I had diverticulitis, but have continued to take sulfasalazine. I am going on the diet to improve my gut health and am worried about the sulfasalazine if I take HCL and pepsin to improve good digestion.

  38. Gillian Nathan says

    I have trouble digesting most fats (nuts, coconut oil, all dairy, eggs, red meat, etc) . Have tried HCl, Beta-TCP, digestive enzymes. Anyone have tips that helped them with fat digestion? Thanks!

  39. Chris says

    Chris, I really appreciate you posting this article and having recovered from GERD using your methodology, I firmly believe that your theory is proven. I’m now 30 years old healthy, but a year ago i suffered from severe heartburn. I thought the only cure was ppi’s, but the side effects of these drugs and my overall health declined. I drew a line in the sand and started tapering off the drug while simultaneously going on a LC diet, fermenting/drinking homade kefir, taking DGL licorice, and using Apple Cidar Vinegar as and HCL w/ Pepsin subtitute. It worked! About 2 months later I was completely off the ppi’s, lost weight (unintentional side effect…i was never really overweight), and felt great! It’s been about a year and I’m still completely off the ppi’s. I occasionally take a vitamin acid reducer (Acid Block by RX) when I eat heavy carbs, but I feel great! Thank you Chris!

  40. Gillian Nathan says

    1- Is there a certain dose I should stop at for the Hcl if i never get to the burning sensation? I have taken up to 10 Pure Encapsulations 520 mg pills. Took it with every meal for a year or two, then on and off since then b/c can’t tell how much difference it makes and never had burning, though i continue to have major GI issues (gas/bloating, extreme food sensitivites, etc).
    2- I have SIBO that has been resistant to all treatment for several years. I was told not to take pre-biotics like Prescript Assist b/c the inulin feeds the SIBO, but you are recommending the soil-based ones. Can you help me make sense of this?
    3- A naturopath and a nutritionist advised me not to take HCl and digestive enzymes within about 15 minutes of e/o b/c the Hcl would eat up the enzyme, but some HCl is sold in a pill with digestive enzymes. What do you adivse?

    Thank you!

  41. Arletta says

    Hello. You said something about bone broth providing gelatin. I can’t remember exactly what you said, and I haven’t the energy to go find it now, so, sorry for not quoting. What I am wondering is if eating gelatin would help to heal the stomach? I know most gelatin has sugar or artificial sweeteners, but, I also know we used to buy unflavored gelatin, when I was a kid.

    No idea if I could still find it, but, if I could, would it be helpful? Because, I generally do not have the bones or the energy to make bone broth.

  42. heather says

    Please need some help, been having throat issues for quite sometime stated in 2009 , after some treatment with nexium and valium to relax it went , around 2012, and since then, went back on nexium take it on and off or as needed, then I still had theis lump in throat feeling and my nose was really congested, saw ENT said I have post nasal drip, and did some allerg test Dust mites reading for the blood allery test was 1665, so gave me some sloan corizone tablets for three months during spring and the congestion and sinus issues cleared, but stil had the slight lump in throat feeling did a gastroscopy came clear, continued nexium when needed. , In the last few months the lump in throat feeling is back, irritated cough that just comes on dry and then turns mucas, I also have asthma, It is driving me insane, but everytime I take nexium I have noted that there is lot of pressure in chest area after a couple of hours, which after quite a while will release and feels like I never had an issue in the chest or throat area,I also have been under a lot of stress I had a headache on eye brows as my nose got congested bad and everytime I tried tofall asleep I would jump up like in a fright went on for two days, so went and saw the doctor some antibiotics on the 17th of June 2014, two tablets adout 12 tablets. Then I started getting this bitter taste in mouth, maybe the tablets were causing it, have taken these tablets before but never had this taste in the mouth feeling. I also started taking the nexium, my throat was so heavy, I would all of a sudden cough dry and ten the feeling that I was going to throw out and it is continuing, I am drinking lemon in water as some say that is good, taking gaviscon dual action, just want to know when you ttake gaviscon tablet if you fel like a cooling sensation from throat to stomach which last for some time, please I need some help, I think it is LPR as it is more in the throat and occassionally I get a burning sensation in stomach which is rare, but also have pain in chest and back sometime but the lump in throat is there most of the time. and before the cough starts I feel like there is some kind of gas that comesand makes me cough and that is wehn I feel like throwing up. What can I do and who should I ask my doctor to give me a referral to check me out for LPR,
    Last few weeks had lump in throat feeling, getting worse, symptoms lump in throat , cough that just comes on dry and then with mucas, and now want to vomit when I cough what should I eat to help my stomach to heal, any information will be appreciated.
    My son too complains of lump in throat and he is 21, his gastroscopy was normal, my daughter 23 had gastroscopy as she had bad bloating cramps in between naval and lower chest area, she burps a lot, said mild gastritis from endoscopy, but she also noted that she cant have dairy since it started in 2012, even though the biopsies test for coeliac disease and h pylori came clear, she also has patchy liver calcificatin that was noted after taking oral barium for abdominal nothing on CT , In 2010 even though previous US scan showed nothing in , MRI in 2012showed nothing too. Just want to know if this is the cause for her bloatines,s gas, cramps Dr think it is IBS, I just want to know if I make a chicken broth with rice will that help to heal my stomach and any remedies please help, God Bless you all
    H_G

  43. Bria says

    I cannot thank you enough for these articles. This has completely changed my life!

    I am a 33 year old female and I have been taking proton pump inhibitors (Nexium, Prilosec, and most recently Prevacid) for almost 7 years! I read your articles two weeks ago out of desperation. I ran out of Prevacid and decided to “tough it out” to see if I could make it through the weekend without taking them. By the end of day one, I was miserable, Acid gurgling in my throat, pain my chest, and such horrible indigestion that I could barely keep down my food. I decided I had to do something to cure the reflux and a quick Google search brought me here.

    I purchased the HCL Pepsin pills at my local vitamin store, and bought the probiotics online. I began taking 2 HCL Pepsin pills before each meal and have worked my way up to 3 with each meal currently. I take 2 of the Prescript Assist probiotics per day, one in the morning and one in the evening.

    Within a day, my heartburn was significantly improved. Two weeks later, and it is 99% GONE!! I am giddy with excitement. I never, ever, ever thought I would stop taking my PPIs. Each time I tried in the past, the reflux came back with a vengeance, even stronger than before.

    I can’t believe my doctors never tried to get to the root of my reflux. I had an upper GI scope, I tried diet modifications, I lost weight, and the reflux was always there (albeit worse at times). I was constantly tired and had no energy, bruised easily, anxious, and constantly nauseated. Now I suspect it was because of my long-term PPI use and lack of stomach acid causing improper nutrient absorption. Time will tell whether all of those symptoms will resolve, but I can already tell you I have more energy and most importantly, NO heartburn.

    Thank you so much for taking the time to shed light on this issue, Dr. Kressler. You have changed my life and I cannot thank you enough for caring to do what other doctors will not. THANK YOU.

    • Sandra says

      Thanks for the comment Bria, I’m similar age to you 32 and have had the same symptoms for six years. Will definitely try the HCL with pepsin. I hope you are still not having any symptoms and are 100% cured.

  44. Daniel Hamilton says

    Is there any links you can provide that will provide a healthy diet that will help us whom have GERD or acid reflux. -Thanks

  45. Tina says

    Thought I have too much acid and that I have to take PPIs to lower the acid forever. After reading these articles, I still think I have too much acid in my stomach bc when I am hungry, my stomach burning, crowing and hurt. Have to eat right away before it damage to my intestinal lining. Regardless, I followed Dr. Kresser suggestion. Below are steps I took.

    1. Killed bad bacteria. Not sure how it survives if I have too much acid… I had antibiotics to kill them quicker with Amoxicilin + Clarithromycin for 10 days, aiming to kill H Pylori (even though Dr wasn’t sure I having it or not; I asked for it). Stomach at the time was very sensitive. This condition is before I found this article. Don’t know what to eat/do to restore the gut beside hopping from PPI to PPI.

    2. Stopped eat these food except rice. I eat bread/rice/bananas every day and eat/drink sweet stuffs thru out the day. Ice cream at night sometime, popcorn or banana before dinner. VLC is hard though.

    3. Took Glutamine, Fish Oil, and drink Probiotics/Kefir. Still take PPIs 20mg when I am hungry and feeling the burning. Just once per day at 5:00 PM, then every other day, then two days.

    In 8 days, my stomach calmed down. I’m at the end of 2nd week, feel the burning sensation is less. The pain at middle of the chest also reduces. Still burping and having gas though…and bad breath I guess. I also ordered DGL/Licorice, Valerian Root, and Mastic Gum. But not HCL. Will research on bile acid or any digestive enzyme. And of course, I also take multi-vitamins.

    Many thanks to Dr. Kresser! We cannot live without you. And thank you everyone for sharing your stories.

    • PJ (RightNOW) says

      Just a note about Valerian root. Not for nothing is it called nature’s valium. 2-3 of those capsules knocks me on my ass and I’m asleep. Does most people — but not all. Don’t take that before driving.

  46. Ms. Hall says

    Hello, I had gerds over a year ago and I did natural stuff after all of the Drs.appts, ENt, Gasto, etc and all of the tests that fo with it. OTC did not help either. It went away and I did not have it for about a year until now. I never have the heartburn, only the constant clearing of the throat and the cough. I lost weigh, no carbs, no sodas, nothing. i am too scared to eat anything. I did everything on this list for the last month and nothing, not even a slight change.People at work are tired of hearing me all day and it is excessive. I took the H2’s with and without the PPI’S, galvas, zantac, the one that says tegrid or something, acv, apples, lemon water. HCL w pepsin, what do I do now..

  47. Brit says

    Hi, I am 43, have had GERD for approximately 17 years, on PPI’s, ranging from Prevacid to Dexilant and stumbled across this website. I have always know I could clean up my diet, quit coffee and sugar, but I am going to try this approach because on my last EGD I did have gastric polyps, benign. But the really worrisome thing is that I had ACL reconstruction w hamstring tendon graft and a meniscus repair 10 months ago, and am really struggling with pain and getting back to my normal high level exercising/athletics, ie :biking, hiking, skiing in the winter. I wonder if there is a correlation to PPI’s and bone healing, after major surgery. It’s not an easy knee surgery to rehab by any means but before my surgery I was skiing 50K Nordic races for fun, now I can only manage 2 hr hikes…..I am otherwise a very healthy female and just wondering if anyone has any experience with anything like this. I am seriously wondering if PPI’s have anything to do with my slow bone healing? I have heard PPI’s can cause osteoporosis, anyone have direct experience or information? thanks

    • louis says

      hi brit,

      i am 58 and been on ppi’s for 16 years and gerd issues for 25.I played competitive racket sports until i was about 46 years old then problems with knees kept me out of competition.I continued playing for fun but then plantar fasciatis started and then never seemed to go away (compared to other people who say it goes away after a while) and now i have it even after long walks.The last couple of years i have improved my diet a lot but cannot get off ppi’s (actually now i am resisting double dose because i have absorption issues).All this to say that i would not be surprised that your comment would be right about healing your knee. The disease grows but the pills only attenuate the symptoms but create others (i.e probably save the esophagus but ruin digestive system).2 hour walks are still pretty good!

  48. Caroline says

    Hi Chris,
    I realize you don’t have time to read and certainly not answer all comments. I was however hoping you (or someone else) might be able to shed some light on an issue I cannot seem to find an answer to, namely what constitutes ‘use’ of ibuprofen in relation to taking HCL supplements. I’ve finally managed to get hold of some HCL + Pepsin (the NOW supplements recommended by Steve Wright) but I use ibuprofen once a month – for my period. This month I tried and was actually successful in using mostly paracetamol, but still had to take some ibuprofen. Is that already too much? Is there a ‘safe’ period to wait in between taking the two drugs? Or is it only unsafe to take the two actively at the same time, ie same day?
    (I have also developed dyspepsia/GERD since going low carb/high fat and later paleo. I had a gastroscopy when I first got the symptoms and despite excrutiating pain I had no sign of ulcers so I don’t think I am high-risk, but I have been taking a lot of ibuprofen in my life due to very painful periods. I also have autoimmune astrophic gastritis and Hashimoto’s.)
    Thank you

  49. R Young says

    Why do the PPIs not work if gerd is due to low acidity? The rebound effect increases acidity so I understand, so surely PPIs would atleast make things better after a short course? The people who take them for ages and then stop with a massive rebound should be digesting all their food well and destroying the bacteria, rather than suffering as they do. Anyone’s thoughts on this? Chris? I’m currently on the low carbs and having iberogast, some herbal thing, and doing pretty well. Avoided the Betaine for now due to recent GI bleeding from a course of ibuprofen, shouldn’t trust these Doctors!

    Ryan Young

  50. Rose Patch says

    I did learn some interesting information from reading your article will be checking into them. Thank you

  51. James says

    Hey Chris,

    So I have DGL chewables, Betaine HCL w/ pepsin and gentian bitters, PreScript Assist Probiotics, and mastic gum supplements.
    I was hoping you could advise on the order in which I should take them. For instance, before each meal, say 20-30 minutes, should I chew a couple of the DGL tablets, then immediately following the start of the meal, should I begin introduction of the HCL supplements? Additionally, I was wondering if I should take the probiotic supplement between meals throughout the day (the recommendation on the bottle says 1 – 2 per day with water, there is no mention of food). Finally, the mastic gum supplements recommend 2 each morning with water or juice directly before breakfast, without any additional use for the rest of the day.
    Does any/ all/ none of that sound appropriate? I read your articles which were truly enlightening, and I picked up the supplements you recommended, based off my minor suffering related to heartburn while sleeping (I wake up with a slightly hoarse voice almost every morning, and I decided to follow your regimen to see if perhaps that would cure what is ailing me), so I was hoping you could offer insight into what I have planned.

    Thanks,

    James

    • Carey says

      I am on the journey and not “there” yet but much improved. Just sharing some ‘anecdotal’ factors that make a huge difference for me, and perhaps might for you if night is the worst?? Eating an early dinner, not too huge, in a relaxed way, chewing slowly, and allowing at least 4 hours between dinner and bedtime helps me. They say 3, but for me it has to be 4! Some suggest raising the head of your bed by a few inches. And I’ve discovered that any supps I take with a meal, including enzymes, must be taken early in the meal– if I forget and take them after, the supps themselves can trigger spasm and discomfort for me. I think little sips of water and the food help the supps go down! So much to remember and consider…. good luck and I hope someone more professional answers you.

  52. Ms. Hall says

    Hello,
    I had gerds over a year ago. I did the usual and went to all the drs, took the meds, ppi’s etc, had the tests from every dr- too many to name but the usual from what yo see on every website from people asking for help. I threw everything out and tried natural stuff like acv with its mother, increased my natural antihistamines because my allergies were out of control and changed my diet- no exercise really or weight loss but then it stopped.I drank the throat coat tea and sinus tea but and boiled thyme spice on a regular. That was last Feb 2013.And now worse than ever April 2014. I followed and did everything you stated and nothing. Still worse.. Please help. I have even lost a lot of weight, took out carbs, sugar, and lost maybe 12 lbs cause I am trying to gut clean from what I have read and still nothing..now I am reading HL with pepsin you are not supposed to take for gerds and it makes my urine smell funny..So what now..oh yes I bought it all..

  53. Michael says

    I went into my family doctor after a year of OTC omeprazole just wasn’t cutting it anymore. He put me on 40mg Protonix, and he scheduled me for an EGD. I was on the Protonix for about 3 weeks before that outpatient procedure, and that happened May 2nd. I was diagnosed with Barrett’s Esophagus & a hiatal hernia. They took a biopsy and it came back good. However, that following week I ended up with the flu, and I started than having a reaction to the Protonix. I felt nauseous, vomiting, the feeling like food just wasn’t digesting so I stopped taking it on May 13th cold turkey, and went to the Doctor the 14th, and she put me on Omeprazole again ta 40mg but took a 20mg instead and still ended up with having that same reaction as I did to Protonix just not as bad. I stopped taking that on the 16th, and I was leaving for vacation on Monday the 19th, and I refused to feel like this at my bestfriends wedding that I was standing in. I felt great the whole week, and then came home felt good until may 27th and then I started feeling that nauseous feeling again, and have been like that now for the last few days.

    I called my family doctor, and she told me to call the gastro doctor who did my scope to see what he thinks the next step is. I am still waiting to hear back but I am to the point where I have done so much research that I am very nervous of taking anymore drugs. I will not take any PPI’s considering how I reacted to them, and then reading about the side effects of things such as Zantac have got me concerned if they decide to take that approach.

    Where do I even begin to figure this out? I am 26, and extremely healthy and exercise 5-6 times a week. Frustration has set in, and it’s like I did not have any issues except for heart burn/acid reflux before this EGD, now it seems like nothing but issues. It seems a lot of these doctors just immediately will write you a script for a drug that doesn’t solve the root issue just covers it up.

    Any ideas because it seems like everyone hear has the same issue or very similar.

    Thank you.

  54. Barbara D says

    I have read the eBook on Heartburn/GERD. It all makes sense to me and I’ve read similar information over the years. My problem is that I have a hiatal hernia which causes the GERD and I never see information re: hiatal hernias. Chris, do you have any insights re: hiatal hernias?

  55. Michele says

    I went on the Paleo Diet three months ago to control my GERD, which I’ve had for 10 years. The diet has done wonders in reducing my acid reflux. Here’s the problem:
    I’m 5’3″ and was 113 lbs. when I started the diet. I’ve lost five pounds. I want to put the weight back on and instead I keep losing weight. How do I maintain my original weight. Please don’t tell me just to eat more of the same. It’s not working. What else can I do? If I eat full-fat dairy products (as a dietician told me to do), will it increase my bad cholesterol?

    • Annie says

      Eat healthy fats like avocado, nut butters, coconut oils and olive oils. Do some strength training. Muscle weighs more than fat and who can deny that we all need more muscle. Good luck on your journey.

  56. Victoria says

    I am a breastfeeding mother and my child (2 months) has GERD. Is there anything I can do to help – in terms of what I eat etc.? Do you have any recommendations for me? Thanks.

    • Annie says

      I would first get some alkaline/acid strips and test to see where your levels are at first thing in the morning, then adjust your diet to bring your ph level to neutral. Look on the web for what foods will do that. You can buy the test strips at most natural/organic markets. Cut out sugar, caffeine, nuts, soy, dairy, wheat and eggs for 7 days and see if that helps your baby. That means you need to eat veggies, fruits, rice and organic meat and fish. Then introduce one food back in to see if that bothers your babies tummy. If not then you can bring that food back in. Wait another week, reintroduce one more food back in and repeat. It may take awhile but it’s cheaper than a blood test. Don’t worry, your baby will still be getting the nutrients from the better food that you will be eating.

  57. Dominic says

    Hi Chris,

    thanks for those well written article. Its funny cause I always thought my problem was to low acid. When I went to see my doctor, I was feeling a pressure in my upper chest, he automatically assumed it was GERD and put me onto PPI.

    As soon as I started those pills, I started to feel some other symptoms I never had before: Bitter taste in my mouth, liquid reflux in my throat, asthma, stomach pain etc…

    So I went back to my doctor to tell him his pills were not working, so what did he say?: ”Probably not strong enough, double the dosage”.

    So I did, and my symptoms only got stronger. So I know there’s something wrong for me with these pills. A gastro told me that it probably was an allergic reaction to Nexium and prescribed me another brand, but I never got onto the new brand as I doubt it was an allergic reaction.

    So now, your article make a lot of sense to me. I’ll make my own research to validate those sayings but I think I’ll give it a try.

    Where do you find HCL and pepsin supplement exactly? Do you need a prescription?

    thanks,

    Dom

  58. Lindsey says

    I’ve been blood tested for H.Pylori and the results came back negative. I have chronic, and painful GERD though. Does this information apply to me if I for sure do not have H.Pylori?

    I’ve always been a bit sensitive to “acid trigger” foods, but the lasting pain and burning in my throat started when I was 20 when I was first diagnosed with GERD and began my long relationship with Omeprazole. I’m 27 now and I had my first round of acute gastritis a couple of months ago with nausea, bloating and extreme fatigue for weeks. I was put on 40mg of omeprazole, and while the extreme part has subsided, I’m still experiencing pain and am EXTREMELY sensitive to all acid triggers.

    I was also diagnosed with generalized anxiety disorder (with occasional panic attacks). I know for sure that when I become very anxious, my GERD gets worse. Is it possible that my GERD is only being caused by anxiety since there’s no h.pylori?

    Any help??

  59. says

    Hi Chris, I’m doing an assignment on the incidence of GERD during pregnancy and I was curious about your thoughts on the cause. Is it still due to low stomach acid and if so why would that occur during pregnancy? Or is it due to the increased pressure on the stomach?

    Thanks!

  60. Shea says

    Hello Chris and everyone,

    I’m ready to take the leap of faith and stop taking Prilosec and Zantac. Currently, I take both twice a day for a total of 4 pills a day and have been doing so for about a month. I have GERD a possible ulcer, and had/might still have H. Pylori.

    For about 5 years on and off (not frequently) I’ve had burning underneath my rib cage when I walk. The past year or so I developed GERD. I had/have an eating disorder not otherwise specified (EDNOS), and I am suspicious of this having been the cause of my troubles.

    Anyway, I’m 34 years old and am tired of not feeling well. I am scheduled to see a GI specialist, but I’ve had an ultrasound, chest x-ray (because I thought I was having a heart attack), and an EKG. Thankfully the test results came back fine! I hope to get an endoscopy so I can see how much damage (if any) has been done to my esophagus and stomach lining.

    I’m nervous to stop taking Prilosec and Zantac everyday because when I tried the a few days ago I didn’t feel so well. However, this time, coupled with a diet that restricts carbohydrates perhaps I will have better luck. Also, I hope to lose some weight to put less pressure around my mid-section.

    Could you or anyone please tell me what you recommend doing if I start getting acid reflux again in the process of not taking Prilosec and Zantac? Do I just “tough it out” until my body adjusts and (hopefully) heals itself? I don’t think I am a good candidate, at the moment, for HCL because I get frequent headaches and take Ibuprofen a couple of times a week. Ibuprofen has been one of the only effective remedies for the headaches I get.

    Thank you very much! I so appreciate these articles and the time it took you to research and write them.

    Sincerely,
    Shea

    • Annie says

      Hi Shea. I’m no doctor so I say this from my own experience, not medical advice. Have you taken the MRT test yet? This is a test that in 150 panel blood test to see what your food triggers are that cause intolerances that can in turn cause major stomach/intestinal imbalances.. Your gastro can prescribe the test IF they know about it. I had mine done and it was an eye opener to what causes my GERD.
      Plus if you’re taking ibuprofen or other NSAIDS, they too can cause GERD so it’s like a vicious circle of damage. Eat food that causes pain, take NSAIDs that causes damage! Educate yourself BEFORE you go in to see the gastro doc with natural ways to heal your gut. You will learn a lot. More pills only masks the real issue as this article states. When your body is out of balance, food can be your medicine IF you know what heals and what hurts. Good luck on your journey to better health.

  61. Eric says

    Dr. Kresser,

    Thank you so much for your article. I was having really bad GERD-symptoms about a year ago and I followed all of your advice in this article, and it was the ONLY thing that worked for me. So this stuff really works guys!

    From another one of your posts I read that one should keep taking HCL for 3-6 months to completely heal the gut. Back when I was having stomach issues, I stopped taking HCL when I didn’t have anymore symptoms. I felt better almost immediately and felt the need to take HCL for only a week.

    I know my stomach acid right now is still a little low. I plan to take HCL with the appropriate meals, etc., until I get a burning sensation from only one pill. Is that a good plan? When should one stop taking HCL/when does one know one’s stomach acid is fine? I’ve googled this question a couple times and I can’t find an answer. Thank you in advance!

  62. annie says

    Kris, on a website called refluxmd they say that once the LES is damagaged by stomach acid it cannot be healed. Do you believe that, or can change in diet etc. heal a person?

  63. says

    While some would view the holistic approach to treating illness and disease contrary to the wisdom of conventional medicine, quite the opposite is true in most cases. In fact, most conventional physicians view a patient with a desire to work to improve their overall health as refreshing.

    Holistic care treats the whole person, rather than just specific areas of the body. The primary difference between holistic care and conventional medicine is that holistic practitioners try to use naturally occurring substances to treat illnesses and disease instead of manufactured chemicals. Additionally, there is a focus on alternative therapies including chiropractic care, acupuncture, massage and even psychotherapy when appropriate.

    My outlook towards alternative medicine changed totally, try this, http://naturalremedies.freshways.info/, my quality of life improved dramatically.

  64. says

    What a great series of articles! I wish everybody – health practitioners, laypeople, would read these. So informative.

    I have a question about a person who takes NSAIDS 3-4 times per year for bad migraines. Would she be able to start doing the HCl and pepsin since her NSAID use is so infrequent? Or does she need to commit to never taking the NSAIDS?

    Thanks Chris

  65. Nancy says

    Hi Chris,
    I have read all your articles on acid reflux and it has inspired me to go off the PPI I have been on for several years. I never even thought I had reflux but my voice kept cutting out and I had to keep clearing my throat to talk so I was put on the PPI. When I tried to get off it then I had terrible heartburn so had to go back on it. I bought some HCL w/pepsin and just taking one pill with each meal I still have terrible heartburn. I was suppose to go up to 2 pills the last couple days but I didn’t know if going to the higher dosage would make the heartburn worse or better. Can you please advise?

  66. bobbie says

    Hi again, I am feeling a whole lot better as far as my Acid Reflux is concerned. I have toned down the carbs but also have started sipping water with bicarb of soda. I mix 500 mils of water to a teaspoon of soda a day, and I have had no flare ups now for well over 2 weeks I get the occasional burps, but it feels normal. My stomach and oesophagus feel so relaxed and wonderful.I also take 1 slippery Elm capsule before my evening meal,and 1 probiotic capsule before bed. I’ve yet to test any real spicy food, although I had a small amount of bread stuffing (which normally flares my heartburn up) the other night, but, nothing. I feel really well and first time in years that I havent had to take antacids every other day. Just thought I would share this information, and thanks for all the articles and info. Cheers.

  67. Elle says

    If you have GERD, LPR, SIBO, IBS try out
    The fast tract diet- one of the only evidence based methods of curing these concerns through diet. Pretty humble researcher but significant results. Cured myself in one month. The problem with traditional Paleo for these concerns is because it endorses significant consumption of fermentable fibers, fructose and starches. You need to start with a solid understanding of how bacteria overgrows to treat it effectively.

    http://digestivehealthinstitute.org/category/fast-tract-diet/

  68. Kmarie says

    Also I have a question about working out the stomach..I have noticed that my stomach acids increase on days I work out my tummy – to the point of throwing up and bad acid for two days…It’s definitely related but why?

  69. Kmarie says

    I have been on the Plaleo diet for three weeks and while some issues have been cleared up I am now getting others. For instance I am constipated. Also I woke up last night choking on burning bile…I have never had that in my life. When I started this diet I also started a supplement with bitters for my gull bladder and liver support as I was having other issues. Now I seem to be having worse GERD and frankly it feels like nothing I eat is right. Now I can not go back to gluten without getting really sick, diary seems to not be the greatest (minus some organic greek yuogrt) and rice and veggies are making me feel ill…so really it feels like I can’t eat anything. Before this diet I had a gull bladder attack every two months but I was going to the bathroom normally and feeling good otherwise on a day to day basis. Now I feel like crap and my oesophagus is burning. I know I have FODMAP and SIBO…and now I can add GERD to the list. Why am I doing everything “right” but getting worse?

    • Elle says

      look at http://digestivehealthinstitute.org/category/fast-tract-diet/

      GERD, SIBO and LPR are largely a result of bacterial overgrowth. This bacteria feeds on essentially carbohydrate in the form of fructose, starch (especially resistant starch), lactose, and fiber of all sorts (prebiotic included). Dairy has lactose, veggies have fiber and rice except for Jasmine rice have resistant starch. No wonder you are getting worse. Check out the above link to learn more about the only evidence based treatment for GERD, SIBO and LPR. I am only endorsing this because I went through all of the folk remedies you see on the internet until I found this method. This is the only thing that has helped- I can control my symptoms through this diet. Good luck!

  70. Janice Cook says

    My 25 year old son was diagnosed with Barrett’s Esophagus 2 years ago. He doesn’t smoke or drink and has always had a healthy diet. The GI doc said he would have to take Dexilant forever and have a scope done every two years to monitor the growth in his esophagus. All this info is overwhelming. What can we do.

  71. Janice Cook says

    My 25 year old son was diagnosed with Barrett’s Esophagus two years ago. He doesn’t smoke or drink and has always had a healthy diet. The GI doctor said he would have to take Dexilant for the rest of his life and have scopes done every two years to monitor the growth on his esophagus. Can you help us. All this info is overwhelming.

  72. samantha says

    Please advise me. I have had sinus problems for a long time, surgery to remove polyps and often taken antibiotics and steroids for them. Then six months ago I suddenly got terrible pain in my stomach. Doctor assumed it was an ulcer so gave me ppis, after a few months stopped taking them and it was fine. But my nose got bad again and doctor gave me steroids to shrink polyps again. My stomach got bad again. Also started to get a 24 7 headache which really brought me down.

    Recently took ceteridine an H2 for the stomach. Was impossible to work out if itwas helping because a side effect is a bad stomach. But noticed that my blocked ear cleared and my headaches totally went away. After four weeks stopped taking them and the headaches and ear came back straight away. Is this GERD? I dont get the other symptoms? Would it be a good idea to go back on ceteridine permanently as I felt so much better? I take
    a probiotic, fibre, omega 3, a lot of vitamins and minerals,
    to make sure that if medication wipes out any vitamins or minerals I replace them. Please say your thoughts thanks.

  73. Leanna says

    hi, i have been suffering from acid reflux since i took an anti anti inflammatory ibuprofen. once i realised it was the medication i stop taking it immediately. after 6 weeks i am still getting symptoms will they easy off in time as it was due to the medication?

  74. Michele says

    I have a problem that I haven’t seen addressed (though maybe I missed it). I’ve had GERD for 9 years and was on PPIs. I finally went off them cold turkey last October when I found out I was gluten intolerant.
    In January, I went on your diet and my GERD is about 80 percent better (still some throat irritation). But I suffer from excruciating leg cramps at night, all night long (not Restless Leg Syndrome). I’ve had my blood tested three times since January and my electrolytes are in the normal range. I’ve been to several doctors and no one can tell me what is causing the cramps.
    Needless to say, I’m exhausted from not sleeping. I’ve tried all of the remedies (soap under the sheet, quinine, potassium supplements, heating pad, etc.) and nothing seems to work. Anyone have any suggestions as to what may be causing them and how I can get them to go away? Never mind the GERD; I’m going to die of sleeplessness.

    • Annie says

      Michele, I have found that Magnesium and calcium supplements and vitamin D3 help with the leg cramps at night. Whenever you do a low carb diet, magnesium levels seem to drop. The vitamin D3 and calcium are also depleted on a low card diet. Get tested first to make sure of your levels and monitor them every 6 months. My doctor is really good about ordering blood tests to help me monitor my levels.

  75. ashy says

    I am a 25 year old female. I have a problem. for the past year or so, I have been letting go of a lot of smelly Gas (Flatulence)I didn’t take it seriously at all. I noticed from last year or October or something I have burping a lot. the doctor gave me gaviscon and a tablet for peptic ulcers.I have been drinking it but it didn’t not get any better.I have noticed that I am suffering from anxiety and panic attacks from this year coz of my gas,i burp the whole day from the time i wake up till the time i sleep. i have chest pains. my tummy pains whenever i eat.i feel like i am going to choke after every meal i have…my attacks of anxiety aren’t coming as often but its just making me really tired of the burping and pains.sometimes i will burp so much that i feel like i am going to black out because i get really dizzy, went for chest x-rays and it came out clear.. went for blood tests and all came out clear…. i can feel there is a lot of gas or acid in my body…what can i do do get rid of it. please help me..
    sometimes when i vomit, i vomit out spit, phlegm or nothing…. and sometimes when i burp, there’s a lot of saliva…i had a constant cough from birth which no doctors could help with, but since i started burping so much my cough has jammed up in my chest…. i even have a wheezing sound sometimes from my chest. i have been on nexium but it did not help… my husband wants me to try something herbal or some home remedy to help me… I am loosing patience now. I feel like I am going to die or this burping will stop my breathing.

  76. ayesha says

    sometimes when i vomit, i vomit out spit…. and sometimes when i burp, there’s a lot of saliva…
    i had a constant cough from birth which no doctors could help with, but since i started burping so much my cough has jammed up in my chest…. i even have a wheezing sound sometimes from my chest. i have been on nexium but it did not help… my husband wants me to try something herbal or some home remedy to help me

  77. ayesha says

    I have a problem. for the past year or so… I have been letting go of a lot of smelly Gas (Flatulence)
    I didn’t take it seriously at all.
    I noticed from last year November I have burping a lot. the doctor gave me gaviscon and a tablet for peptic ulcers.
    I have been drinking it but it didn’t not get any better.
    I have noticed that I am suffering from anxiety and panic attacks from this year.
    i burp the whole day from the time i wake up till the time i sleep. i have chest pains. my tummy pains whenever i eat.
    i feel like i am going to choke after every meal i have…
    my attacks of anxiety aren’t coming as often but its just making me really tired of the burping and pains.
    sometimes i will burp so much that i feel like i am going to black out because i get really dizzy
    went for chest x-rays and it came out clear.. went for blood tests and all came out clear…. i can feel there is a lot of gas or acid in my body…
    what can i do do get rid of it. please help me

  78. bobbie says

    Hi again..well since my last post..I am definitely feeling a whole heap better in the way that I have been treating myself. I have only had 2 antacid tablets the whole week!! Whereas I may have to take up to 3 a day!! I have been taking a supplement called slippery elm twice a day (these can be found at health stores), plus probiotica products to help settle my acid reflux. I have to say, this is the best I have felt in years. I have been using elm for about 3 weeks now. At first I thought it wasnt helping, but along with the probiotics (Yoghurt/capsules/sour milk), it has greatly improved. Fingers crossed my digestive system has settled down. I havent tried any spicy or curried foods yet to see if it flares up, but may try a mild version to put it to the test. I know that when I drink normal tea with milk and maybe a biscuit, especially in the evening, I generally end up with severe heartburn afterwards. So far, that has not happened especially in the last week or so. I will post again down track to let you know, just in case someone else would like a solution. It seems probiotics could be he answer. Cheers.

  79. Hank Koning says

    I have had IBS for about 2 years. About a month after it started I was prescribed Septra for Blasto H and somehow after 5 tablets I found myself dangerously depressed so stopped the Septra. I have not had a history of anxiety or depression until I took the Septra. I was encouraged to go on Remeron, an anti depressant and that kept me feeling normal for 2 years. Over the past 2 years through
    careful dieting I was able to gain my 20 lost pounds back
    and feeling reasonably well. Unfortunately the pills stopped working and I started getting extremely anxious. About a week ago I started getting a burning in my stomach. Since I don’t drink or smoke and eat a balanced diet I thought the anxiety might have caused me to get an ulcer but I haven’t been diagnosed. I thought I would take your recommendations and get a bit more serious about the low carb diet and follow your recommendations rather than
    take the Tecta (antacid) that my doc gave me. I will see how it goes. My question is: Is it necessary to be diagnosed with an ulcer and find out what kind it is before taking the steps you recommend for getting rid of the heart burn.
    Could stress alone cause this? Is it possible to have heart burn on an empty stomach because of stress alone or does it pretty much mean you have an ulcer. Hope you can help.
    I would also be happy to come and see you but I live in Vancouver. Many thanks for sharing your wealth of knowledge.
    Hank Vancouver

  80. Susan Sentilles says

    I cried reading your articles about stomach acid. My mother was sick most of her life with almost all of the symptoms of low stomach acid. All her doctors did was write prescriptions for each symptom, which caused new symptoms. She died being labeled a hypochondriac. I wish I had read these articles in time to save her from her doctors ignorance.

  81. says

    Hi Chris,
    It seems that there is an influx of doctors prescribing PPIs and H2R Antagonists for young children and toddlers. Parents and their children are unknowingly becoming trial patients for these drugs, as they are not intended for or tested on children— until doctors prescribe them.
    My son has only just turned 2, yet at 23 months old his Dr prescribed him famotidine because he suspected that my son’s intermittent vomiting may be caused by GERD.
    After doing a little reading, I decided to wean my son from the famotidine, but now I notice that he is most definitely suffering from heartburn, as he sometimes wakes from naps holding his chest and crying ‘ow’.
    I’m adjusting his diet to reduce or temporarily eliminate the potatoes, pasta and fruits, while increasing the amount of home made ‘lemonade’ (lemon water) he drinks, but I’m concerned that this may be insufficient. We both take probiotics (prescribed by his local homeopathic doctor), but they do not contain the strain you mentioned.
    Would you also recommend Kefir, Kombucha, HCL + pepsin and diluted bitters for a toddler? Do you have any advice on where and how to find a reputable doctor who is knowledgeable in treatment beyond ‘conventional’ pharmaceuticals?
    Thanks!

  82. terri says

    I am craving a burger right now but have been on a low acid elimination diet for two months. I miss corn chips and guacamole and grains most. Also beef and ground turkey burgers…mostly beef. sigh. My birthday is next month and no cannoli or cake to celebrate. I miss homemade cookies too :( I’m so tired of the same 10-12 foods. How much longer??

  83. bobbie says

    Wow..Im so glad I found these articles. Hopefully I can now try and get my AR/Gerd under control. I am type 2 Diabetic, but not on meds as I excercise a lot which tend to keep my blood sugars down.I had an extremely bad scare a few weeks back with acid reflux coming up into my throat and I went to bed sucking on a antacid to try and sleep, but in the middle of the night, I immediately jumped out of bed from not being able to breath at all. My windpipe had completely blocked off and I could not catch my breath for a good while. My husband also jumped out and was beside himself trying to get me to breath, all down to the acid build up in my throat which was really burning at this stage. I hope I dont go through this again in a hurry. Perhaps I need to take another look at my diet as well.I was under the impression that a high fibre diet was meant to help, perhaps this maybe the cause of my problem. I have been taking a supplement called slippery elm, which is suppose to soothe the gullet and stomach. It kind of helps somewhat, but need to take it pretty much every time I eat anything. The probiotic could be a goer. I have had a lot of antibiotics over the past year, and this could have aggravated my stomach problems. I certainly will try cutting further down on carbs and eating a little more protein. I will miss my TREAT of chocolate, which probably doesnt help the situation.I have been like this now for about 6 weeks and finding it stressful trying to figure out what I can or cant eat, which I though I knew.. Thanks so much everyone who have given me some good ideas and especially to Chris for your informative articles. Cheers.

  84. RA says

    Thank you, Chris, for this excellent source of information on digestive disorders. I have read your GERD ebook, and many of the comments posted here. Still, I need some help.

    My husband has developed GERD – AFTER going Paleo in 3/2013. All was well until late 2013, when the symptoms first began. He is now taking two Rx’s (rabeprazole sodium 20mg 1x/day and sucralfate 1GM tabs 4x/day). Tests and gastroscopy have turned up nothing too serious yet (mild inflammation and benign polyps but no cancer, ulcer, or H. Pylori). He is also experiencing intermittent IBS, which evidently is not unusual with GERD.

    Could the increased dietary fats have CAUSED the reflux? Coconut oil, perhaps? We began using that right away as a cooking oil; is it possible that a negative response could be so delayed?

    He wants to get off the meds and remain Paleo, but it is looking like paleo caused the problem. We are struggling here. Any advice from you or readers would be appreciated! Thank you very much.

    • RA says

      Forgot to mention, my husband is 44, and underweight (5′ 8″, under 140 lbs). He has lost weight that he did not have to lose on Paleo and this GERD thing is making it much worse. I don’t think he is absorbing nutrients.

    • Kelly says

      I’m not on a Paleo diet, but I did go gluten-free a few months ago and started using coconut oil around the same time. Soon I developed bad heartburn, and I realized it was the coconut oil – and ALL coconut products, even though I’ve eaten coconut (minus oil) all my life with no problems. Within a couple days of eliminating everything coconut, I was fine. It’s been a few months, and now I can eat products with coconut or hydrogenated coconut oil in them again. (I love coconut milk a few times a month!) I haven’t been been brave enough to try coconut oil in cooking again yet…Good luck to you and your husband!

      • RA says

        Thanks so much for the reply, Kelly. I think we will eliminate cooking in coconut oil for him and see how it goes. CO has been the main source of our coconut consumption. Occasionally we use the flour as a thickener or canned milk in a recipe. Unfortunately, now he also has to wean off those nasty PPI’s. At least he’s only been on them a few months, not years like many. I am very thankful for blogs such as this one. Thanks again, Chris and Kelly!

  85. Stella says

    Thank you for this insightful and informative article =D I have been diagnosed with GERD for 12 yrs and recently Barrett’s in the opening of my esophagus and stomache..tried ALL kinds of PPIs and antacid or combo, they work for a few weeks and most months, then stops so I have to switch to a new drug. If I stop it cold turkey, my heartburn comes back with a vengeance. My stress level is at its peak worrying about cancer but I know stress causes all the gut problems too. What to do? I want to try your remedy but I’m worried it might or might not work on me. Wouldn’t taking more acid HCI give me more heartburn, thus damaging my esophagus further? how do you feel about Chinese medicine and acupuncture vs. western?

    • says

      Look up acid rebound… likely what you are experiencing when you stop PPIs cold turkey. The body resumes acid production at 77% higher rate than before the medication, thus many people have to slowly reduce the dosage (wean) in order to stop taking it.

  86. Joseph says

    I spoke with an RN about the treating of acid reflux with antibiotics. He told me that it is common in the hospital, unless the person is obese, or has some other valid reason for having acid reflux.
    Many people are commenting on treating their symptoms, but I see none mentioning the cure. The RN said that the medical community is slow to catch up with the latest information on how conditions are treated. So I would love for just one of you who is not obese, to go to your doctor and ask for the 30 day supply of an antibiotic that is suitable to treat an infection in the stomach lining. Then come back here and report your findings. Exercise might help the overweight person to avoid diabetes, and a host of other problems associated with being overweight. I imagine if your acid reflux is a result of being overweight, then exercise might cure that too. I guess you all know that when I say exercise, I really mean diet and exercise, because one without the other is not nearly as effective as both.

    • Joseph says

      I spoke with an RN about the treating of acid reflux with antibiotics. He told me that it is common in the hospital, unless the person is obese, or has some other valid reason for having acid reflux.
      Many people are commenting on treating their symptoms, but I see none mentioning the cure. The RN said that the medical community is slow to catch up with the latest information on how conditions are treated. So I would love for just one of you who is not obese, to go to your doctor and ask for the 30 day supply of an antibiotic that is suitable to treat an infection in the stomach lining. Then come back here and report your findings. Exercise might help the overweight person to avoid diabetes, and a host of other problems associated with being overweight. I imagine if your acid reflux is a result of being overweight, then exercise might cure that too. I guess you all know that when I say exercise, I really mean diet and exercise, because one without the other is not nearly as effective as both.

  87. AJ says

    Hi Chris-

    I am on vacation in London and realized I have only one PPI pill for the next 4 days and I am up @ 1 am with acid reflux. Did not want to use it yet and this is when I started to search about other cures that can help and I ran into your articles …. very insightful to me since I always thought that my problem is too much acid but I also knew I have a problem in digesting food over long period of time (which contradicts low acid theory!!)

    Two question:

    1- What is causing low stomach acid that starts this reaction or cycle that leads to GERDS? Could be low exercise? I always thought that low metabolism is my issue and exercise will solve it. So from reading your articles can exercise be the main cause of all of this that leads to low acid which leads to high H. Pylori cycle? We are a society who exercise less and less as we grow older so this follows the theory of low acid that you based your articles on.

    2- I noticed that my heart burn increase with being cold, is there an explanation to this?

  88. Joseph says

    I had acid refulx for many years, so did my mother, and many others I know. One day i had a problem in a organ that was hard to reach with antibiotics. This problem was unrelated to my acid reflux problem. The doctor who treated me, did so with a 30 day supply of antibitics. It wasn’t very long after that, amybe a few months later that I noticed that I had not experienced acid reflux in a very long time. It has been 8 years since that, and I still am free of acid reflux. I eat what I want and i don’t worry about waking at night with burning in my chest, hard to swallow , and a handful of tums. Eventually I took that purple pill that was prescribed for my mother, but only because she had so many of them. Maybe there are a lot of ways to deal with the symptoms, but the cure is to rid youself of the baterial infection in your stomach lining with a 30 day supply of antibiotics.

  89. Simona says

    Hi,
    I am a generally healthy 53 y/old (normal BMI), raised on the Mediterranean diet and – until 2 months ago – a big fan of carbohydrates, especially wheat.
    I had been feeling strange symptoms for about a year (sudden bouts of nausea, the odd heartburn, a constant sweet taste at the back of my mouth), until two months ago, when my symptoms worsened (heartburn every night and more) and I was finally diagnosed with GERD.
    Since then, i have been following first a low-carb diet, and now (for the past two weeks) a low-carb-low-FODMAPs diet + kefir regularly, but all with limited results: much less bloating, but my esophagus is sore and worsening, i have constant sweet taste etc.
    About a month into the diet, another symptom appeared – a feeling of pressure on the diaphragm and on the stomach (like a lump under the lower left rib) especially after eating, even very small amounts of food. This stayed with me for about three weeks and then disappeared, perhaps thanks to breathing and stretching exercises I had been doing for that purpose.
    The persistent burning in the esophagus and throat has been worrying me, however, as I am afraid of scarring. So about 10 days ago i started taking 10 ml of Gaviscon 2-3 times a day to protect my esophagus, LES and throat (this medicine floats in the stomach creating a barrier between the acid and the esophagus but I understand it is considered mild as an antacid) while I continue trying to solve the problem with the diet. Unfortunately, even Gaviscon is not enough, and the burning is still on.
    A gastroscopy does not seem possible in the short term and I am wondering how long it could take before serious, nonreversible damage may occur. I have been resisting my doctor’s insistence that I take antacids (e.g., Nexium – Esomeprazole), but I am starting to falter.
    I wonder:
    How soon should one expect to see results from the diet in case it works?
    What could be the reasons if it does not work?
    How imminent can the risk of scarring, Barrett’s esophagus etc. be?
    Would it be advisable to take Nexium for a short while to allow the esophagus to heal, while continuing with the diet, and try getting off antacids further on, once the esophagus is better again?
    Any help would be greatly appreciated.

  90. Margie says

    I really like what you say about low stomach acid being the problem causing GERD rather than what most conventional medicine adds say is the opposite.
    Do you think low stomach acid therefor low digestion rates can be linked to type 2 diabetes? I have had a theory for a while that inadequate digestion is related to type 2 diabetes.

  91. Andy says

    I’d had tried many different natural remedies and the best I found is Okra. I also tried many types of PPI and acid reducers but these drugs made by us tends to fix one thing but can also damage others. Hence my reasons for sticking to natural remedies. I eat about 7-8(boiled for about 2-3 mins) daily along with whatever I’m having for dinner. I’ve been having Acid Reflux problems ever since I was a little boy and okra has helped me fixed this. Please spread the words if this has helped you.

  92. Ashley Lauren says

    I thankfully found this article after years of taking Zantac 150 twice daily is no longer working. Believe me – I’ve tried the natural remedies as well. They only seem to make it worse.

    I’ve had GERD since I was 16 years old. I’ve seen several doctors and they all tell me to continue taking the Zantac 150 twice daily.

    I am desperate. I read through all of the options in the final article as to how to fix my heartburn the “natural way” but it is overwhelming.

    I have been practicing a low-carb diet for some time now. I began doing that because I stay bloated and thought it might help. It actually made it worse. I decided to limit myself to Ezekiel bread and a few things here and there.

    Should I try taking mastic gum supplements along with the supplements sold in this article? AND drink kefir or eat yogurt? I’ve tried probiotics in the past. I have to be very careful as some of them aggravate my GI issues.

    I truly would love advice. I am suffering as I type this.

    I should probably mention that I do drink coffee daily. I know it isn’t good but I haven’t been able to give it up.

  93. Dennis says

    I just read these articles and now I don’t know what to do…
    3 years ago I was diagnosed w/ Barrett’s esophagus and prescribed 20mg omeprazole/day, indefinitely.
    I definitely noticed that my reflux got worse.
    I told my gastroenterologist that my reflux was worse and that I experienced heartburn for the first time in decades.
    He told me to double my dose of omeprazole.
    I told him that reflux was never a problem for me before I started taking omeprazole.
    He said, “You have Barrett’s esophagus, you have GERD, you have to take omeprazole.”
    I didn’t double the dosage and I didn’t return to that doctor.
    Recently, a sore spot on my throat that I first experienced after starting on omeprazole got worse and became chronic.
    I saw an ENT and he told me that I have Laringopharygial reflux and I need to double the dose of omeprazole and take antacids liberally until my throat heals.

    Now I read your article and I believe that the PPI is making my problems worse.

    My question is, w/ Barrett’s esophagus and the risks associated with it, how do I get off of omeprazole safely?
    Or should I? Would I be trading one risk for another?

    I should also mention that at my first endoscopy I tested negative for H. Pylori. I’ve had one more endoscopy since then, to monitor the Barrett’s and I don’t think I was tested for H. Pylori.

    What should I do???

  94. Kim says

    To DanDan:
    I saw your 1/29 post. Can you share your recipe for the beef broth. And how often and for how many days did you drink that? And then you started the diet you outlined?

    • DanDan says

      Hi Kim,

      I think I did that broth like three times but it lasted me a few days each batch. Nothing fancy but I included veggies in it. The key (in my non professional opinion but based on my research), were the turmeric, coriander, cumin and cayenne pepper. Those 4 are good for your stomach. I think I still use those ingredients whenever I can (have reduced cayenne pepper). I started with the broth then I started incorporating the items I mentioned in my previous post. I have been steadily feeling great!! The only way I get some setbacks is when I have coffee for a few straight days. Also, ever since my post, I learned that having an apple after dinner helps avoid heartburn. That I also read online from someone dealing with heartburn.

  95. Marco says

    Hi Chris
    I’m looking for a ketogenic low-carb for treating a SIBO. The supplement of b12 contains fructose, sorbitol..are day bad for a SIBO? or in a minimum quantities tolerable?

  96. says

    Your articles constantly amaze me. I feel your gift is really getting America healthy again. I have been battling with Gerd for years, depressed and upset and beating myself up because nothing works. I just finished your Gerd series and I finally feel like there is hope in getting over this. There are alot of amazing health doctors out there, but few have the gift of communication you have to help people to take their power back to heal themselves. Man, please don’t stop blogging!

  97. Linda says

    Hi Chris,
    Have you heard of product called Zypan? My yoga instructor recommened it. It was recommned to her by her chiropractor. Seems it’s popular. It’s a proprietary blend of betaine hydrochloride, pancreas cytosol extract, pancreatin (3X), fatty acid, pepsin, ammonium chloride, bovine spleen and ovine spleen. This chiropractor also recommened Gastrex to be taken 15 minutes before meals to reduce gas. Both of these products are available through Standard Process. Your thoughts?
    Thanks,
    Linda

    • Nun Giver says

      There are various versions of the betaine HCL with pepsin, the ones I find as suspect are those that contain alkaline materials. Use of this digestive aid at several capsule per
      meal stopped the dyspepsia and reflux. I didn’t have to take
      it forever either. Granted I use melatonin at bedtime and
      there is research that indicates it should help with the inflammation of the lining of the esophagus; do a PubMed search. I also eat a diet without grains most of the time.
      I strongly disagree with those who suggest vinegar as a digestive aid as this in a person with esophageal inflammation will sweep away the protective mucus lining
      the lumen and frankly burn. Better to swallow a capsule to get the acidic material past the esophagus. Talk to an alternative medicine provider that knows about the use of
      betaine HCL. I wouldn’t suggest anything here, I am only speaking of what I’ve done.

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  99. Penelope Gall says

    This has been an amazing string of articles to find for my husband who has been having significant GERD symptoms that started after he recovered from an episode of botulism about 15 years ago.

    I do have a question about the HCL supplements. My husband has had severe asthma since he was a child. He has been taking Advair for many years as this is the only thing that keeps him under control. I saw that the HCL supplements shouldn’t be taken with corticosteroids. Does that same warning apply to inhaled steroids or just pill form? He is really looking forward to stopping Nexium, but wants to make sure that he can address the whole process and treat the issues, not just the symptoms.

  100. says

    Chris,
    I carry my weight in my belly and I am quite overweight (70 lbs). Do you know of any research of people getting tummy tucks or lipo and then having their gerd healed? I try and try to lose weight on my own but the scale doesn’t budge. I am just wondering if gerd is ever caused simply by excess weight. My gerd got really bad during my last pregnancy 5 years ago and that is when I started the prilosec (which, btw, I think caused my son to have heart problems in utero. Miraculously, his life was saved and his heart is perfect now).

  101. Mariana says

    I’ve been taking omeprazole for about 2-3 weeks and it doesn’t help completely but it helps with my GERD.I started on probiotics about 5 days ago and I can already see it helps a little bit,I’m going to start in HCL with pepsin,when I do should I immediatly stop omeprazole?or I can take all three until I feel free of the symptoms and then I stop omeprazole? thank you!

  102. john eidson says

    im curious as to what the sensation i am suppose to feel from hcl is im very nervous about taking it i have been taking it the past few days but im scared to go over 3 capsules

  103. Max says

    Dr Chris:

    My question is if PPI such as Dexilant works by stopping or reducing acid production, how come you believe that low stomach acid and high bacterial content are key reasons for GERD? I was diagnosed with GERD 6 weeks ago and been on Dexilant (60 mg) for the last 4 weeks. The upper GI scope found that I have Grade C ulcer close to where my esophagus enters my stomach. Dexilant has helped me a lot but I don’t want to be on meds for too long. Just to experiment, I quit taking Dexilant for 2 days and I already feel that my stomach burning and being too hungry feeling is back. I would appreciate if you can explain why Dexilant seemed to have worked for me if my acid levels were low and bacterial levels could been high?

    Thank you very much!

    Max

    • Elizabeth says

      Brad, I have that problem also. It took me THREE gastroenterologists to get to the bottom of this. My first gastroenterologist had me misdiagnosed for 5 years. Finally the third doctor knew what he was doing. I have achalasia. You may have this. You’ll have to undergo a Barium Swalow test and an Esophageal Manometry study to confirm if you have this.

  104. Route says

    My 14 year old son has terrible throat problems. His GI doctor put him on omneprazole and after 8 weeks the feeling went away. A year later he is unable to wean off that prescription dose. Now he is still having a choking feeling. These articles are very helpful. I am wondering if he has a bacterial issue in his digestive system. When he was 12 he had to take an antibiotic for a year and a half during and after treatment for a brain tumor with oral chemotherapy. Could that long term dose of antibiotics be part of what is going on now? It’s so frustrating, but he is encouraged by this series of articles and wants to try changing his diet.

  105. helen says

    My question is i getting from the article you cannot do the hcl with pepsin if you have an ulcer? i have heartburn, ulcer and ibs oh and hashis. i’ve been following paleo feeling much better but now i realise i need to remove more foods that react with ulcers and heartburn. could i do a plain coconut yogurt instead of milk i only started omeprazole yesterday so it shouldn’t cause me problems if i just stop. what can you to for the pain though as it gave relief from that

  106. Rose says

    Hi,
    Thank you for posting this information online, as I would not have found it otherwise and it’s giving me some hope.

    A little over a month ago, I took an antibiotic pill (which I had been on before with no issues) and went to work out. At the end of the workout, I felt a very odd sensation over my body, like I was going to fall over or pass out. I then started feeling chest pains near my heart and tingling in my right hand. I kept alternating between feeling hot and cold. I waited a couple of hours (feeling like this) and had one bite of pasta, which I regurgitated. I went to the ER thinking I was having a heart attack. They found no problems with my heart and let me go the next day or so.

    Once released from the hospital, I started having the chest pain after walking for 15 minutes. I also had some acid reflux but didn’t put two and two together so just took Maalox. I then started having abdominal pain, so a doctor put me on 2 weeks of Omeprazole, 40 mg. The abdominal pain continued and I had black and bloody stool during this time. I then had an endoscopy which diagnosed me with GERD and nothing more. Since, in my opinion, the GERD and GI issues came on all of a sudden that day I went to the ER, could my acid level and bacterial balance have been disrupted in such a short time frame? Do you think that’s the problem?

    They just want me to take Pepcid now, which doesn’t seem to be helping me. I just doubled my dosage and that actually made me feel worse. Today is Day 2 of me not taking anything other than digestive enzymes and DGL licorice. So far I feel better than this weekend when I was on the double dose of Pepcid but I am stil burping all day. I just tried the Kombucha but it seems to have irritated my already inflamed esophagus.

    I am 30 years old and prior to this had no digestive issues. Though this fall I had diarrhea for two weeks every single time I went to the bathroom and took Flagyl for it which seemed to clear it up after about a week or so. I also quit smoking in late July, and I know that changes your gut bacteria make-up. Could I have had a parasite?

    I really don’t want to go back on/become addicted to Omeprazole if at all possible. Given my symptoms, I am a bit afraid to try the HCL in case it makes the burning worse. The at-home baking soda test seems to indicate my stomach acid level is normal, though I know that’s not a foolproof test. Any insight you can give me would be greatly appreciated. The doctor doesn’t seem to care about the cause, even though I’ve removed all trigger foods from my diet and am not overweight.

    • DanDan says

      Rose, read my recommendations in the earlier post(jan 29th). Your case sound just like mine. I never allowed the doctor to prescribed me anything as the more I read online, the more I found out how worse these meds do to your stomach lining. After my post regimen (read my previous post), I stopped having heartburn, chest pains and all that(tingling sensation). However, I started having gases all the time specially at night during my sleep. I stopped my turmeric teas and started having fennel seed + yarrow root teas. You can find those in the natural health food store. In a matter of two days, gases gone! I feel I am back to where I was before all this stuff started taking over my life. I am already drinking coffee again without issues, this time however, moderately…So to recap ( and once again this worked for me):

      – Cayenne pepper for heartburn ( I stopped this after heartburn was gone
      – Tumeric powder + coriander and a bit of cumin for stomach for like 2 straight weeks. Only once a day (sounds grose but the coriander tastes like lemon and if you add unpasteurized honey is not that bad)
      – Fennel seeds with boiling water (tea) for gases.

      Keep up with yogurt or probiotics (at least 2 times a day) and try to have some portions of sauerkraut here and there (is high in Vit C and has good bacteria in it)

      Honestly, it has to work. It worked with me. Get well!

      • Rose says

        Hi DanDan,
        Thanks a lot for your reply. Can you tell me what your initial symptoms were? Was it in reaction to an antibiotic? Did you have burping?

        My heartburn has largely gone away after going off Pepcid a couple of weeks ago. But I am still burping/regurgitating almost every 10 minutes, and it’s really affecting my quality of life. Oddly enough, it seems that my reflux is better at night when I’m sleeping. Anyone have any idea what that means? I wonder if the antibiotic caused autonomic nerve damage. I did the Heidelberg test recently and found that my stomach was not re-acidifying after three small doses of sodium bicarbonate (baking soda).

        Right now, I am taking digestive enzymes, a powdered supplement called Acidgone (with Chinese herbs), and melatonin at night.

        Does anyone know what Chris’s stance on melatonin is in terms of treating GERD? I’ve read that it’s had success due to its ability to inhibit nitric oxide synthesis in the esophagus and thereby tighten the LES. But it also decreases gastric acid secretion–is this counterintuitive to fixing the problem?

        I really wish I could find someone to oversee all of the supplements, etc., I’m taking. Anyone know of any good naturopaths in the NY area?

        • DanDan says

          Sorry Rose, just read this. You know, my sister is a physician and she thinks it could have been the anesthesia (had surgery 4 months ago) that irritated my stomach and all inside. But is just a theory. My initial symptoms were light and I mean light acid reflux. I just ignored them until it got really bad. Then I had the reflux with heartburns. Vomit sensation. Everything was going up my esophagus. For your burping I recommend Fennel seeds. SOunds ridiculous but it worked for me! Just buy some seeds, put them on a metal tea mesh or if you dont have a tea mesh, straight in the water. Have a few teas per day. Usually after each meal. Now what I do (since fennel seeds are not that strong), I grind them and use the powder to make the teas. They do work. If you get a fullness sensation you can also check activated charcoal pills. But Fennel seeds removed the gases for me.

      • Alexandra Bielecka says

        Hello, how did you take cayenne pepper? In a pill form? My mom is suffering from terrible GERD since the smart doctor removed her gallbladder. I would like to put together a diet for her that hopefully will make her life easier . Thank you

  107. says

    I’ve been reading tons and tons of stuff about treating GERD naturally. But I am confused about what to do when coming off of PPI’s. I’ve taken PPI”s for about 3 years straight. I just stopped taking them cold turkey. I’ve been trying HCL with pepsin, probiotics, enzymes, kombucha, kefir, ACV, mineral salt…basically everything. My question is this: When you stop acid suppressing drugs like PPI’s do you then have an over abundance of stomach acid? Is it a good idea to increase stomach acid with hcl at this point? or should I be looking for ways to decrease acid for awhile? I am so confused. My gerd is constant, no matter what I eat or don’t eat I have it. It is accompanied by lots of burping. What would you suggest I try to do to get my stomach producing the correct amount of acid again? I would appreciate any ideas! Thank you!

    • Ginny says

      Hi Emily,

      I quit taking Prevacid back in November pretty much cold turkey. The first few weeks I did have rebound hyper acidity. I found that tweaking my diet (less eggs, smaller meals, avoiding acidy fruits and tomatoes) helped. The one thing that helped more than anything was intermittent fasting. For instance if my last meal gave me heartburn I would skip the next meal or two sometimes. Actually I was just doing what any normal person (who is not depending on a drug) would naturally do. Finally, give your stomach some more time to get over the PPI’s. I’ve been off it nearly 3 months, and I am now experiencing DAYS – not just hours – without any heartburn symptoms. That was just not possible before!

      Now food doesn’t sit in my stomach for hours like before and that’s a good feeling.

      Ginny

      • Ginny says

        (Continued to Emily)

        Had to make this two parts. It’s hard typing on an iPhone.

        I never took HCL/pepsin because it has to be taken whole, and I have a tender place in my esophagus where food and pills get stuck. Even so, over time that place has improved some too. Not as much as I would have liked by now but any improvement is a good thing.

        Ginny

        • Dark_Water says

          When taking betaine HCL with pepsin it’s best to have some boluses of food to knock the capsules down into the stomach. DO NOT take them at the end of the meal.

          While people disagree with me and as I recall I found evidence in the medical lit, that night time reflux is the most damaging form of reflux. For over a year in the past, I used a specially built bed that was inclined in one plane, the head of the bed being raised by 12 inches or more. The commonly suggested 4 to 6 inches at the head of the bed is pretty ineffective. Can yes it was an odd position and I had an attached foot board to keep me from sliding out the bed.
          I built the bed about the time, I started betaine HCL capsules.
          Eventually, I added in 6 milligrams of melatonin and started sleeping on the level.
          And I’ve been good ever since even sleeping on the level.

          When I used PPI meds meals just set in the stomach and churned. At times I was hunger and yet the meal hadn’t exit the stomach after hours

        • says

          Ginny, Thank you. That does give me some hope. Things were not getting any better for me so I did start taking Zantac. I don’t want to take any meds, but I couldn’t function with constant acid burning my throat and mouth. I am trying to decide if I should go see a gastroenterologist now or if I should give it more time. I am thinking maybe i should go get an endoscopy done to make sure I don’t have any precancerous or cancerous stuff going on. It would be nice to know how much stomach acid I actually have, but I really do think I have low acid since I will burp up food from a meal many hours later. It is obviously not being digested quickly. The whole thing is so frustrating. I am on here tonight reading and reading looking for answers or ideas. I want to feel good again so I can parent my 5 sons the way I want to!!

    • Dark_Water says

      Taking PPI meds results in elevated gastrin levels, a hormone related to promoting HCL production. As I recall there are different forms of gastrin some of which are longer acting such that my stomach felt warm for several days after I quit. I quit more than once back in the day.

  108. DanDan says

    This, in my opinion, is the most informative info available on GERD. I wanted to share my experience. Out of the blues started suffering from serious heartburn, acid reflux. I am not overweight and consider myself to have a healthy lifestyle. Non smoker, not a drinker either. Went to the doctor and she soon wanted to prescribe me after getting some tests done. Took matters in my hands, read and tried different things. This is what did the trick for me. I decided to make this beef broth/soup (after reading that beef cartilage helps the stomach) containing veggies with a twist. I added Cumin, Tumeric, Coriander and Cayenne Pepper!! That was instant and I mean instant relief. From there on this was my diet:

    – Morning probiotic before breakfast (Bio-K is what I used)
    – Breakfast (didnt restrict myself to bland foods but no coffee)
    – Papaya smoothie with seeds in it (good blender will make them small) and kefir
    – Any lunch (didnt restrict myself to bland foods)
    – Yogurt after lunch
    – Dinner is the tricky one but whatever I made, I made sure I added cayenne pepper!! and it was as if the acids stopped going up during my sleeps!! and whenever I did not have cayenne pepper in my dinner and as soon as I had acid reflux starting, I would make a tea with cayenne pepper and honey. Its an instant relief after I have those. Little by little following this regime, I have been able to strengthen my system to the point of having a normal day and normal sleeping nights and thus reducing or not needing cayenne pepper anymore. I think cayenne was the main key for my recovery/healing process. Just my 2 cents. Hope this helps others.

  109. Claudia says

    Thank you very much for this helpful article. I had a question. I have been on Prilosec for over six years – am currently in the process of weaning myself off of it. Right now I am dumping out some of the capsule’s contents and dumping out more each week. At this point I am almost taking an empty capsule. I am having heartburn symptoms but not terrible as I taper. My question is does it make sense to start with HCL now or should I wait till I am entirely off the Prilosec? I also just started cutting out gluten to see if it might help.

  110. says

    Another thing to try is to go on a walk after you eat. It will help with your weight but it will also help you in digesting your food. Another thing to consider is losing some extra weight. This could help in alleviating some pressure which is likely to alleviate your heartburn. When you do lay down after you eat this will push the acids in your stomach into the esophagus which will cause your heartburn.You could also try using over the counter antacids which are recommended for heartburn.
    http://heartburnnaturalremediesblog.com/how-to-relieve-heartburn/

  111. Frederica says

    Hello,

    I have been reading these articles and they are very informative and fascinating. I don’t know if anything like this has come up before, but I have a question regarding GERD and children.

    My daughter (4) was diagnosed with GERD practically right after she was born. She experienced severe projectile vomiting several times a day, every day (it began several hours after birth and she vomited amniotic fluid that shot more than a foot out of her – this prompted the hospital to x-ray her stomach and pump out excess amniotic fluid). We got an ultrasound to rule out pyloric stenosis, which she did not have. Her doctor experimented with various acid reducers. She was later sent to a pediatric GI doctor who placed her on Prevacid. She appeared to respond well to this for some time. She was on this medication until she was just over the age of 2.

    Of course, I have been terribly concerned about the long-term effects of this kind of therapy, and have become leery about whether or not this approach was actually helping her. I would also like to add that my daughter has always been quite a picky eater (I breast-fed and supplemented with formula for the first 6 months, as she struggled to keep her milk down) and I can’t seem to get her to eat most foods that would be healthy for her growth and development. She only likes pork, some chicken, most berries, rice, carrots, cauliflower, yogurt, cheese, sometimes green beans, sometimes apples, sometimes bananas, and that’s about it. She loves water. What she is comfortable eating are foods that continue to add to digestive issues (she is often very constipated). Reading your articles got me thinking about whether or not she has low acid. I am convinced that her PPI therapy has contributed to continued digestive issues. She constantly complains of stomach aches. She is quite moody and extremely anxious, to the point where she cannot sleep alone at night. I believe that her gut bacteria is imbalanced. What you have presented seems to make sense to me, but I’m uncertain as to how to go about helping my daughter recover from this. Your recommendations are best suited for adults, I’m sure, but how would I go about helping my 4-year-old daughter? I have considered probiotics. She likes yogurt, but it’s hard to get her to eat it every day, and I’m concerned about the carbohydrate content of dairy anyway. She does not like kombucha (I have offered it to her as I drink it). I have considered making water kefir. I doubt HCL therapy is advisable for her at her age. What do you recommend?

    Thanks.

  112. Kelly says

    I have been suffering for more than 25yrs with this pain. I never leave my house anymore. I dont have a gall bladder and I have a bad thyroid, I was wondering if I should do anything different than the article says. If not, then I shall do my best to get started on your great advice. Anything is worth a try!

    • Linda says

      Well..try it……after 5 years of suffering with throat reflux…such burning and pain I resolved that I would eventually die from it.
      I have followed a strict low carb diet….I think of all the money and time I have spent with western medicine….and the pain I have suffered …in just one week my reflux was cut in half….it’s amazing…I look forward to the next week and week after. I am so committed to this I cannot imagine going back …I only look forward….as well as you should…..just do it for yourself….its going to be amazing…..I finally have hope.
      Let me know how you are doing………I care.

  113. Daisy says

    Hello, I am so thankful that you have shared all of this crucial information. I am 26yrs old. Was diagnosed with Gerd a year ago. its been the most troublesome, stressful, longstanding issue ever. So very disturbing dealing with all the symptoms and consequences of this issue. I hate it. I’ve made many changes but I do not want to be on protonix any longer. no more. PLEASE TELL ME WHICH TYPES OF FIBER AND SUGAR ARE ACCEPTABLE IN MY DIET. I would greatly appreciate any input. I know artificial and processed sugar is no good. what else? i hope i can still eat beans and things like that that contain lots of fiber. I just really want to be healthier and prevent worse conditions. ALSO, IF I IMPLEMENT THE DIET CHANGES & DROP THE PROTONIX YOU HAVE SUGGESTED WILL MY BODY GO BACK TO ABSORBING THE MINERALS/VITAMINS YOU MENTIONED ?? im looking into getting pregnant soon and want to be as healthy as possible. thank you again for all your help.

  114. Jennifer Okanay says

    Just wanted to say thank you for your article. This makes so much more sense than anything else I’ve ever read. I started suffering with GERD 2 years ago. Mine presents as an intense pain in my back between my shoulder blades and in my chest and happens about once a month. It is also accompanied by intense pressure/air in my stomach and constant belching to find relief from the pressure. Your article has really pieced together the puzzle for me as to why this is happening and what I need to do to get my symptoms under control. I found your website at 3AM this morning on my second consecutive night of no sleep due to GERD. I was desperate for relief. After reading this I got up and ate a pot of Activia Yogurt. My GERD pain stopped within 30 minutues of eating the Yogurt. Could be a coincidence, but I don’t think so. So THANK YOU!

  115. Eric says

    Dr. Kresser,

    I am using the Adaptagest Duo and can feel the difference for sure. (I also follow a low-carb diet and have for some time.) How will I know when I can discontinue the use of the supplement? And–how does the use of HCL cause the stomach to start making more of it’s own acid again. I don’t think I read that anywhere in the articles. Thanks!

    • Dark_Water says

      I’ll offer an idea as to how increasing acidity can result in a healthier stomach lining. It is known that Helicobacter pylori, the ulcer microorganism actually causes impaired acid production. This is likely true, IMO that other microflora overgrowths cause reduced stomach acidity and impaired stomach motility that is to say reflux. PPI meds only change the nature of reflux, they don’t stop it. Non-acidity or mildly acidity reflux has it own dangers. People get bile reflux in this context which is also mutagenic.

  116. christine c scott says

    Where do I buy the HCL tabs? and the pepsin? When I asked the pharmacist today, he told me that my reading skills were off in my research. That I was an idiot!!!!

    • Dark_Water says

      A pharmacist would say that. What he is missing in part is that the PPI meds (proton pump inhibitor drugs) can be described as crude copy of melatonin which is used in healthy stomach to control some aspects of HCL release. You should be able to find betaine HCL with pepsin by way of a Google search. It seems you need some hand holding so I’ll suggest going to a Life-Extension/longevity Doctor. Many of these people know about the use of betaine HCL with pepsin and some hook you up with a supply. I went this route and observed that the betaine HCL with pepsin capsules the clinic offered weren’t over priced especially when compared to the small vitamin shops. By the way, baking soda and vinegar are rather poor ideas and are paths to failure. The esophagus is protected in part by a mucus lining which vinegar sweeps away. Not a problem in a healthy person but with a person with an inflamed esophagus due to reflux and sphincter relaxation, the esophagus lining is making less mucus or no
      mucus down toward the stomach. Increasing acidity by lowering the pH measure with supplement is nice because the capsule carries the acidity into the stomach without exposing the lining of esophagus to acid source. Also don’t go for the bile supplements since in this situation, bile is a problem not a solution at least early on. You might read the dead but still present alt.support.heartburn group found buried down in the Google groups. It has some useful clues especially the last person that kept posting to the site.

  117. Jon says

    Chris,
    I have been taking 6 hcl capsules with each meal for 3 months and still do not feel any warming sensation in my stomach. Do I need to be taking more hcl’s with meals?
    Any other suggestions?

    Thanks!
    Jon

  118. says

    I have reduced my LPR considerably by removing Chlorine from my water, but I also found my tap water to be very acidic. I tried adding Baking Soda to the water and was able to reduce my LPR again.
    You can find more out about CL2 in your water at http://www.gerdrefluxcure.com and what doctors are finding out about chlorine and acid in our water supply.

    • denj says

      hi charlie,

      besides the baking soda water, did you follow the other steps of chris kresslers recommendation. ie increase HCL, low carbs, add probiotics & enzymes. If so, did you drink the alkaline baking soda water at the same time as following Chris Kresslers recommendations? Let me know as I wonder if drinking the baking soda water and eating HCL tablets at same time may cancel out the effectiveness of these methods?

  119. max chula says

    I’ve been on antacids for at least 4-6 years and I’ve been doing research on homeopathic alternatives. I’ve been on Protonix on and off for about 4 years and noticed that my acid reflux getting worse by the day. I’ve lowered my intake from 40mg twice a day to 40mg once a day. I’m taking DGL ginger trips and probiotics for the last few weeks which allowed me to lower my ppis to 40 mg a day. My ultimate goal is to cut my PPI intake to 20 mg a day and eventually getting off of them for good!! Any advice???

  120. denj says

    Chris,

    There is a school of thought that Pepsin refluxed into the throat and esophagus is a problem and causes a lot of LPR symptoms and other long term problems. A proposed method to deal with this is to drink alkaline water which breaks down the PEPSIN.

    Do you see this drinking Alkaline water to reduce the pepsin a problem if the goal is to increase HCL in the stomach to improve digestion?

  121. Brooke says

    Hi,

    I just came across this site. I have to say this site has given me some hope. I have suffered from severe acid reflux/ GERD ever since I could remember and I am only 23. I have been to many different doctors with no luck. They all said the same thing or told me to up my dosage of nexium to 40 mg twice a day. I really don’t want to do this because the longterm risk of liver damage. I have had severe symptoms from my GERD that have made my quality of life less than ideal. I’m actually just plain miserable to say it truthfully and am very desperate for some help. Here are a list of symptoms I experience daily. I belch a lot during the day, I have IBS, I have asthma, my lingual tonsils on the back of my tongue are so swollen from prolonged acid exposure I can see them clear as day where most people don’t even know they exist because you aren’t supposed to see them. I had the tonsils on the back of my throat removed or they would probably be swollen too. I wake up constantly with dry mouth and a dry throat with a horrible taste in my mouth I’m assuming from the acid. My vocal chords are damaged and inflamed from GERD at night. I have constant difficulty swallowing and went 4 years without eating solid food because the swelling, discomfort, and difficult swallowingis bad. I live in constant fear that I will develop stomach or esophageal cancer or I will lose my ability to swallow altogether. Afterall, I am only 23 and being so young with these problems doesn’t make my future look too bright. I also suffer from severe anxiety and depression which I attribute to my poor nutrition. I would really like some help from you. I live in an area where we don’t have doctors like you and if you could help me find someone like you that I could see or any advice you could give I would be so very grateful. I can’t take pills because of my difficulty swallowing and is there any way to take the HCl in a different form? Please help! I’m willing to give you my email address phone number or anything.

    Thank you,
    Brooke

  122. Ashley says

    Hi,
    This site has a lot of interesting tips. Unfortunately, for people who have bile reflux, one of the best things you can do is eat whole wheat. The wheat bran decreases the bile acids, and therefore, your esophagus is protected more. I tried a low carb diet and got blazing GERD, so I am back on wheat and much happier. This is because my GERD is bile based. I think the low carb diet might work well for people who have acid reflux only.

  123. Frederik Ackermann says

    Chris – do you have any evidence of your claim that D lactate can be problematic in SIBO?
    I would think that homolactic fermenters like L. Acidophilus, that don’t produce gas would be ideal for IBS – which in my understanding is tightly connected with SIBO.

  124. hereformydoggie says

    Hi, great site! Thanks! I have been suffering for two years from excess mucous pretty much with anything I eat, exercise, just plain moving. I thought I had a candida overgrowth and was hell bent on that was the cause, but I also had LPR as my second diagnosis. I finally went to a MD, gasto guy, who was very arrogant….blah, blah, blah. Well, I decided to let him go down there with a scope and have a colonoscopy at the same time cuz it would be good to know the condition of my inners. Anyway, I was reading a lot but certainly can’t read all of the comments, but what is your opinion on the alkaline water?
    I’ve been putting baking soda in my water lately (1/2 teaspoon per half gallon), but was thinking of getting a water alkalizing machine.
    Also, I went to Dr. Wright’s clinic way back, was tested and I had a lot of food sensitivites, wheat, gluten, dairy, etc. I’m so mad at myself right now for not following up on the advice given at the clinic about the HCL. Going to try it today! Thank you!
    Also, does anyone have mucous when they wipe? I also had a bunch of white stuff a few times (shreds of toilet paper looking stuff and white specks — very white). I showed this pic to the gastro guy and he said it was mucous! No so, in my opinion, it was candida! Any thoughts anyone on this?

  125. Mark says

    I tried HCL with Pepsin as directed here but it gave me diarrhoea.

    Is this a normal side effect? I really had high hopes for this treatment so don’t want to give up. Should I reduce the dosage and try again?

    Thanks

    Mark

  126. todd stratton says

    Hi Chris! I was wondering if you could help me out! In my specific case I have developed very severe LPR, Silent reflux, where the food comes back into the throat but with no heart burn… It started up after a really nasty sinus infection and to my knowledge seems to be the case of bacteria build up and mucus.. I was under a lot of stress as well which I am sure attributed to spasms or something as well…
    SO far got on the SCD diet, gonna get a ph test and peptin test, not gonna touch antiacids or prilosec as in most cases it doesn’t do much for LPR and has too many side effects..

    I am 23 and a bit to new to this to be having a surgery soon, but wondering if a detox diet will help curb this problem… As it is only recent and not a lifelong issue that I have had.

  127. Sarah Joy says

    Ok, you helpful people, I need some advice as well. I love this article, I’ve been trying this method for about 3 weeks and it is definitely helping, but I need some fine tuning advice and my docs are pretty much clueless. They just keep telling me to take Pepcid or whatever.

    I am pregnant, have a hiatal hernia & am dealing with reoccurring yeast infection. So I’m trying to treat reflux and starve out the candida at the same time. While pregnant. Yah. Fun stuff.

    I have cut out all processed carbs and sugars. The only starches I eat are sweet potato and acorn or butternut squash. No sugar, honey, syrup at all. No fruit. The HCl is really helping at meal & snack times but what do I do in the middle of the night? Heartburn wakes me up at least 6 or 7 times at night. Should I just take some HCl and eat something? I’ve tried ACV in a cup of warm water, baking soda in water and tums but all three make me throw up like an erupting volcano.

    Also, I went cold turkey off the Prilosec and started eating fermented foods with every meal. Wow. That did not work well for me. My stomach has been an absolute mess the past 3 weeks. Nausea, constant feeling like something is stuck in my throat, seemingly random vomiting. Although, like I said, I have noticed a huge reduction in heartburn during the day with the HCl. I have found that right now I cannot eat anything fermented at all (not even my beloved kombucha!) and even citrus causes the volcano effect mentioned before. I did start on a quality probiotic since the fermented foods are such an issue for me.

    I’m continuing with the HCl & hoping everything will improve as time goes by. It is hard to wait though. I really, really need some good sleep!

    I would appreciate any thoughts you might have!

    • Ginny says

      Hi Sarah Joy,

      I can only add my 2 cents here. Maybe it’ll be of some help to you. I too went cold turkey off Prevacid back in November when I started the Perfect Health Diet (Jaminet). At first, I actually tried to skip doses and titrate off it. I found this was not helpful at all, so I quit it altogether. I’ve been taking Prevacid for the past 2 years (been on some kind of anti-acid for about 20 years or so!) for acid reflux and pain in my esophagus where food sometimes gets stuck.

      So I’ve been off Prevacid for about 5 or 6 weeks now. I have tweaked my diet a bit, eating smaller meals, intermittent fasting after heartburn (iow I skip the next meal if the previous one caused heartburn), overall eating less fruit, more vegetables (with butter!) and no grains/legumes/veg oils/ and very minimal raw honey (2 teaspoons a day). It’s taking a while to come up to speed according to the PHD plan. Now I usually eat only 1 egg with bacon for breakfast with coffee/cream/coconut oil. I was getting a lot of heartburn eating 2 or 3 eggs for breakfast, and like you, found I could not eat any acidy type foods or wine because it would really cause heartburn pain.

      But I find I am now turning a corner, or at least I hope I am turning a corner. I no longer feel like food is sitting in my stomach for hours after I eat, and in general my stomach feels much calmer, for lack of a better description, whenever I eat a meal. I think this is due to getting the Prevacid out of my system. So, it does take a while to readjust to being off the medicine. I’m sorry I ever took it. It would have been much easier and cost-effective to just eliminate foods/reduce meal size/reduce stress response…etc…. to start with. I ended up with a functional magnesium deficiency and low B12 and D2 from this drug. It’s bad news. Better to take the high road and just say no to drugs.

    • Ginny says

      Sarah Joy,

      After re-reading your post, I have a few thoughts. You may already be doing these things so please excuse me if you are. Also, since you are pregnant, check with your doctor about this:

      Don’t eat for at least 3 or 4 hours before you go to bed. Have less protein at your supper meal and more vegetables. (According to Chris’s nutritionists, lots of protein at the supper meal could interfere with sleep.) And finally, sleep on at least 2 pillows to prevent reflux. Sleeping on your left side could also provide you with anatomical closing of the lower esophageal sphincter (LES) which also can prevent reflux.

      Hope this helps!

  128. says

    I have been seeing a GI Dr. since Oct, and they discovered I had a small hiatal hernia. The Dr prescribed Dexilant 60mg qd and I take Carafate before meals and bedtime. I’ve been reading up on alternatives and I keep asking my Dr if there is anything I can do besides medicine. Then he prescribed Librax, which I lost the rx so I haven’t been taking it anyhow. I was only going to take something when I get flare ups. I don’t like the idea of taking meds for just temp relief. They also informed me I have GERD. I haven’t been able to sleep all night in 3 days and constantly keep jumping up with a racing heart. My throat has been on fire. I know it’s from the heart burn. I’ve been eating maybe a handful of something thru out the day, or just enough to keep my stomach from growing and acid from bouncing around. It’s so miserable, I just want a hamburger from eating like this. I’m terrified to try things that I can eat, bc to each his own. There’s lots of things on the “okay” list that I am allowed to eat, but then again, I’ve tried several things, I’m just out of options. Prayer works wonders and I’ve been feeling better, except for the burning in my throat that is so umcomfortable. I need help from someone that does their homework on Gerd/hiatal hernia/heartburn.
    Thank You

  129. Arley says

    OK….I just wanted to come to this website and thanks Dr. Kresser!!!! I finally can say I got rid of the reflux! It was a long way trying to find a cure and for me, after this battle (5 years on Nexium and Omeprazol) I can say that the big Labs that produces all this pills should be ashamed! they are actually killing us in order to get their profits!

    Everything started one day that I got liver ultra scan (?) or something like that….the person performing the exam was exctatic and surprise about the amount of gases in my gut…like all the way to the rectum….the problem is, I din’t feel anything, at least not more that the usual discomfort or the always present reflux. I got that on my mind all this time up ubntil the moment I saw this webste. Tu sum up, I introduce I follow the diet (altought not a 100%) but I cut a lot of the CARBS I could. For instance, for breakfast I cut any type of bread, or crackers…just eggs, or cheese, with some coffee (yes, Cooffee…you dont have to cut it!!) and that’s it…..then, I love rice, but I cut it too….so, for a period of a couple months I was eating just the protein: fish, meat, chicken…and salad or a vegetable on the side (avoid brocoli, at least while you’re trying to get rid of reflux)……Suddenly, I started to feel better, the reflux was less and less…altough still with problems, but it was working!……second thing I did it was to introduce more youghurt to my diet and some probiotic pills to help my intestinal flora grow……the whole thing is the Omeprazol (or whatever kind of PPIs you’re taking) suppresses the acid of you stomach that you need to breakdown all the food…when this happens, chunks of undiagestive (allow me the word, if exists) food that your gut it’s not able to absorb, creating gases…it’s a vicious circle….that’s why some people claim that vinager or lime juice is good ( I tought they were crazy…but now It make sense because reflux it’s caused by lack of acid on your stomach not for having a lot of it) those accumulated gases, pushes all the acid to your esofagus and slowly kill you! People, read all this articles posted online and apply them…..in all honesty it wasn’t hard, I din;t even follow a super strict diet…but you can feel how you can start releasing gases and burps in a very natural way, without having the reflux again. For me, I just borned again and I can’t thank Dr. Kresser enough for this. I stop taking omeprazol 4 months ago…..ohhh that’s the other part of the story….don’t get rid of it all together, but slowly….Istarted taking from daily to very 3 days…then every week….and then all of sudden the pain was gone, and never again….CUT CARBS NOW, eat yogurth with probiotics, or suplements (suplements just temporary, while you’re body recovers) and then, eat everything you want….Im not even following the diet anymore and feel awesome……important, yes!….dont overeat…small portions…OMG Im so happy, I think I type too fast. In any case, if somebody have question, I will be happy to answer, my emails is [email protected]….and please, DON’T PAY anybody for this…there are a lot of bad people out there trying to make money out others suffering.

    Sorry about my english…Im not an english native speaker.

  130. steve says

    Broad-brush, is it possible to follow this protocol (restrict carbs) while managing kidney stones (add more carbs)?

    thanks,
    -steve

  131. Alan says

    Chris – I have really enjoyed reading your articles! I just was diagnosed with LPR/GERD a couple of months ago after never having any digestive issues (I am 51 years old). I eat healthy and exercise a lot. I have reluctantly been taking Omeprazole, and it definitely helps ease the pain (was coughing up blood at one point). However, I do not want to be on it long term.

    Can you take PPIs and effectively do your plan at the same time?

    I was thinking of at least taking the Probiotics and enzymes to help with digestion.

    Thanks!

  132. Christina says

    A lot of this advice is good, especially reducing fiber and carbs and using probiotics. I combine probiotics (both food and supplements) with the Fast Tract diet (details here: http://digestivehealthinstitute.org/2012/08/sibo-diet-and-digestive-health/). I personally didn’t find natural remedies like marshmallow root, slippery elm, enzyme supplements, etc. to be helpful, and I’m concerned that some of those “mucosal” things might be fermentable by bad gut bacteria, causing more gas and thus heartburn. I also tried HCL supplementation, but it actually caused *more* pain because I was still eating foods that were causing gas pressure in my stomach and small intestine, which pushed the now-more-acidic stomach contents up my throat. Major oww!

    For anyone who hasn’t been able to kick GERD with GAPS, SCD, or the paleo/primal diet, I really recommend checking out Fast Tract. The science just makes sense.

  133. Stacy Palmer says

    I found your website prior to being diagnosed with LPR. Once diagnosed, I decided to try your 3 step method. My voice improved within 6 hours! Still raspy, but not nearly as bad. My question is if I am drinking kefir every morning, should I continue to take the probiotic supplement that I have been taking for the last 2 years? Thanks so much for this fantastic website. I have been passing it along to everyone I know with GERD issues. God bless you!

  134. Mustapha says

    Please i would just like to know do iI
    Take the hcl pills before i drink kefir milk ?
    Take the hcl pills before i have fruits ?
    IS there a supplement i could take that has bone broth and DGL
    So in conclusion i should do the following ,
    Eat low carbs , low fibre food only , drink kefir milk and take the hcl pills before each meal, increase the pills if i dont get a heart burn . drink ginger and bitter things .drink Bone broth and DGL soups

    • Arley says

      Then again, something else I forgot to say in my post…….AVOID, at leat while you improve, any kind of cereals….like Kellogs and all that of “morning” breakfast…..they’re the worst trigger food for GERD.

    • says

      Thanks Charlie for the goodarticle and the website which i put in my favourites.I bought a pitcher from Santevia (you can google to see) in Canada to alkalinize my water at home.But i still drink water at the office so i will check what the chlorine content is and compare with your data.If it is very acidic it can be an issue for sure.Would love to get off the ppi’s but i tried this summer over 2 months and gave myself a serious bout of esophagitis plus lpr which i am still fighting.Wonder if there is any hope outside the surgery?HCL (Zypan) gave me ulcer symptoms so i stopped.

      Louis

      • says

        You’re welcome Louis, I hope it works for you! I updated the site this week with a new blog to track my progress and I have to say, NO GERD since I got off the chlorine! The study above is very interesting and I am wondering if replacement of the HCL is the same as eliminating chlorine from the water to replace HCLO (produced by CL2 and HCL) – “Organic Acid” may be the wrong diagnosis in some cases, where the acid is really changed to HCLO and mistaken for loo little acid or organic.

        • Ginny says

          Well, maybe this is why I get heartburn just from drinking water! And it doesn’t matter if it’s from the tap or from a bottle. I will try boiling my water for 20 minutes and see. Thanks!

  135. Tanya says

    So many comments, I find them as helpful as the articles themselves, thank you! Thank you so much Chris for an awesome web site and giving us this forum. I DO NOT have GERD, obvious digestive problems, nothing like that, never have, but I have had Raynaud’s symptoms for over a decade. This past summer was very stressful and the front of one of my lower legs became numb. Very concerning when I’m not only not discovering the cause of the Raynaud’s, but obviously deteriorating further. I then spiraled into a severe case of anemia, I tried to donate blood and was told “see a doctor.” I didn’t. The last time I tried to address anemia, the ferritin I was prescribed made me ill, I couldn’t tolerate it, and that was a naturopath who was not looking for underlying reasons why I would need to supplement with iron, just prescribed it to me. It was time to take back control, after a decade of wondering what had been at the root of my Raynaud’s symptoms and poking at various possible causes – magnesium supplements were the only thing that gave the greatest relief, though there were tantalizing other clues along the way, including a short experiment with Low Dose Naltrexone, which stopped it in its tracks initially, but not continuously. Interesting!

    I’m not positive I’ve found the answer, but I believe I’m on the right track – the anemia turned out to be pernicious – I was woefully low on B-12 – because supplementing with huge doses of lozenges and sprays brought me back to life and stopped the numbness. I found more than one reference in my research to low stomach acid and a connection to Raynaud’s and neurological issues, such as my numb leg. B-12 supplements brought me back to the land of the living, but along the way I noticed that brewer’s yeast and desiccated liver, and all the liver I could stand to eat in a day did NOT have the same effect without the B-12 supplements. Huh? Intrinsic factor not working? OR…stomach acid not working, period??

    I am now supplementing with HCL w/ Peptin and am up to 10 pills with meals with still no burning sensation, which tells me I need to be supplementing! I’m drinking cranberry juice once a day, and also fresh cabbage juice due to the possibility of h. pylori overgrowth being at the root of the low stomach acid. I’m also taking 5 grams of vitamin C/day to battle the accompanying gum disease issues that also reared its ugly head during my stressed-out summer.

    It is working!! The overwhelming craving for carbs (I started cheating with popcorn daily at the height, or more like depth, of the anemia) is now gone. I’ve gone from 3 naps a day and no interest in life to my old energetic self, though my body can’t quite keep up with me yet…it will! Will my Raynaud’s resolve also? Time will tell.

    My mother has a history of low stomach acid, so I had a clue there, but not having any “classical” symptoms of digestive distress, it took the pernicious anemia and neurological oddities to point me in the right direction. She can’t tolerate dairy, it gives her arthritic pain, and I now wonder if that isn’t possibly related to leaky gut caused by low-acid / h. pylori overgrowth… Clearly low stomach acid presents in a variety of ways!

  136. Ginnyu says

    Ok I need some advice. After several days on this Paleo (Jaminet’s version) diet and OFF Lansoprazole (PPI) I have experienced a reoccurrence of the heartburn (but not as bad as before) and of some pain in the middle of my esophagus where I had pain before the PPI. So it seems clear I have moved too quickly .
    I googled “diet changes for esophageal damage” and here’s what turned up:

    Avoid trigger foods like HIGH FAT (emphasis mine), high sugar, alcohol, acidic foods like citrus beverages and tomato products, caffeine, peppermint, and chocolate.

    Chris, which foods do I really need to avoid? I’m willing to do or give up whatever I need to do. In the meantime, I chew much smaller bites, eat smaller meals, swallow much smaller amounts of whatever I drink (I like coffee in the morning), and I already avoid peppermint, alcohol. Also I don’t smoke (quit 2003). Drinking coffee slowly in very small sips helps. I feel no discomfort. And food doesn’t get stuck if I eat small bites and chew well.

    I LIKE coffee, especially tomato. I will give it up though. Wonder for how long? Six months? Or until I’ve lost a good bit of weight? I need to lose about 60 or so pounds (I’m almost 5 feet tall).

    I can’t afford an upper/lower GI right now because I’ve missed so much work due to the my problem with walking (numbness/heaviness/balance problems). I’m still not up to full-time.

    Thanks!

    • Arley says

      Ginnyu,

      Don’t cut the PPI’s at once…do it slowly…..take it every 3 or 4 days while you’re trying to get better. Something I forgot to mention in my recent post, is that SUGAR is the worse….replace sugar with HONEY. I don’t know where you live but if you have a COSTCO neaby they sell this huge bottle of imported honey for about 14 bucks. It’s worth it! Carbs and sugars are the worse….not the coffee, neither the fats (I mean decent amount of fat, actuallly your body needs it, like REAL butter, and some of the fat from different kind of meats) Also avoid any kind of process food (I guess needless to say) I hope you get better, and also remember, a mild gastritis or hertburn (once in a while) it is normal depending of what you eat…for that you can have some mylanta or tums…it’s fine.

      • Ginny says

        Thanks for your reply, Arley. I did cut back on the Prevacid at first to where I was taking it every 3rd day, but then found out that taking it like that did not help at all. So that’s when and why I just quit. I did have baad heartburn after that, but mainly it was because I was eating 2 or 3 eggs for breakfast with bacon and some kind of vegetable (mostly sweet potato). It was too much fat. So I began cutting down to 1 egg and 1 piece of bacon. Not as much heartburn then but still some several hours after breakfast.

        The other day I slipped up big time and ate a piece of pizza. MAN! I had the worst heartburn after that for several hours. I skipped supper. Learned my lesson. That was the first bit of grain I’ve had in almost 8 weeks. By contrast, the next day I followed my diet to the letter and NO heartburn at all!

  137. Ginny says

    I’ve been having some scary symptoms of numbness in my feet (that goes away with rest) and tremor in my hands for some time now. It got worse about a month ago when I began to feel a very jittery muscular feeling in my legs accompanied by the feeling my knees were going to buckle. All this seems to lessen or stop, except for the tremor which does lessen some, with rest or lying down.

    The neurologist today said it may be due to anxiety. I think he’s a jerk. IOW I’m on my own.

    Anyway these symptoms have scared the crap out of me, enough so to make radical changes in my diet hoping it will help. “The Perfect Health Diet” by Paul Jaminet and his wife is the diet I started this past Saturday (three days ago). I cleaned out my fridge and cabinets and restocked with all healthy stuff.

    Which brings me to my question. Almost. The first full day of following the diet, I forgot to take my Lansoprazole (PPI) which I have been on for almost 2 years. But surprisingly I didn’t need it! YAY!

    The next day, I didn’t take it either. I got a twinge of heartburn that went away rather quickly. Yay! The third day, yesterday, I ate something I probably shouldn’t have. Steak and baked potato. I got heartburn!

    I fasted from 6pm yesterday until 11am this morning. Still following the diet. I got heartburn again today after eating breakfast. Been 3 days without Lansoprazole and don’t want to stop this trend because frankly I only have one pill left and I really can’t afford to get a refill (I was out of work for almost 3 weeks, and am still not back up to full-time yet.) Plus I am wondering if low Magnesium due to Lansoprazole might be to blame for some of the symptoms I am having in my muscles, so I want to come off it.

    My sister, who is a nurse (as I am), thinks my gallbladder is bad. I still have yet to get a probiotic and HCL, (I am eating some pickles.) I have to wait until payday this Friday to get those.
    Do you think I just need to cut my portion sizes? Do you think it’s my gallbladder?

    I’m a little afraid of taking HCL to be honest.

    • Jasmine says

      Hi Ginny,

      Please get your B12 tested. It is a standard blood test and should not cost and arm and a leg. An optimal score for B12 is 1000 pg/ml. The shaking and leg problems are initial indicators of B12 deficiency, which, if left over a year, become permanent and will lead to worse problems. After reading the book ‘Could It Be B12?’ I noticed the shaking in my father and asked if he had leg cramps. He did, got tested and was found to be at a dangerously low level of 165 pg/ml. After receiving a few B12 injections his shaking is gone, his legs no longer hurt, he has bounce and joy again and can retain information. The doctor did not diagnose the problem nor did he think my father (and others we know) needed the injections. He was proven wrong. You may like to get a copy of the book, I hope it helps.

  138. klkks says

    I have been taking 20mg of Prilosec once per day for the past 20 years for acid reflux. Within the past year I have had to take a supplemental famotidine (generic Pepcid) each night before bedtime. Now, the past couple of months I have had to take a famotidine before supper in addition to the one before bed, and I have developed that nagging GERD cough. I would really like to get off all of it. I have tried several times to quit “cold turkey” but that only lasts a few days till I can’t stand the acid reflux any longer. After finding this website today I am quite excited to try the DGL and possibly the HCL and the mastic. However, I have a possible complication that I have not seen addressed in the forum discussions.

    I am 61 years old. I began taking Prilosec in about 1993 for GERD. Since then I have gained about 30 extra pounds. In 1998 I began having symptoms of Reynaud’s syndrome with eight of my ten fingers turning white at the slightest bit of cold. A couple years ago I equated, although unproven, that the constant use of Prilosec may have induced the Reynaud’s because I was not absorbing the proper circulatory nutrients, especially Magnesium. Mag supplements over the past year have significantly reduced the symptoms but not eliminated them.

    In late 2000 and again in mid 2001 I had three pulmonary embolisms which resulted in my being on Warfarin for the rest of my life. I had all the tests known to try to find the cause, with the results that there is not a known cause or origination for my PEs.

    My pharmacist indicates the DGL will probably make my INR rise but I will try it in a few days and go in for the extra blood tests. I have not reviewed every discussion on every page of this website but in skimming the site, I did not see any references to others using Warfarin in conjunction with any of the suggested GERD preventions treatments listed on this site. I’m excited to try some of these treatments and get off Prilosec forever. However, I am cautious because of the possibly interactions with the Warfarin.

    Has anyone who has been on this site had any experience with Warfarin and the GERD treatments listed?

    • says

      Not really related to the GERD discussion or warfarin, but your pulmonary embolisms may have had something to do with MTHFR mutations, so the PPIs could have contributed to that, too. It would probably be a good idea to take methylcobalamin (the active form of B12) and methylfolate.

  139. Marcy says

    Hello,
    I have a hiatal hernia which was found in a CT scan after an automobile accident. I had been having heartburn regularly which got worse and my doctor prescribed PPIs. I have been taking those for about 10 yrs. Now am having bowel trouble, diarhea, which I am thinking is caused from the imbalance in my gut. I also think I may be gluten intolerant and have avoided breads, pastas, etc. for the past two months. I did well up until this week. Have had many bouts with diarhea in the past week – cramps, and bloating. What do you suggest I try first?

  140. DbS says

    My 4-year-old son (who went through cancer at age 2) and I have frequent heartburn. My 8-year-old has started as well. For the last 3 years we have been eating almost exclussively organic and whole foods. Nothing processed, all whole grain and grass fed. However, the reflux is as bad or worse. We live in an agricultural area. Is there any way that the water from our 40ft. well could be adding something to our diets that could cause this, or cause a low stomach acid pH? The pH of the water is 7.5. We are interested in testing it, but aren’t sure what to look for. I found your articles on GERD and raw milk fascinating.

  141. Bruce says

    Hello Chris,
    Thanks for the great article,
    I have been fighting GERD/ Heartburn for the last few years. I believe that Stress and several rounds of antibiotics have set off the chain reaction to cause low stomach acid and a possible case of H pylori
    I have started taking an multi enzyme supplement that has 400mg Betaine Hydrochloride and 20mg Pepsin as well as DGL after meals. I have also just ordered your Prescript-Assist Probiotic to get my gut flora back into shape. How long will it take to start seeing results? When will I know its time to cut back on the Betaine Hydrochloride?

    Thanks
    Bruce

    • Bruce says

      Chris,
      Also wanted to know if extra virgin coconut oil is good for correcting GERD?
      I have read both that it is and that is not which is true?

      Thanks
      Bruce

  142. Lorrie says

    Having terrible GERD symptoms now and they always get worse if I gain weight. This time though I have something new with it… a buzzing in my chest. It’s very weird feeling and I am anxious to get rid of it!! Baking soda usually does the trick for me but not this time :-(

  143. Amiel says

    Hi Chris

    I was recently diagnosed with GERD. After years of eating a mainly curry based diet and enjoying really spicy food.

    I am also diabetic and my GP put me on LENAMET for the GERD and also prescribed antacid treatments for a period of 6 months with severe side effects.

    I would still like to enjoy an occasional curry and a glass of wine or even a sugar free softdrink. Please tell me whats the best way forward naturally to combat the effects of GERD or to eliminate the problem completely.

  144. Dotty says

    Hi Chris, I have been on acid reducers for over 30 yrs. starting with zantac and up to nexium. I now have osteoporosis and had 32 polyps taken out of my stomach. I stopped taking them 3 weeks. I still get heartburn but no aspirating at night. I take Braggs vinegar 2tsp in 1 cup of warm water and 1 tsp of honey every am. I bought DGL but haven’t started taking it yet. I don’t eat wheat or dairy due to allergys.
    Am I taking enough vinegar or do you recommend more? How much DGL do you recommend?

  145. says

    Dear Kris,

    Could you clear up with me if you have to have protein to take the ox bile, or the betaine hydrocholorine with pepsin. Not so sure I eat enough protein-I do not want to hurt my intestines. Otherwise, what should I take?

    Thanks

    Terri

  146. Kelly C. says

    I’m so glad I came across this site on Pinterest! The explanations of the causes of acid reflux are very informative. I’m hoping the treatment options given here apply to LPR, too – I don’t think I have GERD, as my only symptoms are a horrible, dry cough (2+ years now) and a sore throat. My ENT diagnosed me with acid reflux a month ago and immediately put me on Omeprazole without even suggesting I change my diet – makes me mad, now that I think about it. After reading all the dangers of PPIs on this site and others, I’ve decided to take myself off of them immediately. I’ve been on them 4 weeks and I’m getting worse, not better – my cough is just as bad, my throat is sore almost every day now (was rarely sore before), and I’ve been so sick (2 sinus infections, a cold, and two rounds of pinkeye in just a month!!). Oh, and I was diagnosed with asthma, too, while taking it.

    I’m going to start a low-carb, gluten- and wheat-free diet tomorrow, along with taking DGL licorice, apple cider vinegar, kombucha, and kefir. The low-carb part will be REALLY hard, as I love my sweets! Crossing my fingers my sore throat goes away, my cough decreases, and I start to feel healthier. Will consider HCL if none of the above works, but I am hopeful it will!

    I’d love to hear from anyone else with LPR, not GERD, who benefitted from these supplements/diet changes.

    • louis says

      Hi Kelly,
      Just looked at LPR on google and i think i have the same thing.However in my opinion if you have LPR you also have GERD because your throat is irritated by the acids from your stomach coming back up.I hope you can find a natural solution but i have tried getting off the PPI’s and i always end up with painful esophagitis and this time my throat is affected.I am having a mannometry test in two weeks to see if i am a good candidate for Nissen Fundoplication as the pills no longer work well anymore even if they keep the damage from growing too much.Surgery is last resort but i am getting close to that.I tried the HCL,Zypan supplements and i get the same esophagitis symptoms so i don’t think my problem is low acid levels.Hope you find a solution.

    • Jenn S says

      My husband was recently diagnosed with LPR. He has also had chronic cough for years (thought it was asthma), but then began to have laryngospasms (choking attacks) that are a symptom of severe LPR. He was actually hospitalized and had a ton of tests. They did find a hiatal hernia and definite signs of LPR. His prescription is 40 mg of prilosec twice a day and an additional acid blocker at night. Crazy. He is taking it and so far it has seemed to help his cough. He has only had one minor (in comparison) laryngospasm since being on the drugs. I believe what I am reading on this website, but am overwhelmed at the thought of how to transition from the treatment he’s been given to a natural treatment that is really opposite of what the doctors say (building stomach acid instead of stopping it). I guess I’m just looking for some support. Read that you have LPR and wonder if you have tried any of the changes and if you are having a positive result?

  147. Benj says

    I’ve been dealing with severe GERD daily for over 2 years after taking Kre-Alkalyn creatine for only a couple of days, which might have unbalance my stomach Ph or something. Gaz are constantly trapped in my stomach since then. I need to eat at least every 2 hours in order to keep the reflux tolerable. I have been through all the possible tests my gastroenterologist asked me to. I’ve been prescribed anti-acids but they don’t work. I tried alternative treatments such as HCl with pepsin, aloe, slippery elm and other digestive enzymes, without much results. Also more exercise, more fruits and veggies, less single carbs, etc. I’m vegetarian, I don’t smoke and rarely drink alcohol.

    Coffee, diluted apple cider vinegar and fruits gum seem to help a little (which makes me think my stomach Ph might be too low) but the GERD still persists daily. Any suggestions for improvement or healing perhaps? Thank you.

  148. Tim says

    Louis

    Your situation sounds exactly the same as me. I developed GERD 15 years ago and spent 14 years on PPIs. After they stared failing I was endoscoped and polyps were removed. I decided to stop PPIs as I read such bad things about them. I have been consistently tested negative for HP both stomach biopsies and stool test. I have been off PPIs for 9 months now and have had mixed results. Sometimes HCL helps and the only consistent thing is cutting out carbs almost completely. I find this difficult and I still may flare up once in the day. Most days I have heartburn from 11am until bedtime and it gets me down. I also have gastritis (diagnosed during 2 endoscopes. I decided to rule out SIBO and have sent of an expensive but very comprehensive stool test. I am determined to solve this without surgery as I read such bad things about the NF procedure and the Lynx system seems to have mixed results. If you want to look at SIBO in more detail and the possibility that it could be causing your symptoms, then check out a guy called Dave Hompes (YouTube and Web) and also google SIBO. good luck with whatever you try, I totally understand your anguish. People just don’t get how this stuff can destroy your life.

    • LOUIS says

      Thanks Tim for the feedback.I believe when i had gastroscopies they took biopsies and didn’t find anything in the small intestine but i will ask the gastro about SIBO when i go back.Was curious about your symptoms when you stopped the PPI’s…No big ulcer type cramps in the oesophagus?If you don’t have that it means your oesophagus is likely still in decent shape.Low carb diet seems to help me but i still have cramps close to small intestine every day plus nausea etc…from the reflux.Last 3 months it has been in the throat also.I agree with you people have to live through it to understand…

      • Tim says

        Hi Louis. I stopped PPIs having been low carb for a few weeks (trying to lose weight). The only symtoms I received was the usual heartburn. I often get bloating and lower abdominal pain which lasts a few hours but always wears off and I am convinced it is bacterial issues. I came off the PPIs as I had a manometry study, I then decided to stay off them following research which suggested that the polyps in my stomach were likely due to the use of them for 13-14 years. Also reading this article from Chris made me start to appreciate that cutting your acid production is so bad for your digestive system. I have nail issues, itching scalp, fatigue, low emotional states and I think this is all due to mal-absorption of food. I just think that the digestive process in the stomach does not take place, complex carbs go through and feed the bad bacteria in the gut and proteins are undigested and not broken down to amino acids for absorption. I am hoping that the stool test confirms the overgrowth which could be causing the heartburn and possibly the gastritis. The manometry study I had suggested low motility and they say this can be caused by long term exposure to acid in the oesophagus. For this reason, they took 2 biopsies in the oesophagus on my last endoscope which were quite normal. Apart from the symptoms described above (fatigue, heartburn pain etc), I get so worried about damage to the oesophagus so am quite motivated to try to resolve this.

  149. Tammie says

    Hi Chris! I am new to your website. I am loving all your knowledge and wisdom, not only for myself but reading over your site as spurred me on to dig deeper into gut health/digestion for my patients sake. I am a conventionally trained RD and in the past few years I have need educating myself as my conventional education is a bunch of, well, you-know-what! You recommend pepsin with HCL yet your product does not show pepsin in the ingredients. Is there pepsin in your HCL product?

    Thanks!

  150. says

    Hi Chris,
    I have had GERD and been on ppi’s for 15 years.I now have moderate oesophagitis symptoms in parts of my oesophagus and inflammation in two areas of my stomach.I have tried stopping the pills and everytime i get painful response in my oesophagus and this recent try i also developed laringitis in my throat therefore i go back to the pills.I have stomach cramps close to small intestine almost all the time when digesting except for mornings when i have smoothies.I also have a lot of gases internal and external but bloating is reasonable on a light low fat diet.I tried the hydrochloric acid supplement ZYPAN and same thing i got ulcer like symptoms in my oesophagus.Unfortunately my stomach is struggling with the ppi’s but no identified h pylori.I am pushing hard to get the heath system in Canada to consider me for surgery but are there other things i should try first?

  151. Guy Horst says

    Hello Chris –

    What a great series of articles, thanks a lot!
    Do you have suggestions or advice concerning Hietal Hernias, and the symptoms related to it?
    My symptoms are much more like stomach pain, and not the ‘typical’ heartburn feeling.

    Thanks a lot,
    Guy

  152. Lynn says

    I recently had my gallbladder removed. Should I do anything differently than what you recommend. I have been on omeprazole for years.

  153. Misty says

    I’m afraid I’d have to disagree with your assessment that fiber is bad for GERD. Quite the opposite proved true for me. I had to take prescription medication for years, and even that didn’t eliminate it. When I increased fiber in my diet, I began to notice fewer issues, and pretty soon I was able to start NOT taking my medicine every day. After a month, I had no complaint. Twice I’ve had ‘relapses’–both times were following a period of me not paying much attention to my diet (and also not getting significant fiber). Each time, paying more attention to fiber intake has taken care of the problem. My doctor confirmed that fiber is often good for these conditions. I’ve since recommended it to a friend with acid issues, and she too has had a reduction in symptoms. So I’m not sure where you got your info, but it certainly isn’t across-the-board correct.

  154. Claudia says

    Dear Chris,
    Thanks for your well-researched articles!
    I have been suffering from what seems to be GERD for years. I generally eat very healthy, no processed foods, not much sugar, and recently I cut significantly on carbs. I am not overweight and I do not drink or smoke. I started making my own bone broths.
    Yet I still get bloated stomach sometimes even when I have not eaten anything bad for GERD.
    I was once tested positive for h pylori but now it is negative. I tested positive to some parasites that my doctor said were not damaging…

    I have two questions:
    1) is drinking grain coffee ok? (made with chicory and grains)
    2) what can I do to figure out what causes my bloating?

    I hope you can help

  155. barb says

    Hi Chris,
    You mention in the article not to take HCl supplements if you have been taking NSAID’s. I have back issues and do sometimes take them. If I have not taken them for a week or two, is it safe to try the hcl? And if my back pain gets bad, can I take NSAId’s if I stop the hcl (temporarily)? I really want to try it as my dr. is insisting I go on PPI’s.
    Thanks,
    barb

  156. Emily says

    To Vanessa,

    Apples can cause issue for people that have FODMAP intolerance. You can research FODMAP intolerance on the Internet. Some sites will give you a list of FODMAP foods to avoid. I have had to eliminate FODMAP foods from my diet and it seems to help. Also honey and dairy can cause problems with heartburn/reflux. I too cannot eat those and have had to eliminate them from my diet to avoid heartburn.

  157. matt says

    Hi-

    I have recently stopped taking PPIs and have switched to Zypan and probiotics at the recommendation of my naturopath. It has been a few weeks and I am not sure that it is working. Does anyone know how long it can take to respond to this treatment?

    Thanks

  158. Vanessa says

    Hi! Im fromm exico city and have barrets esophagus since age 18 im 40 now , i took omeprazol for almost 18 years until i started. Y spiritual path and took preference in alternative medicine and nowadays even more that i know medicine sometimes is worse than not taking anything, i have been on a paleo not very strict way of eating for 3months and feel grat but i have been feeling lts of acid when i exercise sometimes after my morning juice ( beet, lime, spinach, apple, cucumber and cacao) and sometimes after eating fruit, i dont want to go back too meprazol at all but i dont want esophageal burn either and i have found NO DOCTOR INME XICO CITY is able to treat me without antiacid. PLEASE help me, i recently added some honey and some organic cheese, would this be it, and also cani. Get cured ordoi. Need surgery? I tried to get a consultation inskype but no new patients are accepted now. Please olease help.

  159. jasmine says

    Dr Kresser please give me your advice. I suffer from Gerd along with a bunch of other things. For one I have sarcoidosis and was given protonix to protect my stomach from the prednisone (I’m no longer on prednisone). Now since june I have been battling with chronic sinusitis along with eustachian tube dysfunction and at times have trouble taking a deep breathe and from time to time get discomfort behind my right chest. All of these symptoms occurred after about 2 -3 months of me smoking and eating a lot. This is about the 4th ent doctor I have seen and this one thinks that maybe my issues have to do with Gerd (which I had too, come to that conclusion). He said sometimes though rarely the acid can go back up and affect the sinuses, so he prescribed me Dexilant along with Azelastine HCI & Qnasl. Though I haven’t got the Dexilant and Qnasl yet because there’s an issue with my insurance Im wondering if/when I do obtain either that or a generic form should I take them? I also have a thornwaldt cyst (despite being told its not big) which I believe is another culprit for my Etd. My sarcoid
    1st started in my lungs but was given 6 months of prednisone the 1st time without any PPI. My lungs improved but sadly the disease spread to my liver and spleen enlarging both. So that was the time I was given a PPI to protect my stomach against the steroids this time around. Well the steroids wasn’t effective.My organs are still the same size after about 7 months of taking steroids. So the rhuemotologist wants to try methotrexate along with humira. But I’m wondering should I take a PPI when I do start this cocktail to protect my stomach? I’ve been bothering my G.I doc to do an endoscopy to see the state of my insides if they are damaged from the pills, the over eating and smoking I had did ( I stopped smoking pot since june 22/13, I learned my lesson). But he wants to talk to my pulmonary doctor for clearance because of the trouble breathing (which is not due to the sarcoid of my lungs, because that had improved) but I believe it’s due to the Gerd along with maybe the pressure from both organs pressing against maybe my stomach/lung or whatever . So Dr should I ever take a PPI again in my life is the question, even if when I have to take medicines for my sarcoid? And should I at least take it for a month like Im suppose to for my sinus and eustachian tubes problems before following up with Ent in october? Please give my your input, It seems like only the knowledgeable doctors are either online or are in other states. Im in Nyc but a lot of these doctors I have dealt with are not informed about there own specialties.

    *On a side note I just learned about spirulina and Im gonna try until I succeed to stick to a nice diet where I eat reasonable foods at a reasonable amount.

  160. phil hughes says

    hi im suffering from acid reflux I have to admit that I did drink a few cans of beers a night and my I started to get a beer bellie everything was fine until now I started to feel very bloated and uncomfatable and started to get pains in my stomach I went to see my doctor who put me on omeprazole capsules 20mg ive been taking these for near on 2 weeks and everything looked good but now the pains in my stomach are back these are the kind of pains you get as if someone has punched you in the stomach I find it hard to get to sleep of a night and get if im lucky 2 hrs sleep a night could you please give me some advice as to what these pains could be p.s. I have not had a drink in 2 weeks and just want to get better any ideas ? thanks phil

  161. Melissa says

    Hi Chris,

    Do you have any recommendations for treatments re: GERD for infants? My baby is now 7 months old, and was ‘diagnosed’ with GERD a few month’s ago by our pediatrician. She has been on Nexium for 3 months now, but I am desperate to get her off of this medication. I am currently giving her probiotics and bone broths (as well as some vegetables, fruits and pureed meats). I personally follow a Weston-Price diet. Is there anything else that you can recommend to help remedy her GERD? Also, do you have any information about GERD in infants; ie. why there seems to be an overwhelming amount of babies being diagnosed with this condition and being put on medication.

    Thank you!

    • Emily says

      Melissa,

      Are your breastfeeding her? If not, I would try and get her off cow’s milk and try goat’s milk or almond milk. She may have a problem with cow’s milk protein as my son did. We tried numerous milks until we settled on almond. Soy gave him diarrhea and he didn’t do very well on goat milk either, but I wanted him to have the fat from it as he was still getting most of his nutrition from milk at that point. I eat Paleo myself and and have struggled with GERD for over twenty years before finally finding some relief in pulling out all grains from my diet (I also have nightshade and FODMAP sensitivities). Hope this helps!

  162. Solomani says

    Hi Doctor,

    Great articles. These have helped me a lot in shedding light on this condition that has just hit me. I am a little confused … do you have an opinion on caffeine – good or bad? It promotes acid production it seems but it also relaxes the LES. At least that’s my understanding? Or its one of those if it doesn’t cause a reaction OK to have?

    Thanks in advance.

  163. Starry-eyed says

    Hi Chris (or other knowledgable folk),

    Semi-urgent quick question.

    I have GERD. Also have: bloody stool, green mucus, and white film in stool. (Eek!)

    I’m very young — it appears that I don’t have any tears or blockages from recent ER x-rays (though I’m not sure whether these are even accurate indicators).

    I have been consistently VLC (I have ketones in my urine). Recently, I’ve been developing severe bloating and have trouble digesting GF beef.

    Recently (8 days ago), the GERD + fever + bloody stool all developed at once, and I’m quite alarmed.

    Distended abdomen, diarrhea of all foods, foods pass through in a matter of 1-5 hours. Pain, only eating eggs (nothing else seems to digest) and some Brazil nuts…

    Is there any reason at all I shouldn’t try the HCl supplementation?

    Might I have an ulcer/diverticulis/something else already?

    Any help is appreciated.

  164. feroz says

    Hi Chris
    my symptoms are very similar to Jules above. i have this pain/discomfort in my upper chest area for around three months, it comes and goes, i went to see the GP and he gave gave me Lansoprazole and the pain stopped for a while after a week of taking them which i took for around three weeks then stopped as i’m not comfortable with pills without getting to the root of the problem.the pain is not that bad at the moment its more discomfort just every so often i have an antacid for it. I’m not a big person and around 78kg and do like to go gym alot, want to know if the gym has anything to do with it as i have started taking whey protien supplements.the pain goes away at night when i get in bed which is a bit confusing and then graduallly comes back in the course of the day.

    basically my only symptom is the pain/discomfort in the upper chest area only during the day.
    would i make it worse by going to the gym.

    im going to try the low carb diet and and try the HCL and see where it takes me also do you have any suggestions as to what it could be.

    Thanks

  165. Steph says

    Hi Chris,

    I am in my mid twenties and have been on PPIs for almost ten years. I am currently pregnant, and am unsure what parts of your testing/treatment recommendations are safe during pregnancy. Can you please help advise me? Thank you!

  166. Jules says

    Hi Chris, great site and really interesting series of articles about GERD. I stumbled upon them by accident as I was googling various aspects of low-carb diets. I started a moderately low carb – 50g per day – diet a week ago, I’m avoiding grains and starchy vegetables so the carbs I’m eating are coming from vegetables, a little fruit (berries only) and I’m still eating some Greek yoghurt and a little milk daily. Other than that, fairly high fat and moderate protein. Pretty much Primal.

    I have acid reflux but I’m not sure if it’s GERD – I’m in the UK and medical terminology is sometimes different. There’s a long history that basically amounts to various episodes of acid reflux but the symptoms were NOT heartburn (which I have never experienced), but rather a dry cough and slight sore throat plus extremely severe chest and/or upper back pain. I had a lot of hospital tests to rule out any cardiac or pulmonary issues because of the main symptom being chest pain. I’m in my mid-30s and a little overweight – about 155, BMI about 26.5. That’s why I’ve just gone on a low carb diet!

    The end of the story is I’ve been taking Lansoprazole on and off for the last year or so. I say ‘on and off’ because basically I’m not very good at taking it (!) What happens is I forget for ages and then the chest pain comes back and that obviously makes me remember (I was off it for 3 months earlier this year before the pain came back). The chest pain is pretty extreme so that does make me slightly nervous about this approach.

    I have had a gastroscopy nothing significant found apart from an apparently ‘very minor’ degree of irritation in the oesophagus.

    That said, I think it’s possible I may have a sliding hiatal hernia, usually triggered by certain kinds of exercise (episodes appear to occur more frequently after intense and more-than-usually-acrobatic personal training sessions!) but I’ve only noticed this a couple of times so can’t draw a clear link, though my general practitioner thinks I may be right.

    Bearing all of this in mind, does it feel reasonable to try this approach? (I’ve read the instructions and understand about ramping up dosage slowly but obviously I’ll need to come off the Lansoprazole too hence the nervousness. I’m mainly asking as I’m not sure if, with my main symptoms being chest pain rather than heartburn, I’d be a suitable candidate.)

  167. Kristine says

    I read in one of the posts – “A rare percentage of people actually do over-produce stomach acid, so it’s important to make sure you’re not one of them.” If this is me, what then?

    ACV, lemon, HCL, any enzymes, garlic, spicy anything, even in teeny-tiny amounts causes so much gut inflammation that I can’t eat for 24 hours. I am severely malnourished (100lbs, 5’10”) going on 13 years now, unknown cause, other than malabsorption. Significant hiatal hernia and BE. I’ve been on GAPS and lots of good probiotics for 2 years, which helped me feel a LOT better, but has led to further weight loss. I recently tested positive for h.pylori, but know I can’t handle the antibiotics because of gut sensitivity. PPI’s give me intolerable side effects as well. I’m trying manuka honey with no luck, mastic gum gave me terrible mood swings.

    I’m confused, doesn’t h.pylori produce a low acid environment? I clearly can’t handle more acid, so what next? Even though the head of my bed is up on 5 1/2″ blocks, that pain under the breastbone is acting up badly and I have a 3 month wait for an endoscopy.

    • Jennifer says

      Dear Kristine,

      I feel like I have the same problems as you. I have severe acid reflux for years. I have tried everything and every kind of medicine, but the only thing that helps me is eat an extremely bland diet. I have eaten low carb for years but have lost too much weight. I am 5ft and at my lowest I have weighed 85 lbs. I can not eat anything acidic at all (high fat, spices, citrus, oil, garlic, etc). I have managed to get off of medicine for the most part and just eat extremely mild food. I feel like my body does produce too much acid. I don’t know what to do, but Paleo is not for me because no grains causes me to lose more and more weight because I can’t eat high fat food. If you find some answers let me know. I’m in the same boat as you.

      Jennifer,

  168. Ellis says

    From this article, I gathered that, regardless of other suggestions, the crux Dr. Kresser’s plan is a permanent low to moderate carbohydrate diet. I’ve thought a bit about this and it’s simply not feasible for myself. I have a very fast metabolism and at 6’5, 210 lbs, I have to eat A LOT of food on a daily basis. To regulate my diet to only be able to eat a small amount of carbs seems impossible and would negatively affect my quality of life more than I want.

    Is my understanding of Dr. Kresser’s plan correct? Would other suggestions in the plan be effective if I left out the low/moderate carb diet?

    • Valerie says

      I would suggest that you read “The Art and Science of Low Carbohydrate Performance” by Volek and Phinney.
      It explains the use of a low-carbohydrate diet for athletes, especially those who do what I would call extreme sports requiring great endurance, such as marathon running and long-distance cycling. It is also great for lesser mortals!
      You can get all the energy you need, without loading up with carbohydrates. Your quality of life would improve!
      Don’t just say it seems impossible. Give it a go! But read the book first.

  169. Alyeska says

    Hi Chris,
    I have a question and I’m hoping you can help. I started taking a digestive enzyme supplement with Betaine HCL a few days ago and, although it seemed to help on the first day, I’m back to having reflux and bloating after meals. I also have abdominal pain sometimes randomly during the day. I looked at the supplement and the dosage of HCL is very low (120 mg). Could it be that I just need to take more? Or could it be that I have an ulcer? If I suspect an ulcer, could HCL make it worse?
    Thank you for your help!

  170. Mike says

    In regards to ‘very low carbohydrate’, how low is ‘very low’? Below 50g per day? Or is 100-150g acceptable. Also, could you tell me how long is the ‘vlc’ phase typically for? Days? Weeks? Months? Trying to get a perspective on what sort of time-frame and values I should be aiming for here.

  171. Elaine says

    I have been suffering from acid reflux for years but didn’t realize it until recently. I do not have heartburn but I always feel something in my throat and can never clear it out. Not to mention I have suffered from bb for years as a result of this. I am mostly vegan and therefore do tend to eat a lot of carbs and fiber. I have been taking digestive enzymes and probiotics for years and continue to do so even though it has not really helped. I will try taking the HCL with pepsin immediately to see if it helps. I would also like to switch to a VLC diet as suggested but can anyone please recommend a specific diet regimen? I am open to eating pretty much anything if it will help (except dairy). thanks in advance!!

  172. amy says

    I just wanted to say thank you for taking the time to educate yourself outside of the box and make this information public so that we could all benefit from it. You helped my problems (and it seems many other people’s too) when my doctors couldn’t. I’ve spent so much time and money to get the answer, and here you have it free and easy. The world truly needs more doctors like you! Thanks for caring and being so great at what you do.

  173. Brittany says

    In a nutshell acid reflux can be caused by either high or low stomach acid?

    If my pH is 7.0 I still have terrible reflux- is that normal?

    Lastly, HCL should not be used if the reflux has caused esophageal ulcer correct?

    Thank you!

  174. Alexander Hamilton says

    I still had a bloated feeling after lunch, and am still refluxing. My throat, both last night and today, hurt a bit more than normal and had a slightly acidic feeling in my stomach. Thus I’m going to take it easy tonight and skip the HCL tablet and reassess tomorrow.

    Thus the jury is still out…

    • Emily says

      Alexander,

      It is possible that you are a candidate for the Paleo diet. The HCL did not work for me either. I had to get off all grains and dairy to kick the heartburn. Previously I had tried gluten-free/dairy-free, but that wasn’t enough. I stopped eating oatmeal in the morning and surprise, had no heartrburn. I stayed off grains the rest of the day and bam, no heartburn. Just a suggestion. Those are hard to give up, but if you really want to feel better, you’ll decide to try it.

      • Alexander Hamilton says

        Yes, good call. So my update a few days later is that I’m still having mixed results with the Betaine HCL. I don’t notice any less reflux when I take it with a meal, on balance, but I notice that when I reflux my throat hurts a bit more.

        I have noticed my acid reflux is worse after big, heavy meals (duh). And that I am more congested at night when I eat closer to bedtime (duh).

        I have a suspicion I have more reflux with greek yogurt & kefir (supposedly safe for those with lactose intolerance), and slightly more reflux when I eat kimchi with meals (for the probiotics, but it is spicy). Also, I seem to have more reflux with steak than poultry or fish. Grains also do “seem” to be an issue. I’ll have to stop getting my veggies by cooking them with brown rice… Since I do have variation in reflux after each meal, and I now eat 4-5 meals a day, each one of these theories should be testable…

        • Alexander Hamilton says

          Another update: W/ apologies for spamming, but I’m hoping this may be helpful for other readers whose lives are being ruined by acid reflux.

          So last night I had a smallish very low carb dinner 5 hours before bedtime, and it worked. I did start getting a bit hungry around 11. Before my diagnosis, I would have satisfied that hunger, but no chance now. I was definitely less stuffed than when I eat larger meals. However, I still refluxed, even though all I ate was four pieces of chicken and a half cup of chicken broth. I still woke up in the middle of the night with a dry throat feeling, and a slightly clogged nose, so my problems haven’t been solved, but there was clear improvement. I could at least breathe (somewhat) out of both nostrils, a rarity.

          Of course, I ate dinner at 7 and went to bed at 12 — the obvious way to work on this improvement is to start eating dinners earlier and earlier, and do the bulk of my eating earlier in the day. If I do better eating a light dinner 5 hours before bedtime than with a bulky dinner 4 hours before bedtime, it stands to reason that I could improve with eating an even lighter dinner 6 hours before bedtime, while also adding in an additional post-lunch snack.

          Eating a VLC paleo diet does seem to help. I seem to reflux no matter what I eat, but I reflux less when I eat less. High fat meals are more filling than carbs, and imply eating less overall. Thus there is a positive mechanical impact of of VLC diets. The second impact is that while I’m already thin, I could easily lose 5-10 pounds which implies less pressure on the stomach and could also help with acid reflux according to the literature.

          I’m also going to increase my bed tilt another 1/4-1/2 inch and see if it helps…

          • Thorstein Veblen says

            Yet another update: My H Pylori test came back negative (took a week), and my primary care physician is gone for summer. Her stand-in said he would not give me a referral to a GI specialist until I’d tried more drugs!

            The picture I’m getting of what happened to me is that I took a bunch of codeine when I broke my leg and had surgery, and this weakened my LES tone. So my acid reflux isn’t caused by low acid or a food allergy to dairy/grains, which I’ve been avoiding.

            My breathing was better last night with an even earlier dinner — dinner finished by 6, bed at 12:30. But even then, I still woke up and though my nose wasn’t stuffed up I had a surprisingly sore throat. Thus, I’ve got another three pronged strategy for tonight: 1. Again moved up my dinner time slightly, 2. Again increase the tilt on my bed, the NIH page on GERD actually says 6-8 inches: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/ , 3. The NIH page also lists Gaviscon as a potential remedy. While Gaviscon is another antacid, and doesn’t sound like something I want to take long-term, I like the “barrier” idea and the idea of protecting my esophagus. It’s supposed to be less of an antacid than Zantac. My plan is to let my dinner digest and then try my generic Gaviscon (cheaper than the real thing) tonight.

            Hopefully, these three things will do the trick…

            • Thorstein Veblen says

              Update: Past couple of nights early, light dinners (5 PM, 7 hours before when i sleep) plus an enormous lift in bed plus Gaviscon right before sleeping have done the trick, thank god.

  175. Alexander Hamilton says

    Update II: i took the first betaine hcl with dinner yesterday, after taking a dgl pill earlier. during the meal i felt a bit bloated, and immediately after i still had some rumbling, belching, and stomach uneasiness. however, when i woke up in the middle of the night i had noticeably less stuffiness than usual — it is seemingly working. on the other hand, my throat was a bit more sore than normal. i also feel a bit better today. not wanting to overdo it, i did the dgl pill but not the hcl pill for breakfast, but then took the hcl for lunch with my chicken soup. i’m still having some acid reflux, but it’s only day 2.

    the early results are promising.

  176. Alexander Hamilton says

    Update: I did see my doctor — she had never heard of taking HCL for acid reflux, said “you don’t don’t want to do that. Wasn’t familiar with the logic. She did run some tests, one for H pylori. Apparently I have to wait 5 days for the results. I need relief now, so I went ahead and bought betain HCL with Pepsin and DGL. Chicken soup is on the stove. We’ll see what happens…

  177. Alexander Hamilton says

    A second question — I notice you don’t link or reference any academic studies. If this 3 step method is such a powerful way to treat acid reflux, then there should be some randomized academic studies in support. It’s simply not the case that the entire medical establishment are idiots. I saw one positive study by that brazilian doctor on HCL with other supplements including melatonin, but I read that he later sold his supplements commercially and so appears self-interested.

    I think most doctors would say that for something like probiotics, there are plenty of reasons to think that they are helpful, but that there is simply no definitive evidence just yet. What’s the harm of saying that?

    • Alexander Hamilton says

      i hadn’t read your other articles when i wrote this, where you do link some academic studies in support…

  178. Alexander Hamilton says

    Recently diagnosed with acid reflux. First prescribed omeprazole by my allergist. It cured my nighttime stuffiness, but made me feel incredibly fatigued during the day. I believe my troubles actually started when I broke my leg requiring surgery, and probably took too many pain killers to help sleep at night… I then felt sick from acid reflux, felt sick, and got my doctors to give me antibiotics….

    Anyway, I’m meeting today with my primary care physician for an ENT referral. My plan is to give diets/alternative remedies a go, and see what advice they say. I already quit coffee and red meat, eat plenty of probiotics, anise, fish and steamed vegetables every day, and take melatonin at night and have seen very modest progress.

    I haven’t yet done the HCL/pepsid and DGL. I’m a skeptic, and so I have a strong suspicion I’ll be one of the “10%” that this doesn’t work for. I’ll give it a go, see what happens, and report the results here.

  179. 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!!

  180. 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.

  181. 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.

  182. 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?

  183. 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!

  184. 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!

  185. 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.

  186. 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.

  187. 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.

  188. 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.

  189. 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.

  190. 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.

  191. 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.

  192. 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.

  193. 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!!!

  194. 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

  195. 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

  196. 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

  197. 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!

  198. 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.

  199. 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!

  200. 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?

  201. 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

  202. 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

  203. 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.

  204. 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 .

  205. Ashley says

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

  206. 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 :)

  207. 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.

  208. 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?

  209. 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

  210. 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

  211. 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!

  212. 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

  213. 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.

  214. 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.

  215. 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?

  216. 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?

  217. 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. :-)

  218. 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!

  219. 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.

  220. 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

  221. 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.

  222. 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.

  223. 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?

  224. 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!

  225. 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.

  226. 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

  227. 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.

  228. 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?

  229. 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!

  230. 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…

  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. 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

  233. 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

  234. 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!!

  235. 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

  236. 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).

  237. 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.

  238. 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.

  239. 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.

  240. 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

  241. 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

  242. 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

  243. 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.

  244. 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.

  245. 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.

  246. 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.

  247. 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

  248. 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!!!

  249. 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!

  250. 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.

  251. 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?

  252. 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.

  253. 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.

  254. 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.

  255. 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…

  256. 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.

  257. 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. :-)

  258. 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.

  259. 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

  260. 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.

  261. 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.

  262. 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.

  263. 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.

  264. 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

  265. 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

  266. 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.

  267. 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!

  268. 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.

  269. 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 [email protected]

  270. 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

  271. 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

  272. 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??

  273. 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.

  274. 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

  275. 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.

  276. 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?

  277. 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.

  278. 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

  279. 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.

  280. 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?

  281. 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.

  282. 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?

  283. 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.