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:
- Reduce factors that promote bacterial overgrowth and low stomach acid.
- Replace stomach acid, enzymes and nutrients that aid digestion and are necessary for health.
- Restore beneficial bacteria and a healthy mucosal lining in the gut.
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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 diet would reduce bacterial overgrowth. In studies done to test this hypothesis, the results have been overwhelmingly positive. Carbohydrate intake (especially simple sugars) is correlated with GERD symptoms, and reducing that intake can lead to a reduction in those symptoms. (1)
In a study performed by Professor Yancy and colleagues at Duke University, researchers worked with five patients with severe GERD that also had a variety of other medical problems, such as diabetes. (2) 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 diet.
Another study was performed by Yancy and colleagues a few years later. (3) This time they examined the effects of a very-low-carb 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 low-carb diets are also very effective for promoting weight loss.
An alternative to a very-low-carb 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 very-low-carb 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 a Paleo or ancestral 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 to 20 percent of the starch we consume escape absorption. (4) 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. (5)
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 low-carb 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 very-low-carb or low-carb 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. (6) 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.
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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.
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 five to seven 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.
While I previously recommended a combination of HCL and enzymes called the AdaptaGest Duo, those supplements are no longer available. I now recommend Betaine HCL/Pepsin by Thorne Research and Super Enzymes by Now.
Bitters
More recently, studies have confirmed the ability of bitters to increase the flow of digestive juices, including HCL, bile, pepsin, gastrin and pancreatic enzymes. (7)
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 five 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
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. (8) Probiotics have also been shown to be effective in treating Crohn’s disease, ulcerative colitis, and other digestive conditions. (9)
Probiotics have also been shown to significantly increase cure rates of treatment for H. pylori. (10) 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 trillions of 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 to 15 percent. (11)
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.
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. I recommend the Daily Synbiotic from Seed.
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. (12) 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. (13) For more on the healing power of bone broth, see my article “The Bountiful Benefits of Bone Broth: A Comprehensive Guide.”
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. (14) In animal studies, DGL has even been shown to protect the stomach lining against damage caused by aspirin and other NSAIDs. (15)
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
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.
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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.
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
Thanks Tim,
I’ll try that. Is it easy to get the almonds? I’ve never bought that before.
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.
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?
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!
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…
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?
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
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
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!!
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.
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
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
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
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
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.
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
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
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).
I saw your comment yesterday. I’m not a doctor but I have read about reflux and I think you should do an endoscopy. I don’t want to frighten you. But it’s much better if you do an endoscopy to avoid later costs and problems.
Please do an endoscopy soon.
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.
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.
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!
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.
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 🙂
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
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
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
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.
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.
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.
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?
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.
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
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
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.
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
Try blending up pineapple, stem and all, as the most beneficial part of it is mostly in the stem and pineapple will smooth out scar tissue. They use this on patients before and after small intestinal surgery. We’ve tried it and it seems to help.
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.
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.