Pills or Paleo? Reversing Heartburn and GERD
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Pills or Paleo? Reversing Heartburn and GERD

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The incidence of GERD continues to rise dramatically, but current treatments not only don’t address the cause, they have potentially life-threatening side effects. Find out how a modified Paleo diet can prevent and reverse GERD naturally.

paleo diet for GERD
Popping antacids for heartburn and GERD is a less than ideal solution for relief. istock.com/ckellyphoto

This article is part of an ongoing series comparing prescription medication with a Paleo diet as a means of treating common diseases and health problems. Click here to read the other articles in the series.

Gastroesophageal Reflux Disease (GERD), a more serious form of acid reflux, is the most common digestive disorder in the United States. Sixty percent of the adult population will experience some type of GERD within a 12-month period, and 20 to 30 percent will have weekly symptoms. The diagnosis of GERD increased by an unprecedented 216 percent between 1998 and 2005.

Drugs for heartburn and GERD are cash cows for the pharmaceutical companies. More than 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium, the most popular, brought in $5.1 billion alone – making it the second highest selling drug behind Lipitor.

Got heartburn? Find out why acid-stopping drugs are a bad idea, and what to do instead.

As sobering as those statistics are, it’s likely that the prevalence of GERD is underestimated because of the availability of antacids over-the-counter. This permits patients to self-medicate without reporting their condition to a doctor.

What Really Causes GERD and Heartburn? (Hint: It’s Not Too Much Stomach Acid.)

If you ask the average Joe on the street what causes heartburn, he’ll tell you “too much stomach acid.” That’s what most of the ads seem to suggest too.

However, anyone familiar with the scientific literature could tell you that heartburn and GERD are not considered to be diseases of excess stomach acid. Instead, the prevailing scientific theory is that GERD is caused by a dysfunction of the muscular valve (sphincter) that separates the lower end of the esophagus and the stomach. This is known as the lower esophageal valve, or LES.

In GERD, the LES malfunctions because of an increase in intra-abdominal pressure. This pressure causes distention (i.e. bloating) in the stomach, which pushes the stomach contents—including acid—through the LES into the esophagus.

But what causes the increase in abdominal pressure in the first place? Ironically, one of the main causes may be too little stomach acid, which in turn contributes to an overgrowth of bacteria in the small intestine. This idea is supported by studies on mice that have been genetically altered so that they are incapable of producing stomach acid. They develop bacterial overgrowth in their intestines—as well as inflammation, damage, and precancerous polyps. (1)

The understanding that not enough—rather than too much—stomach acid may be to blame for heartburn and GERD has important implications when it comes to determining what the safest, most-effective, and longest lasting treatment would be.  With this in mind, let’s see how conventional treatment of heartburn and GERD measures up.

Conventional Treatment of Heartburn and GERD

Conventional treatment of heartburn and GERD involves the use of drugs that suppress the production of acid in the stomach. There’s no doubt that these drugs can be effective in reducing the symptoms of GERD. After all, if there’s no acid in the stomach, then no acid will escape into the esophagus.

But is suppressing stomach acid production really the best approach—especially if low stomach acid is one of the potential underlying causes of GERD in the first place?

Believe it or not, stomach acid isn’t there just to punish you for eating Indian food. Acid is in the stomach because it’s supposed to be there. It is found in all vertebrates. And while it isn’t necessary for life, it is certainly required for health.

Most people have no idea how many vital roles stomach acid plays in our bodies. Such misunderstanding is perpetuated by drug companies who continue to insist that stomach acid is not essential. Meanwhile, millions of people around the world are taking acid suppressing drugs that not only fail to address the underlying causes of heartburn and GERD, but put them at risk of serious (and even life-threatening) conditions, including:

It’s worth noting that proton-pump inhibitors (PPIs), the most commonly used class of acid-suppressing drugs, were only approved by the FDA for 8 weeks of use. They were never intended to be prescribed for years or even decades, as is often done today.

Perhaps this is why the FDA has issued a series of reports cautioning against the prolonged use of PPIs, citing increased risk of infection, bone fractures, and life-threatening infection (clostridium difficile) as the primary concerns. (2, 3, 4)

So if acid-suppressing drugs aren’t the answer, then what is?

A (Relatively Low-Carb) Paleo Diet for Heartburn and GERD

If GERD is caused—or at least contributed to—by low stomach acid and bacterial overgrowth in the intestines, it follows that the best way to treat it is to improve stomach acid production and reduce bacterial overgrowth. This strategy actually addresses the underlying causes of the problem, whereas the conventional approach (acid-stopping drugs) merely suppresses the symptoms.

In his excellent book, Heartburn Cured, microbiologist Dr. Norm Robillard argues that carbohydrate malabsorption leads to bacterial overgrowth, resulting in the increase in intra-abdominal pressure that drives reflux. When stomach acid is sufficient and carbohydrates are consumed in moderation, they are properly broken down into glucose and rapidly absorbed in the small intestine before they can be fermented by microbes. However, if stomach acid is insufficient and/or carbohydrates are consumed in excess, some of the carbs will escape absorption and become available for intestinal microbes to ferment.

The standard American diet is high in carbohydrates—particularly refined carbohydrates like flour and sugar that feed bacteria in the small intestine. It shouldn’t come as a surprise, then, to find that low-carbohydrate diets have been shown to be effective in managing the symptoms of GERD.

For example, in one study at Duke University, patients who had failed conventional GERD treatment (i.e. acid-stopping drugs) experienced a complete resolution of their symptoms within one week of adopting a low-carbohydrate diet. This was true in spite of the fact that some of the patients continued to drink alcohol, smoke, and engage in other “GERD-unfriendly” lifestyle habits. (5)

In another study, also at Duke, a low-carbohydrate diet was just as effective as PPIs in a group of obese patients with GERD. (6)

There are many ways to do a low-carbohydrate diet. I suggest a low-carb version of the Paleo diet for my patients with GERD, since it restricts gluten and other foods that may be problematic, in addition to reducing carbohydrate intake. (For more tips on how to treat GERD naturally, see this article.)

In most cases, once you’ve addressed the GERD and improved your digestive function, a Paleo diet that includes a moderate amount of “real-food” carbohydrates like fruit and starchy plants such as sweet potatoes should be adequate to prevent a recurrence of symptoms. A very low-carbohydrate diet is not only unnecessary for most people over the long-term, it may cause problems of its own.

I’ve found Paleo to be remarkably effective for reversing GERD in my work with patients, and I’ve also heard success stories from literally hundreds of readers, like this one from Laura L.:

I found the paleo/ancestral community initially by reading Dr. Loren Cordain’s book; my further research lead me to Chris Kresser. At the time I was readying myself for a surgical procedure for my unremitting GERD. I was taking 80mg of Nexium per day and two extra-strength Tagamet pills prior to going to bed. Under the care of one of the leading Gastroenterologists from Columbia Presbyterian in NYC; I was given no alternative but to go through a drastic procedure which had a 40% sucess rate. Not the best odds, for sure. My other alternative would be to stay on PPIs the rest of my life (I had already taken them for 3 years); destroying my bones; and leaving me open to infections, etc. that occur when you reduce necessary stomach acid over long periods of time. From time to time I would try to stop taking my meds but the rebound reflux was unbearable.

After reading as many Paleo books as I could get my hands on and following more blogs than I can count; I started the Paleo diet removing all sources of grains, dairy, and industrial seed oils from my diet. In the meantime I gradually reduced the Nexium, etc.. As the weeks went on I could feel myself getting better and better. It took me a year to get off those nasty drugs and I could not have done it without the diet. I’ve been Paleo since 2008 and I’ve never looked back. I’ve been able to add safe starches to my diet but never anything containing gluten (activates my reflux within hours).

So what will it be for you? Pills, or Paleo?

If your answer is Paleo, make sure to check out my book (just published in paperback with a new name: The Paleo Cure) for a detailed explanation of how to use the Paleo diet and lifestyle to prevent and reverse disease and feel better than you have in years.

As always, check with your doctor before starting or stopping any new treatment plan—including what I’ve suggested in this article. This is not intended to be medical advice, and is not a substitute for being under the care of a physician.

125 Comments

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  1. My own experience with GERD is this. I am a 60-yr-old female. In otherwise good health. I started getting mild acid reflux around ten years ago, on a more often than not basis. About four years ago it started getting worse, including actual pain, and started to concern me. About that time my triglycerides were going up and after some research I decided to go on a somewhat keto/paleo type diet and eliminate all of the ‘bad’ carbs from my diet (flour, sugar, grains, etc.). To my utter astonishment, my GERD went away completely. Let me repeat: completely, no acid reflux what-so-ever, nada, zilch. I am so, SO happy. So I’m convinced that it was the processed carbs causing my GERD. And kind of to back this up, if I happen to go back to eating processed carbs, like if I go on vacation (it’s so hard to avoid breads in restaurants and people’s homes), and eat carbs for four or five days in a row, the GERD will come back! I seem to be able to tolerate the odd thing now and again—a croissant with coffee, bread pudding at a friends house, but after too much, the GERD is back. Had I not likely figured this out, on my own, I might have been on meds by now!!

    • Same exact thing here. It’s the grain. My first paleo stint this year included some sugars and cheese and still my gerd vanished. It’s the grain for me that is the culprit. Even when I eat gluten free (but not grain free) the gerd is there. And like you I can have a treat in a day and it will be fine but after a number of days of treats the acid creeps back.

  2. I was diagnosed with an ulcerated oesophagus (lower third) in May. I was prescribed Nexium to control it, but decided to follow a Paleo Lifestyle straight after my hospital Gastroscopy result in May.

    It’s been great removing the symptoms of Reflux (which is what has caused the ulceration), the sickness and uncomfortable feeling after every meal but now I have another problem.

    For the last two months, I have lost my voice. Completely. It’s constantly dry, wheezy and I cannot swallow or breathe properly. The doc prescribed me a puffer almost a fortnight ago to see if my symptoms would improve, but they’ve not. I know he suspects it to be Reflux Laryngitis and I’ll be getting referred to a specialist on Tuesday.

    I’m absolutely petrified of them putting me on a heap tablets which will not only upset the good gut flora I’ve built up, but also only disguise what’s really going on. But at the moment, after two months of having no voice and following Paleo to a T for 5 months, I’m feeling a little deflated and defeated. 🙁

    • At night use a vaporizer. My voice did the same thing and a vaporizer/heat is very healing… eyes, sinuses, esophagus, bronchial, lungs, etc. Cannot tell you how much it has helped. Sometimes I stand over the steam and breath and relax while listening to good music… most helpful… even your skin benefits

      Also, drink a glass of Benefiber after meal. Amazing results. Will not last however… so keep looking for the answers. I have had to drink this drink and set up for a period of time in the middle of the night…

      p.s. sleeping sitting up at night is no fun.

  3. I’m on day 16 of the 30 day protocol in The Paleo Cure and have not experienced any relief from reflux. I take a probiotic and cod liver oil caps. I’m not taking digestive enzymes. I have tried several times in the last few years to take HCL with pepsin but even one cap was excruciating. I haven’t tried it again in these 16 days.
    In tracking my responses to food in this PAleo Cure Diet, I think any more than two or three ounces of meat at a time causes reflux. I don’t do well on many fruits and some smoothies. Cherries, berries, bananas are fine; other fruits not. I also think too much healthy fat at a time, e.g., salmon salad with homemade mayo, avocado, and bacon, creates reflux. I don’t have a lot of confidence in my own diagnoses. At age 76 i have tried a jillion things, including weight loss surgery 15 years ago which resulted in a loss of 210 pounds and which I’ve maintained. I’m still obese at 230. During the WLS the doctor removed my gall bladder as it was about to burst. I remain a lot more comfortable in my head than my body.

    • Caryl, I totally sympathize with you; I am 77 and, despite picking up a lot of good habits, have not felt well for at least ten years. I don’t know if it is really possible to bring health back to a body that has suffered problems for years. In my case, I have also lost organs to cancer, cannot replace their properties truly with medication. In your case, I would think that years of heartburn have brought some damage to your esophagus, making it sensitive to many things a normal organ would have no problems with. There is also the extra weight you are carrying around, may increase acid reflux all by itself. Perhaps some fasting, if possible, might help. Or even an enema containing probiotics. Have you read Dr. David Perlmutter on the microbiome? I hope you find some solution that makes you more comfortable in your body – and find it soon.

  4. My tips on how I completely cured my heartburn & acid reflux.
    Tip 1; an immediate relief is found via root ginger. Seems to neutralise the esophagus immediately.
    Tip 2; apple cider vinegar diluted with a bit of water and then down it. Every morning.
    Tip 3; have a look at the free video on http://solvehealthproblem.com/acidreflux and just follow the methods it gives you. Takes about a week but reflux symptoms will then be gone forever.
    Tip 4; dont push your luck! once you feel your symptoms have relieved still don’t be silly and have that greasy take away! Be cautious what you eat without it ruling your life.

    Acid reflux can indeed cause many various symptoms, I think thats another thing what struggled me for many years when i had it

  5. Since February I have been suffering from Laryngopharyngeal Reflux. I wake up every morning with a sore throat. It goes over pretty fast but it’s annoying nevertheless. I am taking 40mg PPI’s medication every evening before dinner, but it does not seem to be working. Lifting the pillow hasn’t helped either. I am not obese I do not smoke, do not drink…My gastroenterologist told me not to worry about that, but I am fed up with it already. I have started taking Iberogast (2 weeks now) but see no improvement. Any thoughts?

    • ANNA – Please see my original post of 1-16-15 and another post of 1-30-15 along with Frances R. post to me of 1-21-15. Sometimes I truly wonder what these doctors are doing out there. No wonder Chris’s site & practice flourishes. I started with a low grade sore throat. My PCP sent me to an ENT who diagnosed me with Laryngeal reflux and put me on Prilosec for 14 days. All I got out of this was digestive problems from the Prilosec for 3 months but still had a sore throat only worse. So my PCP then referred me to a G.I. specialist. He did an endoscopy. He found no reflux or erosion or problems of any kind except on the biopsies which showed H-Pylori. I went on carpet bombing medications for ten days for the H-Pylori Jan.18 to Jan.27, had a fecal occult study which showed the H-Pylori not eradicated. Saw the G.I. doc. again and he wanted to put me on another round of meds. I told him no as I was still after all this time suffering the collateral digestive damage from the first round of meds. When I asked him if H-Pylori was life threating, he replied NO and said 3 out of every 4 people in the world have it and it usually doesn’t cause problems and that I probably have had it in me all my life and if it hasn’t caused any problems by this time that it is unlikely it ever would. I then told him he should have told me this in the very beginning as I would have never gone on the first round of meds. because of the side effects from them. Evidently, he was trying to justify the endoscopy. By the way, after the endoscopy, my sore throat was worse. Two and one-half months later, I am still having gas and bloating, occasional nausea , and still losing weight probably because I am not getting the benefit of the food I am eating etc. from the side effects of the meds as my food struggles to digest. And this is all because the flora in my stomach is still out of balance from the meds. The past three weeks I have been taking the strongest probiotic I could find and started eating a jar or two of fermented vegs. with live culture both of which has helped tremendously. It took 2-1/2 months to get my stomach back on track the first time and this time it will probably take another month or so because of the antibiotics. And, of course, I continue to lose a little more weight which I can no longer afford to lose. Remember, I had no GI problems until the meds each time. Infact, I had no health issues at all, except for the sore throat. Oh, I have seasonal allergies in which my sinuses drain into my throat constantly which is probably why the sore throat. Allergy meds don’t agree with me and I can’t take them. In fact, I am one of those people that most meds don’t agree with. The bottom line is beware. I had a mis-diagnosis to start with, an endoscopy for nothing and medication that did nothing but upset my good flora in my stomach. AND I STILL HAVE A SORE THROAT.

      • Hi Judith,

        Some of your issues resonate with me. You might consider trying a 30 day trial of Fluconazole for yeast overgrowth. An ENT Functional Medicine Dr prescribed this for me after performing a Laryngoscopy and finding a yeast infection on my vocal chords. This totally cleared my sore, hoarse voice and throat. I hope this is helpful.

        • ALICE – Thank you so much for the info., I will try anything. I went to my PCP last week as I now have swollen glands in addition to the sore throat. He referred me back to the ENT again who I haven’t seen since the misdiagnosis last year. I have printed out your reply and will take it with me next week to the appt. After two years, I think I am about due for a winner on this.

          • Hi Judith, have you had any luck treating the reflux? I have the exact same symptoms and am looking for some relief.

            • Make sure you don’t have any lyme related infections like chronic fatigue syndrome, epstein bar virus, cytomegalovirus or hhv6. You could have been bit by a tick without a bullseye rash. Look into lyme and sibo

      • I have a question- do you eat dairy? I get terrible sinus congestion and mucus drainage in my throat with dairy. Same with rice and carbs.

  6. I’ve been addicted to PPI for many years and tried to quit before but failed.
    I’m trying Hcl with pepsin, taking a dose with each meal and some between with water when there’s discomfort. The protocol says to increase the dose until discomfort and then retreat a little but how do GERD sufferers discriminate between pain from reflux and pain from excess stomach acid from overdose?

  7. About 3 months ago I was taking doxycycline for about a week and stopped because I started getting a lot of stomach problems. About a week after I started getting severe heartburn, so bad I actually went to the hospital because I wasn’t sure what was going on. Of course they put me on Omeprazole (Prilosec), I took it for about 3 months and am now trying to cure my heartburn naturally by eating paleo and supplementing with Betaine with every meal. My heartburn is no where near as bad as it was but I am still experiencing it pretty regularly, I am wondering if it is going to take some time for possibly the bacteria overgrowth to die off somewhat before I stop getting heartburn. Am I on the right track here?

  8. Chris, and the rest of the paleo community, we should be looking at this from an evolutionary perspective. Through millions of years of evolution, humans have only been sleeping on level surfaces for a very, very short period of time. Even in prairie lands of middle America or floodplains on the coasts, land is never naturally level. So it makes sense that throughout most of our evolution, we have been sleeping on non-level surfaces. It also makes sense, that when we were sleeping on non-level surfaces, we were sleeping with our head on the higher end of the non-level surface. So much of this epidemic of GERD can be associated with the fact that we sleep differently than how our bodies evolved to sleep, much like the fact that we eat differently than our bodies evolved to eat. At night, the acid creeps into our esophagus and creates irritation and inflammation. Then during the day, when we eat, the acid runs into the irritation and inflammation and causes discomfort. So then we blame the food in the stomach acid, instead of the ongoing irritation and inflammation caused by the way we sleep. I had GERD symptoms. I was diagnosed with Barretts esophagus. I went on Nexium. I stopped Nexium. I raised the head of my bed. No GERD. No medication. No dietary restrictions.

  9. For whatever it is worth, I suffered heartburn for many years. Tums and other medications worked for very short periods of time, but were at best treating symptoms. Once I cut out wheat and lowered my carb intake, my heartburn disappeared.

    Good blog post. Thank you.

  10. Judith Scott – There have been some great advice in the replies on this site. Paleo is the way to go for your problem and in particular stay away from gluten, dairy & seed oils. Use coconut oil as much as possible.

    I think one key to your problem is the h pylori you have been diagnosed with. See also Honora Renwick’s comment on Jan 14. I also have read just yesterday that h pylori, in order to survive the acidic environs of the stomach, somehow can actually increase the ph (which makes the stomach more alkaline not acidic – acidic is a lower ph) of the stomach acid. This allows the h pylori bacteria to stay alive and then lodge in the stomach lining and proliferate. You do not want a more alkaline stomach acid as this is usually what causes reflux etc.
    Chris’s article explains this fully.

    I’m not sure how you get rid of the h pylori (I know there are antibiotics but I hate to recommend that avenue) but I do recommend you take a good high strength probiotic and there are ones I think that are good for overwhelming h pylori. Also check out zinc carnosine which is apparently excellent for repairing the mucosal lining of the whole gastro intestinal lining (also helps improve leaky gut). Good Luck!

    • Frances R. – Thanks for your reply. I bit the bullet and opted to go on the ten day regimine of Prilosec and Pylera antibiotics for ten days with very little side effects. I also have done an immense amount of reading on H-pylori. It is not as uncommon as one thinks. First of all, 2/3 of the WORLD has H-pylori and 1/2 of them don’t even know they have it. Some acquire it and some are born with it. There are billions of good and bad bacteria in all of our guts.. They are symbiotic unless something sends them out of balance. When I took the 14 days of Prilosec for my supposed laryngeal reflux, it created a low acid environment which H-pylori thrives in and, thus, activated it. It took me two months to get the acid and bacteria in balance again. Remember, I had no digestive issues at all before taking the Prilosec the first time. Just a sore throat. After the endoscopy, I found out I had no reflux of any kind. My stomach and esophagus are great and my duodenum showed a slight imflamation. The biopsy showed H-pylori. There were no ulcers or erosion of any kind. Obviously, I was mis-diagnosed in the first place and had I not been, I would not have taken the Prilosec to start with which created the acid and bacteria imbalance that caused the myriad of problems I had. Now, other people out there that really have GERD or LERD, ulcers, erosion, etc., etc., they are the ones that are surely candidates for H-pylori, ulcers, cancer, etc. IF (and that is a big IF) they have the H-pylori in them to start with. Remember, H-pylori is not present in everyone. Obviously, it was in me and the PPI Prilosec activated it with an acid free environment. I just finished my meds two days ago. In a week or so, I will have a fecal occult study and find out if the H-pylori is all gone. There is a success ratio of 90% with the med regimine I was on. If it didn’t do the job, then I will have to go on another regimine with different meds to knock it out. Believe me, diets are always better than PPI meds. And guess what, after all this, I still have a sore throat which is, obviously caused by something else yet to be determined.

      • I think you may have Candida overgrowth….this can cause a sore throat. Western medicine doctor’s have a hard time diagnosing Candida as they don’t believe a person can get it…sometimes and certain situations.

    • I have had success with taking mastic gum in terms of treating the h.pylori. I still struggle with heartburn at times, but if I take mastic gum, it generally stays away. It usually comes back when I’m not taking it, but still looking for cure, not just treatment.

      • You need to kill off the bad bacteria in the gut, then implement an SCD Probiotic, like Klaire Labs sells.
        To kill off the bad bacteria you can do that with Dysbiocide, or take Berberine and FC Cidal.
        The other alternative is an antibiotic, like Xifaxan.
        You have an imbalance of the good gut flora vs. the bad gut flora. Perhaps you don’t have enough Bifidum bacteria in the colon as well. When this happens it has been said that the bad bacteria translocates into the small intestines…this is causing the heartburn in the stomach (bad bacteria in the small intestines.

  11. Interesting article recently came out about the impact of proton pump inhibitors on the microbiome:
    Freedberg, D E, Lebwohl, B, & Abrams, J A. (2014). The impact of proton pump inhibitors on the human gastrointestinal microbiome. Clinics in laboratory medicine, 34(4), 771-85.

  12. I STARTED OUT WITH A SORE THROAT FOR SEVERAL MONTHS MY PCP SENT ME TO AN ENT (EARS. NOSE & THROAT DR. WHO DIAGNOSED ME WITH LARYNGEAL REFLUX EVEN THOUGH I HAD NO SIGNS OF REFLUX. HE PUT ME ON PRILOSEC FOR 14 DAYS. I WAS NEVER SO SICK IN MY LIFE. PAIN WHEN I ATE, GAS, BLOATING AND COULD NOT EAT MORE THAN THREE FORKFULLS OF ANYTHING AT A TIME. FOOD TASTED ABSOLUTELY AWFUL. I TRULY THOUGHT THIS WAS THE END. THE DIFFICULTY, PAIN AND NAUSEA WENT AWAY AFTER A MONTH BUT I WAS STILL LEFT WITH GAS AND BLOATING FOR ANOTHER TWO MONTHS. OVER THE THREE MONTHS I ALSO LOST 35 LBS. MY PCP TOLD ME I HAD AN INTOLERENCE TO THE PRILOSEC. HE THEN REFERRED ME TO A G.I. DOCTOR WHO TOLD ME THERE WAS NO WAY THE MEDICATION DID THIS. I THEN HAD AN ENDOSCOPY. I WAS DIAGNOSED WITH H-PYLORI FOR WHICH I WAS GIVEN A PRESCRIPTION FOR PRILOSEC TO BE TAKEN TWICE A DAY FOR TEN DAYS AND A PRESCRIPTION FOR PYLERA WHICH IS A COMBINATION OF THREE DRUGS IN ONE LARGE CAPSULE. I AM TO TAKE THREE OF THESE FOUR TIMES A DAY FOR TEN DAYS. I HAD THE SCRIPTS FILLED AND HAVE BEEN LOOKING AT THEM SITTING ON MY KITCHEN COUNTERTOP FOR OVER A WEEK. I AM SCARED TO DEATH TO START THIS REGIMINE FOR FEAR OF THE SIDE EFFECTS. YOU SEE, I AM BACK WHERE I WAS FOUR MONTHS AGO FEELING WELL PHYSICALLY AGAIN BUT STILL WITH A SORE THROAT. I COULD NEVER GO THROUGH WHAT I HAD BEFORE AGAIN AND I CERTAINLY CANNOT SUSTAIN ANOTHER 35 LB. WEIGHT LOSS. I WAS NEVER OVERWEIGHT TO START WITH. I DON’T KNOW WHAT TO DO. I KNOW I NEED TO GET RID OF THE H-PYLORI BACTERIAL INFECTION AND I GUESS THE ONLY WAY IS TO TAKE THE MEDS. BUT I HAVE WORKED MYSELF INTO SUCH A STATE THAT I HAVE HAD KNOTS IN MY STOMACH FOR A WEEK NOW.
    JUST THE THOUGHT OF HAVING TO TAKE 20 PRILOSE AND 120 PYLERA FOR TEN DAYS IS MORE THAN I CAN GET MY ARMS AROUND. IT’S LIKE CARPET BOMBING THE PROBLEM. THE MEDICATION IN MY VIEW IS ENOUGH FOR AN ELEPHANT. HAVING BEEN READING CHRIS KRESSER’S ARTICLES FOR A COUPLE OF MONTHS NOW, I AM NOT ENTIRELY SURE THIS IS THE WAY TO GO. CAN ANYONE SHED ANY LIGHT ON THIS?

    • As the article above indicates, STOP eating wheat and all forms of gluten immediately. As a precaution, stop all dairy too. It’s really not as hard as it sounds. Replace your cravings with coconut products and other fats (avocados, nuts). Try it, you have nothing to lose by giving it a shot. I was in your position 15 yrs ago, had the surgery but was back to square one within about 8 yrs. Then I discovered that gluten caused my symptoms. You must be VERY strict to avoid gluten because even a little will cause reflux to recur.

      • Cindy, I have been eating Paleo for years yet have developed silent reflux after having to take several broad spectrum antibiotics. Paleo is not a magic solution, there are so many other factors that need to be considered.

        • Have you looked into the possibility you have SIBO or Lyme disease? You don’t have to have a bulls eye rash to have it. Also, people who have Lyme have SIBO. Get a breath hydrogen test from a GI doctor to confirm what types of bacteria you’re feeding. I was a methane producer and the doctor’s really messed up my life and now I have fungus growing throughout my entire body.

        • Has your doctor suggested an operation for you, to stop the reflux? I feel very sorry for you.
          In my case if I eat late, and particularly fat, I feel it afterwards and usually about 5 hours after I have eaten it. I have often been woken at night choking on my own acid in my lungs which is very painful. Lesson: Don’t eat after 6 p.m. or if you do, no fried food, no butter, no shellfish. I love bread but hardly ever eat it, as it puts weight on me. Cakes are full of fat. I had a colonoscopy and the doctor told me to reduce my PPI’s to only 15 mg per day. I now only take one every two days, if I remember, or if my stomach reminds me. I eat a lot of fruits and vegetables. I read somewhere that if you forget your medications on holiday, eat a green salad and that will calm your stomach. I tried it and it works. I now try to eat organic whenever I can. Finally, my mother, who lived disease free, died naturally at 97 and took Brewers Yeast tablets all her life, nothing else. My dad grew our vegetables. Now I take Brewers Yeast every day. I don’t know what it does but I feel alright. I swim as often as I can and exercise. Get out walking in the fresh air.

          • You need to wean yourself off of PPI’s as they are dangerous..they will cause GERD and potentially Barrett’s esophagus, cancer at the proximal opening of the esophagus. I know numerous people who have this and this is due to a small intestinal bacterial overgrowth in the small intestines. Get a breath hydrogen test done by the GI doctor. Your western medicine doctor’s don’t understand this. Please have a GI doctor do the Breath Hydrogen test…then depending on the type of gas you’re producing in the intestines depends on what your’e prescribed antibiotic wise. Rifaxamin or an herbal antibiotic is what is used to kill off the bad bacteria for a couple of weeks then you start in with probiotics.
            This world is so messed up…by what we take into our bodies..if we weren’t breast fed, born caesarian birth, eat a high carb diet etc. eat foods with herbicides or pesticides in them…these things all contribute to messing up our gut micro biomes. I am one of them….with a fungal overgrowth as well that spread into my tissues. I am not going to survive this…but you can…so please get some help ASAP! Don’t mess around with this. My brother in law has gotten off PPI’s and is now doing better but he still has to take herbal products to keep the bad bacteria down. My mother in law has diarrhea and GERD and continues to be blinded by western medicine….she took antibiotics continually through out her life for bronchitis as she was a smoker. Look what happened to her….I was given them for MVP and acne and other minor things. I should have never been given antibiotics! None of us should have….its in our food chain too…animals are treated with them…and they get into our water unless your water is filtered by a system that removed them. You have no idea how bad are in this world.

  13. Chris- I have successfully gotten off of Nexium by using the SCD diet which is similar to the paleo diet, however, constipation was always a problem. I tried more water, and could only eat so many veggies and fruits. The only way I could combat this was eating a bowl of oatmeal and a slice of high fiber bread a day. Do you have any suggestions in what I can eat that would take care of this problem or do you think the oatmeal and one slice of high fiber bread won’t make that big a difference if I continue to eat paleo for the rest of my day?

  14. Depending on the person, I’ve had success weaning people off acid-blockers and even adding in some Betaine HCL, depending on the function and health of the lower esophageal sphincter.

  15. I had heart burn since grade school and finally submitted to pyloroplasty/partial vagotomy believe AMA medicine. I later consented to esophageal fundoplycation(sp?)(sur

  16. On the subject of GERD. I suffered from this for 25 years and took almost every type of acid reducer ending up on PPI’s. I went to various MD’s including a Specialist. I followed the suggested diets, raised the head of my bed, etc. On the drugs I developed anemia, suffered from sinus problems and acquired Gastritis. Nothing helped any longer. Finally I started taking digestive enzymes and all of the above illness went away. I have been GERD FREE for 10 years now. I maintain a moderate diet of good food with nothing to excess. I eat normal amounts of most anything I want now. As long as I take my digestive enzymes, I am fine. This has worked for me. Good luck in finding what works for you.

    • Dear Jefry,
      Can you let me know what type of digestive enzymes you took? And what is the dosage?

    • What enzymes do you take. I have GERD since January 2015. Gad an endoscopy at Mayo. Take omniprezole 20 mg daily, but now it doesn’t work. Started today the paleo diet today. I am so tired of pain and burning sensation in my throat. I also have had my bed elevated since 2015.

      • I am wondering if you’d feel better if you took a probiotic. I did when I had the mild reflux and heartburn. You don’t have the right bacteria in the gut helping you to digest certain foods. So you get a build up of gas in the intestines that creates this pressure in the stomach. I am wondering if taking S. Boulardi would help. I would defer to Chris and Dr. Pimental.

        • Thanks Ann for your reply. I have taken Probiotic 10 from Natures Bounty, but nothing improved. Yesterday I started taking alive RAW Probiotic from Garden of Life 85 Billion life cultures. They are expensive, but I need to get well. Also wrote my doctor at Mayo a letter. I want some more testing to find out why I am not getting better.

  17. i was diagnosed with Laryngopharyngeal Reflux (aka LPR, Silent Reflux). it only happened at night (with me), hence it is sometimes known as night-time reflux as well.

    i believe my issue was due to a weakened lower esophageal sphincter (LES) muscle.
    i decided that i needed to give my LES ‘a rest’ & allow it to recover/repair/strengthen. so after doing some research i eliminated dark chocolate & caffeine. the rest of my diet was pretty clean/paleo/phd.

    eventually after a few months things cleared up & i reintroduced caffeine. this was nearly two years ago & all is still good.
    i have never had the urge or taken the ‘risk’ to reintroduce dark chocolate.

    apparently chocolate can weaken the LES, most likely due to the methyl xanthines (caffeine and theobromine).
    (i’ll try an add a ref in a separate comment below).
    & from memory the darker the chocolate, the higher the caffeine and theobromine content.

    Since caffeine does not seem to be an issue for me, i put it down to theobromine being the a problem for me.

    all anecdotal of course.

  18. Been on ppi’s for 15 years due to GERD.Finally got the ph test to prove it but gastrospecialist said not significant enough for surgery.He said to try and reduce ppi’s and move to h2 blockers.Tried a couple of times too fast and didn’t work.With better diet and slow removal i was close to finally removing them (and replacing with xantac) when i started developing respiratory (short breath at certain times of day) issues.Had full pulmonary function test which came out flying colours last september.With xantac only my digestion was better with less abdominal cramps and morning nausea.Try a different gp to see what they would say and as expected they want me on another month of ppi’s to see if that will improve the respiration.Can’t win…Anybody dealt with similar issues on withdrawal of ppi’s?

    • Louis,
      I was able to stop ppi without any problems after losing 20 plus kgs and stopped eating bread, pasta and rice.
      Don’t know if this is of any help to you. I did read that the bodies response to stopping ppi is to over produce acid for a while. Also I did not take anything else after stopping, no Zantac or any over the counter antacids. The only time heartburn CAN bother me is if I overdo alcohol since I normally do not touch it.

    • Louis – You may want to go to Procaps.com. Andrew Lessman has this website featuring all the vitamins and supplement he makes. Look for Aloe Vera & Ginger Root and read all of the reviews. That particular product has worked wonders for people with GERD. I personally know friends who take this and they swear by it. Can’t hurt to try. I use many of his vitamins and supplements and love them. They are very high quality.

    • Somewhere on this website, I read a comment about how much Zantac (ranitidine) one can take at a time. The bottle says take no more than two-150 mg. tablets per day. But the comment I read said she takes 300 mg. at a time. I’ve been doing this, but it can total way more than 300 mg. per day, obviously.,

      Anyone, please, get back to me!

  19. Thanks for your clear explanation. To summarize, the 2 main causes for GERD and acid reflux is too little stomach acid (resulting in indigestion) which in turn contributes to an overgrowth of bacteria in the small intestine.
    To counter the above, i have been taking Digestive enzymes and probiotics. This solve my indigestion problem and probiotics are often called “good” or “helpful” bacteria because they help keep my gut healthy.

    • When I am eating a lot of fruit I get acid reflux and because I live in New Zealand and it is hot here at the moment and eat more fruit. Never sleep properly any night due to my stomach. I am underweight as am following Autoimmune diet. Taking digestive enzymes and probiotic at the moment.

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