In my case, I stopped my gastrig reflux in the nights after some experimenting: 1 - Last meal 3-4 hours before going to sleep 2 - Last meal must have little volume and no fat 3 - Before going to sleep I am hungry again, so I eat 5 or six biscuits (no fat, just flour and sugar) with no drinks, or very, very little. I never take any pills, and I don´t normally have spicy meals. I don´t smoke, nor alcohol. In my case this solves the problem 100% Trial and error until you get results
Very interesting and useful! Before Christmas, I got quite big reflux and I was taking pepcid ac for about 2 months every day before that. At this point, pepcid ac didn't work anymore. What worked for me was to not eat for 3 hours before bed, take less water before bed and also to stop completely pepcid ac. It was difficult for a few day, but I endured the reflux and then it got away 90% better. What I read is that is needs to be as acid as possible in the stomach to command the brain to close the upper valve, so that there is no reflux. This is why pepcid ac, by reducing the acidity, it made me have more reflux.
Is it possible that PPIs and other drigs to reduce acidity could actually increase reflux, by delaying emptying of the stomach? I heard that the sphincter into the intestines opens in response to a certain level of acidity. Apologies if that's incorrect. Also, does reduced acidity mean higher risk of gut dysbiosis?
I don't know the answer to your question, but 'reduced acidity' also means your stomach is less able in making Vit B12, plus killing bacteria & viruses
Thank you. I live in Australia and I'm shocked my doctors didn't mention raising the bed head. I'll be raising my bed head and stopping eating earlier today.
I used the raised bed thing 30 years ago. I think I will try it again. Thanks for the reminder and explanation. Good job and this will help many people. People avoid chocolate also.
What a timely video. I am currently fighting aspiration pneumonia due to gastric acid flooding my mouth in the night 10 days ago. Literally burned my whole mouth / lungs / and nasal passage. Really having problems healing.
In my case, I stopped my gastrig reflux in the nights after some experimenting: 1 - Last meal 3-4 hours before going to sleep 2 - Last meal must have little volume and no fat 3 - Before going to sleep I am hungry again, so I eat 5 or six biscuits (no fat, just flour and sugar) with no drinks, or very, very little. I never take any pills, and I don´t normally have spicy meals. I don´t smoke, nor alcohol. In my case this solves the problem 100% Trial and error until you get results Best wishes for you.
Thank you I have had GERD the last 20 years but I ignored it. Now just over 80 it has become a problem: excessive burping, scared to attend gathering Had difficulty swallowing sore throat Had barium test Endoscopy all clear. I am taking Rabeprazole sodium before bed, it has improved but not the excessive burping, I will try elevating bed
Thank you from a SLP who has seen an explosion of GERD related dysphagia in the last 10 years. More than 75% of my outpatient MBSS now carry this diagnosis compared to less than 5% 20 years ago. What happened? Our diets? This is exactly the recommendations I give. So glad I can offer this video now as well.
@@theancientsancients1769 I'm saying 10 years ago, GERD was rarely the cause of the complaints of dysphagia. Now it's usually the cause of the dysphagia. I don't know why. Is it doctors recognize dysphagia of any cause so are referring more often or more and more people are getting dysphagia. Or some other reason.
The problem with PPIs and H2 blockers is that they become ineffective after a period of time and aren’t supposed to be taken for extended periods anyway. I found myself switching back and forth and then finally giving up on both of them. There is also an issue with the drugs contributing to osteoporosis, which I have and am taking Fosamax for. GERD has been an issue with me for decades and I do have Barrett’s esophagus and a hoarse voice.
Another, rarer thing that reflux can cause is patulous eustacian tube, where the valve is damaged and does not close properly, then you hear your own voice conducted through your head when you talk.
I use 3 pillows that work great…I don’t eat large meals or before bed…don’t eat fried foods or spicy foods, no sugar on empty stomach…it all helps… do core exercises to strengthen my abdominal muscles
Sorry, Doctor. I suffered from acid reflux for a year and a half about 8-9 years ago, could hardly eat and lost much weight. I was diagnosed with the disease after Gastroscopy test and was given the usual medications. Apple cider vinegar cured me in a week. I took a teaspoon in a glass of water in the morning (drink with a straw as to not cause teeth damage). The effect was immedate. I stopped taking it after a few days and I was cured. Nowadays when heartburn occurs (about once in three months) I drink it once and it's gone.
It's a matter of whether you have enough stomach acid to digest your food. Many do not. Therefore, the food sits and rots, causing gas which puts pressure on the valves. Not the same thing as valve disfunction. Now can years of low acid cause problems with the valve? I'll bet it can.
@@MeanOldLadyApple cider vinegar helps only if it's caused by low stomach acid , if not it makes things worse! Glutamine helped me to improve stomach lining and Carnosine and Zinc mixture which can be purchased. The root cause could be H Pylori infection or SIBO infection which needs a breath test . SIBO is behind most IBS research shows .
This won’t cure the problem from the root cause. My experience is 1. Lose weight 2. Add apple cider vinegar pills before your meals. I used to take med for heartburn. Now I don’t have heart burn anymore for over a year.
Diagnosed with early Barrett's 8 years ago along with hiatal hernia. Gastro put me on PPI but never discussed the REAL CAUSE of WHY the LES was no longer staying closed! I knew PPIs were bad for the kidneys so I was motivated to get off them. A few folks above mentioned Apple Cider Vinegar... This WORKED Soo well! These reasoning is that the LES will CLOSE if the acidity (level of HCL) in the stomach is correct. The level of HCL naturally decreases with age, and ACV simply encourages the stomach to produce hydrochloric acid (HCL) Which helps the LES function correctly! Problem solved, no meds. ACV also has numerous other metabolic benefits. I've been taking it daily for 8 years with FANTASTIC results! Research this online to see how many people tout this as a great solution.
Thank you for your clear message and the amazing work you do‼️Is it possible that some people may need to not eat or drink anything for 4 hours instead of 3? I have worked with patients who say they don’t see improvement by not eating or drinking for 3 hours. Sometimes I wonder how accurate their “clocks” are or if they have delayed gastric emptying from DM and should aim for a 4 hour window? Peace & Health, Liz
Yet another excellent explainer video Doc! Another topic of interest would be esophageal stricture. When I was practicing (D.C.), I had a few patients with that condition. Medical treatment for that condition was palliative rather than corrective. Anyway, thanks for these interesting videos and hope that all is well. 👍👍
I second that request for discussing an esophageal stricture. I go in this Thursday have mine stretched, the fourth time I have needed that. I also have an hiatal hernia.
Walked into an office of a physical therapist who told me I had acid reflux. Gave me breathing exercises to help reset my organs. Went away. Whenever I have an issue go back and spend a few minutes a day doing them. Blew me away.
As always Doctor S you are top notch. I have a hiatal hernia and can get short of breath with lots of coughing, so I am aware of foods that exacerbate my system. They can be quite individual because for me, it’s gluten and dairy. I adopted a four hour timing for no food at night, which is even better for me. I do not elevate the upper part of my body yet because I have a hard time sleeping in that position. The other thing I have tried actually is to exercise my throat by humming and singing and breath control. I did this as I have quite a dry throat problem in my old age and I found that it helped but it also seems to help the Gerd and asthmatic reactions. not sure if anyone else has tried this, but give it a try anyone who has troubles and see if it helps a little🇨🇦🙏
I had reflux for maybe 15 years. And not just a simple one, i had severe esophagus pain all suddenly, not just some acidity, and so on. I have taken ppi or over 10 years to prevent it. Could not leave it, as soons as i quit those pain came back. Then i had cryoablation or my atriall fibriallation (arythmia) almost 2 years ago. After that i was able to leave PPI completely. No acidity, or chest pain ever since. Whatever the corellation is?
Zinc carnosine mixture has helped me a bit. However the root cause is different for each person and sometimes it's stress related. The more stress the more out of balance the stomach goes. For some SIBO or H pylori infection is the cause. SIBO is tested through a breath test and h Pylori through endoscopy biopsy or stool test .
As a GERD patient with a hiatal hernia taking Metformin for diabetes, I have great trouble with carb fermentation in the colon, which generates a tremendous volume of gas, which in turn inflates the colon, which then pushes up on the stomach and propels its contents up the oesophagus. I am also a cyclist, so sports drinks & energy bars are practically unavoidable. A cycling acquaintance tried converting to fat as the preferred fuel and made himself very ill indeed. It's not all bad: our parrot has learnt to imitate the sound of flatus to perfection. "♫The hills are alive....".
I eventually cured my LPR (laryngopharyngeal reflux) after years of suffering.Here’s what I did. No food after 5pm (16/8 fasting) and cut out tomatoes from my diet, it was my number 1 trigger food. And that did it for me. Thanks for posting Dr.
Yeah, tomatoes are a trigger for me too, so I eat them sparingly. Same for cooked carrots unless I drain off the oily water & rinsing them before adding them to whatever I'm cooking.
I was hoping you would point out the esophageal plexus as one of PNS irritation causing symptoms related to vagus nerve malfunction. Unfortunately, it wasn't in this excellent citing of the patient notes.
I have Scleroderma and am on Nexium for life. I got a Sleep Number bed. Huge improvement from a wedge. I slid down the wedge while sleeping and ended up flat anyway, so it was useless.
I had hiatal hernia and esophageal reflux. I give up caffeine for a while and took for a period Aple Cider Vinegar ,a spoon in a glass of water, 3 times a day 20 min. before eating. No more problems !!! Even if I am eating tomatoes 😊 !
Hi Dr. Seheult, you know I was just thinking about my sleep number bed with the adjustable base when you explained how that wouldn't be a good idea. I don't have reflux problems, but good to know!
Can Physical therapy bring the stomach below the diaphragm, couple PTs advertised. Will it work for sliding Hiatal hernia. PPIs have bad side effects, need a solution to bring the stomach back in its place, without surgery. Thanks very much, I enjoy your videos, the best.
I have heard people suggest drinking water to fill the stomach then jumping up and down to allow gravity pull out back down into place. You might ask someone about that. I suppose the professionals could do an ultrasound to see if something like that was successful.
Taking Pantoprazole & Omeprazole tanked my magnesium & sent me to the ER for severe vomiting & diarrhea that wouldn't stop. While I was recovering from that, I got whammied by covid (before anyone knew what it was & just assumed it was a particularly nasty SARS variant floating around, which it is... SARS took out my mom in 2016, so the family was familiar with it.) 2 years later I was diagnosed with a hiatal hernia & Barrett's esophagus & had a TIF procedure to fix it. It worked great except that it's easier to bloat & I can't vomit since then, so I always carry around zofran just in case, because retching with no solution is horrible...
One month in with the mattress on a tilt. GERD improvement is minimal, back and neck hurt all the time and I'm knackered every morning. I feel 10 years older than I did a month ago. I'm 77, and in July I was happily riding > 60 miles per outing: this month I'm dragging myself round 30-odd and feeling miserably tired the whole time. To hell with it, I'm going back to my old system.
Please make an in depth video on hiatus hernia - what causes it? If it is a mechanical problem, are there any non-surgical mechanical methods that can help or cure it? (yoga stretches, chiropractors, self massage of diaphragm, etc.). When is surgery considered, what options are there, how does it work, what is the probability of a permanent cure? What is the surgery like? I have many dozens of questions about this, you barely scratched the surface. Thank you
Interesting video! I recently started with medication. I have got long covid and increasingly suffer from reflux problems. Do have an explanation why this happens? It is worse when I am tired of when I during walking/cycling when tired. Is this related to the diaphragm or other cause? And what is the best treatment?
Thanks for that, I was aware of the Barrett's issue and PPI ineffectiveness but the rest was very new. I've had problems with reflux since being put on beta blockers after a couple of stent operations and a bypass operation. I've tried slowly weaning myself off the PPI in the hope that was part of the sphincter issue (was told that the sphincter relaxes more in the absence of acid stimulation) but that didn't work for me, and supposedly the beta blockers are for life 😞. BTW, I discovered that steroids cause hiccups if you're on beta blockers (at least the ones ones I am on).
Can weight loss (I'm 20lbs overweight) dietary changes, elevating the head of bed, eating dinner sooner and changing the types of food triggering reflux, can those changes reverse a hiatal hernia, or does a hiatal hernia always require surgery?
I try and do all the things you suggested, and it works well for me. Back when I was diagnosed with berets esophagus I also changed jobs because I think the environment inside a foundry was affecting my lungs and esophagus, I haven't been scoped for a while but had it done a couple times and was ok. Thanks
Many of the gastrointestinal issues are caused by the body's production of weak stomach acid. This is particularly common as one gets older. To be able to digest the food and compensate for the weaker acid, the body secretes more acid. The excessive digestive acid is what causes the acid reflux. Taking antacid and proton pump inhibitors will exacerbate and ultimately make this problem worse even while it may offer temporary relief. The solution is straight forward but counter-intuitive. Get the body to produce less digestive acid by making the digestive acid stronger which will then make it unnecessary for the body to produce more. This will very quickly reduce GERD. To this end and for severe cases, taking digestive enzymes is the fastest and quickest way to resolve the issue. For others, just adding vinegar to one’s meal will already achieve the effect of resolving GERD. This approach can be combined with common sense approach such as taking one's meal earlier and reclining the bed and before long, GERD will be a thing of the past.
@@mballer my point was, if you truly have a hernia, a Chiropractor can adjust you and if he/she knows what they are doing the adjustment should & will hold... that is all. 😊
I have GERD pretty bad. And it's frustrating because I'm in my 30's, slim and healthy and eat very healthy (probably in the 99th percentile). I don't drink or smoke. But yet I still have GERD.
@@Medcram Please do another video after you've studied lowering PH and sphincter leakage. In this video you say reducing the acid doesn't fix the leakage. We need more acidity. Do you measure stomach PH before prescribing acid blockers?
Does using CPAP to treat OSA have a tendency to resolve or decrease symptoms of GERD? I haven't had symptoms of GERD since I began using CPAP of 12 eighteen years ago.
I've had adverse reactions to both PPI and H2 blockers. Really bad reflux if I eat a regular sized meal, even If I wait 4 hours before sleeping. I do have scarring in my lungs. Radiologist called it "smoker's lung." But I haven't smoked for more than 40 years. I put the head of my bed on bricks, but nothing seems to be helping. Gah!
Try sleeping on your left hand side and use Gaviscon advance - it forms a raft over stomach contents to stop them refluxing,.It doesn't last long though so you may have to take it before bed and again during the night. I take a second dose when I get up to pee!)
Well, I went the "tip the whole bed" route, but used a wedge to tip the bedspring rather than the whole bed, which would apply unwonted stresses at the joints. Observations: reflux is slightly less, yay, hoist a flag and fire a gun. However, a 20cm lift in 190cm yields a 10.5% slope, which is enough for the burial-at-sea effect to intrude: for the last 3 nights I have been climbing back up the slope in search of my pillow, whose lack has resulted in a very stiff neck. And of course, I'm dog-tired every morning. Ah well, you can't be ill without suffering. Might as well get on with it.
I do that too! I once woke up with the back of my knees over the bottom of the mattress & my feet on the floor! I too wake up with a stiff neck every morning, but I'd rather have that than the pain of the reflux! I try to sleep on my left hand side &, when I do that, I don't seem to travel down the bed as much as I do when I'm on my back! I'm trying to think of a way to attach a pillow to my head so that when I slide down the mattress the pillow comes with me!
Best solution for me was as follows: 1. No eating after 5pm 2. No sugar/very little 3. 2 tbls of ACV daily diluted in a full glass of water I have pretty much eliminated my Acid reflux which was debilitating on a regular basis. No drugs needed. Won’t solve the problem.
I tried ACV but it didn't work for me as I have a hernia and that stops the LES from being able to function properly. Also I have bile reflux as well as acid reflux. So many things can go wrong with digestion! My neighbour's reflux was cured when she cut down on vegetables as they were giving her a lot of flatulence which was putting pressure on her stomach & causing the reflux! Finding the root cause is key, as reflux can be caused by many things, or combination of things. What can help one person may not help another, or may even make it worse.
Thank you for these, but from my own experience these are bandaids, just like the maintenance PPIs treatments we see RXed for pretty much everyone. We're still not addressing the root cause, which in my case was H.Pylori, damage to my stomach, parietal cell antibodies and as a result hypochloridia. Taking Betaine HCl (the opposite of our treatments nowadays) is what put my symptoms in remission, helped me digest my food and healed many conditions I had.This is also coming from someone who lost my mom to stomach cancer. We need to figure out how to make our stomachs work again, produce enough acid and at the right pH in order to digest all those foods that are upsetting us. There is a also complex process between the acidic pH of the stomach and the release of enzymes from the pancreas. These enzymes are critical in IBD,IBS for example. How many people also suffer with these? Avoiding foods is only causing deficiencies therefore many health conditions. I wonder how many people are like me out there? Do we test these people for this or the intrinsic factor antibodies? That's just two that I've discovered researching on my own. I'm only posting this here because I've followed you, since the pandemic started, and I know you can think outside the box, unlike majority of the doctors out there. I hope you'll look into this because we have so many people suffering with digestive issues. In my opinion if your stomach doesn't work nothing will; it'll only be downhill from there.
I have Barretts Esophagus. I will have my third biopsy coming up in September as my Gastroenterologist is "monitoring for malignancy". I don't look forward to it as I have to be put under and every time I do that it seems to take longer for my memory to get back to normal (montfs). I'm already a breast cancer survivor since 2016. I do take panto for my reflux. I took pepcid for many years and my doc said "well it didn't work did it". If I had honestly believed i would be facing a second cancer diagnosis before the age of 60 I would have done things differently. Please listen to the doctor here on his advice. It may save you a cancer diagnosis.
The question is what is root cause of reflux? Most of people can eat spicy food and drink coffee everyday and they are fine. All those metioned "solutions" only manging the syptoms. Are peopel with acid reflux are attrached to elevated bed for the rest of their life?
I wonder if part of it could be genetic? My mum suffered from gerd as do I and my son does too, I know pregnancy/childbirth can put pressure on the the LES & weaken it, but that doesn't explain it away for men! Also I've known people who smoke, drink, eat spicy food & just before going to bed, & are very over weight, who never get it! So, although those things may put you at a higher risk, I think there's more to it than that.
For the last decade plus iv'e been on PPI, raised bead and no food 3hr before bed... also suck on a couple of Gaviscon tablets as i fall asleep. Need to lose more weight though. Such is life.
Doctors are not supposed to prescribe a PPI long term. It causes other problems. They go for an H2 blocker instead, but even that is not a health minded solution.
Question: where is data for head2toe bed lift. Shopping mattresses and all the marketing literature supports adjustable beds fir GERD. Best science I can find barely supports any lift, with no distinction for head2toe vs adjustable. I’m following the video advice, but I come here for science over marketing
I think it's about pressure on the abdomen? If you think about it if your top half is raisedm but bum & legs are flat, (like an L shape) you are bent in the middle so there's pressure on the abdomen. Whereas if your body is straight but just on a slant there isn't. I remember years ago reading that we should eat stood up, to aid digestion, or stand up for a while after eating. I suppose it's a similar thing? And eating sat upright at a table is better than slumped in a chair with a tray on your lap in front of the TV as, again, pressire on abdomen?
Oh I think it makes sense, following the advice, though there is more discomfort than I expected. My question is where is the science. Maybe a Makary ‘Blind Spot’, but ai can’t find any quality studies on the head lift, much less the no bend posture. Every adjustable frame bed manufacturer I checked said their head and knees high position was good for Reflux. I come here for study backed or hypothesis under experimentation data.
Sugar is evil. Years ago the sugar industry convinced America that fat was evil and was going to kill you. They reduced the fat in products and upped the sugar. Or more likely, high fructose corn syrup. In the old days this country used to drink its corn surplus.
Thank you for your information. I was a bulimia sufferer for many years. However, I find myself having automatic reflux almost after every meal. I was not concerned before but after watching this link, I am. Should I be concerned.? What is my next step to improve my condition? I guess I am in a high risk of stomach cancer?
the diaphragm being skeletal muscle can be trained and strengthened......I once with a respiratory virus coughed for 3 days...so much so that my abdominal muscles were very sore....no reflux for a few days....
Really appreciate this. I had reflux was thin, didn’t eat much, no idea why but I also had IBS. Spent years on H2 then PPIs. Then a friend got me to take HCL Guard by healthy gut. I also did some months of Aura products to target H Pylori. 95-100% better. Lately I have had some return of IBS, tested and HP so back to aura. Evan Brand does a lot on naturopath gastric issues. Thanks for the work you do!
I cannot tolerate h2 blockers and Dr Jamie koufman, leading expert says PPIs are very dangerous and should be taken off the market . She also says to find an ENT who knows about LPR and performs TNE instead of a gastro who does endoscopy because it is a dangerous procedure ( look what happened to joan rivers ).
How does COVID infection lead to reflux and why would ppis make symptoms of chest pain much worse? My personal experience would point towards a fungal infection/allergy facilitated by covid that leads to irritation/inflammation in the chest and impairment of nerve function. The other symptoms being incapacitating exhaustion and the usual long COVID group of symptoms.
what if loose sphincter is actually hypothyroid, given that it's one of these muscles that is right next to the thyroid so getting biggest thyroid hormone gradient. The incidence of reflux tipping towards males vs hypothyroid towards females could be partially explained by wrongly accounting for alcohol intake, which directly irritates sphincter muscles: because of size, men drink more for same buzz, so irritation of sphincter is much higher. Also, women have higher esophageal occludin, which protects the sphincter. Also, gerd defined by heartburn and common symptoms seems to be about even between genders in a european population study, so the higher incidence in men doesn't seem credible, most of those were specifically looking at esophagus injuries not gerd symptoms. In other words, hypothyroid as cause, which is much more prevalent in women, would be compatible with incidence data. Prevalence of gastro-oesophageal reflux symptoms and the influence of age and sex, 2009
I’ve been struggling with this. Had an emergency upper endoscopy back in November for food impaction. My twin sister is an endoscopy nurse and gratefully recognized the peril I was in. The doctor she works/worked with took care of me. I’ve been on40 mags of Omeprazole since, I’ve struggled with eating small meals, eating the last meal early and staying away from foods that induce GERD. My sister had told me about caffeine and chocolate, specifically opening and loosening the esophageal sphincter. I get home from work and am hungry for chips and crunchy things and we don’t get supper on the table till about 6:30 or 7. It’s all me making poor choices. Despite this I’m not grossly overweight and intermittently make good dietary choices. I think I’ve suffered with chronic mostly silent reflux for a while. I know staying on the PPI is both good and bad in that it’s necessary to prevent damage to the esophagus with this condition yet it can lead to absorption problems. I do have asthma and have had “colds” in the last 2 years that loss of voice has happened. I had never had that problem before. Oh yah and I’m 54 yr and don’t smoke or drink.
Wow! I had no idea that PPIs and H2 blockers worked in that way… I thought they were stopping the reflux material from coming up all together- but they aren’t!!! Do products like tums also just reduce the acid but continue to allow contents to move up the esophagus? Thank you for sharing!
Thank you so much! Even most GI Dr's don't understand this. I was born with GERD and now have pulmonary fibrosis and Barrett disease. Lost four upper back molars 😢
After 15 years of having to have several antacids during the night, I discovered apple Cider Vinegar. One tablespoon in a glass of water sorted me out for 6months - and it was alway a very rich food that triggered reflux. Stomach acid needs to have a ph of between 1.5 - 3, otherwise the valve between the oesophagus and stomach stays open allowing stomach acid to reach the delicate wall of the oesophagus. In 4 years I've probably had to have 4 lots of apple cider vinegar. Just add vinegar or lemon juice to your salads etc if you don't like the drink. It really really works - but as the antacid business is worth over 5 billion pa, your GP or medic are not going to tell you this.
Thank you very much!!! I have this since a few years now! Especially also when eating Italian food like spaghetti, macaroni or lasagna. And of course when lying down. But when it is more severe sometimes and I go and sit right up I get trouble breathing and have to hold my head up and backwards! What I found to be helping instead of medicines is baking soda. (Natrium-Bicarbonate or Na(HCO3)2). I thought about it myself. Bicarbonate is the natural thing that lowers acid in the bloodstream so why not use it to lower the acidity in the esophagus. And it works well. You only have to pay attention with how much to dissolve in a glass of water. Too much and it makes you feel weak in the stomach, too little and it does not help so much. I usually take about 25 cl and about 2 grams of Na(HCO3). Let it dissolve and that helps a lot! Thank to you I am going to heighten my bed and try whether it improves my situation!
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I weaned myself off Prilosec. I started taking a probiotic and it seems to have gotten rid of my GERD. Im coughing alot less too. I thought it was allergies. This might not help everyone. And I do have a hiatal hernia.
So, why do so many people resolve their GERD on low carb diets? And what about the folks who swear it went away with taking cider vinegar? Do we really understand WHY it happens in the first place?
Intolerance testing solved mine. One was basil not tomato, for my daughter it was glutin not tomato. Also whey was a huge problem for both of us. Gotta find your own. Basically, I've found if you burp it hours later it's suspect.
Can you comment on the theory that reflux can be caused by not having enough stomach acid to signal the lower esophageal sphincter to close, in which case HCl supplementation before meals can reduce reflux?
@@Medcram How much acid is too much acid? What was the pH of the too much acid? Did you measure it? How much data do you need? You could have a plethora of data by asking your GERD patients to eat a salad with vinegar dressing. Surely you must know a knowledgeable dietician or two. Did these patients have a defective sphincter? Was there a mucus production problem?
I had gastric reflux for so long that my esophagus is scared. And because I had violent hiccups when triggered by small grains (coocuse, dry bread on a sandwich, even rice without a sauce) that i got an esophageal balloon. But wait there's more... my esophagus ripped and needed 3 staples to heal. But now I can again eat mostly what I want a year later I have only 3 times had a minor cases since. These hiccups problems progressed to just about every meal. Found my own ways to address a 2hr to 6hr calming session during the meal. Tips I found that heled were: have a room temp full glass of water at onset, cool creamie vanilla icecream, or having something on the bread or sauce on the grain. Thank you for sharing this video.
Sleeping on left side at night has changed everything, apparently keeping the flap closed on the stomach acids? Not eating right before bed had also been very helpful, as you mentioned.
I found that cutting out caffeine made a big difference.
Coffee in general, even decaf will trigger heartburn for me.
I've ditched coffee and always sleep on my side, the left side helps keep everything im the stomach
In my case, I stopped my gastrig reflux in the nights after some experimenting:
1 - Last meal 3-4 hours before going to sleep
2 - Last meal must have little volume and no fat
3 - Before going to sleep I am hungry again, so I eat 5 or six biscuits (no fat, just flour and sugar) with no drinks, or very, very little.
I never take any pills, and I don´t normally have spicy meals. I don´t smoke, nor alcohol.
In my case this solves the problem 100%
Trial and error until you get results
Very interesting and useful! Before Christmas, I got quite big reflux and I was taking pepcid ac for about 2 months every day before that. At this point, pepcid ac didn't work anymore. What worked for me was to not eat for 3 hours before bed, take less water before bed and also to stop completely pepcid ac. It was difficult for a few day, but I endured the reflux and then it got away 90% better. What I read is that is needs to be as acid as possible in the stomach to command the brain to close the upper valve, so that there is no reflux. This is why pepcid ac, by reducing the acidity, it made me have more reflux.
No eating after 5pm helped me a lot!
Is it possible that PPIs and other drigs to reduce acidity could actually increase reflux, by delaying emptying of the stomach? I heard that the sphincter into the intestines opens in response to a certain level of acidity. Apologies if that's incorrect. Also, does reduced acidity mean higher risk of gut dysbiosis?
You are correct according to my functional medicine Dr. 😊
I don't know the answer to your question, but 'reduced acidity' also means your stomach is less able in making Vit B12, plus killing bacteria & viruses
Thank you. I live in Australia and I'm shocked my doctors didn't mention raising the bed head. I'll be raising my bed head and stopping eating earlier today.
Excellent presentation, as expected. Thank you doc!!
I used the raised bed thing 30 years ago. I think I will try it again. Thanks for the reminder and explanation. Good job and this will help many people. People avoid chocolate also.
Anything with a lot of oil, really & also tomatoes.
What a timely video. I am currently fighting aspiration pneumonia due to gastric acid flooding my mouth in the night 10 days ago. Literally burned my whole mouth / lungs / and nasal passage. Really having problems healing.
Aww, I hope you get well soon!
In my case, I stopped my gastrig reflux in the nights after some experimenting:
1 - Last meal 3-4 hours before going to sleep
2 - Last meal must have little volume and no fat
3 - Before going to sleep I am hungry again, so I eat 5 or six biscuits (no fat, just flour and sugar) with no drinks, or very, very little.
I never take any pills, and I don´t normally have spicy meals. I don´t smoke, nor alcohol.
In my case this solves the problem 100%
Trial and error until you get results
Best wishes for you.
I would encourage you to try acupuncture. Plan on 6-8 treatments, initially. Be well.
Thank you I have had GERD the last 20 years but I ignored it. Now just over 80 it has become a problem: excessive burping, scared to attend gathering
Had difficulty swallowing sore throat
Had barium test Endoscopy all clear.
I am taking Rabeprazole sodium before bed, it has improved but not the excessive burping, I will try elevating bed
Thank you from a SLP who has seen an explosion of GERD related dysphagia in the last 10 years. More than 75% of my outpatient MBSS now carry this diagnosis compared to less than 5% 20 years ago. What happened? Our diets? This is exactly the recommendations I give. So glad I can offer this video now as well.
I recently developed dysphagia after reflux .. are you saying decades ago people had no dysphagia with reflux or? Thanks
@@theancientsancients1769 I'm saying 10 years ago, GERD was rarely the cause of the complaints of dysphagia. Now it's usually the cause of the dysphagia. I don't know why. Is it doctors recognize dysphagia of any cause so are referring more often or more and more people are getting dysphagia. Or some other reason.
The problem with PPIs and H2 blockers is that they become ineffective after a period of time and aren’t supposed to be taken for extended periods anyway. I found myself switching back and forth and then finally giving up on both of them. There is also an issue with the drugs contributing to osteoporosis, which I have and am taking Fosamax for. GERD has been an issue with me for decades and I do have Barrett’s esophagus and a hoarse voice.
Yes 😢 I have all of that plus pulmonary fibrosis, which is terminal
@@tonyagarcia4871i am truly very sorry
@@tonyagarcia4871check out Anthony William’s books at the library. ❤
Another, rarer thing that reflux can cause is patulous eustacian tube, where the valve is damaged and does not close properly, then you hear your own voice conducted through your head when you talk.
I use 3 pillows that work great…I don’t eat large meals or before bed…don’t eat fried foods or spicy foods, no sugar on empty stomach…it all helps… do core exercises to strengthen my abdominal muscles
Sorry, Doctor. I suffered from acid reflux for a year and a half about 8-9 years ago, could hardly eat and lost much weight. I was diagnosed with the disease after Gastroscopy test and was given the usual medications. Apple cider vinegar cured me in a week. I took a teaspoon in a glass of water in the morning (drink with a straw as to not cause teeth damage). The effect was immedate. I stopped taking it after a few days and I was cured. Nowadays when heartburn occurs (about once in three months) I drink it once and it's gone.
ACV also causes me problems & will intensify any heartburn that's going on, but it works wonders for the hubby & his heartburn.
So drinking a dilute acid cures acid reflux? You should publish this anecdotal evidence.
@@buckbenelli8 There are endless videos on youtube, some by medical doctors, about it.
It's a matter of whether you have enough stomach acid to digest your food. Many do not. Therefore, the food sits and rots, causing gas which puts pressure on the valves. Not the same thing as valve disfunction. Now can years of low acid cause problems with the valve? I'll bet it can.
@@MeanOldLadyApple cider vinegar helps only if it's caused by low stomach acid , if not it makes things worse! Glutamine helped me to improve stomach lining and Carnosine and Zinc mixture which can be purchased. The root cause could be H Pylori infection or SIBO infection which needs a breath test . SIBO is behind most IBS research shows .
This won’t cure the problem from the root cause. My experience is 1. Lose weight 2. Add apple cider vinegar pills before your meals. I used to take med for heartburn. Now I don’t have heart burn anymore for over a year.
Diagnosed with early Barrett's 8 years ago along with hiatal hernia. Gastro put me on PPI but never discussed the REAL CAUSE of WHY the LES was no longer staying closed! I knew PPIs were bad for the kidneys so I was motivated to get off them. A few folks above mentioned Apple Cider Vinegar... This WORKED Soo well! These reasoning is that the LES will CLOSE if the acidity (level of HCL) in the stomach is correct. The level of HCL naturally decreases with age, and ACV simply encourages the stomach to produce hydrochloric acid (HCL) Which helps the LES function correctly! Problem solved, no meds. ACV also has numerous other metabolic benefits. I've been taking it daily for 8 years with FANTASTIC results! Research this online to see how many people tout this as a great solution.
What's the role of melatonin in lower esophageal sphincter tone? Is that pituitary or locally synthesized? Does light or IR affect that level?
Thank you. I have a Hiatal Hernia, but no one has ever explained so clearly what that really means.
Sleeping on the left side helps also.
Very Insightful. Explained in layperson language. Thank you!
Thank you for your clear message and the amazing work you do‼️Is it possible that some people may need to not eat or drink anything for 4 hours instead of 3? I have worked with patients who say they don’t see improvement by not eating or drinking for 3 hours. Sometimes I wonder how accurate their “clocks” are or if they have delayed gastric emptying from DM and should aim for a 4 hour window?
Peace & Health, Liz
Yet another excellent explainer video Doc! Another topic of interest would be esophageal stricture. When I was practicing (D.C.), I had a few patients with that condition. Medical treatment for that condition was palliative rather than corrective. Anyway, thanks for these interesting videos and hope that all is well. 👍👍
Yes. Doing well!
I second that request for discussing an esophageal stricture. I go in this Thursday have mine stretched, the fourth time I have needed that. I also have an hiatal hernia.
Go to medcram.com for more CME/CE videos!
Cutting out carbs solved my acid reflux in a week. Have heard same from many others.
Walked into an office of a physical therapist who told me I had acid reflux. Gave me breathing exercises to help reset my organs. Went away. Whenever I have an issue go back and spend a few minutes a day doing them. Blew me away.
As always Doctor S you are top notch. I have a hiatal hernia and can get short of breath with lots of coughing, so I am aware of foods that exacerbate my system. They can be quite individual because for me, it’s gluten and dairy. I adopted a four hour timing for no food at night, which is even better for me. I do not elevate the upper part of my body yet because I have a hard time sleeping in that position. The other thing I have tried actually is to exercise my throat by humming and singing and breath control. I did this as I have quite a dry throat problem in my old age and I found that it helped but it also seems to help the Gerd and asthmatic reactions. not sure if anyone else has tried this, but give it a try anyone who has troubles and see if it helps a little🇨🇦🙏
I had reflux for maybe 15 years. And not just a simple one, i had severe esophagus pain all suddenly, not just some acidity, and so on. I have taken ppi or over 10 years to prevent it. Could not leave it, as soons as i quit those pain came back. Then i had cryoablation or my atriall fibriallation (arythmia) almost 2 years ago. After that i was able to leave PPI completely. No acidity, or chest pain ever since. Whatever the corellation is?
Very insightful explanation. REQUEST: Could you please make a VDO on the different surgical procedures to correct this?
Yes please.
Zinc carnosine mixture has helped me a bit. However the root cause is different for each person and sometimes it's stress related. The more stress the more out of balance the stomach goes. For some SIBO or H pylori infection is the cause.
SIBO is tested through a breath test and h Pylori through endoscopy biopsy or stool test .
As a GERD patient with a hiatal hernia taking Metformin for diabetes, I have great trouble with carb fermentation in the colon, which generates a tremendous volume of gas, which in turn inflates the colon, which then pushes up on the stomach and propels its contents up the oesophagus. I am also a cyclist, so sports drinks & energy bars are practically unavoidable. A cycling acquaintance tried converting to fat as the preferred fuel and made himself very ill indeed.
It's not all bad: our parrot has learnt to imitate the sound of flatus to perfection. "♫The hills are alive....".
I eventually cured my LPR (laryngopharyngeal reflux) after years of suffering.Here’s what I did.
No food after 5pm (16/8 fasting) and cut out tomatoes from my diet, it was my number 1 trigger food.
And that did it for me.
Thanks for posting Dr.
Tomatoes are a trigger for me as well although I would be very reluctant to give up ethnic foods, especially Mexican and Italian.
@@Patrick_Ross I hear you, I’m married to an Italian and she makes some great lasagna. :)
Yeah, tomatoes are a trigger for me too, so I eat them sparingly.
Same for cooked carrots unless I drain off the oily water & rinsing them before adding them to whatever I'm cooking.
I was hoping you would point out the esophageal plexus as one of PNS irritation causing symptoms related to vagus nerve malfunction. Unfortunately, it wasn't in this excellent citing of the patient notes.
Noted thanks! It’s why I encourage comments to add to the presentation
Very very interesting information ❤❤❤❤❤❤❤
All through childhood into ADULTHOOD
I have Scleroderma and am on Nexium for life. I got a Sleep Number bed. Huge improvement from a wedge. I slid down the wedge while sleeping and ended up flat anyway, so it was useless.
Trying to sleep on a wedge was ridiculous because of the sliding.
Stress ulcers since a car accident at 15. At 66 burst my appendix & the surgeon said it was an esophageal hernia not stress ulcers for 50 years.
I use squishmallows to elevate my head. Much more comfortable!
I had hiatal hernia and esophageal reflux. I give up caffeine for a while and took for a period Aple Cider Vinegar ,a spoon in a glass of water, 3 times a day 20 min. before eating. No more problems !!! Even if I am eating tomatoes 😊 !
Great content, thanks for sharing.
Hi Dr. Seheult, you know I was just thinking about my sleep number bed with the adjustable base when you explained how that wouldn't be a good idea. I don't have reflux problems, but good to know!
Thank you, very informative (as always). I would be interested in more information on Barretts and possible treatment s for this.
www.ncbi.nlm.nih.gov/pmc/articles/PMC9495642/
Can Physical therapy bring the stomach below the diaphragm, couple PTs advertised. Will it work for sliding Hiatal hernia. PPIs have bad side effects, need a solution to bring the stomach back in its place, without surgery. Thanks very much, I enjoy your videos, the best.
I have heard people suggest drinking water to fill the stomach then jumping up and down to allow gravity pull out back down into place.
You might ask someone about that.
I suppose the professionals could do an ultrasound to see if something like that was successful.
Taking Pantoprazole & Omeprazole tanked my magnesium & sent me to the ER for severe vomiting & diarrhea that wouldn't stop.
While I was recovering from that, I got whammied by covid (before anyone knew what it was & just assumed it was a particularly nasty SARS variant floating around, which it is...
SARS took out my mom in 2016, so the family was familiar with it.)
2 years later I was diagnosed with a hiatal hernia & Barrett's esophagus & had a TIF procedure to fix it. It worked great except that it's easier to bloat & I can't vomit since then, so I always carry around zofran just in case, because retching with no solution is horrible...
I will wake up chocking even if completely sitting down if I fall asleep to close after eating...
One month in with the mattress on a tilt. GERD improvement is minimal, back and neck hurt all the time and I'm knackered every morning. I feel 10 years older than I did a month ago. I'm 77, and in July I was happily riding > 60 miles per outing: this month I'm dragging myself round 30-odd and feeling miserably tired the whole time. To hell with it, I'm going back to my old system.
Please make an in depth video on hiatus hernia - what causes it? If it is a mechanical problem, are there any non-surgical mechanical methods that can help or cure it? (yoga stretches, chiropractors, self massage of diaphragm, etc.). When is surgery considered, what options are there, how does it work, what is the probability of a permanent cure? What is the surgery like? I have many dozens of questions about this, you barely scratched the surface. Thank you
Interesting video! I recently started with medication. I have got long covid and increasingly suffer from reflux problems. Do have an explanation why this happens? It is worse when I am tired of when I during walking/cycling when tired. Is this related to the diaphragm or other cause? And what is the best treatment?
Thanks for that, I was aware of the Barrett's issue and PPI ineffectiveness but the rest was very new. I've had problems with reflux since being put on beta blockers after a couple of stent operations and a bypass operation. I've tried slowly weaning myself off the PPI in the hope that was part of the sphincter issue (was told that the sphincter relaxes more in the absence of acid stimulation) but that didn't work for me, and supposedly the beta blockers are for life 😞. BTW, I discovered that steroids cause hiccups if you're on beta blockers (at least the ones ones I am on).
Very helpful from one who suffers from hiartus hernia. You have given me hope.
Can weight loss (I'm 20lbs overweight) dietary changes, elevating the head of bed, eating dinner sooner and changing the types of food triggering reflux, can those changes reverse a hiatal hernia, or does a hiatal hernia always require surgery?
Fantastic! I really appreciate the work that goes in to these videos.
I try and do all the things you suggested, and it works well for me. Back when I was diagnosed with berets esophagus I also changed jobs because I think the environment inside a foundry was affecting my lungs and esophagus, I haven't been scoped for a while but had it done a couple times and was ok. Thanks
My reflux comes far less often with intermittently fasting, spacing 2 meals at least 4 hours apart. 🙄😃
Lying on your left instead of right side helps. Gravity...
Sleeping on the left side might help.
Many of the gastrointestinal issues are caused by the body's production of weak stomach acid. This is particularly common as one gets older. To be able to digest the food and compensate for the weaker acid, the body secretes more acid. The excessive digestive acid is what causes the acid reflux. Taking antacid and proton pump inhibitors will exacerbate and ultimately make this problem worse even while it may offer temporary relief.
The solution is straight forward but counter-intuitive. Get the body to produce less digestive acid by making the digestive acid stronger which will then make it unnecessary for the body to produce more. This will very quickly reduce GERD. To this end and for severe cases, taking digestive enzymes is the fastest and quickest way to resolve the issue. For others, just adding vinegar to one’s meal will already achieve the effect of resolving GERD.
This approach can be combined with common sense approach such as taking one's meal earlier and reclining the bed and before long, GERD will be a thing of the past.
Correct
Digestive enzymes work for me.
Thanks a lot for this video. Could you please shed some light on H Pylori?
I think you should also mention in this video the potential risk of long-term usage of PPIs.
If the stomach gets pushed up, how about getting on a trampoline or rebounder to pull the stomach back into it's proper place?
A local Chiropractor can usually adjust you to put you back into place... very easy!
@@allison471
Home self care is easier and repeatable.
@@mballer my point was, if you truly have a hernia, a Chiropractor can adjust you and if he/she knows what they are doing the adjustment should & will hold... that is all. 😊
@@allison471
Do you know of any videos of chiropractors and hiatal hernias?
I'm becoming interested in that.
I have GERD pretty bad. And it's frustrating because I'm in my 30's, slim and healthy and eat very healthy (probably in the 99th percentile). I don't drink or smoke. But yet I still have GERD.
Do you drink coffee?
@@ZzTop-vj5wo No. No caffeine.
I'm the same. Eat nothing spicy or fatty. Stop eating around 6.00. Still get heart burn. Weigh 8 st
Thank you
Incredibly helpful. ❤
Glad it was helpful!
@@Medcram
Please do another video after you've studied lowering PH and sphincter leakage.
In this video you say reducing the acid doesn't fix the leakage.
We need more acidity.
Do you measure stomach PH before prescribing acid blockers?
Does using CPAP to treat OSA have a tendency to resolve or decrease symptoms of GERD? I haven't had symptoms of GERD since I began using CPAP of 12 eighteen years ago.
It reduces it since it eliminated the negative pressure ventilation
I've had adverse reactions to both PPI and H2 blockers. Really bad reflux if I eat a regular sized meal, even If I wait 4 hours before sleeping. I do have scarring in my lungs. Radiologist called it "smoker's lung." But I haven't smoked for more than 40 years. I put the head of my bed on bricks, but nothing seems to be helping. Gah!
Try sleeping on your left hand side and use Gaviscon advance - it forms a raft over stomach contents to stop them refluxing,.It doesn't last long though so you may have to take it before bed and again during the night. I take a second dose when I get up to pee!)
2 tea spoons 🥄 of apple 🍎 cider vinegar in a 🍵 teacup of water helps digestion
Well, I went the "tip the whole bed" route, but used a wedge to tip the bedspring rather than the whole bed, which would apply unwonted stresses at the joints. Observations: reflux is slightly less, yay, hoist a flag and fire a gun. However, a 20cm lift in 190cm yields a 10.5% slope, which is enough for the burial-at-sea effect to intrude: for the last 3 nights I have been climbing back up the slope in search of my pillow, whose lack has resulted in a very stiff neck. And of course, I'm dog-tired every morning.
Ah well, you can't be ill without suffering. Might as well get on with it.
I do that too! I once woke up with the back of my knees over the bottom of the mattress & my feet on the floor! I too wake up with a stiff neck every morning, but I'd rather have that than the pain of the reflux! I try to sleep on my left hand side &, when I do that, I don't seem to travel down the bed as much as I do when I'm on my back! I'm trying to think of a way to attach a pillow to my head so that when I slide down the mattress the pillow comes with me!
Best solution for me was as follows:
1. No eating after 5pm
2. No sugar/very little
3. 2 tbls of ACV daily diluted in a full glass of water
I have pretty much eliminated my Acid reflux which was debilitating on a regular basis. No drugs needed. Won’t solve the problem.
I tried ACV but it didn't work for me as I have a hernia and that stops the LES from being able to function properly. Also I have bile reflux as well as acid reflux. So many things can go wrong with digestion! My neighbour's reflux was cured when she cut down on vegetables as they were giving her a lot of flatulence which was putting pressure on her stomach & causing the reflux! Finding the root cause is key, as reflux can be caused by many things, or combination of things. What can help one person may not help another, or may even make it worse.
Thank you for these, but from my own experience these are bandaids, just like the maintenance PPIs treatments we see RXed for pretty much everyone. We're still not addressing the root cause, which in my case was H.Pylori, damage to my stomach, parietal cell antibodies and as a result hypochloridia. Taking Betaine HCl (the opposite of our treatments nowadays) is what put my symptoms in remission, helped me digest my food and healed many conditions I had.This is also coming from someone who lost my mom to stomach cancer.
We need to figure out how to make our stomachs work again, produce enough acid and at the right pH in order to digest all those foods that are upsetting us. There is a also complex process between the acidic pH of the stomach and the release of enzymes from the pancreas. These enzymes are critical in IBD,IBS for example. How many people also suffer with these?
Avoiding foods is only causing deficiencies therefore many health conditions.
I wonder how many people are like me out there? Do we test these people for this or the intrinsic factor antibodies? That's just two that I've discovered researching on my own.
I'm only posting this here because I've followed you, since the pandemic started, and I know you can think outside the box, unlike majority of the doctors out there. I hope you'll look into this because we have so many people suffering with digestive issues. In my opinion if your stomach doesn't work nothing will; it'll only be downhill from there.
The best way is to allow the stomach to rest. One way of doing this is intermittent fasting rather than grazing all day.
I have Barretts Esophagus. I will have my third biopsy coming up in September as my Gastroenterologist is "monitoring for malignancy". I don't look forward to it as I have to be put under and every time I do that it seems to take longer for my memory to get back to normal (montfs). I'm already a breast cancer survivor since 2016. I do take panto for my reflux. I took pepcid for many years and my doc said "well it didn't work did it". If I had honestly believed i would be facing a second cancer diagnosis before the age of 60 I would have done things differently. Please listen to the doctor here on his advice. It may save you a cancer diagnosis.
When you have Barretts, they can scrape the cells. Ask for it and remove those cells of the inner wall to prevent cancer!
Panto terrible drug. Gave me severe anxiety and headaches and stomach pain. Snd nearly had a seizure stopping it. Always taper slowly off any drug.
www.ncbi.nlm.nih.gov/pmc/articles/PMC9495642/
Prayers for you. Thank you for your post.
To semi quote Star Wars, This is not the doctor you are looking for.
Really great info. I may be one of these examples
Thank you for the information..
Thanks, good info, well presented.
I wonder of excess abdominal mass may be playing a role here?
Your advices are lifesavers! Thank u, Doc!
The question is what is root cause of reflux? Most of people can eat spicy food and drink coffee everyday and they are fine. All those metioned "solutions" only manging the syptoms. Are peopel with acid reflux are attrached to elevated bed for the rest of their life?
I wonder if part of it could be genetic? My mum suffered from gerd as do I and my son does too, I know pregnancy/childbirth can put pressure on the the LES & weaken it, but that doesn't explain it away for men! Also I've known people who smoke, drink, eat spicy food & just before going to bed, & are very over weight, who never get it! So, although those things may put you at a higher risk, I think there's more to it than that.
For the last decade plus iv'e been on PPI, raised bead and no food 3hr before bed... also suck on a couple of Gaviscon tablets as i fall asleep. Need to lose more weight though. Such is life.
Doctors are not supposed to prescribe a PPI long term.
It causes other problems.
They go for an H2 blocker instead, but even that is not a health minded solution.
Have you seen a gastroenterologist?
This info is SUPER helpful. I will share it with others for sure! 🙏Thank you for all the great info on this channel!
Best information around during Covid.
great video; however, the red marker was hard to follow which graphic you were drawing on. Try another color.
Noted!
@@Medcram
I would prefer the while page to be color inverted, to make the whole page black with white lettering.
(also less blue light eye damage)
Question: where is data for head2toe bed lift. Shopping mattresses and all the marketing literature supports adjustable beds fir GERD. Best science I can find barely supports any lift, with no distinction for head2toe vs adjustable.
I’m following the video advice, but I come here for science over marketing
I think it's about pressure on the abdomen? If you think about it if your top half is raisedm but bum & legs are flat, (like an L shape) you are bent in the middle so there's pressure on the abdomen. Whereas if your body is straight but just on a slant there isn't. I remember years ago reading that we should eat stood up, to aid digestion, or stand up for a while after eating. I suppose it's a similar thing? And eating sat upright at a table is better than slumped in a chair with a tray on your lap in front of the TV as, again, pressire on abdomen?
Oh I think it makes sense, following the advice, though there is more discomfort than I expected. My question is where is the science. Maybe a Makary ‘Blind Spot’, but ai can’t find any quality studies on the head lift, much less the no bend posture. Every adjustable frame bed manufacturer I checked said their head and knees high position was good for Reflux. I come here for study backed or hypothesis under experimentation data.
I cut out sugars of all kinds. GERD gone, joint pain gone, weight down, trigger finger gone and I sleep better.
Sugar is evil. Years ago the sugar industry convinced
America that fat was evil and was going to kill you.
They reduced the fat in products and upped the sugar.
Or more likely, high fructose corn syrup. In the old days
this country used to drink its corn surplus.
IPF here - so a wedge may help, already to the others...
Thanks!
Thank you for your information. I was a bulimia sufferer for many years. However, I find myself having automatic reflux almost after every meal. I was not concerned before but after watching this link, I am. Should I be concerned.? What is my next step to improve my condition? I guess I am in a high risk of stomach cancer?
Not high risk but the esophagus should be checked out with endoscopy.
Trying some or all of these interventions and see if it works.
Thank you.
the diaphragm being skeletal muscle can be trained and strengthened......I once with a respiratory virus coughed for 3 days...so much so that my abdominal muscles were very sore....no reflux for a few days....
Really appreciate this.
I had reflux was thin, didn’t eat much, no idea why but I also had IBS. Spent years on H2 then PPIs. Then a friend got me to take HCL Guard by healthy gut. I also did some months of Aura products to target H Pylori. 95-100% better. Lately I have had some return of IBS, tested and HP so back to aura. Evan Brand does a lot on naturopath gastric issues. Thanks for the work you do!
I cannot tolerate h2 blockers and Dr Jamie koufman, leading expert says PPIs are very dangerous and should be taken off the market . She also says to find an ENT who knows about LPR and performs TNE instead of a gastro who does endoscopy because it is a dangerous procedure ( look what happened to joan rivers ).
How does COVID infection lead to reflux and why would ppis make symptoms of chest pain much worse? My personal experience would point towards a fungal infection/allergy facilitated by covid that leads to irritation/inflammation in the chest and impairment of nerve function. The other symptoms being incapacitating exhaustion and the usual long COVID group of symptoms.
what if loose sphincter is actually hypothyroid, given that it's one of these muscles that is right next to the thyroid so getting biggest thyroid hormone gradient.
The incidence of reflux tipping towards males vs hypothyroid towards females could be partially explained by wrongly accounting for alcohol intake, which directly irritates sphincter muscles: because of size, men drink more for same buzz, so irritation of sphincter is much higher. Also, women have higher esophageal occludin, which protects the sphincter.
Also, gerd defined by heartburn and common symptoms seems to be about even between genders in a european population study, so the higher incidence in men doesn't seem credible, most of those were specifically looking at esophagus injuries not gerd symptoms. In other words, hypothyroid as cause, which is much more prevalent in women, would be compatible with incidence data.
Prevalence of gastro-oesophageal reflux symptoms and the influence of age and sex, 2009
I’ve been struggling with this. Had an emergency upper endoscopy back in November for food impaction. My twin sister is an endoscopy nurse and gratefully recognized the peril I was in. The doctor she works/worked with took care of me. I’ve been on40 mags of Omeprazole since, I’ve struggled with eating small meals, eating the last meal early and staying away from foods that induce GERD. My sister had told me about caffeine and chocolate, specifically opening and loosening the esophageal sphincter. I get home from work and am hungry for chips and crunchy things and we don’t get supper on the table till about 6:30 or 7. It’s all me making poor choices. Despite this I’m not grossly overweight and intermittently make good dietary choices. I think I’ve suffered with chronic mostly silent reflux for a while. I know staying on the PPI is both good and bad in that it’s necessary to prevent damage to the esophagus with this condition yet it can lead to absorption problems. I do have asthma and have had “colds” in the last 2 years that loss of voice has happened. I had never had that problem before. Oh yah and I’m 54 yr and don’t smoke or drink.
Wow! I had no idea that PPIs and H2 blockers worked in that way… I thought they were stopping the reflux material from coming up all together- but they aren’t!!! Do products like tums also just reduce the acid but continue to allow contents to move up the esophagus? Thank you for sharing!
Thank you so much! Even most GI Dr's don't understand this. I was born with GERD and now have pulmonary fibrosis and Barrett disease. Lost four upper back molars 😢
After 15 years of having to have several antacids during the night, I discovered apple Cider Vinegar. One tablespoon in a glass of water sorted me out for 6months - and it was alway a very rich food that triggered reflux. Stomach acid needs to have a ph of between 1.5 - 3, otherwise the valve between the oesophagus and stomach stays open allowing stomach acid to reach the delicate wall of the oesophagus. In 4 years I've probably had to have 4 lots of apple cider vinegar. Just add vinegar or lemon juice to your salads etc if you don't like the drink. It really really works - but as the antacid business is worth over 5 billion pa, your GP or medic are not going to tell you this.
Thank you very much!!! I have this since a few years now! Especially also when eating Italian food like spaghetti, macaroni or lasagna. And of course when lying down. But when it is more severe sometimes and I go and sit right up I get trouble breathing and have to hold my head up and backwards!
What I found to be helping instead of medicines is baking soda. (Natrium-Bicarbonate or Na(HCO3)2). I thought about it myself. Bicarbonate is the natural thing that lowers acid in the bloodstream so why not use it to lower the acidity in the esophagus. And it works well. You only have to pay attention with how much to dissolve in a glass of water. Too much and it makes you feel weak in the stomach, too little and it does not help so much. I usually take about 25 cl and about 2 grams of Na(HCO3). Let it dissolve and that helps a lot!
Thank to you I am going to heighten my bed and try whether it improves my situation!
❤❤❤
Thank you.Great contribution.
The role of Helicobacter..in significant cases..needs to be considered..in..Indian scenario..requiring Antibiotics..such as Thromycin or derivatives..Pro.Dr.Nandakumar
Cons.chronic dis.
Cons.Diabet.&
Cardio Vascular Diab.
Physician Sonologist.
@Chennai.Puducherry.Tiruchy.wKLy.Thank you
I weaned myself off Prilosec. I started taking a probiotic and it seems to have gotten rid of my GERD. Im coughing alot less too. I thought it was allergies. This might not help everyone.
And I do have a hiatal hernia.
So, why do so many people resolve their GERD on low carb diets? And what about the folks who swear it went away with taking cider vinegar? Do we really understand WHY it happens in the first place?
Intolerance testing solved mine. One was basil not tomato, for my daughter it was glutin not tomato. Also whey was a huge problem for both of us. Gotta find your own. Basically, I've found if you burp it hours later it's suspect.
Can you comment on the theory that reflux can be caused by not having enough stomach acid to signal the lower esophageal sphincter to close, in which case HCl supplementation before meals can reduce reflux?
Would need more data. I’ve seen terrible esophagitis from too much acid and reflux.
@@Medcram
How much acid is too much acid?
What was the pH of the too much acid?
Did you measure it?
How much data do you need?
You could have a plethora of data by asking your GERD patients to eat a salad with vinegar dressing.
Surely you must know a knowledgeable dietician or two.
Did these patients have a defective sphincter?
Was there a mucus production problem?
I had gastric reflux for so long that my esophagus is scared. And because I had violent hiccups when triggered by small grains (coocuse, dry bread on a sandwich, even rice without a sauce) that i got an esophageal balloon. But wait there's more... my esophagus ripped and needed 3 staples to heal. But now I can again eat mostly what I want a year later I have only 3 times had a minor cases since. These hiccups problems progressed to just about every meal. Found my own ways to address a 2hr to 6hr calming session during the meal. Tips I found that heled were: have a room temp full glass of water at onset, cool creamie vanilla icecream, or having something on the bread or sauce on the grain.
Thank you for sharing this video.
Sleeping on left side at night has changed everything, apparently keeping the flap closed on the stomach acids? Not eating right before bed had also been very helpful, as you mentioned.