Acid Reflux and Fats

[SJC]

I have acid reflux which flares up real bad from time to time. When it flares up I take PPI medication and usually it settles down in a few weeks until next time. Since going on the LCHF my acid has been raging. I am on 2 x PPIs a day now and I can still feel the effects from it quite badly. I am wondering if it's all the extra saturated fat I have been eating. Is anyone else having this problem?

 

[ally1]

hope the acid relux eases off
i get bad indigestion when i eat cheese

 

[SJC]

hope the acid relux eases off
i get bad indigestion when i eat cheese

Thanks See? That's hard saturated fat isn't it?

 

[noblehead]

I use to get really bad acid reflux but don't get bothered as much now, was prescribed a drug called Lansoprazole and was on a 15mg dose once a day.

High-fat food is known to cause acid reflux, reading this article I see that caffeine can cause it too, strange that as I give up drinking caffeinated drinks some time ago:

http://healthyliving.msn.com/diseases/heartburn-and-gerd/7-foods-that-cause-acid-reflux-1

 

[SJC]

I use to get really bad acid reflux but don't get bothered as much now, was prescribed a drug called Lansoprazole and was on a 15mg dose once a day.

High-fat food is known to cause acid reflux, reading this article I see that caffeine can cause it too, strange that as I give up drinking caffeinated drinks some time ago:

http://healthyliving.msn.com/diseases/heartburn-and-gerd/7-foods-that-cause-acid-reflux-1

Had a hunch it was the fats. Sad though as it's helping keep my BG down. I have only drunk decaffeinated for years. BG or acid? Acid or BG? Hmm? Here we go!

 

[Indy51]

I'm the exact opposite - I was on PPIs for many years for reflux. As soon as I stopped eating any processed foods, especially grains, and added lots of saturated fat to my diet, I was able to stop taking them and very rarely get symptoms nowadays, unless I eat certain foods (like bananas and capsicums). Often too much gas in general can cause upward pressure on the stomach valve. I have a small hiatal hernia but it doesn't seem to cause me too many issues unless I eat too close to bedtime or eat too much in one sitting. PPIs themselves can cause issues - coming off them can have a rebound effect that makes the reflux worse. There are so many different things that can affect it. Taking digestive enzymes also helped me a lot.

 

[Thundercat]

My brother suffers a lot with reflux from a hiatus hernia. Fatty foods are a no-no for him or on comes excruciating pain. Natural remedies that work are apple cider vinegar and diluted freshly made carrot juice ( both are alkalis and neutralise the acid)

Sent from the Diabetes Forum App

 

[SJC]

I'm the exact opposite - I was on PPIs for many years for reflux. As soon as I stopped eating any processed foods, especially grains, and added lots of saturated fat to my diet, I was able to stop taking them and very rarely get symptoms nowadays, unless I eat certain foods (like bananas and capsicums). Often too much gas in general can cause upward pressure on the stomach valve. I have a small hiatal hernia but it doesn't seem to cause me too many issues unless I eat too close to bedtime or eat too much in one sitting. PPIs themselves can cause issues - coming off them can have a rebound effect that makes the reflux worse. There are so many different things that can affect it. Taking digestive enzymes also helped me a lot.

I have a hernia too. I wondered about PPIs causing the issue actually as in the past I got an email from a professor suggesting that I may not be producing enough acid which actually gives similar symptoms. Who would I approach for digestive enzymes , though I have had blood tests. Would blood tests show a problem with enzymes?

 

[SJC]

My brother suffers a lot with reflux from a hiatus hernia. Fatty foods are a no-no for him or on comes excruciating pain. Natural remedies that work are apple cider vinegar and diluted freshly made carrot juice ( both are alkalis and neutralise the acid)

Sent from the Diabetes Forum App

Hi
I tried apple cider vinegar but it didn't help. Think I may lay off the PPIs for a few days actually and see if it helps.

 

[Serena51]

I too was taking iLansoprazole but since going low carb have had no more problems and stopped taking them altogether. On the odd occasion that I have had bread the acid refluxx reappears.

If I remember rightly, milk thistle is an alternative method of dealing with acid reflux.

 

[SJC]

I too was taking iLansoprazole but since going low carb have had no more problems and stopped taking them altogether. On the odd occasion that I have had bread the acid refluxx reappears.

If I remember rightly, milk thistle is an alternative method of dealing with acid reflux.

Thanks. Maybe I am barking up the wrong tree with the fats. I am also getting a massive increase in wind but of course am eating much more salads and veg.

 

[catherinecherub]

There are also problems associated with PPIs.

PPIs should have a black box warning.
"Compounding the problem of massive inappropriate use, recent evidence has documented several serious new safety problems with long-term PPI use. For some of these risks, current FDA-approved PPI labels do not mention the adverse effect at all, including the potential for developing dependence on the drugs, which results in rebound hypersecretion of stomach acid and recurrence of symptoms after stopping PPI use.

For other risks, even if mentioned, the label does not adequately explain or emphasize them. There are currently no black box warnings in the label of any PPI.

This petition outlines the current state of evidence of the risks involved with short- and long-term use of PPIs and asks that the FDA make prescribers and consumers aware of these risks through the following labeling changes."

http://www.medicalnewstoday.com/articles/233272.php



Case reports of hypomagnesaemia
Severe hypomagnesaemia has been reported infrequently in patients treated with PPIs, although the exact incidence is unknown. A review of case reports described in the literature or reported to regulatory authorities in Europe suggests that PPIs may cause hypomagnesaemia. Some cases occurred after 3 months of PPI therapy, but most occurred after 1 year of treatment. Serious manifestations of hypomagnesaemia—fatigue, tetany, delirium, convulsions, dizziness, and ventricular arrhythmia—can occur, but they may begin insidiously and be overlooked. In most case reports, hypomagnesaemia improved after magnesium replacement and discontinuation of the PPI.

For patients expected to be on prolonged treatment, and especially for those who take PPIs with digoxin or drugs that may cause hypomagnesaemia (eg, diuretics), healthcare professionals should consider measuring magnesium levels before starting PPI treatment and repeat measurements periodically during treatment.



http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON149774

 

[Indy51]

You can get digestive enzyme supplements from most health food stores - even some pharmacies have them. If it's been suggested that low stomach acid is the cause, you can get supplements that contain Betaine HCL and Pepsin to help digestion.

Now that you've mentioned wind (produced by our gut bacteria digesting food), then I'd definitely be thinking about SIBO as a cause - there's a book by a Dr Mark Pimentel (a gastroenterologist who works at Cedars Sinai) and his theory of IBS is that bacterial overgrowth is the cause of many issues. There's another author who has written extensively on reflux called Norm Robillard and he thinks FODMAPS are the main culprit for many people for both IBS and SIBO.

I know for myself if I eat certain foods nowadays it will set off the equivalent of a fermentation factory in my gut - when that happens, I know wind, burping and reflux may be following. You might want to look more into the FODMAPS issue.

 

[SJC]

You can get digestive enzyme supplements from most health food stores - even some pharmacies have them. If it's been suggested that low stomach acid is the cause, you can get supplements that contain Betaine HCL and Pepsin to help digestion.

Now that you've mentioned wind (produced by our gut bacteria digesting food), then I'd definitely be thinking about SIBO as a cause - there's a book by a Dr Mark Pimentel (a gastroenterologist who works at Cedars Sinai) and his theory of IBS is that bacterial overgrowth is the cause of many issues. There's another author who has written extensively on reflux called Norm Robillard and he thinks FODMAPS are the main culprit for many people for both IBS and SIBO.

I know for myself if I eat certain foods nowadays it will set off the equivalent of a fermentation factory in my gut - when that happens, I know wind, burping and reflux may be following. You might want to look more into the FODMAPS issue.

There are also problems associated with PPIs.

PPIs should have a black box warning.
"Compounding the problem of massive inappropriate use, recent evidence has documented several serious new safety problems with long-term PPI use. For some of these risks, current FDA-approved PPI labels do not mention the adverse effect at all, including the potential for developing dependence on the drugs, which results in rebound hypersecretion of stomach acid and recurrence of symptoms after stopping PPI use.

For other risks, even if mentioned, the label does not adequately explain or emphasize them. There are currently no black box warnings in the label of any PPI.

This petition outlines the current state of evidence of the risks involved with short- and long-term use of PPIs and asks that the FDA make prescribers and consumers aware of these risks through the following labeling changes."

http://www.medicalnewstoday.com/articles/233272.php



Case reports of hypomagnesaemia
Severe hypomagnesaemia has been reported infrequently in patients treated with PPIs, although the exact incidence is unknown. A review of case reports described in the literature or reported to regulatory authorities in Europe suggests that PPIs may cause hypomagnesaemia. Some cases occurred after 3 months of PPI therapy, but most occurred after 1 year of treatment. Serious manifestations of hypomagnesaemia—fatigue, tetany, delirium, convulsions, dizziness, and ventricular arrhythmia—can occur, but they may begin insidiously and be overlooked. In most case reports, hypomagnesaemia improved after magnesium replacement and discontinuation of the PPI.

For patients expected to be on prolonged treatment, and especially for those who take PPIs with digoxin or drugs that may cause hypomagnesaemia (eg, diuretics), healthcare professionals should consider measuring magnesium levels before starting PPI treatment and repeat measurements periodically during treatment.



http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON149774

Thanks. What I would like to say is this.
I was talking to a man a couple of years ago and he told me his story of acid reflux and hiatus hernia. At the same time of suffering, his best friend did. They were both put on PPIs. His friend gave up taking them after a few weeks and vowed to handle it by diet. This didn't work for him but he still didn't take the PPIs. He developed Barrets osoephagus then osoephageal cancer and died. The man I was talking to took PPIs constantly for 3 years. He then decided to take up Buddhism and became a rekei therapist. He gave up the PPIs and never suffered again. Hes ten years down the line with no symptoms.

 

[SJC]

You can get digestive enzyme supplements from most health food stores - even some pharmacies have them. If it's been suggested that low stomach acid is the cause, you can get supplements that contain Betaine HCL and Pepsin to help digestion.

Now that you've mentioned wind (produced by our gut bacteria digesting food), then I'd definitely be thinking about SIBO as a cause - there's a book by a Dr Mark Pimentel (a gastroenterologist who works at Cedars Sinai) and his theory of IBS is that bacterial overgrowth is the cause of many issues. There's another author who has written extensively on reflux called Norm Robillard and he thinks FODMAPS are the main culprit for many people for both IBS and SIBO.

I know for myself if I eat certain foods nowadays it will set off the equivalent of a fermentation factory in my gut - when that happens, I know wind, burping and reflux may be following. You might want to look more into the FODMAPS issue.

Thanks. Oh nooo, not more limitations on food! I see cauliflower's off the menu then along with a host of other foods. At this rate, with my other conditions I will soon have little choice of menu. Apparently Pimentel treats with antibiotics...hmm?

 

[Indy51]

Well, if I'd given them up and still had persistent symptoms, I'd probably have done things differently. But the lifestyle, diet and supplements worked for me.

It was reading these two studies that convinced me I wanted to give them up and I started experimenting. I've also read (on coeliac support boards) that it's a very common experience to have been taking them, then go on to be diagnosed with coeliac - anecdotal evidence, I know, but I believe real life experiences by real people count (otherwise I wouldn't be here, I guess).

http://www.ncbi.nlm.nih.gov/pubmed/21894279
http://www.racgp.org.au/afp/2011/september/proton-pump-inhibitors/

I went back on them for about 3 days after my diagnosis with gastritis and had a recurrence of all my gluten intolerance-like symptoms (bloating/gas), so stopped them and the symptoms went away. That was the final nail in their coffin for me.

 

[Indy51]

Thanks. Oh nooo, not more limitations on food! I see cauliflower's off the menu then along with a host of other foods. At this rate, with my other conditions I will soon have little choice of menu. Apparently Pimentel treats with antibiotics...hmm?

Not all the foods will give you problems. Cauliflower is definitely not a problem for me. My biggest issues are artificial sweeteners, honey and grains.

I think he treats some patients with antibiotics, but they're specific antibiotics that don't decimate the entire gut flora. It's been a while since I read the book but one of them is called rifaximin or something like that.

 

[SJC]

Not all the foods will give you problems. Cauliflower is definitely not a problem for me. My biggest issues are artificial sweeteners, honey and grains.

I think he treats some patients with antibiotics, but they're specific antibiotics that don't decimate the entire gut flora. It's been a while since I read the book but one of them is called rifaximin or something like that.

Thanks. I will certainly give it serious consideration. I burp all day long. I get so much wind it feels like I can't breathe at times. Only gaviscon gives me some temporary relief. I don't like the idea of just taking enzymes. Surely there must be some test or someone specific you can see to determine whether you have a specific gut problem. Had all the absorption coeliac tests etc, but my gastroenterologist has little interest in my plight.

 

[anteater2012]

I too was on Lanzaprole, but they simply did not do anything for my acid reflux. Having a doctor at the time that didn't give a toss didn' help either.

In the end I found that the low carb diet has helped massively - however I still can't do the fat part very well - even using "healthy" fats. Things such as mackerel/sadines will cause me problems which is really annoying as I love them. Cream and butter also cause problems at times, but if I don overdo things I can mostly get away with it.

I have over time managed to create a list of foods I can tolerate that contain fat/carbs that don't cause me acid or spikes - it has taken trial and error. I usually start out by banishing a food completely from my diet for about 4 weeks and then reintroduce it. Not sure why - my body seems to need a "reset" on certain foods sometimes.

I will admit to living on salad most of the time, but I don't mind them. I do experiment with what I serve them with i.e.

small piece of salmon / grilled chicken / tuna / omelette/ mixed bean
I do cheese - but not cheddar - I use salad cheese/feta or buffalo mozerella and for english cheese I use wenslydale or cheshire and sometimes white stilton
For grains I have less issue with rye based bread/crackers than with wheat, but still keep it a restricted part of the diet.

I did invest in a low carb cookbook wich has been most useful for prompting ideas. - more so in winter when hot food is preferable "The Complete Book of Low-Carbohydrate Cooking" Elaine Gardner

Try restricting both grains/fats for a while and then re-introduce them as required.
Hope this helps
Eater of Ants

 

[Indy51]

Thanks. I will certainly give it serious consideration. I burp all day long. I get so much wind it feels like I can't breathe at times. Only gaviscon gives me some temporary relief. I don't like the idea of just taking enzymes. Surely there must be some test or someone specific you can see to determine whether you have a specific gut problem. Had all the absorption coeliac tests etc, but my gastroenterologist has little interest in my plight.

Unfortunately that was my experience too - all they want to do is prescribe PPIs - it seems to be their only answer to everything.

I read Dr Pimentel's book, read a lot about digestion on the net and came up with my own plan. Then for the past year, I've also been seeing a naturopath to fine tune some of it. The supplements she's given me have made a big difference. I wouldn't say things are 100% fine now, but compared to what they were like when I was diagnosed, there's no comparison.

I think I got a kick start though by having 2 lots of antibiotics for a UTI (also part of my diagnosis) - so gave me a clear playing field for dietary intervention. Another thing that makes a big difference to dysbiosis for me is keeping my Vitamin D levels topped up - too much or too little and my gut tells me about it.

I think there's some kind of breath test for SIBO - but not sure if it's done in the UK - most of the stuff I've read about it comes from US sites.