It starts slow. Chest pain, a little burning, maybe a sore throat. A few months later, you’re still in pain after meals, only the episodes are lasting longer and longer. Your sore throat has become chronic and is coupled with a cough. It feels like food is stuck in your throat, only nothing ever gets resolved.
Knock, knock. Who’s there? Acid reflux. The joke’s on you.
It’s no secret that acid reflux is a major problem for 30% of the American population. Thanks to the “great” standard American diet and the work ’till you drop mentality, we’ve eaten and worried ourselves into chronic illness over the years. Convenience has a cost. Stress has consequence. Poor food choices do affect long term health.
I was one of those tragedies. It started with a little chest tightness, shortness of breath, a chronic sore throat and a persistent cough. After 3-4 months, and the symptoms progressively getting worse, I went to see my doctor. I feared the worse – I’m dying, right, I asked? Oh no, it’s “just” reflux. “Just” reflux – whew! She handed me a script for a PPI (proton pump inhibitor) and sent me on my merry way. She said avoid spicy foods, alcohol and chocolate; take this pill 2x a day and you’ll be fine. Great!
At first, the results were promising. My symptoms did recede, but after some time, they returned and would sort of come and go and certainly they did nothing to address the symptoms I was experiencing in my throat – the hoarseness, chronic pain, excessive mucous and globus sensation. Those continued to persist unchecked even with the medication. When I would go off the PPI here and there, I would experience rebound reflux that was far worse than anything I initially had.
A few months later, I went to see an ENT for more information. “Fire engine red” was how he described my throat. He told me to stay on the PPIs and try and avoid spicy foods, etc etc etc. Back home, I was miserable. I could hardly swallow. I was clearing my throat all day long. I was losing my voice. And I was in so much throat pain day after day. If reflux wasn’t that big of a deal, why was it so hard to cure? Why wasn’t the medication working? I would come to find out that the answers are far more complex than I ever thought possible.
Over the next couple of years, I would vacillate between using the PPI and trying to get off the medication. I would make small adjustments to my diet when I was in a flare-up, but never made any lasting changes. My ENT and I were on a first name basis. My primary care even prescribed anti-anxiety medication as years of this was causing me so much worry and concern. Finally, after a serious bout of reflux coupled with IBS -D and eczema that ruined me for about 6-9 months in 2018, I decided to get serious. Endoscopies showed esophagitis & gastritis – inflammation of the esophagus and of the stomach. My voice box was greatly inflamed and I was on my way to permanent voice loss. At this rate, I feared I was on the road to a cancer diagnosis in 10 years or less if I didn’t get this figured out. I was losing weight, having chronic stomach aches, my mineral levels were low, indigestion was off the charts and my skin was screaming out for help. And yet, specialist after specialist just kept telling me to take the acid-blocker and stay away from “trigger” foods. Oh yeah, and manage my stress.
I hit my breaking point. It was time to figure this out on my own. The first thing I learned, and was horrified to find out, was just how terrible long term PPI use can be. They kept me on a rotating on-again off-again cycle with the medication so I wasn’t on it continuously, but it was like putting a Band-Aid on a gunshot wound. Recent studies have found that long term PPI use does have adverse effects including an increased risk of stomach cancer, bone density loss, increased osteoporosis, anemia, B12 deficiency, and SIBO. As a greater number of Americans are now taking PPI’s to curb their reflux, this increase in usage has brought to light the long-term effects of these medications.
I have learned so much about acid reflux over the past 2 years and specifically, around the delicate balance of the gut and digestive system in relation to the condition. To heal acid reflux, you have to address the whole gut and work to restore balance and optimal function from the root and not just by putting a patch on a symptom or set of symptoms. It’s all connected.
You need proper acidity levels in your stomach for optimal digestion. PPI’s are a potent inhibitor of gastric acid secretion, thus eliminating the refluxing of acid into the stomach, esophagus and throat, but also eliminating the ability of your stomach to efficiently digest food. If you can’t digest food, it essentially sits in your stomach undigested, minerals and nutrients unabsorbed, resulting in gas, bacterial overgrowth in the intestines, stomach pain, indigestion, and mineral deficiencies. So taking your PPI for your 8 week cycle (at a time or more if you are on it long term) might reduce some of the heartburn symptoms, but what kind of damage are you doing underneath? And long term – we’re talking potential bone fractures, anemia, chronic acid reflux, esophageal cancer, stomach cancer, kidney disease, and Alzheimer’s.
I decided to try and heal the things internally that weren’t working. Something obviously was wrong, but what exactly was it? A properly functioning digestive system would eventually heal my reflux, but I had a lot of work to do to get there. I threw out the PPIs and got to it. Research indicates that there are countless root causes of acid reflux and IBS. I had to address them all and attack the source.
Step 1: Throw out the pantry. I reverted back to a very basic diet of steamed broccoli and zucchini, olive oil, himalayan sea salt and coconut yogurt for two weeks (see Reflux Reboot protocol). Gone was anything gluten, sugar, dairy, processed, caffeine, citrus, garlic, peppers, onions, grains. Slowly after I started to see the inflammation diminishing, did I start to bring in a more robust, but still vegan diet, adding back in more diverse vegetables, non-acid reflux triggering berries/fruit, and nuts. *I now do eat meat, but conscious choices like sustainable, wild-caught salmon and organic, grass-fed beef on occasion.
Side note: when choosing how to scrub your gut clean for a reset, make sure you work with a nutritionist or doctor and have allergy testing done to eliminate histamine producing foods that can also trigger reflux. I also have a histamine intolerance so keeping histamine producing foods and supplementing with DAO is important for my personal reflux and digestive imbalance. I had no idea!
Step 2: Choose the right supplements. At the beginning I worked with Slippery Elm, DGL, Marshmallow Root, D-Limonene, Zinc L-Carnosine, Magnesium Glycinate, Sublingual B12, Aloe, Melatonin and Mastic Gum. I also drank copious amounts of ginger tea.
Step 3: Breathe right. I started working on my breathing and practiced diaphragmatic breath exercises twice a day to strengthen the diaphragm (which has a role in the lower esophageal sphincter) and can affect reflux disease. A strong diaphragm muscle improves the competence of the LES. Consistent breathwork led to more meditative practices so combined, they were helping to engage the parasympathetic nervous system – easing digestion and calming anxiety.
Step 4: How, when, why, what you eat matters. I had to look at when I ate meals and started working with intermittent fasting which gave my digestive system an opportunity each day to reset. I have found a 16-8 daily intermittent fast to be a sweet spot. Chewing mindfully seems silly, but is so important. We begin digestion in our mouths with saliva secretion. Chewing 30 times per bite slowed down the eating process and put me in a better place for optimal digestion. Snacking all day had to go too. I found it worked for me to eat small meals and give my body 2-3 hours between consumption. I also stopped drinking anything before, during and right after meals for 30 minutes as to not interrupt the stomach’s HCL levels.
Step 5: Downregulate. Instead of heavy exercises that trigger acid reflux, I spent a year in a light state of activity. Gentle walking – lots of it, especially after meals to stimulate digestion – became my go-to form of movement. Upright yoga poses and bicycling worked well. Save the high intensity, cross-fit and inversion practices until after you have fully healed or no longer experience regular flare ups. Listen to what your body needs. Now, I can say I am able to do most of those activities again – of course no less than 3 hours after a eating or drinking.
Step 6: Invest in a sleeping wedge. Elevating your bed and also sleeping on your left side are good anti-reflux tips. I also don’t lay down for at least 3 hours after my last meal. No more late night snacks.
These are all just ideas and tips based on what worked for me, my digestive system, and in curing acid reflux once and for all. I am still not 100% better, but on most days I am 99.9% better with an occasional flare up that is manageable through natural means. I haven’t taken a PPI in 2 years and I promise to look back 20-30 years from now and thank my younger self for giving my body a better future without the side effects of long term PPI usage and chronic digestive issues.
I think a huge takeaway for me was the realization that it’s not about putting a PPI Band-Aid on a gushing wound just so I could keep taxing my body with things that weren’t working for me such as coffee, chocolate, onions, garlic, alcohol, late meals, large meals, etc. It’s about figuring out, at the root, what is causing your symptoms, and working to address those systemically and holistically so you can find a way of living and thriving that works for you own unique and beautiful body.
UPDATE…I followed up with an otolaryngologist at Johns Hopkins in 2019 who was amazed with the progress I had made on my own. He said, whatever you are doing, keep doing it! What an inspirational appointment and affirmation that you can take control of acid reflux; that your body is truly amazing and intelligent and strives to heal whenever you give it the tools and opportunity to do so.