A few years ago I went through that “foods to avoid” list with my husband and we were both left wondering what he could eat! Fortunately following a healthier diet & cutting out bread/grains helped rid him of his GERD without medication. Unfortunately these types of diets are hard to follow long term - there’s just so much yummy bad-for-you food!! We’re both working on moderation & eating less (Americans eat way TOO much food).
There always seems to be unintended consequences to these marvelous modern medicines and you have shown how important it is to understand what these medications do to our bodies. I have always thought it should be better to treat the root cause rather than the symptoms!
Yes, it's quite sad that the answer is to remove nearly everything to avoid symptoms from occurring. However, this explains why people who consume carnivore or keto diets greatly improve; the heavily restricted diet likely removes so many bad foods. I think it's really telling of our modern diets.
RN/VA: My peers and I have noted that 15 years ago or so almost all of our patients (psyche) were on omeprazole, then starting about 2 years ago almost no one was. We assumed it was because of the co-morbidities/side effects mentioned in your very thorough paper.
That's interesting. I wonder if the perspective back then was that there would be no harm to even try it? I did not look deeply into the policy changes but I wouldn't be surprised if hospitals and other medical settings decided to stop massively distributing it at some point.
I have heard that 25% of meds approved by FDA are eventually recalled. New med out...someone complains of a stomach ache or heartburn...gets new med. 20 then 40mg. Years later correlation found between the med and other problems. Investigation, communication, conscience, and fear of harm to patient. "lets try something else" eventually FDA recalls med. Now extrapolate that concept out to 4 billion people many of whom have had catastrophic reactions to New med. How long before medical personnel decide to stop massively distributing it?
I believe it's because many drugs that make it to the market are essentially in a "Phase 4" trial which is to approve of a drug but monitor it for the next 5-10 years or so for adverse reactions. It's likely where these drugs end up showing concerning results. Unfortunately, it's an issue that may not be resolved with more testing. It reminds me of new models of phones or laptops. You can do so much testing as possible in a lab but individual differences can really affect what people do with their phones and the number of ways you can damage them. Unfortunately it's only when you provide something to a large number of people that you may begin to notice concerning signals.
I put the head of my bed higher by placing wood blocks under the legs of the head of the bed. It works some of the time, other times not as well. The problem is, my wife can't sleep like that. She has to lie flat. So I either sleep alone with a raised bed and no PPI. Or sleep w/ my wife and a PPI. Neither choice is ideal
That sounds very frustrating. I'm sorry to hear that and it really seems to create for a difficult situation. Now I'm thinking of those new therapedic beds (forgot what they're called) that let's you raise only one side but that sounds extremely expensive.
Thank you my friend. It is frustrating. The PPI's work but I'm only 59. I shudder to think that I'm stuck on these meds for the rest of my life. My mother has been taking them since they were released. So it's a def possibility.
A month of 8 oz of fresh celery juiced first thing in the morning, without anything in it, without anything in the stomach, restored the stomach enzyme and/ or acid balance needed to close the esophagus and stop reflux. Now I just blend celery in a high-speed blender to maintain the balance, and get the fiber. It's so easy healthy fix.
It's something about the particular salts in the celery. The esophagus valve is supposed to close when the stomach acid gets to a certain level (which is why antacids don't solve the problem). The salts in the celery juice help the stomach acids in a way that signals that esophagus valve to close.
I had a lot of digestive issues for a while, and fresh celery juice was a big part of my healing. I actually did it for almost a year, but felt better within a month. 💃
All right. I am going to have to try this one. I have a blender and celery is cheap. So heck why not. Thanks for the idea. I'd really like to get off of the PPI's I'm on.
Get yourself a couple of wedge foam pillows.. on the good nights with low GERD symptoms,use one wedge .. on the bad nights with high GERD symptoms,use both wedges together.That way the wife is happy and you are PPI free win win !
You are pretty knowledgeable about this. I have had sleep studies done. They always tell me that I'm borderline needing a CPAP. I went so far as to try them on two separate occasions. Man I could just never get used to them. I wanted them to help, but they seemed to wake me up more than help me sleep.
There are CPAP machines and then there are oral devices and even surgery. A good CPAP provider will sit with you and have you try out different headgear to get something that works. Plus you can turn the machine up to full blast or get a new one that is self regulating. They work a lot better than the old machines. It takes maybe two uncomfortable 30 minutes sessions for it to figure out the best settings.
If you get a king frame it takes to long twins I think. But you can also put a king on it if it’s a not too thick foam mattress
This is a nice mattress. I’ve bought a number of foam mattress. My favorite are tempurpedic but they raised their prices too high and it isn’t worth it. Now with the adjustable bed it doesn’t matter because it’s so comfortable.
I left it out mostly due to size constraints. However, it's an observational study, the average age was in their 60s (the researchers stratified for age but I couldn't find any table or graph), predominately white. There's lots of confounding variables that doesn't make the evidence as clear as 1/500 deaths. And even then, the evidence seems to increase greatly with use reaching one or two years which doesn't appear to be the recommended time of use as well. There's a lot to consider here so I would argue it's not as clear cut.
The big problem of this drug is that it is very often taken for years, contrary to official recommandations (2-4 months). In France, a study showed that 8 millions people (out of 16 millions who tool the drug the past year) took it everyday for the entire year. It is difficult to stop taking it once you start it. And doctors do not mind. This is a health crisis.
There are plenty of herbs which alleviate symptoms of GERD without the side effects that these drugs have. Slippery elm bark, licorice, ginger, turmeric, Salvia miltorrhiza, and Japanese honeysuckle come to mind as I have successfully used them for patients with this condition. A multi herb product called Iberogast works well. https://acrobat.adobe.com/link/track?uri=urn:aaid:scds:US:4172b036-2b21-3606-8b56-bb65f2700cb2
I just looked up the Iberogast one and it appears to have several good studies in regards to it. I would like to look into the pharmacology of it. It's a shame that so many herbal remedies have very limited mechanisms of action.
In that regard I would reiterate that we should always examine the mechanism of action of herbs with the same level of discernment as those of pharmaceuticals. If a compound in herbs targets these proton transporters through covalent bonding as well then we may raise similar concerns with herbs as we would with pharmaceuticals. However, I have a working hypothesis in regards to plants and a bit of evolutionary theory I may write about at some point.
Aloha. I would suggest the opposite, that many herbs have multiple modes of action. Many herbs have upwards of several hundred different phytochemicals,, acting in different ways upon our bodies, sometimes synergistically work each other. For example licorice is antiviral, it's is also useful for gastrointestinal issues, it is also a good synergist with other herbs or medicines in that it interrupts the CYP pathways leading to higher concentration of, for example, strongly antibiotic herbs such as Cryptolepis or Sida species.
Many herbs have traditional uses in multiple body systems. This is another form of "evidence" based medicine.
So the allopathic approach to herbs tends to be limited to "this herb does this one thing" or marketed that way, when the evidence is that it is useful for many things.
Oh I see I didn't state my sentence properly. I meant that many studies have not elucidated many of these plants mechanisms of actions, not that many herbs don't have many mechanisms of action, such that many herbs may have antimicrobial or antiinflammatory properties but the exact compound and enzyme/protein may not be found in the literature. Sorry for the confusion.
And often it's not the identified compound. For example artemesinin from Artemesia annua is the "identified" anti parasitic for malaria and so has been extracted for malaria treatment. However, the organism will develop resistance to it, and not to the plant. And the plant with artemesinin removed is more effective than artemesinin alone. The plants are pretty smart, eh?
So I did not finish the story and say that my stomach has gotten much better and I actually stopped taking the ranitidine after my prescription was done- I'm pretty sure it was not GERD. I believe it was because of my poor diet/really bad dehydration that I went through in school/college that likely led to my symptoms. But afterwards my symptoms definitely reduced. Thanks for sharing your concerns!
It's probably a good idea not to fall towards heuristics and assume that anything said by any agency is immediately accurate or correct. I think people should be more skeptical and anything that is mentioned with absolute terms should be regarded with greater skepticism.
A few years ago I went through that “foods to avoid” list with my husband and we were both left wondering what he could eat! Fortunately following a healthier diet & cutting out bread/grains helped rid him of his GERD without medication. Unfortunately these types of diets are hard to follow long term - there’s just so much yummy bad-for-you food!! We’re both working on moderation & eating less (Americans eat way TOO much food).
There always seems to be unintended consequences to these marvelous modern medicines and you have shown how important it is to understand what these medications do to our bodies. I have always thought it should be better to treat the root cause rather than the symptoms!
Then how will pharmaceutical companies make MONEY? :)
Yes, it's quite sad that the answer is to remove nearly everything to avoid symptoms from occurring. However, this explains why people who consume carnivore or keto diets greatly improve; the heavily restricted diet likely removes so many bad foods. I think it's really telling of our modern diets.
RN/VA: My peers and I have noted that 15 years ago or so almost all of our patients (psyche) were on omeprazole, then starting about 2 years ago almost no one was. We assumed it was because of the co-morbidities/side effects mentioned in your very thorough paper.
That's interesting. I wonder if the perspective back then was that there would be no harm to even try it? I did not look deeply into the policy changes but I wouldn't be surprised if hospitals and other medical settings decided to stop massively distributing it at some point.
I have heard that 25% of meds approved by FDA are eventually recalled. New med out...someone complains of a stomach ache or heartburn...gets new med. 20 then 40mg. Years later correlation found between the med and other problems. Investigation, communication, conscience, and fear of harm to patient. "lets try something else" eventually FDA recalls med. Now extrapolate that concept out to 4 billion people many of whom have had catastrophic reactions to New med. How long before medical personnel decide to stop massively distributing it?
I believe it's because many drugs that make it to the market are essentially in a "Phase 4" trial which is to approve of a drug but monitor it for the next 5-10 years or so for adverse reactions. It's likely where these drugs end up showing concerning results. Unfortunately, it's an issue that may not be resolved with more testing. It reminds me of new models of phones or laptops. You can do so much testing as possible in a lab but individual differences can really affect what people do with their phones and the number of ways you can damage them. Unfortunately it's only when you provide something to a large number of people that you may begin to notice concerning signals.
Drop the drugs and buy a wedge pillow, better yet buy an adjustable bed. You need to prop yourself up at night. The GERD will go away overnight.
I put the head of my bed higher by placing wood blocks under the legs of the head of the bed. It works some of the time, other times not as well. The problem is, my wife can't sleep like that. She has to lie flat. So I either sleep alone with a raised bed and no PPI. Or sleep w/ my wife and a PPI. Neither choice is ideal
That sounds very frustrating. I'm sorry to hear that and it really seems to create for a difficult situation. Now I'm thinking of those new therapedic beds (forgot what they're called) that let's you raise only one side but that sounds extremely expensive.
Thank you my friend. It is frustrating. The PPI's work but I'm only 59. I shudder to think that I'm stuck on these meds for the rest of my life. My mother has been taking them since they were released. So it's a def possibility.
This is great. Sweetnight SN-ABB002-SCLK Adjustable Bed Base, Split California King, Orange https://smile.amazon.com/dp/B08TN1RBWF/ref=cm_sw_r_cp_api_i_3FHD7CWF2X94WF5VN1FT?_encoding=UTF8&psc=1
A month of 8 oz of fresh celery juiced first thing in the morning, without anything in it, without anything in the stomach, restored the stomach enzyme and/ or acid balance needed to close the esophagus and stop reflux. Now I just blend celery in a high-speed blender to maintain the balance, and get the fiber. It's so easy healthy fix.
That's interesting! Do you know what within the celery was the likely therapeutic agent?
It's something about the particular salts in the celery. The esophagus valve is supposed to close when the stomach acid gets to a certain level (which is why antacids don't solve the problem). The salts in the celery juice help the stomach acids in a way that signals that esophagus valve to close.
I had a lot of digestive issues for a while, and fresh celery juice was a big part of my healing. I actually did it for almost a year, but felt better within a month. 💃
All right. I am going to have to try this one. I have a blender and celery is cheap. So heck why not. Thanks for the idea. I'd really like to get off of the PPI's I'm on.
Great, let me know how it turns out for you. 👍🏽😊
Get yourself a couple of wedge foam pillows.. on the good nights with low GERD symptoms,use one wedge .. on the bad nights with high GERD symptoms,use both wedges together.That way the wife is happy and you are PPI free win win !
Then try the pillow. It won’t affect her. You might want to prop yourself up a little higher.
7.5" Wedge Pillow For Acid Reflux - Dr. Recommended Height, Luxurious 2" Memory Foam Pillow Wedge For Sleeping, GERD, Post Surgery, Heartburn, and Snoring - Washable Bamboo Cover (25"W x 26"L x 7.5"H) https://smile.amazon.com/dp/B07JVDZGWQ/ref=cm_sw_r_cp_api_i_JWRFRMN88K4YX4S19727?_encoding=UTF8&psc=1
Nice adjustable split bed.
Sweetnight SN-ABB002-SCLK Adjustable Bed Base, Split California King, Orange https://smile.amazon.com/dp/B08TN1RBWF/ref=cm_sw_r_cp_api_i_EHXQ4JSW3JG4ZG5M35QT?_encoding=UTF8&psc=1
Thank you. I failed to mention that I have tried the wedge. I could never get comfortable. But the split bed thing looks interesting.
You might need to have a sleep study done. It might be something more than GERD like sleep apnea.
Oh BTW, I know obesity is a risk factor. Sadly I am already pretty thin. I wear a 32" waist. So I am not able to do much more on that front.
You are pretty knowledgeable about this. I have had sleep studies done. They always tell me that I'm borderline needing a CPAP. I went so far as to try them on two separate occasions. Man I could just never get used to them. I wanted them to help, but they seemed to wake me up more than help me sleep.
There are CPAP machines and then there are oral devices and even surgery. A good CPAP provider will sit with you and have you try out different headgear to get something that works. Plus you can turn the machine up to full blast or get a new one that is self regulating. They work a lot better than the old machines. It takes maybe two uncomfortable 30 minutes sessions for it to figure out the best settings.
If you get a king frame it takes to long twins I think. But you can also put a king on it if it’s a not too thick foam mattress
This is a nice mattress. I’ve bought a number of foam mattress. My favorite are tempurpedic but they raised their prices too high and it isn’t worth it. Now with the adjustable bed it doesn’t matter because it’s so comfortable.
American Mattress Company 8" Graphite Infused Memory Foam-Sleeps Cooler-100% Made in The USA-Medium Firm (King) https://smile.amazon.com/dp/B07PB6FMQ6/ref=cm_sw_r_cp_api_i_VY25HZ0BQ07D1VWX6JGX?_encoding=UTF8&psc=1
They are very comfortable.
You have the American 8"?
Yes
Didn't you miss that important study ? https://bmjopen.bmj.com/content/7/6/e015735 PPI seem to cause 1/500 deaths each year.
I left it out mostly due to size constraints. However, it's an observational study, the average age was in their 60s (the researchers stratified for age but I couldn't find any table or graph), predominately white. There's lots of confounding variables that doesn't make the evidence as clear as 1/500 deaths. And even then, the evidence seems to increase greatly with use reaching one or two years which doesn't appear to be the recommended time of use as well. There's a lot to consider here so I would argue it's not as clear cut.
The big problem of this drug is that it is very often taken for years, contrary to official recommandations (2-4 months). In France, a study showed that 8 millions people (out of 16 millions who tool the drug the past year) took it everyday for the entire year. It is difficult to stop taking it once you start it. And doctors do not mind. This is a health crisis.
There are plenty of herbs which alleviate symptoms of GERD without the side effects that these drugs have. Slippery elm bark, licorice, ginger, turmeric, Salvia miltorrhiza, and Japanese honeysuckle come to mind as I have successfully used them for patients with this condition. A multi herb product called Iberogast works well. https://acrobat.adobe.com/link/track?uri=urn:aaid:scds:US:4172b036-2b21-3606-8b56-bb65f2700cb2
I just looked up the Iberogast one and it appears to have several good studies in regards to it. I would like to look into the pharmacology of it. It's a shame that so many herbal remedies have very limited mechanisms of action.
In that regard I would reiterate that we should always examine the mechanism of action of herbs with the same level of discernment as those of pharmaceuticals. If a compound in herbs targets these proton transporters through covalent bonding as well then we may raise similar concerns with herbs as we would with pharmaceuticals. However, I have a working hypothesis in regards to plants and a bit of evolutionary theory I may write about at some point.
Aloha. I would suggest the opposite, that many herbs have multiple modes of action. Many herbs have upwards of several hundred different phytochemicals,, acting in different ways upon our bodies, sometimes synergistically work each other. For example licorice is antiviral, it's is also useful for gastrointestinal issues, it is also a good synergist with other herbs or medicines in that it interrupts the CYP pathways leading to higher concentration of, for example, strongly antibiotic herbs such as Cryptolepis or Sida species.
Many herbs have traditional uses in multiple body systems. This is another form of "evidence" based medicine.
So the allopathic approach to herbs tends to be limited to "this herb does this one thing" or marketed that way, when the evidence is that it is useful for many things.
Just sayin'
Oh I see I didn't state my sentence properly. I meant that many studies have not elucidated many of these plants mechanisms of actions, not that many herbs don't have many mechanisms of action, such that many herbs may have antimicrobial or antiinflammatory properties but the exact compound and enzyme/protein may not be found in the literature. Sorry for the confusion.
And often it's not the identified compound. For example artemesinin from Artemesia annua is the "identified" anti parasitic for malaria and so has been extracted for malaria treatment. However, the organism will develop resistance to it, and not to the plant. And the plant with artemesinin removed is more effective than artemesinin alone. The plants are pretty smart, eh?
Sorry to hear about your stomach, hard to have that happening so regularly. We all have to eat!
So I did not finish the story and say that my stomach has gotten much better and I actually stopped taking the ranitidine after my prescription was done- I'm pretty sure it was not GERD. I believe it was because of my poor diet/really bad dehydration that I went through in school/college that likely led to my symptoms. But afterwards my symptoms definitely reduced. Thanks for sharing your concerns!
Oh good! 💜
Yeah poor diet is a problem. Good luck.
It's probably a good idea not to fall towards heuristics and assume that anything said by any agency is immediately accurate or correct. I think people should be more skeptical and anything that is mentioned with absolute terms should be regarded with greater skepticism.
For sure. It's gotten to the point that whenever they say anything, I reflexively think it must be the opposite.
I’m sure Mark Levin has that covered in one of his books.