Sunday, January 13, 2008

Causes of GERD

OK it's time to get down to the nitty gritty.

Theories (hypotheses? I get them confused) on the causes of GERD (gastro-intestinal reflux disease) are abundant. They say you have GERD if your reflux is persistent, not if you only have occasional problems with reflux. I will call it all GERD because it makes things easier for me. One thing the following theories have in common is that they eschew acid-reducing pills and medications like Mylanta, Zantac, and Prilosec. These are not only bad for your stomach and digestive tract, but bad for your overall health. You need acid to digest proteins. You need acid to make the whole cascade of events that happens later to occur as it should.

The low-carb theory blames it all on carbs, natch. In the book, Heartburn Cured, by Norm Robillard, the author states that if you cut your carbs really low, down to 25 to 35 g per day, you will find lasting relief almost immediately. Before I went low-carb, I was consuming 200 to 300 g per day, so you can see why cutting down to 25 would make a huge difference. Don't try to do this yourself without reading Protein Power Lifeplan to help you with the transition. I stumbled along and gradually got that low over the course of 2 years. You can check your current carb intake on the USDA MyPyramid Tracker website.

Once you have completely eliminated your symptoms, you can then experiment with adding more carbs back into your diet until symptoms return, then stay at that level or a little below. In my experience, this method will work for most people suffering from GERD. As Robillard points out, it's the carbs that create gas, especially in the small intestine, which then pushes up on the stomach from down below, which forces open the LES (lower esophageal sphincter) and allows stomach acid to flow up into the esophagus. The book is short and easy to read and includes an easy to follow description of the digestive process.

For a more thorough description of the whole process, I recommend Why Stomach Acid is Good for You by Jonathan Wright. This book has more detail and some excellent diagrams to help you get familiar with the digestive organs and the digestive process. Wright's suggested remedies are more mainstream, though, i.e., looking for specific foods, like spicy foods, etc., that might be your own triggers. I found that for me this is not the case. There isn't any one food that sets me off, but carbs in general do add to the problem. However, his solutions other than using HCL (hydrochloric acid) and pepsin are quite helpful. I am reluctant to use HCL without a doctor's assistance.

The HCL probably would work, though, because as Wright says, it isn't that you have too much stomach acid, it is that the acid is in the wrong place (your esophagus). He claims that most people have too little stomach acid and the remedy is to increase the acid signaling the LES to stay shut tight. There is some evidence that he is right, so I have followed his recommendations for taking bitters before a meal to increase stomach acid. He also recommends DGL (deglycyrrhizinated licorice) which I have tried (definitely an acquired taste) and other natural remedies like vitamin C and L-glutamine. Even chamomile tea will sooth the esophagus.

Another theory can be found in the book by Konstantin Monastyrsky called Fiber Menace. His theory is close to the low-carb theory but he puts the blame on the fiber that comes with carbs and not on the sugar content. He has a point when he says that fiber swells up inside our digestive tract with the liquids we drink with meals and may cause blockages. I have followed his advice to drink water, or some other liquid like herbal tea, an hour or one-half hour before a meal and not afterwards. That gives the liquid time to clear through the stomach before filling it with food. The liquid our stomach uses to make the chime that is sent to the small intestines comes from our blood. BTW, if you are having constipation, read this book before you reach for the Metamucil!

But the thing that has really gotten me off the Zantac and on the road back to my normal good health is melatonin about which I'll have much more to say later.


  1. I ate a large quantity(for me) of meat during our 20-day trip to NZ. Our friends told us that they don't practice factory farming in NZ; all their animals are raised on pasture. So I ate lamb, beef and chicken.

    I am happy to report that the only skin irritations I had were attributable to sandfly and mosquito bites. My high-tech scale says that my weight was steady, but my body fat went from 25.5% to 23%.

    I didn't exercise much besides the usual sightseeing walking and morning stretches.

  2. I was just reading about how antacids also interfere with your body absorbing vitamin B12 - something that might not become obvious for years after you start to take them.

    I'm also a paleo diet person (I found your blog through Grace) - are you a member of the Yahoo group?

  3. Hi Rebekka,

    Yes, antacids are bad news, but some people are desparate.

    Thanks for the tip about the Yahoo group. I do eat sort of Paleo, but Cordain's position on saturated fats bothers me. I tend to trust Mary Enig's research on that matter. I had been thinking of joining the Active Low-Carb Forum at since they are a group that discusses all of the low-carb diets including my current favorite--Protein Power.