How can seven million Americans endure multiple reflux or heartburn episodes weekly? Physicians write 116 million prescriptions every year, and sufferers spend 5.6 billion dollars (2016) annually, and the number of sufferers increases. Something is amiss.
Acid reflux or heartburn, symptoms of Gastroesophageal Reflux Disease (GERD), are not something you take much notice of until you suffer. Then, they demand hyper-attention, and recently they took hold of me.
Insomnia had become severe for me when my sister suggested my insomnia could be caused by acid reflux.
What!! Really!!
Think about it. Regurgitated acidic stomach contents enter your oesophagus. An inbuilt reflex action kicks into gear to prevent acid from entering and burning your lungs. Suddenly from a deep sleep, you are bolt upright and wide awake. I had never linked these recurring sleep disruptions with GERD before. How did I know so little about GERD when the world is drowning in suffering and medications? And if those medications are so good, why is the problem increasing yearly?
Well, now I am awake, physically and metaphorically, and I want answers.
I had been vaguely aware of this nameless condition as a child. Our Pop had a never-ending supply of Quick-eze on the table beside his armchair. After a meal, he would carefully roll one out of the packet to chew, face grimaced, holding his chest. However, the long threads of outer wrapping and the inner silver paper shreds left on his side table every day told a story of what it took to get relief from what I thought to be an 'old person's condition'.
At the time, cylindrical packets of Quick-eze looked exactly like that classic hard candy Lifesavers sweet with a hole in the middle, designed to resemble a life preserver. We loved Lifesavers and were experts at rolling them out of their packets one at a time without spilling them everywhere.
Pop's lifesavers were mint-white rather than the lustrous cherry, raspberry, watermelon, orange and pineapple of our childhood favourites. He warned us they were his 'Lifesavers', not ours, and we shouldn't eat them.
What kid isn't going to test this?
Well, Pop's mint-white lifesavers tasted disgusting!
This nameless condition didn't cross my radar again for decades until recently.
This first realisation that my insomnia might be linked to GERD sent me to the pharmacy for antacids to relieve this unpleasant sensation, get some sleep and get on with my life.
Uggh! Still as disgusting as my childhood taste of Pop's 'Lifesavers.'
My continuing education eventually led to the horror of what GERD meant.
Wide-ranging symptoms include a burning sensation in your chest, painful swallowing, the sensation of a lump in your throat, regurgitation of food leaving a sour taste, belching, bad breath, chronic cough, hoarseness, persistent cough, laryngitis, asthma, disrupted sleep. If you are a sufferer, I am not telling you anything new.
However, it was the dire consequences that shocked me into action. Oesophageal cancer is a pretty big turn-off.
I know. I know.
Right now, it's driving you crazy. You can't sleep. You don't know what causes it. You look for triggers that people tell you about and think, 'I can't give that food or drink up!' You pop antacids in some form because you have to work, live your life, and you need a quick fix.
If the antacids don't work, you might kick it up to over-the-counter H2 Blockers that can only be used for a short term. The next step is a quick visit to your doctor for a prescription for the mother of all antacids PPIs.
GERD medications range from acid-neutralising antacids to acid-production-blocking drugs called H2 Blockers, or prescription-based PPI (Proton Pump Inhibitors)
Ahhh! That's better...
Yes, that is one way of kicking reflux and heartburn overnight.
But, have you ever looked at the side effects of these 'easy answers'?
Marketers paint such a soothing picture of antacids; you chew a tablet or pour a calming mixture down your throat to put the fire out. But, I kept seeing aluminium as the main ingredient. Tinfoil in my system! No way!
Antacids are designed to neutralise stomach acid. Do you remember from biology class that we need stomach acid to digest food? So, what are antacids doing to our digestive system? Are we working with our bodies or against them? It didn't make sense.
What are these drugs doing to our bodies?
Side effects of H2 Blockers like over-the-counter Zantac include constipation or diarrhea, headaches, fatigue or impotence. This range of side effects also applies to PPI (Proton Pump Inhibitors), like Nexium, prescribed freely by doctors.
More importantly, acid-neutralising antacids or acid production inhibitors (H2 or PPI) can open the stomach up to bacteria that the acid could have kept in check as nature intended, leading to a doubling of bacterial infections like pneumonia in older adults.
Once on these prescription drugs, it isn’t easy to wean yourself off them. I watched my sister reduce her dependence on PPIs as a long and challenging process.
Quite often in life, the easy way becomes the hard way, and the hard way becomes the easy way!
With a prescription for PPI in my hand and a determination not to fill it, I started looking for a different solution. The internet offers many 'solutions'. How can they be so different - for the same condition?
It led the researcher me to Heartburn Cured: The Low Carb Miracle by Norm Robillard, PhD, who makes a bold claim:
The simple truth is that the consumption of excess carbohydrates is the main cause of GERD and the cure is a reduced carbohydrate, high protein, high fat (that's right, high fat) diet.
Could the answer be so simple? The author, a 20-year veteran researcher in the pharmaceutical industry, explains the digestion process in detail. I must say I wasn't too interested in the detail of the digestive process but flicked forward to the solution.
He suggests a low-carb regime of 25 grams of carbs a day for a week, 45 grams of carbs in week two, leading to week three, where you test 70-100 grams of carbs to see if symptoms return. Contrast that with the average western diet of 250-350 grams of carbohydrates per day. Yes, it's a dramatic chop!
Is it worth it?
I went straight to 60 grams daily, the author's long-term carbohydrate level, and my relief was instant. I slept soundly. My GERD symptoms disappeared overnight and have not returned.
Then, I devised a daily meal plan with a spreadsheet, a carb counter, and a calculator. Using the information in Heartburn Cured, my WeightWatchers lifetime member experience with counting macro-nutrients, the daily schedule was simple, easy to follow, and satisfying.
One of the worst things about low-carb is giving up bread. Thanks to the Keto world, many low-carb products fill supermarket specialty aisles. I found an 85% reduced carbs, high protein, high fibre, and satisfying bread that doesn't soak up my daily carb count. Instead of 26 grams of carbs in my lunchtime sandwich, there are now only 2.5 grams in my two slices of tasty bread. It is the only low-carb processed product that I use. The rest of the meal plan is simple, unprocessed foods.
I watched excess weight fall off and my digestion ease into a new effortless cycle. It's hard to imagine something so simple could be so effective without the cost of drugs or further oesophageal damage.
A few weeks in, I know I will never return to the old me. I feel lighter and relieved of sluggish digestion. It feels so good.
I also recognise that my weakened lower oesophageal sphincter (LES) means GERD is always in the background.
You could say that having reflux was a wake-up call. The awareness of the condition and an unwillingness to go down the path of a drug solution has forced me to live a deliberately healthier lifestyle as I age.