Background: I have Crohn's Disease and on August 1, 2009 started eating ZC/VLC. I was pretty strict meat only for a month or two and then started adding in some dairy such as cheese and heavy cream. My goal was zero starch, zero fiber, zero carb, but I accepted the carbs that came along with cheese and cream as tolerable pragmatic concessions, even if lactose is probably a bad idea given my goals. Since early November I've been largely subsisting on a pasture-raised, grass-fed/finished cow I got from a local farmer.
Fast forward to Sunday, April 18, 2010. I'm driving home from a weekend of paintball in Virginia. I see a sign advertising cheap porterhouse steaks and force my convoy to stop. Turns out it was some sort of truck stop/meat buffet. Awesome. I ate a bunch of steak and some porkchops, and a couple of bites of some random meat from a stew.
Within hours I was burping like crazy, and by the next day swallowing anything but water hurt like a bitch. I ignored it for Monday but on Tuesday capitulated and went to a GP. They gave me a prescription for Nexium and referred me to a gastroenterologist nearby. The pain essentially disappeared in the next few days (I never did fill the Nexium prescription), but the constant burping after meals remained (and is still with me).
I ended up getting an endoscopy last week, and just got a phone call telling me that I have GERD and need to start taking Nexium right away. I'm going to make an appointment to talk face to face before I start doing that.
Presumably it's not possible to suddenly, magically get clinical GERD from one meal, so this must have been brewing for a while, with me either not noticing or ignoring the symptoms.
So after all that, my question is:
Has anyone else had GERD/Reflux get worse/appear on a high fat diet?
(I noticed another question on here referencing coconut oil specifically, but I have been strictly meat, eggs, butter and cheese with cream as a fat supplement for the past nine months.)
Editing this with some research/self-test findings, since there don't appear to be a lot of GERD topics on here.
1) If you have low stomach acid, taking HCl pills may help you. If you don't have low stomach acid, taking HCl pills makes you nauseous and gives you diarrhea. At least, that's my conclusion after three days of HCl therapy. Something wasn't right there. Listen to your body or convince your doctor to get a test!
2) Another approach, which has the benefit of an actual clinical trial, is to take 6mg of melatonin every night before bed. Dr. Eades attempted and failed to market a supplement based on these studies:
If you google around you can see some conversation about this elsewhere as well. I'm presently giving this a shot and so far so good. I'm burping a little less but it's very difficult to tell if I'm actually helping anything, since I wasn't very symptomatic to begin with. I'll probably have to wait until my next endoscopy.
asked bypfw (7821)
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on May 13, 2010
at 07:51 PM
Read this very well researched blog post before you take a PPI.
on May 16, 2010
at 11:41 AM
GERD manifests in multiple ways. While it's not a bad idea to get an endoscopy to rule out Barrett's esophagus (pre-cancerous state) it's hard to make a diagnosis of "GERD" from one. I've had it done twice, both times everything looked fine despite the ferocious pain. I had been taking a PPI since about 2002 but stopped about two months ago with only minor flareups, the latest after eating a nice but semi-carby meal at this fussy Italian place the other night. Losing 30lbs also helped as I have or had a hiatal hernia; fat loss reduces internal pressure of the stomach against the diaphragm. This hernia can mimic GERD symptoms.
Eating out esp. if you have reflux or Crohn's is always risky as you have NO idea what's in the food, how it was prepared, or how it was raised. It's super-easy to claim that meat is pastured when it's not, and charge a premium for it, and most people wouldn't know. Someone needs to start a chain of primal restaurants!
on May 15, 2010
at 05:18 AM
Have you tried probiotics? I know most of the post of them I found were by people who had Crohns when i was researching, but usually GERD/IBS is from messed up gut flora.
Whats else are you supplementing/using? any micro nutrients you could be low in as well? Maybe too much o6's from the seed oils/grain fed meat? or maybe you really did get some other nasty bacteria/food poisoning that's exacerbated by your previous damage?
For mine I not only take probiotics, but also Kombucha (probiotic + bitters/ACV type effect), D3 and Mg + a whole foods multi.
The other things that are supposed to rock for repairing damage are actually covered here at paleohacks in another question I'll link.
on May 13, 2010
at 08:31 PM
I had some issues with burping after being off the paleo diet during a trip through central Europe. I basically kicked it by going on a fast and then only eating raw unseasoned fish and raw grassfed ruminant meat, plus some raw berry and egg smoothies. After awhile I guess the inflammation subsided and I now am cooked medium-fat paleo again, but there are great support forums for raw paleos if you chose to try this.
I was also dairy-free during this period. I wasn't zero carb though, I ate as much raw fruits and vegetables as I wanted.
My theory is that for people with problems, any sauce, oil, cornfed meat, or crap formed by cooking can be inflammatory, but I only have my own anecdote to back that up. On the hunting class trip I took, we ate several low carb meals from normal restaurants with factory farmed meat (and probably glutened sauces) and they did upset my stomach.
on June 06, 2013
at 05:12 PM
Hi, I am a nutritionist and I related to the post about the throat constriction/ lump in throat. I also get acid reflux from grains. I do high greens (raw) and primal. I also use xylitol and stevia for any sweet craving. I don't eat low carb, per se, just low processed foods. Lots of fermented foods. Biggest meal of the day is breakfast. This resolved all issues except the constricted throat. Turns out it is a response to dairy. Even lactose free. Try to remove all dairy sources for three weeks, then re-introduce and watch for inflammation. I have also seen coughing from dairy. It is pro-inflammatory and while it does not cause weight gain, it can contribute to inflammation and allergy symptoms. Hope this helps.
on April 04, 2013
at 02:48 PM
Two years ago, an Upper Gi revealed several ulcers and a hiatal hernia. I was put on a PPI and followed the regular advices for this conditions, raising the head of the bed, no eating or lying down for three hours before sleeping, etc... Through months of frustrating trials and errors, I am now eating like a king at breakfast, a prince at lunch time and a pauper at dinner. I almost don' t eat red meat but lots of fish and chicken. My latest upper GI revealed still some irritations but no ulcers and the hiatal hernia disappeared (it can corrects itself as well as reappearing even after surgery as many of you may have read). PPI should not be used for more than two years but many testimonies I read were from people who were on them for 5 and more years and could not live without them. Getting off them is difficult since stopping abruptly can create a surge of acidity as the body returns to its normal function. My nutritionist recommended a book called "dropping acid" by Jamie Koufman, Jordan Stern and Marc Michel Bauer. I got it at Amazon for $17 and can be bought used for around $13. This book was very helpful. (you can read the customer reviews at the store website to have an idea about the book. I was getting so very discouraged but living with discomfort, having sleepless nights and dragging in the morning, being afraid to ingest anything, isn't the way to live. The low acidity diet (from that book) I am following is great once you accept you cannot eat like you used to. On the bright side, once your digestive system is cured, you can start reintroducing the foods you should stay away from and watch for reaction. If one, like say green peppers, is still giving you trouble after you ingest it in your meal, it is either too soon for you or it may have to be put on the list of banned foods. Yes it is not a quick solution but my quality of life is back. Next step is to taper off the PPI. I have great respect for doctors but no matter how competent in their field of expertise, they have little or no knowledge on nutrition. It is not part of the curriculum and even, finding a good dietitian can be a challenge. I don't reject medication either but this should not be a chronic condition that warrants taking medications for the rest of your life. The low acidity diet will be hard for people who are used to some mild discomforts but not the agony I experienced at some times in my journey. Giving up carbonated beverages, caffeinated drinks, or alcohol for any length of time will not be suggestions that people will accept readily. People will refuse even if that means going though all the misery of GERD, and other digestive symptoms. I am not better than they are, it is just that, eventually, I got so fed up that I finally resigned myself to try anything to get better. Wish me luck as I am continuing my journey and if you can relate to my story, give a chance to this book, even if you are frustrated and almost accepting a life of misery as part of getting old or as being normal. It is not! You, I, we, all deserve better.
on April 04, 2013
at 01:21 PM
I've posted on here elsewhere, but I've been Paleo for more than 2 years and started having throat pain (like something stuck in my throat). Eat lots of veggies, grassfed meats, eggs, yogurt and do use coconut oil and butter/ghee to cook with.
Saw an ENT who said I have silent reflux and she prescribed a PPI. My regular Dr suggested trying HCL, but after trying it for a few days my belly button started feeling sore. When I stopped the HCL most of that pain went away. Reluctant to take the meds I tried some Inner-Eco Water kefir pro-biotics and Kombucha. Neither of those has helped my throat constriction either (and haven't relieved the belly button soreness). So may try the meds, but may also visit a gastroenterologist as well.Bit confused why all of a sudden started having this problem. Never had any real health issues before going Paleo and was fine the first 2 years.
on April 03, 2013
at 04:44 PM
I got GERD in the course of one night, too. It was due to a medicine the emergency room gave me, called Lorazepam/Ativan. The next day, I could not eat a single morsel of food. The lorazepam permanently damaged my LES. I was eating lamb chops and chocolate the night before my visit. 1 year afterwards, I cannot eat chocolate at all and meat is still hard for me to digest.
on October 11, 2012
at 02:36 AM
I suffered from GERD for years, often waking at night with heart burn and the feeling of needing to vomit and somtimes choking on vomit. I found that if I didn't eat late at night or after 6:00 pm that I would be ok. What really fixed my esophageal sphincter muscle was the daily drinking of the herbal tea ginger. Ginger tones up the sphincter muscle. I drank 3 to 4 cups per day and over a period of several months my GERD problems disappeared. Don't drink peppermint tea as it has the opposite effect of loosing the sphincter muscle.
on July 06, 2011
at 06:54 PM
hi.i kept a keto diet for about 3 months and i didn't get relfux but after a season of hard study and some bodybuilding suplements i got a realy bad GERD without acid relfux more alkaline reflux,i never get the pain in my stomach or burnin sensation but i get low energy and weakness after protein meals like chiken breast eggwhites etc....
regarding melatonin if i take it i get really drowsy feeling in the morning....how are u feeling after melatonin???
on May 17, 2010
at 06:53 PM
Well, the buffet place probably cooks with PUFA on the grill. And there may be trace gluten or CC (cross contamination) on the grill. Possible variables for consideration.
Have you seen the Cooling Inflammation blog, re: Crohns?
on May 14, 2010
at 08:04 AM
Google fundoplication. Someone I know was very happy with this procedure.
on May 13, 2010
at 07:46 PM
I was diagnosed about a year ago after an endoscopy, but once I did some research on the meds I quit taking them. Once I went primal, I have had no problems at all-UNLESS I cheat and eat grains. I ate jalapenos this weekend with no problem, but a piece of toast did me in last night.
It seemed to take a short period of time for my body to adjust, but once it did I have had zero problems.