LPR: what works for me

If you've been following this blog, you know I've been suffering from a relapse of GERD and LPR. I've dug myself out of the hole over the past four weeks, and I'm not there yet. But it's pretty clear to me now what helps and what doesn't. The information about LPR on the web is scattered and inconsistent, and from an academic point of view, we really only have Jamie Koufman's template to draw from. So I thought it would be of some use to someone to summarize what helps me and what doesn't.

FOODS

Generally speaking, I find a low-acid, low-fat, small-meal regimen to be most useful. Low acid because the Koufman diet works for me. Low fat because fats slow down digestion , which increases acid production, and increases bile production since bile is released to break down fats- which can cause problems too.

I don't snack much, usually a piece of fruit or some RAW almonds if at all. Rather I stick to five small meals a day. By "small" I mean a cup of grain, a cup of veg, sometimes a small amount of meat; a half sandwich with one slice of turkey and lots of vegetables; a small bowl of salad.

Fennel- very useful. Lowfat and alkaline. Chop up the bulb and use in stir fries and salads; add the fronds to eggs, potato and pasta salads, etc.

Ginger- use this very carefully. It does bother some people. But personally it settles my stomach, so less gas- less acid in the esophagus.  Goes great in stir fries, sweet breads, squash soup.

Avocado- Very alkaline. High fat, but fat also adds to satiety. If you are drastically decreasing how much you eat, avocado can see you through. Add to salads, beans, tofu burgers, etc.

Eggs- the yolks do have fat and cholesterol, but eggs in general are easily digested and well tolerated when you have active LPR symptoms. Soothing on the throat, filling and nutritious.

Water with baking soda- just put a scant 1/8 teaspoon and tepid water in a water bottle and take SMALL sips all day. Keeps you from getting dehydrated, which is as irritating  as much as ice water can be (ice cold beverages actually aggravate the lump in your throat, so be careful).

Steamed vegetables and rice- one of my staple dishes. Snow peas, bamboo shoots, lotus root, fennel bulb, spinach, green beans, even lettuce. Steam or saute in water and serve with soy sauce and a tiny bit of sesame oil.  Five spice powder seems ok too. When you are feeling better, add broccoli and use HOMEMADE BONE BROTH for flavor. Do NOT use commercial broths- most have dangerous additives like citric acid as a preservative or garlic and onion.

Roast chicken and bone broth- roast a chicken, stuffing the chicken with parsley, fennel and sage.  Serve the roast chicken with green beans or peas, mushrooms, steamed or mashed potatoes or rice. Take most of the meat off the bones, then simmer the carcass in sufficient water to cover with fresh parsley and savory, if you have it. low and slow for about an hour an a half. Let it cool in the fridge overnight. Skim the fat off in the morning (easy- it will be solid). The stock should be gelatinous. Pour into ice cubes and freeze, then put cubes into plastic bags. Use a cube of broth when you in the past might have used oil to saute something. Gives it a lot of flavor and the collagen helps heal your stomach lining.

Artichokes and olives- add a little fiber and zest to your dishes. Rinse olives thoroughly and don't use the marinated artichokes.

Rice. All kinds. Wonderful stuff.

Whole grain breads- make yourself a turkey sandwich with lettuce for lunch. Fennel is nice on there, too.  I have never had problems with mayo, but be careful, some have more vinegar than others. Either way use only very little mayo.

As Jamie Koufman suggests, Get a loaf of artisanal whole grain bread and cut it into slices of half slices. have some all week.

Rycrisp and similar rye crackers- these are the ONLY crackers I can eat. Serve with a salad or a smooth, gently herbed chicken broth potato or pea soup.

Squash- all kinds. Seed and bake spaghetti squash acorn squash or butternut squash in the oven- put water in the cavities. Low fat and delicious. make into soup or serve with roast potatoes and chicken, salmon or turkey. Bake strips of zucchini dipped in egg white and bread crumbs for delicious "fries."

Melons and apricots- THE best fruits for LPR and GERD sufferers. Alkaline. Soft. Soothing on the throat and tummy.

Red apples- seems a bit counterintuitive when you are suffering- but they do help. In the acute phase, you probably want to peel and chop the apples to avoid getting the skin stuck in your throat. Avoid green or sour apples.

Parsley, Cilantro, dill- alkaline herbs. Helps alter ph of meals. OK in acute phase, chop very finely though.

Oregano, Rosemary, Thyme- I would not use until your severe symptoms have subsided. But they are alkaline and relatively safe.

Beans- as long as you don't over-season them, they are a vital source of fiber and minerals. Don't overdo, though, as beans can cause gas- which leads to burping- which leads to acidic vapor in the esophagus, which can re-damage you.

Tofu- excellent source of protein. Mild and easy to digest. common  flavorings (soy sauce, sesame, mirin) have been fine for me. Even the mirin which is  sweetened rice wine. Just use it for marinade- the alcohol burns off in baking. Bake cubes of drained, marinated tofu in the oven- it reduces somewhat and takes on an almost cheesy consistency. Does have fat, but it doesn't seem to bother me.

Lettuce- I try to have lettuce with most meals. Sandwiches always have it (unless it's peanut butter!). a small salad with a creamy, low-fat yogurt-based dressing and a rycrisp cracker make a satisfying meal.

Spinach- low acid and chock full of vitamins in minerals. Mild enough, it doesn't bother me whether cooked or raw. Serve raw in salads, or steamed or microwaved, blotted dry, in pasta, on potatoes, with rice.

Note: leafy bits like lettuce, spinach, parsley, etc. can get stuck in your throat if it is restricted. Best to approach cautiously in the acute phase.

Corn- mild, sweet, no problems with corn. I mix with beans, cilantro, cubed jicama, then season with cumin and oregano for a lpr-friendly pico de gallo.

Potatoes- absorb acid, provide potassium and magnesium- these stalwart tubers should be eaten regularly. It fills you up, provides needed nutrients, and calms the stomach.

Carrots- raw and cooked. sometimes I will just munch on a bunch of carrots for a meal. Chew thoroughly, they cause me hardly any problems. Throat feels soothed and I experience almost no gas. Cooked carrots are mild and sweet and go well with fennel and ginger.


SUPPLEMENTS

DGL Licorice- soothes the throat. DGL lines the stomach- along with bone broth, it helps heal the stomach. Suck on them, don't chew.

Slippery Elm tablets- better than even DGL for soothing throat. reduce inflammation too. I take them before and after meals and when my throat feels sticky or dry.

Calcium tablets with Magnesium- typical example being Rolaids. Good for emergencies when you feel a flare-up coming. Chew 2 after a meal on bad days.

Magnesium and Melatonin- I take these at night and they seem to help me calm down enough to rest.

Gaviscon- on bad days I take a swig of Gaviscon before and after meals. really seems to help.

Gaviscon advance- I take a teaspoon of this before going to bed to keep stomach contents in the stomach.

Please reach out to me any time if you have any questions. I moderate all comments, but I get them in emails.

Also consider following me on Instagram- I've started posting #lowacid and #lowfat meals. @michaelsalmons

Newsflash: Larynx damage is going away, clouds lifting, birds chirping, sun shining

Just a quick update for those who might be wondering: it seems the damage caused by my LPR episode is going away. It seemed to be almost gone about a month ago, and then I had a bad day which brought it back. But this time that I think it might really be over, some things are different. For one, I have encountered foods that were way spicier than I realized, twice, and it caused irritation, but then went away. For another thing, I haven't needed to chew cinnamon gum constantly for, like, three days in a row now. Three: I had not one, not two, but three kinds of allium in my stir fry last night, without incident. And finally, I am drinking limited amounts of coffee and tea with no negative repercussions. I feel very optimistic! I need desperately to get back into eating allium with cruciferous vegetables, for it's abundantly clear the way to maintain health is to include both in your diet daily.

Does it have anything to do with my daily supplement regime? Possibly, who knows. I have been taking four digestive support supplements with marshmallow root and slippery elm a day, along with four probiotics, selenium, and L-Glutamine. I'll post a more thorough list of what I've been taking here in a bit.

For lunch today, I'm thinking broccoli and whole wheat pasta with raw garlic and olive oil. I can't wait.

EDIT: People have been asking about the supplements, so here's the list.

Selenium- 100mcg/day

L-Glutamine 500mg/day

Three sprays a day of two different formulas: one, a proprietary blend courtesy a local health foods market that has slippery elm, aloe, licorice and fennel in it; the other is Thayers Dry Mouth Spray, which primary coats and protects, I think.

4x daily: Vitamin Research Products Bio Pro. It contains Pantothenic acid, Fructooligosaccharides (prebiotics), and freeze-dried probiotics with all of the usual species.

4x daily Vitamin Research Products GI Cell Support, which contains DGL licorice, N-Acetyl Glucosamine, Marshmallow, Berberine Sulfate, Cabbage leaf, Slipper elm, Phosophatidycholine, Gamma Oryzanol.

No, I'm not 100% sure if I need all these things. But as long as I don't do something stupid, it really seems to be helping my digestion and keeping my throat from experiencing additional damage.

SOAPBOX: Kids and food

Let's just call this my kids and food manifesto.

I've had it. Our kids diets are appalling. They barely eat one fruit or vegetable per day. They gorge themselves on frozen processed foods, super salty ramen noodles, and snack on candy. If it weren't for ketchup, all their meals would be monochromatic.

I'm ready to lay down the law. Our mission is clear--this is our summer to get the family healthy

• Start them all on a kid's dietary supplement that isn't heavy with artificial colorings.

• Get them involved in planting and growing vegetables in our garden.

• I will start keeping food diary--I want to keep track of what they're eating and how quickly afterward someone has a meltdown, asks for a snack, or complains of being tired. Kids can have bad reactions to food colorings and nutritional deficits, which might manifest themselves as mood swings, anger issues, and an inability to express oneself clearly.

• I want them on probiotics. Kids who have had repeated ear infections and courses of antibiotics can have an excess of candida in their systems. Candida causes yeast infections and produces toxins--another factor that might contribute to mood swings. Probiotics would counteract the bad effects of antibiotics.

• Get the kids involved in food production--baking, cooking, mixing stuff in the kitchen

• Place a stronger emphasis on healthy foods in the diet

1. Order some nutrition books geared toward kids--convince them that they will be happier and healthier if they eat more fruits and veggies. Our kids will probably need more convincing than most and a definitive outside source would help tremendously. While discussing nutrition, they frequently seem to be somewhat mystified on how to define "healthy foods." A good book would go a long way to clarify some issues for them. I found a book on Amazon: My Food Pyramid
2. Talk with them at meal times and at the grocery store about healthy choices. Get them into a constant dialogue regarding what foods and activities would keep them strong and healthy.

• Stop serving junk. Throw all the junk away. No more chips. No more nuggets. Nothing fried. No more cereals with marshmallows. No more super sweet yogurt in dayglo colors.

I honestly don't mean to be a Nazi about this, but I feel enough is enough. I won't deny them the many pleasures of good food. This campaign of mine isn't about denial. It's about adding more things to the diet and judiciously expending their "pleasure" calories on foods that are higher in quality than Trix cereal or some damned box of cookies that contains garbage none of us can pronounce. Homemade pleasures are in abundance at our home and the kids can get involved in making those things. I know how to make homemade marshmallows for crying out loud! Mama ain't no slouch in the kitchen. The Chips A-frickin'-Hoy are not entering this household ever again!

--A