Gerd-friendly breakfast burritos

 If you're a regular reader around here you know I live for breakfast burritos. Problem is I've suffered from GERD for years now and spicy foods can cause flareups. So can some ingredients, like my beloved onions, and cooking methods like frying and sauteing.  I went through a phase of frying potatoes and onions on a cast-iron grill pan for the browning. Every burrito gave me indigestion and I questioned every ingredient but the potatoes. It's the oil, and the oils that are transformed by the heat. Recently I've gotten good results when I follow a low-fat, high-carb diet, vegan except for eggs. No meat, no dairy, no processed oils. Lots of vegetables, mushrooms, and grains. So here's a breakfast burrito that is tasty and filling and works to calm your inner fire too.

Ingredients

--Potatoes. Figure one small potato for each burrito, one medium potato for two, one large potato for three.

--whole grain tortillas

--one pound of dry beans

--one onion, skin removed

--two cloves garlic, skin removed

--four bay leaves

--1/2 green bell pepper, diced 

--1/2 cup corn kernels

--teaspoon each of thyme, cumin and paprika

--one bunch cilantro

Method

Required equipment: large pot with lid, stovetop grill pan

The night before, soak the beans in water. Rinse in the morning. Add fresh water so it is at least 3 inches above the beans.

Cook the beans on low with the bay leaves, half the onion (whole. Store the other half, or finely dice for burritos if fresh onion doesn't bother you), and the two cloves of garlic. About an hour in, add half the bunch of cilantro, whole. Cut up the other half and reserve.

When beans are soft, add the spices. Let it sit in the pot to absorb the flavor, about an hour.

At this time bake some medium russet or gold potatoes if you choose to bake them.

Remove the bay leaves and cilantro stems from the beans. Let the potatoes cool.

Cut a baked potato into cubes, or microwave a whole medium potato for 3-4 minutes until tender, then cut it into cubes when it's cool enough to handle.

On the grill pan, let the green pepper cook a few minutes. Add the corn kernels, salt and pepper to taste, then set aside.

Dry grill tortillas until starting to brown. Warm the tortillas before serving if necessary. 

To a warm tortilla, add any cheese you like, I use a commercial vegan shredded cheese usually.

Add some potato, drained beans. Sprinkle on reserved cilantro.

That's basically it. You can add a sauce, if you can tolerate it. If not, a spice mix of smoked paprika, crushed thyme and oregano, cumin, coriander, salt and pepper is nice. you can toast that on the stovetop grill for a couple of seconds after the tortillas are finished. 

I avoid onion and garlic powder as those give me problems whereas onions and garlic stewed low and slow, as we did above with the beans, don't.

Fold the ends in and then tuck the filling into the middle as you roll the closer end away from you. If using a fresh tortilla, take it oout of the pan before it is browned, tuck the sides in like forming a pocket and finish on the hot grill until it browns lightly.

Hope you enjoy!

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Hiatal hernia-aggrevated IBS-C and GERD: life hacks

 Blogs are basically extended memory- many times I've found myself just wanting to document a body of knowledge I've gained- but in the public sphere, putting things out there, hoping they help or resonate. This past 12 months I've gone through the hellish experience of dealing with yet another LPR throat burn and accelerated GERD thanks to a hiatal hernia. The key to getting all of this under control was dealing with the hiatal hernia, and in the end I did get to the point that the hernia was bothering me very little and my digestion was quiet. 

First, the TMI bit. I'm quite sure the hernia was brought on by straining on the toilet. I have a sluggish thyroid and one of the unfortunate symptoms of that is constipation. Just generally body processes not moving along the way they should. So every bowel movement is difficult. This likely was a contributor to my IBS-C diagnosis as well.

This was exacerbated by my love for coffee. Coffee has great cognitive benefits, but terrible effects on digestion. One that I'd read about but has been an overwhelming presence the past few years is dehydration. I've come up with a simple protocol to cope- drinking one glass of water for every cup of coffee- but I think the ultimate solution might be giving it up, I'm afraid. Anyway caffeine does stimulate peristalsis, which ought to help with constipation, but I guess with a sluggish thyroid they cancel each other out a bit. Then add the dehydration on top, which makes your poops dense and difficult to pass, and you can find yourself in quite a jam- literally.

Constipation led to straining, which led to developing my tear, yadda yadda.

What happens with a hiatal hernia is part of your stomach bubbles up through a tear in the hiatus muscle, which normally separates the esophagus and stomach.  This in effect forms a small "pre-stomach" where acid can wreak havoc, forcing itself up the esophagus due to limited space. This was the cause of the LPR damage, the subject of which I've already blogged about extensively. Today's post is how I managed the GERD and hiatal hernia and in fact I believe was healing up by the end.

Hack #1: Benefiber in your drinking water.

I thought job #1 was to solve the constipation- the root of the problem. It's important to keep hydrated already- moreso when dealing with both constipation and GERD. I've tried morning doses of Benefiber and it had basically no result.  I think it was on Reddit that someone posted this suggestion from their doc: to a 16-oz water bottle, I add 4-5 teaspoons of benefiber and sip on it throughout the day. This addresses the situation in an ongoing fashion so your poops are lighter and easier to pass in general, which reduces the need to strain.

Hack #2: Enlist herbal assistance

When it's bad, look in herbal tea blends for buckthorn and senna- these both have a laxative effect that can help things get moving. They can't fix problems that are already developing, but used on a semi-regular basis, they will help soften stools and prevent genuine crises. For maintenance, choose herbal blends with dandelion, ginger and chicory. I like steeping Traditional Medicinal's Dandelion Chai Probiotic and Ginger Aid blends together for a one-two anti-inflammatory, colon-toning punch.

Hack #3: replace your morning coffee with chicory

Speaking of chicory, it's very popular in roasted and ground form and serves as an excellent coffee subsitute. And it's an excellent root for increased intestinal motility.

Hack #4: get your caffeine from green tea and chocolate

One of the most agonizing decisions I made was to give up coffee. If you can tolerate it, it's good to get caffeine in small doses for a cognitive benefit. The most satisfying way I've found to do this is by drinking green tea and eating dark chocolate. Now, when my digestion was triggered and sensitive, chocolate was a total no-go. But now that things are calmer, I've finally been able to reincoporate this indulgent, healthy snack. But I've never had problems with green tea, thankfully. It has multiple benefits including reducing inflammation- very helpful when dealing with IBS-C and GERD both.

Hack #5: heal your gut like healing a wound

Things for me really turned around when I encountered Alanda Jones' video on YouTube about healing the esophagus. Calendula is known for its wound-healing properties- we were already using it in puppy paw balm and personal hand creams. I bought calendula steeped in olive oil on Etsy, then bought a big bag of the dried flowers. when my batch began running out, I just started adding more flowers and oil. To 6 oz of warm water, add a teaspoon of manuka honey and a dropper or two of calendula oil. Have this first thing in the morning, and last thing in the evening until the honey runs out. Manuka honey- especially the effective stuff- is expensive, so you don't want to be eating a lot of it on an ongoing basis. Wait a week and see how you feel and there is no improvement in your GERD, try another round of it.

Related to this is taking a high-quality probiotic and digestive enzyme. If you have GERD, you're probably taking PPIs, and those deprive your digestion of acid, the greatest weapon your body has for breaking food down into usable nutrients. You need to give your digestion some help in the form of enzymes and probiotic supplements. Take the probiotic once or twice a day, and take the enzymes with every meal. Also be sure to eat some raw fruits and veg every day, which have all of their enzymes intact. Which leads neatly to-

Hack #6: Have a salad every day- sometimes drink it!

One thing you must do to get beyond this is have fiber in every meal and snack. This means snacking on fruit (I like banana and dried figs best) and nuts like whole almonds, and experimenting with whole grains and beans. A salad every day can be an efficient catch-all for many of these things. But a vegetable and fruit smoothie will absolutely transform your life. All it takes is one 6 oz. smoothie a day to see really dramatic results. I like berries for the anthocyanins, and pineapple for the digestive enzymes.Any greens can be used but the easiest and most abundantly available are baby spinach and kale. you can even find them in a mix. Just toss them in and mix. It takes away the excuse most of us have for putting it off or not doing it at all.

Hack #7: maintain beyond the symptoms

Every day I make a large thermos of hot water and drink herbal tea throughout the day. I also drink the water supercharged with Benefiber every day. and though I don't do the manuka honey and calendula every morning,  I do still put calendula in the herbal latte I start every day with- I'll post that sometime.

I hope you find this information useful and helps you get your inner self in better shape to help combat hiatal hernia and GERD.

Bold but gentle: low-acid chili

A while back my son surprised me by asking to have a wedge pillow like the one I sleep on. I pried a bit and he admitted he had problems with acid reflux. Poor guy! That's usually my department. For a while he'd been avoiding foods he's traditionally loved, like spaghetti and pizza, and dumb me did not connect the dots. So ever since I've felt free to unleash my inner Koufman groupie and serve more modified low-acid foods for dinner.

A recent party plan of Abbey's presented an interesting challenge: make a chili that everyone would like. Abbey is no fan of chili, but I am- despite my ongoing issues with reflux. Many a time I've had to make chili for one or forgo it altogether. This time I was determined to make an all-purpose chili with some specific objectives: (1) it would not burn the acid-sensitive folks, (2) it would be good enough even non-chili people would like it, (3) would be vegetarian to accommodate some guests but (4) also taste good on a hot dog.

The one ingredient that really seems to irritate the digestion of the reflux-prone is tomatoes. It was forgone that there would be no tomatoes in this chili. Not a problem: the original dishes that can be considered the antecedent for today's chili had, of course, chiles as a main ingredient- and frequently the only non-meat ingredient, except for perhaps onions, some masa, and herbs like wild oregano or epazote. Tomatoes were not really part of the equation and meat was the main attraction- so in addition I would have to add some things to make up the meaty flavor. I needed something zingy, yet mild, to stand in for tomatoes and came up with a compromise that would help fulfill multiple needs. I blistered two red bell peppers, mostly peeled them, and processed them in a food processor until smooth. I used a can of the one ready made mild, red enchilada sauces that had no tomatoes (The brand I found was Las Palmas, and their sauce is quite good). The roast red pepper sauce and the enchilada sauce, along with some faux-beef broth, formed the base of the chili. Then I borrowed from my own bag of chili hacks- none "secret" exactly, but some perhaps not intuitive, and came up with a chili that, I am happy to say, pleased everyone!

Bold-but-gentle chili (low acid, low fat, vegan)

The Ingredients

1 tbl olive oil
2 cans of red beans
1/2 to 1 sweet potato, roasted, or equivalent in cooked diced sweet potato
1 can of mild red enchilada sauce with no tomatoes (check labels or look for Las Palmas)
two cloves of roast garlic (from a head of roast garlic- you do roast heads of garlic, right?)
one medium yellow onion
1 tbl Worcestershire sauce (not vegan, there are vegan varieties though)
2 tbls premade black coffee (dark roast, again for our acid-sensitive friends)

2 tbls corn meal
1 tbl nutritional yeast
Enough not-beef bouillon (check label if you are gluten sensitive) to make 2 cups of broth
2 cups water
2 tbl ground cumin
1 tbl chili powder (I used Frontier spices, which contains oregano cumin and garlic powder)
1 tbl brown sugar

The Method

Put a stock pot or enamel pot on a burner set to medium low. Preheat the oven to broil.

Wash the red peppers and place on a cookie sheet.

Peel the onion and cut into medium to fine dice according to your tastes.

When the oven is hot, place the peppers in the oven, top rack, as completely under the flame/element as possible.

when the stock pot is warm, add the olive oil, coat the pan bottom, and add the onion. cook until translucent and starting to brown, about 7 minutes. stir periodically.

Check the peppers. When the sides facing the broiler are blistered and mostly black, rotate 45 degrees and repeat, checking every few minutes and rotating until all sides are done.

Microwave 2 cups of water or bring to boil in a pan. When it is hot, add the bouillon and let it sit for a few minutes. Stir to consistency when the bouillon is blooming and looks loose.

Blanch the peppers in ice water, then peel (or use the paper bag method, which I never knew about until Abbey told me what I was doing was strange!). Do not completely peel, leave a little of the burnt skin for the flavor. Seed and stem the peppers. Toss them in a food processor and whizz. They should be wet enough to form a thick sauce, but if needed, add a tablespoon of water.

when the onions are about done, add the spices and let them toast for 30 seconds. Mash the roast garlic into the pan and mix it all together into a paste.

Add the can of enchilada sauce and the pepper sauce. Turn up to medium high and bring to a boil.

Dice the sweet potato (how much depends on how much you like sweet potato) and add. Break up the sweet potato some but not completely. The chunks of sweet potato will serve as our diced "tomato."

Add the beans, spices, and brown sugar, then turn it back down to low to bubble.

Add the nutritional yeast, worcestershire sauce, corn meal, and coffee. Let it continue to bubble for a least five more minutes while the corn meal dissolves into the chili.

By now the chili is starting to thicken. Thin it with the broth to the consistency you'd like. For me it took about a cup and a half of broth.

Five more minutes to bring the broth to temp.

Please let me know if you try it and how it turns out.

For GERD, eat more like Japanese people

After eating a fairly traditional Japanese lunch and not experiencing the usual post-meal reflux, I went searching for evidence that a Japanese diet could help with GERD. What I discovered was it's not just what you eat, but how.

I found a very interesting site- the Digestive Health Institute. There was a post on their forums by a user named Pompadur. In it I thought were some really helpful tips:

We talk about a lot of things to improve health at this forum. And here is another one suggestion.
A Japan study “Lifestyle factors affecting gastroesophageal reflux disease symptoms: a cross-sectional study of healthy 19864 adults using FSSG scores”finds two important things:

1. Sleep quality is essential for GERD treating (unfortunately i can’t find exact how long one should sleep in the case of GERD)
   It is well-known that nighttime GERD symptoms are the crucial cause of sleep disorders [32,33], but recent studies also suggested that a link between sleep problems and GERD might be bidirectional, for example, due to the influence of sleep stages on esophago-upper esophageal sphincter contractile reflex [34] or due to reinforcing perception of intra-esophageal acid [35]. Therefore, improving quality of sleep might be essential for relieving GERD symptoms.
2. Eating habits – not what you eat, but how you eat!
   Accordingly, such dietary habits as the following should be avoided:
   • having dinner a few hours before going to bed
   • the habit of eating a midnight snack
   • frequently going without breakfast
   • the habit of quick eating.
   It should be noteworthy that these four diet-related factors present more significant effects than alcohol or smoking on GERD symptoms. 

Rather inteeresting, isnt’t it? Maybe it can be helpful…

I think these are very helpful tips.

But what about eating Japanese? The struggle many of us have with GERD and LPR are related to weight.  Turns out Japanese culture does in fact have something to teach us.

In her book Japanese Women Don't Get Fat or Old, Naomi Moriyama observes that her usual way of eating in Japan kept her slim, and when she moved to the US, her western diet made her gain weight almost instantly.  In Japan, the norm was to not eat out much. But when we think of Japanese cuisine, probably some very complex sushi or sashimi comes to mind. But in fact, Japanese home cooking is often uncomplicated, consisting of fish and rice and fruit, served with miso soup and green tea- all wonderful for both GERD and general health. The Japanese also eat smaller portions- the "80% full" rule comes from Japan- and exercise in the form of biking, walking and gardening are important parts of daily life in Japan.

So if you are looking for guides for better living to help with GERD, traditional Japanese culture might be a great model.

An internal mystery: acid reflux and GERD

It all started in February. Coffee has been giving me trouble since about the age of 35. Before then,  I could drink coffee from the work pot with impunity, black, cup after cup. It would accelerate elimination, that was about it. But then in my mid thirties, acceleration started to feel like diarrhea. It would make me feel sick like I had the flu in those parts of me, so I learned to lay off, though I could still have a morning latte and not have it affect me much.

Fast forward ten years. By then, even the daily latte was too harsh, and I could only indulge periodically. And I also had issues with caffeine, as documented here elsewhere. One morning at work, I had decided I would indulge in a cup since I was feeling especially draggy. After a couple of swigs, a weird pain hit me in the area known as the fundus. It was a sharp pain than would build up, hurt, then recede, in the space of about a minute. Then, two minutes later, it would hit again. This cycle continued for 24 hours straight. It was pretty hard to get to sleep that night, if for no other reason, I was just a tad freaked out by it. When I woke up in the morning, it was still there. It receded finally later in the morning.

Needless to say, that was the last cup of coffee I ever had.

It didn't come about until around Easter, when I had some bacon at my inlaws. We usually eat turkey bacon, but they eat the real thing, thickly sliced and crusted with fat. I couldn't resist having a piece while waiting for breakfast. It happened again, this time lasting a day and a half. So, no more bacon then. The final straw was maybe a month later, when I had a cup of black tea. This time, I had the pulsing pain, and then started to feel a side stitch, with a little back pain, whenever I ate.

That persists more or less to this day. I was diagnosed with GERD (Gastroesophageal reflux disease), and sent off to take Omeprazole once a day and not eat too much saturated fat. I did this, and actually felt like I was managing my symptoms, and wondered if it had passed, so to find out, I stopped taking Omeprazole for a couple of days. That was a big mistake, as the pain in my fundus became worse, turning into sharp pains that came and went, a constant dull ache, and the feeling of fullness at all times.

That scared me into the emergency room, but they just sent me away with a prescription of Carafate, which coats the stomach, making it less susceptible to damaged caused by stomach acid, and an order to double the omeprazole. Keeping on this regimen helps a little. Now, I feel uncomfortably full after eating a small meal (I cam actually feel the fullness coming on while I eat, which is a strange sensation), rather than it feeling full all the time. In order to avoid pain, I have been extremely strict with diet and only eating small amounts at a time, so much so that I have lost an additional 15 lbs since the trip to the ER.

Even stranger and more worrying, an herbal supplement got stuck in my throat, and ever since then, little bits of lettuce, spinach and fruit skin do the same. I have to clear my throat more often and I wake up with a raw feeling in the back of my throat some days. I'm afraid that means my esophagus is restricted, which is one of the symptoms of GERD. Acid splashes up into the esophagus and damages it. If I can't get a handle of this, it will lead to Barrett's Esophagus, and possible to cancer, so healing it has become something of a crusade for me. I'm trying slippery elm and licorice, which are known to coat the esophagus.

I've been interested in other natural remedies, too. I read that both honey and apple cider vinegar can help, so I've been taking a couple spoonfuls of a mix of these before meals. I was surprised that drinking vinegar would have no immediate repercussions, but it's true, it really does help with reflux.

Next week I will be the recipient of an endoscopy, down the hatch and into the stomach. They can dilate the esophagus at that point, which is sometimes needed in tough cases, apparently.  It shows only minimal signs of relaxing at this point, so I think I'm a candidate for that procedure.

Needless to say, I am freaking out about this right now.

For years now I have a been a pretty random eater- whatever sounds good, whenever I feel like it. GERD has certainly been changing that. One theory that makes sense to me is when you overeat, your stomach produces more acid to digest the food, so you are in a more or less constantly acidic state.  GERD has actually been helpful in that regard: overeating is no longer a problem for me. I approach everything I eat with caution. I know eating too much will lead to physical discomfort.

What remains a mystery, however, is what is really causing this and how to prevent it permanently. Overproduction of acid may not be the culprit. There is a theory that the flora in the small intestine can get so far out of whack that it produces inordinate amount of gas. That explains the bloated feeling of premature fullness I feel, perhaps. That increases pressure in the stomach and forces acidic gas into the esophagus. Perhaps that is the root cause, but correcting it seems elusive. I take a probiotic everyday but it doesn't seem to be doing the trick. Another theory states that the problem is a lack of pepsin, the stomach's main digestive enzyme. So I'm supplementing with enzymes as well.

I'll keep you posted, readers.