Minimizing indigestion: try aloe vera juice

My father-in-law is known for being rather gullible when it comes to what I'd politely call alternative medicine- really outright quackery. He subscribes to a number of odd catalogs with supplements claiming everything from restoring hair and eyesight to reversing dementia. He was well aware of my problems with acid reflux (Abbey and her mom talk frequently about whatever I'm going through- this month or that year, there always seems to be something) and said to me when we stayed for a few days recently: "Have you tried aloe juice for your stomach problem?"

Just a random, non-sequitur question, so I just said "no- why?"

"I've been having problems with reflux too," he responded. I read in [insert wacky catalog name here] to try aloe juice. So I did. my problems completely disappeared. No more reflux, no more stomach pain, no more problems of any kind."

"Completely disappeared" always raises a red flag for me, but I said something like "wow, really?"

"Yep!" he thundered. "I thought of you, too, and bought you a jug. Happy Birthday!" And he presented me with my own gallon jug of aloe juice. ($5.99 at Walmart, by the way.)

The regimen, according to him, is two 8-ounce glasses of the stuff a day. I started that while we were still visiting, but found it hard to stomach 8 ounces. Still, I swilled it down (it's not the greatest tasting stuff. Tip: it's better chilled.) for the next day or so, and  it had a pretty remarkable, almost instant positive effect on me. So I continued doing it, dropping the amount down to about two old fashioneds of aloe a day. Someone in those kooky catalogs is onto something. My digestion has been rock-solid every since. I hardly ever even burp anymore. That sounds crazy, doesn't it? But it's true. I am not being paid by anyone to say this. But if you are in the acute phase of LPR, this stuff might really help you keep the burping and gagging down to a minimal level- as you are aware more than anyone by now, I'm sure, all it takes is one burp to bring that acidic gas back into your throat and mess with you. Maybe aloe will help keep it down.

Note: you may freak out when you go to buy this stuff, as I did, and discover all the varieties you find have added citric acid. Supposedly, aloe is so alkaline, the citric acid is added to neutralize the ph. I was very skeptical, but I think this may be true- aloe has an extraordinary calming effect on my digestion, more so than even baking soda.

I hope it does on yours, too.

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

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.

Prostate enlargement sufferers: Alpha blockers can relax the LES

I mentioned in a previous post that my new set of health issues is having an enlarged prostate (BPH). If you suffer from it, you know there are not so fun symptoms you have to deal with. The worst is a weak pee stream. If your condition gets bad enough, it can progress to the point that you can't pee at all. Then it's catheter time.

So I had extra incentive to figure the problem out. I take a regimen of herbal supplements that help, to a degree. I'm not back to anything resembling normal flow, but it keeps the pipes running, at least. I basically scared myself into seeking a prescription from my doctor. The standard starter drug in most cases is FloMax, a so-called alpha blocker. Alpha blockers work by  relaxing certain muscles, and helping small blood vessels remain open. This improves blood flow and also reduces blood pressure. It helps BPH sufferers by relaxing muscles down there so pee is easier.
It has some drawbacks. One of the biggest problems is it does not deliver the medicine gently- which means when it takes effect, your blood pressure drops quickly, and it can make you dizzy or feel faint. Some people actually do faint when taking an alpha blocker. That's a pretty bad scene to say the least. You don't want to be driving a car when this stuff kicks in.

As readers of this blog know, I have a history of suffering from severe vertigo due to a still-mysterious inner ear problem. I am already prone to dizziness, so this was a side effect I really didn't want to have. So my doc suggested Doxazosin, another Alpha blocker which achieves the same result but is easier to "titrate-" that is, apply in graduated doses until you reach the level you need. I started taking this pill a few months ago.

Another drawback is it makes you feel sluggish and- dare I say it- dumb. For at least a four-hour period, every day that I took this stuff, it made me feel sluggish, sleepy, and out of it. I would not be quite ready with a clever pun like I would be before this stuff. and most evenings consisted of coming home, eating dinner and slinking off to bed without saying much at all.

To help alleviate this, I started taking my dose before going to bed, figuring I would be sleepy when I am already sleeping, and more with it. Let me introduce you to drawback #2: paradoxically, you feel more tired and out of it while at the same time you have problems sleeping. Insomnia, That's right. Such a cruel side effect since the drug already zonks you. To not let you rest on top of that? Suffice to say on some days while taking this stuff, I wasn't 100% what I was doing all the time. I was artificially spaced out and sleep deprived at the same time.

But the most "fun" side effect of all was a total surprise. And you don't see this mentioned a lot unless you find the comments of someone who experienced it. Along with all the other things it relaxes, it also relaxes the Lower Esophogeal Sphincter (LES)- the muscle that keeps stomach acid from splashing into your esophagus. So yeah, my throat is re-injured thanks to this evil drug.

So I am back on the low-acid regimen- the Koufman diet, eating really small meals and sleeping with my head raised. Ugh.

Since I have stopped taking it, I have gone from constant reflux- a bubbling you can feel happening all the time, which basically feels like hell has taken up residence in your stomach- to just days spendt dealing with the throat damage. Throat lozenges. Chomping on DGL tablets and Gaviscon.  That's where I am now.

I really controlled, mild diet does seem to prevent pain most of the time, but it's not easy to maintain. Plus this time I can really see what Jamie Koufman said about nerves. The actual damage may be happening anymore, but the throat is very sensitive to anything that might normally cause damage, even if it isn't, because the nerves have been damaged as well. Convincing them to calm down is hard, and the last time I had to do it, it took nearly a year.

So if you are someone like me who is dealing with BPH and LPR issues at the same time, be very wary of alpha blockers. It could set you back, like it did me.