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.

Five years later: my struggle with Laryngopharyngeal Reflux

In 2012, my doctor diagnosed a pulsing pain in my stomach that would last for days, then mysteriously disappear for days or weeks. He called it "gastritis" and prescribed a proton-pump inhibitor. Apparently his intention was for me to take this drug for the rest of my life.

Paradoxically, soon after beginning the drug, I noticed an increasing occurrence of reflux. Thinking it was coincidental, it just made me feel more like I should perhaps be taking this drug after all.

I took this drug dutifully for two months. Once, on a weekend visit with inlaws, I realized I had run out of the medicine. Instead of refilling it, I assumed there would be no harm in skipping it for a couple of days. I was tragically mistaken. For dinner one night, we went out for pizza, and I had a beer. That night, thinking nothing of it, I went to bed.

In the middle of the night, I woke up with the sensation of searing pain in my throat and what felt like the canal between my ears. I sat upright, then drank a glass of water. It hurt to swallow. It continued to hurt to swallow, every time I swallowed, for months thereafter.

My doctor, at that time, did not believe LPR existed. He just sent me to an ENT to stick a scope down there.  The ENT reported clear signs of irritation in my throat, but nothing conclusive was decided. In the meantime, I had daily irritation, swelling and lump formation that prevented the consumption of all but the smallest, smoothest bits of food.

With no clear guidance from doctors, I turned to the web. I discovered  what proton-pump inhibitors actually do, and how quitting them cold turkey can cause the acid backlash- a concept still resisted by doctors but unquestionably real- that damaged me. I decided to taper off of them, very gradually. To accomplish this, I took the advice of some in the online community and bought the version that consists of a gel capsule and small grains of the drug. I took months counting out individual grains and gradually reducing them a few grains at a time. I chewed on deglycyrrhizinated licorice tablets to reduce the PH in my mouth and throat and soothe irritation. For acid reflux relief, I used Gaviscon, which is believed to form a barrier between food and the esophagus that is hard for acid to splash through. I think they both contributed to my healing.

At the same time, I adopted Jamie Koufman's acid reflux cure diet. I read her theory that acid hung out in the throat and caused continual damage, that it was only by banishing acid foods and liquids from even passing through that could give your throat the time it needed to heal. In the process I lost a lot of weight, which in and of itself has the effect of reducing the amount of esophogeal reflux.  So it's not 100% clear in my mind which really caused my symptoms to stop and the healing of my throat, but either way it resulted in the desired effect.

Finally, after what seemed like an eternity, I became symptom free and could live a normal life again. I have occasional flare-ups, but nothing like it was before, just a minor lumpy feeling in there if I've overeaten or ate too much acidic food. Fortunately it's very rare.

 My slow healing process was documented on this blog pretty well. I've posted some low-acid recipes, and discussed symptoms I experienced from day to day. Some of you have reached out and  hope our interaction has helped you.

So, why am I commemorating this journey now? Well, unfortunately, we are only human, and let's be honest, it is hard to keep things on the straight and narrow. I feel like there has to be a transformation in your mind to make lasting, permanent changes. Unfortunately, I'm afraid my own changes were merely reactive- specifically, reacting to pain and discomfort- and I did not not successfully integrate mind and body.

I have hope. I made a complete change in my habits over the period of a couple of years. I can do it again. It's just this time, my motivation has to be from a desire to be better, not in reaction to pain.

I kept private notes away from this blog during my episode. I will be documenting some of those notes here. I hope you find some of the insights contained within useful. At the same time, I am going to devote time on this blog to finding the path forward- really, finding the dual path of mind and body, progressing together.

Please let me know about your own struggles, I'd love to share your experiences here.

"The Changing American Diet" suggests important advice for everyone

I've stated more than once on this blog that weight- especially around the middle- exacerbates reflux and affects gut health, organ health, metabolic health, and longevity in various negative ways. The Flowing Data resource called The Changing American Diet has been causing a stir in the health twittersphere, because within it lie clues to the current obesity, metabolic syndrome and diabetes epidemic that afflicts the western world and beyond.

In the data, you'll see two rather glaring changes in our diet. One is the increase of consumption of vegetable oils. It's been observed that high consumption of fats exacerbates reflux. It also drives up caloric values very efficiently. If you have used a calorie tracker for sufficient length of time to be begin seeing patterns, one thing that is very clear is it only takes a couple of teaspoons of oil to throw a diet off track and into the high-calorie weeds.

Try this strategy:

Only eat oils for their flavor. The next time you make pasta, use a teaspoon of extra virgin olive oil to help flavor it. Or make a potent and delicious pesto out of EVOO, garlic, basil, parmagiano (the real stuff, please) and the nut of your choice. It only takes a teaspoon or two to impart incredible flavor to a dish.

On the flipside, stop using oil to cook food. get some essential nonstick pieces- at minimum, a 10" fry pan and an oven sheet. Make roast vegetables, chicken stir fry and eggs with no added fat. Use a little broth or water and a lid when making eggs- if the pan is nonstick, that's all you need. (Or, poach them!) Most vegetables can be successfully sauteed with only a little broth. Add flavorful oils, if the recipe requires it, at the end, and sparingly.

Wheat is one commodity that has always been high- but it is ever on the increase. Baked goods are the most common way industrial food sneaks vegetable oil into our diets. Even bread is a source. Here's a challenge: go to a supermarket bread section. Find two types of bread with no soybean oil. unless you look at the artisanal breads, you will find this to be a difficult task! The solution is to eat bread made the old fashioned way. Did you know baguettes have almost zero fat? Now that was a pleasant discovery!

Another not so glaring but telling datum is the continual rise of cheese consumption. Again, it's a matter of caloric density. Cheese is delicious, yes! But try using it for its own flavor. By that I mean don't use it unless the flavor is going to be a star of the dish. Parmegiano Reggiano in pesto. Brie on a baguette. Also you should check out lower fat cheeses- not modern low-fat miracles, just the cheeses that tend to be lower in fat, like real Swiss cheese.

One thing I would like to remind our GERD and LPR-suffering readers: fats are hard to digest and make the body produce extra stomach acid. Best to stick to naturally low-fat foods and eat fat sparingly and for its flavor. Here is a gastroenterologist's take on a GERD-friendly diet. Guidelines we should all be sticking to, as the GERD diet is also a great way to shed pounds.

One thing we already know, but is not reflected in this report, is the rise in our consumption of added sugars. This chart listing the source of calories in the western diet claims the two highest sources added sugars and vegetable oils/dairy fat. How to relate this back to the food groups in our diet? Check out the data about the actual foods that contribute to our calories.

The top categories are:

• grain-based desserts
• pizza
• yeast breads
• soda/energy/sports drinks
• chicken dishes. We eat a lot of chicken, people.

So it comes full circle. Now you see what we are eating most of, and that happens to be what's making us fat. I certainly wouldn't condemn healthy versions of these items, such as skinless chicken breast or whole grain artisanal bread, but that isn't how most of us eat these things.

I would reconsider your consumption of these specific foods and in particular the sources of refined oils in your diet. Think of ways to trim them down or eliminate them completely. The healthy way forward for all of us is a rejection of industrial calories and return to eating real, whole food.

Chub 'n' Tuck is nothing to laugh at

I've had the pleasure of talking to some readers of this blog, and talking to them has reinforced my impression that for some people, maybe most people who have experienced LPR, there is no definite end. For many of us, being "healed" really means feeling normal most of the time mixed in with some not so great days. Old, bad memories are revived when we take chances on a beer or soda. For me, discomfort appeared during a bad spate of allergies. So it is an ongoing struggle for most of us.

I've tried a variety of diets in an attempt of avoid exposing my throat to acids, minimize too much acid production, and slim down to cut down on esophageal pressure. Readers probably already know about Jamie Kaufman's Dropping Acid: The Reflux Diet Cookbook & Cure. I followed that diet for several months, and I am sure it contributed to healing, as during that time the acute symptoms (every swallow hurting, pieces of food getting stuck in my throat) disappeared.  I found it restrictive as an ongoing diet, however.

 Lately I have been having good experiences with a low-fat, high-fiber diet. Fat is harder to digest, so there is a danger of excessive acid production. Conversely, fiber speeds food to digestion, and signals the brain to stop the digestive process. Furthermore it helps keep digestion active and, as the term goes, "regular." By moving food through digestion, fewer calories are consumed, which of course helps out with the old waistline. The book that clued me into this idea is

The Choose to Lose Weight-Loss Plan for Men: A Take-Control Program for Men with the Guts to Lose by Ronald S. Goor. Goor explains the biology related to fat and fiber in a way that totally clears up the fuzzy thinking I've had about it all this time. It's quite simple: when you eat fat, it goes right to storage. It makes more fat. When you eat carbs, they are burned since carbs are the preferred fuel. When you eat refined carbs, they are burned completely. When you eat unrefined carbs, they are burned inefficiently- a lot of it passes through undigested. So the body has to turn to fat stores to make energy. It's quite easy to wrap your brain around it when presented that way. 

  Granted, it is a man-centric book, but men do have their own special needs regarding weight loss. For one thing, excess calories go to a guy's spare tire, and when yours is overgrown, it can cause all kinds of problems. The one that is most pertinent to LPR sufferers is the extra pressure it puts on your esophagus, which creates more opportunities for reflux, especially at night- when most cases of LPR occur. Other problems include more danger of developing metabolic syndrome, heart problems and cancer. So trimming down the gut is of utmost importance.

  

So, guys, it's incumbent upon us to get real about controlling our cravings, getting out there and being more active, and making better choices at mealtime. It will help our reflux and lead to a longer, healthier life. We can do it!

LPR Update: how I'm doing, what worked

A reader contacted me for some advice recently, which woke me up to the fact that it's been months since I've posted anything here. I feel guilty! When I began my research into LPR when I first had problems, I'd visit forum after forum, and in each case someone would discuss what they were using to control their symptoms, then they'd just disappear. One can only assume they finally healed, had no further need for the forum, then just got on with their lives.

There's certainly nothing wrong with that. That's what we all want to do anyway, right? Just move on. But I don't want to leave people hanging. There is light at the end of the tunnel- I feel pretty well healed now. My life is not completely normal again, though- certain foods and drinks will set it off. Nothing severe, mainly it's just a little difficult to swallow once or twice. For some reason, cold iced tea gives me problems, for instance.

Here are some things I used to treat myself- and how effective I think they were.

DGL Licorice- I prefer the chewable tabs made by Nature's Life. They had the most bearable taste and seemed to help the most.

Slippery Elm lozenges- honestly I didn't think they helped much other than for temporary relief, but for that they did the trick. I liked Thayer's the best.

Gaviscon chewables- I'm pretty sure this got me over the biggest hump: keeping your throat acid-free while giving your throat time to heal, which can take months. They form a barrier in your stomach, which prevents the acid from splashing up.

Alkaline water- I'm just really not sure about this, though it does make sense that it would help keep the acid level in your esophagus under control. Nevertheless, I did chug Iceland Spring throughout my ordeal.

Celery. I ate it constantly. Definitely my favorite low-acid snack.

Jamie Koufman's Dropping Acid: The Reflux diet cookbook and cure. I didn't try every recipe, in fact I don't think I used many at all, but I think the principles are sound and there are references I used in the book to determine the acidity of meals. For at least a couple of months I stuck to a low-acid diet religiously. Interesting side-effect, I also lost weight on that diet. Which brings me to:

Losing weight- that might have been the thing that helped the most. I was overweight when I had this problem. Being at your natural, or regular, weight is probably the most effective preventative for acid reflux in general.

I hope you find this useful. Please feel free to ask questions! I'd love to help.

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.

LPR Reflux: Light at the End of the Tunnel

Those of you who follow this blog probably know by now Mike's Health has been more or less on hiatus in 2012 due to my battle with acid reflux. It's been nine months of hell now; however I'm optimistic regarding my recovery, and expect to be relatively normal in 2013. But it's not over yet.  I still have to adhere to a daily routine that involves taking an antacid that contains alginate before every meal and bedtime, sucking on DGL licorice and slippery elm lozenges throughout the day, and sticking to small, low-acid, low-fat meals throughout the day rather than three normal-sized meals. As recently as a month ago, eating anything vaguely acidic resulted in immediate pain and swelling in my throat. Now I am able to eat a small amount of acidic foods, including a limited amount of fresh and cooked tomatoes, though I am instinctively avoiding citrus fruits and juices. I sleep on a wedge or, if I sleep on my side, only on my left side, which minimizes the chance of nighttime reflux. Some days are better than others, but there seems to be a very slow progression in the right direction. Only a few weeks ago, the slightest burp resulted in pain. Now that has mostly passed. Most days I feel pretty normal in the morning, but in the late afternoon and early evening my throat starts to feel a little lumpy and ragged- not quite the globus that used to present itself regularly, but not comfortable either.

One thing of which I am convinced: this is not the result of too little acid, as the health food store guru believed. I tried taking a supplement with Betaine HCl (that's hydrochloric acid, kids) and pepsin, wishing to test the theory that my reflux is caused by not enough acid being generated by my aging digestive system. My system reacted very badly, in fact wiping out all of the progress I had been making. I was starting to feel almost normal. In the aftermath of taking that pill, my throat was re-damaged and the globus came back on as worse as it ever had been. It's taken a few weeks to get the discomfort back down to a manageable level. So, be warned if you suffer from LPR and want to test the low acid theory: wait until your throat is fully healed before trying HCl supplements.

I am more convinced than ever LPR would not exist if it were not for the easy manner in which Americans, encouraged by the pharmaceutical industry and celebrity shills like Larry the Cable Guy, can take very dangerous acid suppression drugs like proton pump inhibitors. I have never had much trouble with acid reflux and certainly nothing at all like the throat damage that characterizes LPR before taking PPIs.  I was misdiagnosed with GERD, I now believe, when really what I suffered from was intermittent gastritis due to my atrocious diet. Ever since I was on the PPIs I have been struggling with a number of reflux-related symptoms. Now that I have been off of them for a month, my digestion seems to be normalizing, though the process is very, very gradual.

I am not out of the woods yet. Every day I experience symptoms which make me fear I might be slipping backwards. But when I calm myself and look back at the trouble I've had in the past, I realize I am a very slow road to recovery.

LPR diet: Spelt pancakes with pear-ginger sauce

We've been cooking with spelt a lot lately because it's not a genetically modified monster like its hard wheat cousin that is used in practically all commercial bread nowadays. The main problem with this modern wheat is the gluten has been pushed to the max so high, light loaves can be made from it. But people who have gluten sensitivity can have pretty serious problems with this kind of wheat. So what, you might say- you don't have gluten sensitivity. Here's the deal: people are developing gluten sensitivity in record numbers nowadays, and maybe because of repeat exposure to this supergluten. Some experts think gluten sensitivity develops the same way lactose intolerances develop: continual exposure to the offending molecule just wears out your system's ability to digest the little bugger. This leads to chronic problems, one of which is our old friend Acid Reflux. So I've been trying to limit exposure to this wheat.

Abbey made a fantastic spelt focaccia recently. Since it is low in gluten, it results in a crumbly, dense texture- which makes it a delicious choice for a single rise bread like focaccia. It is almost like eating cake- a savory cake upon which you can make a sandwich. It may sound odd, but it is divine. So, I thought its cakiness ought to lend itself nicely to a pancake. The result was pretty marvelous. Here's the recipe:

Dry ingredients:

1 cup spelt flour. I used Bob's Red Mill.
2 tsp baking powder
1 tsp sugar
1 tsp cinnamon
a pinch of kosher salt


Wet ingredients:

1 egg's worth of Ener-g egg replacer, prepared with water
1 1/2 cups coconut milk
1 tsp coconut oil, melted if necessary

Whisk together the wet ingredients. Whisk together the dry ingredients. Fold them together until just combined, and let sit for ten minutes. Cook as you would any pancakes.

Ginger and honey are both good for the vocal cords, so I decided to combine them with a convenient ripe pear to make a nice sauce. Just multiply the below ingredients to make a larger quantity.

1 pear, peeled
1 tsp grated fresh ginger
3 tsp honey

I diced the pear in my hand and let it drop into a saucepan on medium heat. then I peeled a piece of ginger and grated that right into the pan. lastly, I added the honey, one tsp at a time, and brought to a gentle boil, and let it cook for ten minutes until it started to thicken.

After standing a few minutes, do whatever feels right- I put a line of it down the center of my pancakes and ate them like little tacos. Our daughter patted the sauce out evenly on hers, then added maple syrup. Either way it will be delicious!

The Reflux saga continues: LPR reflux

I've been struggling with the effects of acid reflux for nearly nine months now. Lately it's mostly manifest as Laryngopharyngeal Reflux, LPR Reflux, or Silent Reflux- whatever you want to call it. This is a cagey kind of reflux, the hardest to diagnose and the hardest to get rid of. I've had to pretty much throw my old way of living out the window. I can't drink any alcohol, coffee, or tea. I can't eat tomatoes, peppers onions, garlic, of spicy food. I need to severely limit my intake of fats. So, just about any comestible which has given me comfort over the years is out. I am back on the proton pump inhibitors- yes, if you've read this blog, you know they are the evil meds which gave me reflux to begin with. The goal as far as the medical industry is concerned, now, is to reduce the acid level in my gut to near zero, so there is nothing to splash up into my esophagus.

The only problem is, damaged laryngopharyngeal tissues are very sensitive. Any fluctuation in the acid level in the esophagus results in a flaring up of symptoms. Even the smallest of burps can bring it on, then it's with me all day long until night. The symptoms, in a nutshell, are inflammation of the vocal cords, which means it feels like there is something like a marble in the back of your throat. It's hard to control, and if it can't be controlled, eventually forming of abnormal tissues, which can result in cancer. So this thing is freaking me out pretty badly right now.  My basic tools for fighting it are: small meals more frequently through the day, elimination of snacking, drinking lots of water, chewing gum constantly (it generates saliva, which is alkaline), eating several tabs of deglycyrrhizinated licorice a day, propping myself up at night to avoid nighttime reflux, losing weight, and eating a mostly alkaline diet.

Turns out our training in veganism is proving to be quite helpful. Often the fat content in meat substituts is  pretty low compared to the real thing. Whole grains and vegetables- other than the aforementioned- should make up the bulk of my diet now. So vegan cooking is pretty close to an ideal diet for this affliction. The only modification is I need to eat a small amount of lean meat because the PPIs inhibit your ability to absorb iron, so it's easy to get pretty anemic on these things. I eat leafy greens for the iron, but also bolster that with small amounts of chicken, fish and turkey.

One resource that has helped me is the book Dropping Acid: The Reflux Diet Cookbook & Cure by Jamie Koufman, MD.  The induction diet is kinda hard to stick to because every aspect of it has to be managed. That takes some discipline, something I have always found lacking. I'm getting the hang of it, but man, it is slow going.

So some things I eat work. Some things don't. I find the jury is totally out on what works from person to person. It's subjective, but it's also largely undocumented. The things that don't bother me, I will post- maybe some poor soul suffering from this illness will benefit from my experience.