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.

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.

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.

Delicious homemade fiber snack bars

Fiber is an essential part of any diet, but especially someone who suffers from acid reflux. Fiber keeps things moving along, and one theory is reflux occurs when food that is not digested rapidly- a big ol' steak, for instance- just sits there in your stomach. Fiber helps with that situation. So my problem is I'm always on the prowl for high-fiber snacks- particularly, fruit and nut bars. But they are so expensive! This led me to recently purchasing some dates with the vague idea of making bars and using dates as the thing that holds them all together. If I can't manage to act on an idea, there eventually comes a point at which I need to just wing it or drop it. So, I winged it.

Unlike I lot of things I just wing, this didn't just sit in the fridge waiting for me to decide I didn''t want to look at it anymore. They were good! But something else was going on- it seemed like for every one I ate, three disappeared. Out of the blue Abbey said she had nothing but these bars for dinner. That's how much she likes them! I think you will too. And think of all that healthy fiber!

Makes one 12x12 inch pan.

A handful of Medjool dates- 6-8 ought to do
1/2 cup quick oats
1/2 cup walnuts
1/4 cup pepitas
1/8 cup sunflower seeds
1 tbl water or vegetable oil
3 tbl sesame seeds
1/4 cup of dried fruit of your choice
optional: 1/4 cup coconut flakes- toasted briefly in a pan is nice, not necessary

Pit the dates, if needed. Process the walnuts, dates and oats together until sticky but crumbly. Add a little water or oil if it's needed to help everything combine. You might have to push it down occasionally with a spatula. Include the optional fruit if it's big, like prunes or apricots. Transfer the contents to a bowl. Mix in the remainder of ingredients except the sesame seeds. Put 1/2 the sesame seeds in a 12x12 baking dish. Press the mixture into the bottom and flatten with a spatula. sprinkle the top with the rest of the sesame seeds and press into the bars. Chill for at least an hour, then cut into pieces the size of your choosing. Enjoy!

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.

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.

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.