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.

30 days of vegan: my favorite vegan eggs

Recently I posted my musings on my favorite breakfast food- the burrito. In it, I blithely said go forth and find one of the many, many copycat recipes on the web that rely on kala namak and turmeric to impart eggy color and flavor. 

But that was lazy of me. And a bit disingenuous. When I first endeavored to go vegan, I knew meat would not be a problem for me. I've never been a meat fan, even in childhood. I always went for the most processed meats: sausages, hot dogs, things that didn't seem like meat. A slab of flesh always freaked me out. One encounters weird flavors, textures, chewy, slimy, stringy bits. Gross.

I always thought cheese would be the really hard thing. I've had love affairs with whole branches of cheese. In the fake cheese realm, varieties such as Swiss do not translate nearly as well as cheeses like Cheddar. Parmagiano and Romano are struggles, too. The substitute recipes often have Italian herbs or spices, as if to say, we know this isn't going to work, the best we can do is remind you of a food with real cheese in it. 

But I got over cheese (thanks in no small part to nutritional yeast). It turns out the very hardest thing for me to abandon was the humble chicken egg.

I have always loved eggs. As a kid, while my classmates sat at tray tables watching cartoons and guzzling down sugar bomb cereals, I was feasting on fried eggs and bacon, scrambled eggs and toast, omelets stuffed with ham and cheese, or my beloved creamed eggs. I come from farmer stock. I spent a lot of days and nights sleeping under the roof of my maternal grandparents. They raised chickens and ate a lot of eggs. So really, eggs are my soul food.  The prospect of giving them up was, ultimately, the most difficult choice. The heavy-handed treatments that are the gold standard for vegan eggs in the online cooking sphere- heavy with garlic and onion powder, turmeric, soy sauce or liquid aminos- while not unappetizing, scream "I am not eggs" to this egg lover. And so a suitable egg substitute has been my philosopher's stone.

I've settled on tofu as a base, just like the most popular variants out there. But I forgo the firm and extra-firm refrigerated packs for the silken tofu-based shelf-stable aseptic packs. All of the aseptic grades you find are based on silken tofu, though you can find soft, firm and extra-firm varieties. My favorite for this dish is firm.

Of all the common flavorings used for tofu eggs, I have found only black salt, nooch and butter to be indispensible. I don't like turmeric for the coloring agent; in terms of flavor, I prefer annato or saffron. Both impart delicate color and flavor- exactly the mood I want to strike with simple scrambled eggs.

There are different ways to achieve the flavor and texture of butter. Cooking the tofu in coconut oil mixed with nutritional yeast works nicely. But I find using a plant-based butter-like spread to be perfectly fine.

I prefer a healthy grinding of black pepper, but that's a personal choice.

So, here's how you make my delicate, simple take on classic scrambled eggs.

Ingredients

• 1 brick of aseptic pack tofu- any grade is fine, but firm is probably best
• 1 tsp black salt
• 1 tbl plant based butter, or 1 tbl coconut oil
• 1/2 cup plant milk- I prefer organic, unsweetened soy milk with no fillers
• 1 tsp all-purpose flour
• 1/4 tsp baking powder
  
• 1/4 tsp annato or a healthy pinch of saffron
• 2 tbl nutritional yeast
  

Method

1. If using saffron- heat the plant milk in the microwave for 15 seconds. Add the saffron to the milk and set aside to bloom.
2. Put the tofu, salt, flour, baking powder, nutritional yeast and milk in a blender or food processor and process until smooth.
3. At this point, you can add any veggie additions. Some ideas are sliced green onion, diced roasted red pepper or tomato, precooked broccoli florets cut small, or thinly sliced cooked mushrooms.
   
4. Heat a non-stick skillet to medium. add the butter or oil. use a brush to coat the pan entirely.
5. pour in the mix. This will lower the temp of the pan. Give the mix two minutes to cook. Turn heat to medium low.
   
6. This is when you can decide if you want it omelet or sandwich style, or scrambled. If scrambled- break the disc up into large pieces and start tossing them gently. Break them up a second time if you want the pieces smaller. They should be starting to brown, but not completely set. If going for an omelet, begin checking the edges. the flour and baking powder give them a little structure, so you should be able to flip as one whole disc. But be careful to not overcook, this is why we've turned the heat down. The top should be lightly browned. Give the bottom another minute to do the same.
   
7. Remove from the pan to a bowl or plate covered with a lid until ready to serve. If you are melting vegan cheese on top for sandwiches, put it on now and cover.
8. Enjoy!
   

30 Days of Vegan: Breakfast Burritos

Is there a more perfect food than a burrito? Right off the bat, it has portability going for it- something I apreciate it because I rarely want to sit down for a meal. Just how I'm wired I guess. The burrito is like a Rhumba: it has key ingredients and signature moves that define the category, but beyond that, the sky is the limit. It can be made up of almost anything. It varies from the Guisado, basically in a stew in a tortilla- to the Mission, with its massive girth and plentiful rice and beans; to the Chimichanga, essentially a fried burrito; to Korean versions. And what is Moo Shu, if not a stir-fry burrito with paper-thin pancakes and plum sauce? The breakfast burrito is yet another variation, and can consist of whatever you like for breakfast wrapped in a tortilla. 

I tend to be pretty trad about mine: they are usually a combination of beans and avocado, sometimes with cheese, sometimes with potato or rice, slathered in taco sauce or salsa. But I've been known to take last night's curry, wrap it in a tortilla and call it breakfast. My choice of bean is usually black, but I go for pintos and red beans too. Avo is pretty much a requirement. Stacey's organic are the best vegan premade tortillas on the market. Violife makes an excellent shredded cheddar-like product that is my current choice for breakfast burritos. I recommend pico de gallo or corn relish as additions, and taco sauce or homemade salsa as condiments. But honesty, like its cousin the sandwich, almost anything is possible.

In terms of preparation, I don't have fixed directions for that, though I follow general guidelines. Generally I like to get all of the ingredients that should be warm heated up before wrapping, Further cooking is for the benefit of the tortilla or to melt any cheese. I prefer avocado to be sliced thinly and plain as opposed to chunked or made into quacamole- makes for a more consistent flavor and it's easier to layer with other stuff. 

If you lightly oil and salt the tortilla and cook them on cast iron, they take on a delicious, crispy character. You can also stovetop grill them for some retention of tenderness with flavorful sear lines and good inside warming. If you make your own tortillas or find raw tortillas at the store, you simply must try baking them in the oven for an incredible taste experience. Heck, even using the microwave works. I'd suggest lightly wetting the tortilla, wrapping it in a towel and 'waving the tortilla for ten seconds, then filling and building, rewrapping and giving it another 20-40 seconds depending on size.  

I gravitate toward the grilling method and a "soft taco"-sized tortilla that yields a burrito about  2" in diameter and 6-7" in length. Anymore is too much for me in the morning. But you probably like something else! And that's the great thing about burritos.Wrap one up in parchment paper and take it on your next morning journey.