Join Date: Feb 2011
Location: Texas, USA
One Month Without Meds, Still Doing Well
My GI took me off all meds one month ago and I'm still doing well. I posted here quite a bit during my reflux flare-up earlier this year. I was troubled by the fact that everyone on the boards had a bad story and decided that if my GERD/LPR symptoms ever improved, I'd be sure to share a positive story. So here it is.
I first experienced GERD/LPR symptoms in December '10. My symptoms ranged from occasional heartburn to regurgitation to sore throat to hoarse voice to raw throat and mouth to a bad taste in my mouth (the bad taste was my most common symptom early on). In hindsight, the "trigger" was almost certainly stress-related; my wife had just had a baby, lots of family was coming and going, and I wasn't getting any sleep. In addition, I was drinking a lot more coffee and alcohol than I would typically drink.
My PCP thought that acid reflux was the culprit but wasn't sure. I'm young (32 -- 33 now), generally healthy/not overweight, and have a fairly healthy lifestyle. But the symptoms all pointed to GERD/LPR, so the doctor put me on Dexilant, a 24-hour, time-released PPI. When Dexilant didn't help, the PCP referred me to a GI. The GI had me continue Dexilant and scheduled me for an upper endoscopy. The endoscopy revealed no problems -- esophagus looked fine and the doctor saw no hiatal hernia. He said my LES may have been a little bit loose, but he couldn't measure my LES strength with the scope alone. I stayed on Dexilant from January '11 through March '11.
By April, my symptoms were less frequent and less severe. I'd go a few days with next to no symptoms, followed by a few days of mild to moderate symptoms. I saw the GI in early April and, since things were looking somewhat better, he moved me to Zantac 300.
I took Zantac 300 for April and May. During that time, my symptoms again improved but did not completely go away. Also, by that time, I had finally found a medication that treated my symptoms: Gaviscon Advance liquid. I have to mail order the stuff from the UK, but it worked wonders for the symptoms I would occasionally have.
At my June GI appointment, the doctor told me to stop Zantac and take the Gaviscon Advance as needed. He said that he doesn't think I have bad reflux any longer. He also said that everyone has some reflux, mine is probably worse than average, but, because I went through a bad spell, I'm probably much more aware of my reflux than are most people.
So I stopped taking Zantac. Much to my surprise, my symptoms did not increase, but actually seem to have decreased. I've experienced very mild heartburn three times in the past month. When that happens, I just take the Gaviscon Advance. My mouth and throat have been fine.
I wish I could explain what caused my improvement. I have a few hunches but ultimately don't know for sure.
One factor may be time. Way back in December, my PCP told me that he has a lot of GERD patients who need to go on PPIs for three months or so out of every two to three years. In fact, his initial recommendation was to take Dexilant for three months, cut down to an H2 blocker for two weeks, and then cut out everything. So, there's a good chance that my improvement is due solely or mostly to the passing of time.
As for supplements, I tried everything. Early on I went to a naturalist who gave me a series of Chinese herbs. None of that seemed to make a difference. I took enzymes, probiotics, lemon juice, apple cider vinegar, L-glutamine, fish oil, multivitamins, and on and on -- my symptoms did not seem to change at all during the time I was taking those things. Melatonin may have helped, but I was never sure.
The one exception is calcium citrate liquid. Several sources indicated that calcium citrate liquid can strengthen a loose LES. My improvement coincided with when I started taking the calcium citrate liquid, and since my underlying problem was probably a stress-induced loose LES, it would make sense that the calcium citrate would help. I still take the calcium citrate liquid.
Another thing that may have helped is going to the gym. I used to work out a lot (mostly weights), but when the GERD/LPR came on, I hadn't been to the gym in a couple of years. So, I signed up and got a trainer. I explained that I need to be careful with lifting and diet because of my GERD/LPR due to a loose LES. He said that's interesting, because when you lift weights, your body responds by producing growth hormones. Those hormones help to strengthen all of your muscles -- not just the muscles that you target with the weights. He didn't have any LES-specific science, but he said that getting back into a weight routine could very well help strengthen my LES. Also, weight lifting is a great stress reliever. I've been consistently lifting weights four days a week over the past three months or so, and my GERD/LPR has steadily improved over that same time period. Here too, I don't know if my lifestyle changes caused my improvement, but the improvement followed my lifestyle change and I have a sensible theory one why one could cause the other. Take it for what it's worth. (As an aside, I realize that every doctor's recommendation to GERD patients is to avoid lifting weights, as weight lifting puts pressure on the LES. For all I know, my improvement would have been 100% -- but is instead only ~95% -- but-for my weight lifting. My hunch, however, is that the weight lifting helped by reducing stress and possibly strengthening my LES.)
As for diet, I found that Dr. Koufman's recommendations really helped when I was experiencing frequent symptoms. I'm not convinced by Dr. Koufman's pepsin theory, but the diet itself helped me keep my symptoms under control. Note that I don't think the diet helped to strengthen my LES, but only that it helped to control my symptoms. I also tried the trendy alkaline diet based on an Internet recommendation, but that diet did not help in my case.
Today, I eat pretty much whatever I want -- which happens to be very healthy. I eat a lot of eggs, chicken, salmon, rice, oatmeal, and fresh vegetables. Over 95% of the liquid I drink is water. The rest is milk and an occasional glass of tea. No soda. I stray from that diet without trouble on special occasions. If I'm out to a social breakfast, I'll have a cup of coffee. If I'm on a date, I'll have a glass of wine. If I'm traveling and can't control what's served, and I just eat what's in front of me, but I keep the portions small with some things (e.g., beef). I haven't yet had a problem with that approach.
Like I mentioned above, I still have occasional symptoms, and I'm sure I'll end up back on a PPI at some point or points in my future. I just hope that's later rather than sooner. But, for now, I am basically well.