GERD

 Mark Sisson posted a link to a sad essay called IBS Is Why I'm Still Single. Every day I'm able to eat and live normally, I am so grateful. You see, most of my life I had painful stomach problems. When I was four I remember crying in the bathroom. I remember at sleep away camp being too embarrassed to use the communal bathrooms and sneaking out in the middle of the night to the isolated outhouse. It wasn't until I was 15 or so that I was diagnosed with IBS. When I was a freshman in college it became so disruptive to my life that I was finally given Librax. At that point I was also on quite a bit of asthma medication. Then I started having serious heartburn. I went on proton pump inhibitors. At my low point I was on Allergra, Advair, Singulair, Albuterol, Librax, Nexium (Prilosec stopped working at some point), and continuously on and off antibiotics for various ailments ranging from yeast to sinus infections. I was miserable. I missed most of my classes. 

The single part of that essay hit home because I remember my first Valentine's day with my first boyfriend. We had a delicious meal, but soon after I was bent double with incredible pain and spent most of the night in the bathroom. I didn't think I'd be able to do anything. 

I honestly thought that my condition was caused by eating fat, tomatoes, and peppers. The handouts my doctor gave me insinuated as much. I really didn't like all the side effects of the medications I was on, but when I complained to one of my doctors he said I'd on them for the rest of my life. I tried all kinds of high-fiber low-fat veg*n diets to no avail. 

I didn't want to live like this. But all the sudden my condition took a turn for the worst. I felt like my whole body was falling apart. One day I collapsed in the hallway of the dorm. I was diagnosed at the hospital with chronic salmonella. That's not something a 19 year old should have. Afterwards I had trouble with constant burping.

I vowed to do more research and found a small study on GERD and low carbohydrate diets. I also discovered Evolutionary Nutrition on Art De Vany's site through the blog Marginal Revolution. I learned about the Specific Carbohydrate Diet and wondered if my symptoms were caused by bacterial overgrowth. My first attempts to get off my medicines didn't work. I tried to eat low-carb in the dining hall, but I guess the foods had too much crap on them. Luckily, I took summer school and lived dining-hall free in graduate student housing, though my "kitchen" had only a microwave. Looking back, my diet wasn't all that great. I didn't know that much about cooking and nothing about meat. The first meat I bought was some sausage, which I tried to cook in the microwave only to get a massive bowl of exploding grease. Gross. I had to eat out a lot, but stayed mostly paleo and very low carb. I tried lots of remedies like probiotics and drinking apple cider vinegar after each meal. I started drinking kombucha. I read everything I could get my hands on about traditional nutrition. It seemed clear my illness was a modern disease. 

I had a goal in mind: as a freshman I had tried spicy food for the first time and learned to love it, but I had thought it was causing all my problems. When it was clear that this was a secondary problem to the inflammation and dysbiosis, I decided to make eating it without pain a goal. I didn't reach that goal until six months into the regimen, but I've been eating delicious curries without incident ever since. 

I've also been able to travel extensively without incident, something I thought I'd never do. 

Unfortunately I still had some residual IBS issues. I realized a year ago that I was going to have to let go of beer and gluten-containing cheat meals. The IBS has been gone ever since, but I really do miss some of those foods. 

So basically the principals I went on were that bacteria was at the root of most of my problems. Being born by C-section, a low-nutrient diet, and constant antibiotic use had put my gut ecology into an imbalanced state. Probably some of my medications made it worse, like Prilosec/Nexium, which is known to allow bacterial overgrowth. My principles were to first starve out the bad bacteria, which was inspired a bit by Hyperlipid, and then gradually try to balance the gut through gentle traditional probiotic and nutrient-rich foods. I suspect I had both hypochlorhydria and small-bacterial overgrowth, which was why I was so excited by the paper I just blogged about. 

I'm still quite fiber-intolerant. I can't really do brown rice, quinoa, or many other fiber-rich grains. But I am able to eat a fair amount of carbs, which I'm happy with. As an aside, even some in the alternative health community are very wrong about IBS. Giving up simple sugar will do nothing, as they are digested in the small intestine, which is a point made by the SCD diet. It's the complex sugars that cause the problems in the lower intestine. 

As for romance, duh it's easier when you aren't a miserable gas-filled bloated cramped up woman who alternates between diarrhea and constipation (with hemorrhoids) every two days... 

So when people say paleo or traditional foods are trivial, I'm just happy I can live a relatively normal life thanks to them. So I thank these things for my good health

• High fat
• Low carb
• Probiotics
• Acidic foods like pickles, kombucha, and apple cider vinegar that helped make up for my low stomach acid
• Traditional foods
• Grass-fed meat
• Gluten-free

In news from stupid-land: The FDA cautions against high dosages or prolonged use of acid inhibitors.

It's kind of criminal that these medicines are still in use, given that the latest studies published in journals show that the cause of GERD is not too much acid. So while proton pump inhibitors might mask the symptoms, they get rid of stomach acid, which we kind of evolved for a reason- to help digest food and to protect against pathogens.

The agency said it would order revised labeling on packages of the drugs to reflect the fact that they have been associated with an increased risk of fractures of the hip, wrist and spine…The drugs have previously been linked to an increased risk of contracting pneumonia and the troublesome bacterium Clostridium difficile, as well as to an increased risk of dementia. A recent study found that the drugs increase the risk of bone fractures by about a quarter. It is not clear what the mechanism of the increased fractures is. Most researchers believe it is due to decreased absorption of calcium from the diet because of the reduced stomach acid, but it is possible that the drugs interfere with bone maintenance.

I am particularly incensed because last year my younger sister started having problems with GERD. She is only 19 and the doctor's recommended Prilosec. Instead she is now paleo and her symptoms have resolved. It's lucky that she knew that the paleo diet could treat GERD and she didn't get on the PPI wagon of dooooom like I did. Here is what I can remember:

It started when I was 18 or so. I was overweight and had terrible stomach problems. My internist gave me Zantec but my mom thought it was unnecessary and I never took it. Over the next two years I lost some weight on a vegetarian and then vegan diet, but the heartburn just got worse and worse. I couldn't sleep or concentrate on my school work. My school doctor finally convinced me to get on Prilosec. The spiel for these pills is that you take them for a month and it helps heal your esophagus, but of course it never works. I try to go off them after a month and the heartburn returns with a vengeance.

So I stay on them, but my IBS just gets worse. My allergist, who is treating me for severe asthma gives me an anti-spasmodic for my IBS and tells me not to worry about the PPIs. He says I'll probably be on them for the rest of my life, but not to worry since they are mostly harmless. At least I can eat pizza as much as I want now...

At some point I get really really sick. My doctor at school thinks it's just my IBS, but when I collapse and end up in the E.R. I finally get diagnosed with chronic salmonella. What should have been a one day bout of food poisoning decided to settle down in my weak digestive system. I take heavy antibiotics and recover...sort of. Now pretty much EVERYTHING upsets my stomach and even worse....I get chronic burping "attacks" all the time. I'm sickly in general- I get yeast, urinary tract, and sinus infections constantly. I get tested for all sorts of things like celiac and Crohns, but no dice. I do some research and find that PPIs might be causing some of my problems. Through looking at Pubmed I find out about a small study that effectively treated GERD with a low-carb diet. I try that for awhile, but using foods at the dorm cafeteria. I just end up feeling crappy... and no wonder with the factory farmed meat and gluten-laced sauces.

When I encounter Art De Vany's site through Marginal Revolution, I am intrigued by a more vegetable-heavy version of low-carb. I try it and it helps my IBS, but I'm still on the PPIs. When I try to go off I feel really terrible. I find a site where people tout apple cider vinegar as a cure. I start eating mostly paleo and taking apple cider vinegar diluted in water after every meal. I start eating a wide variety of vegetables and trying fish for the first time. It's not perfect, but I'm finally at the point where I can at least function without PPIs. I do an egg fast for a week. It takes about six months, mostly very low carb, but eventually I find myself...not taking any medicines at all. 

A journey to get rid of heartburn fixed much more than that. At my worst I was on thirteen different medications and dependent on antibiotics every month. I haven't taken antibiotics in two years now...nor had to go to the doctor for IBS, GERD, or asthma. PPIs are hard to kick, but it was worth it.

My sister and my father have been sucessful with this approach as well, though they were lucky that they never took PPIs. PPIs alter your digestive system and it can be hard to get it in working order again.

 Two years back I started sending my dad a paleo article or two every once in awhile. My dad was really into exercise, but despite exercising every day he was having a tough time with his weight. It's no wonder. Growing up I remember he would take us out to the infamous Cici's All You Can Eat Pizza where well...we would eat amounts of sugar and junk that I shudder to look back on.  

With exercise not working, he decided to read up on Art De Vany and Gary Taubes He found it was a simple diet that made sense to him logically. I write lots on this blog that is about adding in neglected foods or tweaking nutrient ratios, but my father is testament to the simple formula of meat, seafoods, vegetables, and fruit. He said he didn't do anything fancy, because he was already used to cooking and eating meat. Giving up sugar was hard, but the hardest part was giving up foods that are seen as healthy like fruit juice. Primal Body Primal Mind, which I gave to him after I read it, helped him realize the problems with fructose. 

So far he has lost 50 lbs, his athletic performance is better, and he doesn't have GERD anymore. I think Art De Vany in particular is a great role model. In an age when older men are portrayed as overweight and bumbling (a la Family Guy or The Simpsons), Art has aged gracefully and retained his masculinity. 

It's interesting because he started the diet after I left home, so many of our eating habits are different, but either way we are both testaments to the importance of eating nutrient dense HUMAN food and ditching sugar. 

Before:

After:

Cattle to human health logic:

What's also true is that E. coli only showed up so prolifically in the guts of cows since they've been fed corn in the last 50 years or so. A starchy food the grass-eaters didn't evolve to consume, corn produces an acidic mess in their stomachs that E. coli bacteria apparently loves.

I just realized today that you could totally rewrite that sentence and it would still be true.

What's also true is that E. coli only showed up so prolifically in the guts of human since they've been fed so much corn in the last 50 years or so. A starchy food the meat and vegetable eaters didn't evolve to consume, corn produces an acidicmess in their stomachs that E. coli bacteria apparently loves.

It's not just acidic stomachs of cattle that E. Coli love, it's acidic stomachs of humans too. The amount of food poisoning cases attributed to pathogens that aren't big fans of acid, like salmonella, has dropped. Well, except for in the other extreme end up acidity, which is the growing population treated with drugs like Proton Pump Inhibitors that reduce acid too much, thus leaving them susceptible to other nasty types of food poisoning.

All that is clear is that in the US our stomachs are a mess. We should make an effort to get them back to normal by elimating both grains and acid-reducing drugs.