4 ms·

I’ve been dealing with chronic reflux for about 8 mos now. On PPIs and they don’t seem to do much. But once I get away from my typical routine of work/dadding t

I’ve been dealing with chronic reflux for about 8 mos now. On PPIs and they don’t seem to do much. But once I get away from my typical routine of work/dadding then all the symptoms vanish, even to the point of being able to eat foods that are not good for reflux: spicy things, tomatoes, a bit of coffee. In my case, this is absolutely a downstream symptom of something mind-body. Already been scoped and got a diagnosis of visceral hypersensitivity, which is medical speak for “nerves in esophagus are too sensitive.” The question of why is out of scope. In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse. I’ve made some life changes (new job) to see what happens here. But I also have to be prepared for the possibility that it doesn’t fix it. Been working through The Body Keeps The Score as well. Looking forward to seeing what the author discusses here.

justinrubek 1y ago
I seem to have something very similar going on. I'm on the early end of trying to understand it. Coffee was the first indicator because it'd ruin my day to drink some. I hope the best for us.
johnisgood 1y ago
Have you tried H2 blockers? And as you have said, avoid anything that increases stomach acid production (such as caffeine or even tea, along with spicy food). You might also have success with Venter[1] (Sucralfate). [1] https://www.medicinesfaq.com/brand/venter https://www.medicinesfaq.com/brand/venter
- mattgreenrocks 1y ago
  Yep. I track which foods affect that and try not to stack them. In addition, I take famotidine in the evening with two different antihistamines. I suspect I have a histamine intolerance behind it all, as it tends to be comorbid with ehlers-danlos.
  - johnisgood 1y ago
    I have never heard of Ehlers-Danlos syndrome. Does it really cause histamine intolerance? You may try 1st generation ones. In any case, good luck and I hope you can find something that makes it manageable at the very least.
homefree 1y ago
For me, the two big things that help are losing weight and reduced anxiety. When either are high the problem is noticeable when both are low it’s gone. Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.
xgb84j 1y ago
Hey, I just wanted to let you know that I have the _exact_ same issue as you since 2 years. It was much worse than what you described 2 years ago. Now it's just very annoying. The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body. The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day). I wish you all the best and thank you so much for sharing.
- ansc 1y ago
  How'd you get started?
  - xgb84j 1y ago
    If you mean the Buddhist meditation: I joined a local group a few years ago. I wasn't super serious about the practice until I saw how directly it can improve my life. Even now it's hard to find this much time every day. This is a book that helped me getting started: https://www.amazon.com/Roaring-Silence-Discovering-Mind-Dzogchen/dp/1570629447 https://www.amazon.com/Roaring-Silence-Discovering-Mind-Dzog...
amelius 1y ago
I had this for years. Then I took vitamin K2 (about 50mcg per day I think), and after a few months it went away. No idea why, though. Anyway, happy that I can drink coffee again :)
Micanthus 1y ago
FYI, The Body Keeps The Score is full of misinformation, and is alternately ignored and criticized by other psychiatrists > The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019). https://web.archive.org/web/20250120164320/https://journals.sagepub.com/doi/10.1177/10497315231206754 https://web.archive.org/web/20250120164320/https://journals....
glasscannon 1y ago
The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space
nickspacek 1y ago
Lots of anecdotal cures here, but I'll add Aloe Vera gel to the mix since it seems to help* both soothe/recover/prevent the return of my reflux symptoms for long periods of time.
- mattgreenrocks 1y ago
  Gel, as in, applied to your skin? I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.
eddythompson80 1y ago
> In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse. Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it. I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief [1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.
- qzw 1y ago
  Western medicine “can’t treat stress” but Eastern medicine definitely claims to be able to. But then so do various nebulous “alternative medicines”. Another comment mentioned deep meditation as being effective, and I believe there are a number of studies that have shown it to have actual effect. I’ll add another tried and true stress cure but with a twist. Exercise has consistently been shown to help reduce stress, but I find that you have to pick an activity that’s different than what you normally do, e.g. if you’re a runner, try swimming or tennis. The goal is to actually raise the stress level while exercising by doing something unfamiliar and therefore more challenging. In my experience, if the exercise is too relaxed or routine, it doesn’t allow your mind to disengage from the other stressors that are causing symptoms. Of course, all this is pure anecdata from an internet rando.
qzw 1y ago
> I think it kinda pisses them off not know, tbh Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.
- rendaw 1y ago
  I'd be fine with that if the posturing didn't go along with unnecessary medication and the lack of suggestions to search for treatment somewhere better equipped.
- deleted 1y ago
  [deleted]
- qualeed 1y ago
  >But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits. A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.
ruthvik947 1y ago
I had this for about a year, and it really only went away when I quit my job. It wasn't even a particularly demanding job, but I guess the lifestyle + the fact that I felt I was wasting my life away might have played a role. Nothing else is really different.
- anonymars 1y ago
  Most people are familiar with the Peter Principle where it talks about people rising to their level of incompetence. But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
- mattgreenrocks 1y ago
  I have had near-debilitating non-GI physical symptoms when it was time to leave a job in the past. I might just be bad at responding to those before it gets to be a five alarm fire. Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!
PixelForg 1y ago
https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/ This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too Edit - Changed the link, had posted something else by mistake
- jrgoff 1y ago
  Thanks for this - it looks interesting, I'm planning on giving it a try for my low level reflux that's been bothering me for over a decade (but always had other health issues that seemed higher priorities to try to address).
- ProllyInfamous 1y ago
  https://news.ycombinator.com/item?id=42528399 https://news.ycombinator.com/item?id=42528399 Since reading the above HN comments, I have lost ten pounds and (mostly) stopped drinking carbonated beverages. My GERD is vastly reduced. ¢¢
  - mattgreenrocks 1y ago
    Thanks for this, will add it to the experiment queue while I work on losing the slight dad bod I have going on.
  - grep_name 1y ago
    I don't see anything about carbonated beverages in those comments? I've had good results with some of the exercises mentioned there, but since then have been in a rut unable to make it stop (my only symptom of GERD is a small persistent cough, which sucks more than it sounds like). I drink a lot of sparkling water though. Do I need to give that up too?
    - 1y ago
wincy 1y ago
All of my reflux went away last year when I started tirzepatide via my Zepbound prescription. I was having horrible heartburn daily and it’s just completely gone. I used to take tums and omeprazole literally daily, now it’s basically never.
globnomulous 1y ago
Just a sidenote: GERD can lead to Barrett's Esophagus (precancerous changes in tissue), and erosive damage to the esophagus can accumulate over time and abruptly become life threatening. After decades of terrible GERD, my father nearly died from exactly such an undetected gastric bleed, losing 11/12 of his blood (which doctors replaced as it coursed out) before an emergency-medicine team finally found and sealed the rupture. He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't. I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet. Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.
amai 1y ago
Sleeping on a inclined bed can help with GERD: -https://www.healthcentral.com/digestive-health/acid-reflux-elevate-bed https://www.healthcentral.com/digestive-health/acid-reflux-e... -https://www.refluxguard.com/the-acid-reflux-game-changer-sleeping-on-an-incline-could-change-your-life/ https://www.refluxguard.com/the-acid-reflux-game-changer-sle...
- snozolli 1y ago
  I had terrible acid reflux at night when I was in my 20s. It was awful. I was getting a couple of hours of sleep per night, then waking up in terrible pain, stuffing down plain yogurt under a doctor's orders, and sitting up on a sofa for the rest of the night. Putting my futon on a sheet of plywood with two concrete blocks under the head completely solved the problem within a few days. It takes a while to adapt to sleeping on an incline. I kept it up for about a year, then went back to a flat bed. I've never had acid reflux again.
Chyzwar 1y ago
For me intermittent fasting after 6pm and small diet changes fixed my acid reflux. PPI were not helping and making things worse. I actually took Betaine HCI supplements to fix digestive issues after PPIs.
an_aparallel 1y ago
I had the same diagnosis, and treatment was getting on serious antidepressants for their nerve dulling properties. After getting that diagnosis. I eat everything within reason. I decided not to take medication, knowing whats up with my body is sufficient. I mainly try to do all eating 4 hrs before bed. What i have read is that covid may be responsible for micro lesions in the esophagus...acidic foods are essentially rubbing salt in the wounds. Just a note about VH - it is more so over sensitivity to regular digestive function. Which is why feeling super full after eating/dispepsia is common as well. Im sure you did a 24 hr acid monitoring test - i pressed the reflux button during all my trigger foods and was surprised to see ph levels as neutral.

justinrubek 1y ago

I seem to have something very similar going on. I'm on the early end of trying to understand it. Coffee was the first indicator because it'd ruin my day to drink some. I hope the best for us.

johnisgood 1y ago

Have you tried H2 blockers? And as you have said, avoid anything that increases stomach acid production (such as caffeine or even tea, along with spicy food). You might also have success with Venter[1] (Sucralfate). [1] https://www.medicinesfaq.com/brand/venter https://www.medicinesfaq.com/brand/venter

mattgreenrocks 1y ago
Yep. I track which foods affect that and try not to stack them. In addition, I take famotidine in the evening with two different antihistamines. I suspect I have a histamine intolerance behind it all, as it tends to be comorbid with ehlers-danlos.
- johnisgood 1y ago
  I have never heard of Ehlers-Danlos syndrome. Does it really cause histamine intolerance? You may try 1st generation ones. In any case, good luck and I hope you can find something that makes it manageable at the very least.

homefree 1y ago

For me, the two big things that help are losing weight and reduced anxiety. When either are high the problem is noticeable when both are low it’s gone. Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.

xgb84j 1y ago

Hey, I just wanted to let you know that I have the _exact_ same issue as you since 2 years. It was much worse than what you described 2 years ago. Now it's just very annoying. The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body. The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day). I wish you all the best and thank you so much for sharing.

ansc 1y ago
How'd you get started?
- xgb84j 1y ago
  If you mean the Buddhist meditation: I joined a local group a few years ago. I wasn't super serious about the practice until I saw how directly it can improve my life. Even now it's hard to find this much time every day. This is a book that helped me getting started: https://www.amazon.com/Roaring-Silence-Discovering-Mind-Dzogchen/dp/1570629447 https://www.amazon.com/Roaring-Silence-Discovering-Mind-Dzog...

amelius 1y ago

I had this for years. Then I took vitamin K2 (about 50mcg per day I think), and after a few months it went away. No idea why, though. Anyway, happy that I can drink coffee again :)

Micanthus 1y ago

FYI, The Body Keeps The Score is full of misinformation, and is alternately ignored and criticized by other psychiatrists > The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019). https://web.archive.org/web/20250120164320/https://journals.sagepub.com/doi/10.1177/10497315231206754 https://web.archive.org/web/20250120164320/https://journals....

glasscannon 1y ago

The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space

nickspacek 1y ago

Lots of anecdotal cures here, but I'll add Aloe Vera gel to the mix since it seems to help* both soothe/recover/prevent the return of my reflux symptoms for long periods of time.

mattgreenrocks 1y ago
Gel, as in, applied to your skin? I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.

eddythompson80 1y ago

> In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse. Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it. I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief [1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.

qzw 1y ago
Western medicine “can’t treat stress” but Eastern medicine definitely claims to be able to. But then so do various nebulous “alternative medicines”. Another comment mentioned deep meditation as being effective, and I believe there are a number of studies that have shown it to have actual effect. I’ll add another tried and true stress cure but with a twist. Exercise has consistently been shown to help reduce stress, but I find that you have to pick an activity that’s different than what you normally do, e.g. if you’re a runner, try swimming or tennis. The goal is to actually raise the stress level while exercising by doing something unfamiliar and therefore more challenging. In my experience, if the exercise is too relaxed or routine, it doesn’t allow your mind to disengage from the other stressors that are causing symptoms. Of course, all this is pure anecdata from an internet rando.

qzw 1y ago

> I think it kinda pisses them off not know, tbh Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.

rendaw 1y ago
I'd be fine with that if the posturing didn't go along with unnecessary medication and the lack of suggestions to search for treatment somewhere better equipped.
deleted 1y ago
[deleted]
qualeed 1y ago
>But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits. A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.

ruthvik947 1y ago

I had this for about a year, and it really only went away when I quit my job. It wasn't even a particularly demanding job, but I guess the lifestyle + the fact that I felt I was wasting my life away might have played a role. Nothing else is really different.

anonymars 1y ago
Most people are familiar with the Peter Principle where it talks about people rising to their level of incompetence. But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
mattgreenrocks 1y ago
I have had near-debilitating non-GI physical symptoms when it was time to leave a job in the past. I might just be bad at responding to those before it gets to be a five alarm fire. Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!

PixelForg 1y ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9550520/ This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too Edit - Changed the link, had posted something else by mistake

jrgoff 1y ago
Thanks for this - it looks interesting, I'm planning on giving it a try for my low level reflux that's been bothering me for over a decade (but always had other health issues that seemed higher priorities to try to address).
ProllyInfamous 1y ago
https://news.ycombinator.com/item?id=42528399 https://news.ycombinator.com/item?id=42528399 Since reading the above HN comments, I have lost ten pounds and (mostly) stopped drinking carbonated beverages. My GERD is vastly reduced. ¢¢
- mattgreenrocks 1y ago
  Thanks for this, will add it to the experiment queue while I work on losing the slight dad bod I have going on.
- grep_name 1y ago
  I don't see anything about carbonated beverages in those comments? I've had good results with some of the exercises mentioned there, but since then have been in a rut unable to make it stop (my only symptom of GERD is a small persistent cough, which sucks more than it sounds like). I drink a lot of sparkling water though. Do I need to give that up too?
  - 1y ago

wincy 1y ago

All of my reflux went away last year when I started tirzepatide via my Zepbound prescription. I was having horrible heartburn daily and it’s just completely gone. I used to take tums and omeprazole literally daily, now it’s basically never.

globnomulous 1y ago

Just a sidenote: GERD can lead to Barrett's Esophagus (precancerous changes in tissue), and erosive damage to the esophagus can accumulate over time and abruptly become life threatening. After decades of terrible GERD, my father nearly died from exactly such an undetected gastric bleed, losing 11/12 of his blood (which doctors replaced as it coursed out) before an emergency-medicine team finally found and sealed the rupture. He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't. I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet. Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.

amai 1y ago

Sleeping on a inclined bed can help with GERD: -https://www.healthcentral.com/digestive-health/acid-reflux-elevate-bed https://www.healthcentral.com/digestive-health/acid-reflux-e... -https://www.refluxguard.com/the-acid-reflux-game-changer-sleeping-on-an-incline-could-change-your-life/ https://www.refluxguard.com/the-acid-reflux-game-changer-sle...

snozolli 1y ago
I had terrible acid reflux at night when I was in my 20s. It was awful. I was getting a couple of hours of sleep per night, then waking up in terrible pain, stuffing down plain yogurt under a doctor's orders, and sitting up on a sofa for the rest of the night. Putting my futon on a sheet of plywood with two concrete blocks under the head completely solved the problem within a few days. It takes a while to adapt to sleeping on an incline. I kept it up for about a year, then went back to a flat bed. I've never had acid reflux again.

Chyzwar 1y ago

For me intermittent fasting after 6pm and small diet changes fixed my acid reflux. PPI were not helping and making things worse. I actually took Betaine HCI supplements to fix digestive issues after PPIs.

an_aparallel 1y ago

I had the same diagnosis, and treatment was getting on serious antidepressants for their nerve dulling properties. After getting that diagnosis. I eat everything within reason. I decided not to take medication, knowing whats up with my body is sufficient. I mainly try to do all eating 4 hrs before bed. What i have read is that covid may be responsible for micro lesions in the esophagus...acidic foods are essentially rubbing salt in the wounds. Just a note about VH - it is more so over sensitivity to regular digestive function. Which is why feeling super full after eating/dispepsia is common as well. Im sure you did a 24 hr acid monitoring test - i pressed the reflux button during all my trigger foods and was surprised to see ph levels as neutral.