After a long time and a few posts, I have finally been diagnosed with GERD. Apart from additional meds, I am not sure how to deal with this.
I know I will have to watch what I eat, but apart from this would be grateful for any advice on how to control this. At the moment it is affecting my quality of life and is not a pleasant thing to live with.
I would be grateful for any tips on what and what not to do. I have been told that this problem is common amongst people suffering from Parkinsons.
Many thanks, in anticipation of your replies.
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Court
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Have you ever been tested for Helicobacter pylori infection? It is a cause of GERD and has been shown to interfere with the absorption of levdopa thus causing additional movement problems for PD patients.
Helicobacter pylori infection is associated with worse severity of Parkinson's disease.
There have been several eradication studies of H. pylori and PD. In one study eradication had no effect. In another it improved symptoms and the third, incomplete eradication of H. pylori, worsened symptoms.
"Therefore, the authors suggest that HP eradication may improve the clinical status of infected patients with Parkinson disease and motor fluctuations by modifying l-dopa pharmacokinetics."
Eradication failure worsened symptoms:
"A worsening of symptoms was noted with eradication failure.The prevalence of H pylori in Parkinson's disease was reported in four studies and ranged from 37% to 59% which is similar to that of the general population."
As for HP therapies, proton pump inhibitors should only be used with antibiotics in order to eradicate the bacteria. Proton pump inhibitors change stomach acidity and make the stomach a target for other bacterial infection.
"By multiple mechanisms, PPIs appear to increase susceptibility to the following bacterial enteropathogens: Salmonella, Campylobacter jejuni, invasive strains of Escherichia coli, vegetative cells of Clostridium difficile, Vibrio cholerae and Listeria. We describe the available evidence for enhanced susceptibility to enteric infection caused by Salmonella, Campylobacter and C. difficile by PPI use..."
Yes. A few years ago I tested positive for H Lylori infection three times. At the time I wondered whether this was linked to Parkinsons and, in fact, I posted a question about this. I have not been tested this time.
Thank you for the information you sent me. I will read this with interest.
Asiaticoside is from the herb Gotu Kola. Not sure the drug was ever developed but asiaticoside is certainly good for PD. This is an internet search and there are quite a few results:
I do not have PD but do have off the charts Hp. Done the treatment but it comes back. Dept. in UVa medical school which specializes in Hp says yogurt ( a good one like plain Dannon, Stiny Brook or Brown Cow) is the best management. Somehow just taking the bacteria doesn't do as good a job when I get tired of eating yogurt. Best find so far: zinc carnitine.
GERD is caused by reflux of acid, often into the mouth. As acid is very toxic it can cause damage on the way up. This can result in ulcers, and in very extreme cases, cancer. Diet seems a key factor in controlling acid and I am trying to sort out diet for Parkinsons, in conjunction with diet for GERD.
Hi ginglou. Thanks for this info. My late wife suffered from that after having had a galbladder operation, and it was referred to as 'reflux' and she was being treated for just that, but what she really had at that time was angina, with the result that she had a massive heart attack and died. Things aint always what they seem!
The three things that helped me most were: 1) Leaving at least 2 or 3 hours between the last meal/snack and going to bed. 2) Chewing each bite of food very, very well. 3) Not eating animal protein (meat, fish, milk products, eggs) and starchy foods/sugar (like potatoes, bread, pasta, desserts) in the same meal. There is some research on the internet that indicates these two groups of food need very different environments in the stomach to completely digest, and eating them together will cause one group to just sit in your stomach and not digest well. The theory is also controversial, but I tried it and it proved to work for me so I continue it.
since it comes from a variety of causes, three of which i listed, i would hope you would consider finding out which is(are) the actual cause(s). they can look at your sphincter muscle and see if it works. if it doesn't, you need a fundoplication. they can test your motilitiy. if they find it is slow then there are ways to improve that. if it is food monkeying around in your stomach because it isn't digesting, you can take enzymes. if it is HPylori, they can easily test for that and it can be addressed. it could be multiple things but maybe you need the process of elimination to help you figure out which ones are at work.
I take 2 tablespoons of Diamitreous Earth which I get at the health food store (the one for hunan consumption of course). It aids in digestion and kills parasites and bacteria. I very rarely get heartburn!
Use Heartburn Relief by Enzymatic Therapy. It was the first of the citrus extracts on the market and I still think the best. Quite remarkable. Finishdinner before seven no wine or tomato sauce. Buy book, Drug Muggers...it will tell you what supplements you need when you are on meds. Invaluable.
The question you need to ask is about the reason for the Gerd. It could be the sphincter muscle between the esophagus and the stomach is weak but it might also be that you aren't digesting your food well or that the motility rate is slow, leaving food to decay in the stomach to emit gases which back up into the esophagus and nasal passages and cause mischief. It could be one or all of those factors. In my case, I had all the tests done and the sphincter was strong but stuff going on in the stomach was creating gas pushing back into unwanted areas. The esophagus is not built to handle those gases and gets irritated. Digestive enzymes, increasing motility rate was my key. My handicapped grandson on the other hand, had a weakened sphincter and had to have fundiplication. I do not have PD but husband does and used the same knowledge with him. Took him off omeprosol which has long term bad side effects. Successful. Read: Drug Muggers.
I've had issues with GERD and acid reflux for years so I can offer my thoughts on it as far as it has affected me. Firstly, I've done everything I can to avoid PPI's. They've always been the first thing doctor's and gastro's have prescribed but the more I've learned about them the more I've been convinced that they're not the way to go, especially for the long term. I've had many prescriptions for PPI's that were meant for long term use which is crazy since even the manufacturers recommend them only for short term use (I think about 8 weeks max) simply because they know they come with serious side effects. Yet some people use them for years. Just google "dangers of PPI's" and you'll see that they come with lots of potential problems. I've even read recently that long term use may increase the likelyhood of dementia. If that doesn't make people think twice, I don't know what would. I know some doctors recommend them for short term use just to reduce the symptoms quickly, which may suit some people fine but the symptoms will almost always come back. It's not really worth relying on them alone, especially when there are simple, practical things you can do to reduce GERD and reflux in the first place. You don't necessarily need medication, or at least I didn't and I began with a lot of damage in my esophagus years ago. So much so that, at one time, they abandoned one endoscopy half way through because there was so much damage done to my esophagus. I had to wait six weeks until everything had healed before they tried again. My gastro gave me a prescription for PPI's after the first attempt and assumed, six weeks later, that I'd been taking them because there was almost no damage left. I hadn't taken the PPI's at all. What I did instead (in desperation) was make a few changes for a few weeks.
I'd recommend doing a few things that will almost certainly make a difference and, if you've done any research on the topic you've probably come across some of them already.
One, as you say, you will have to watch what you eat, but also when you eat it. Not eating spicy or acidic foods is obvious. Chocolate, alcohol is the same. Losing weight and quitting smoking I didn't have to worry about but, if they're relevant to you, you'll know that they could make a difference. Try not to eat large meals and you mustn't eat within two or three hours of going to bed (or lying down). MOST OF YOUR PROBLEMS WILL EASE OFF if you keep strict control of what you eat, how and when you eat it, believe me.
Two, you must lift the head of your bed by about eight inches. Not just raise the pillows but lift the head of the bed itself so that your stomach is never in a bent position and so that any acid in your stomach stays there. I put that one off for years because I thought it was such a wierd thing to do and also because I sleep with my wife which meant she had to sleep in such a very different position too. But, it was probably THE MOST IMPORTANT thing I did to heal the damage in my esophagus. Because you almost eliminate reflux during your sleeping hours by sleeping in this position, you give the damage caused by acid in your esophagus around eight or so hours to heal again. This makes a huge difference. It makes sense that your esophagus will begin to heal if it's allowed to. Ongoing acid reflux, day and night, is what does the damage. Giving it those long night time hours to heal properly will help a lot. Actually we both find it more comfortable lying on a slope than lying flat now. When we stay away from home and sleep in hotels and B & B's on beds that are flat we don't sleep as well and I'll often have some reflux during the night. That's also more likely to happen because we eat later than we normally do and I'm not always as careful as I should be about what I eat when we're having a break. I do know though, that once I get to our own bed and back to not eating problematic foods, the GERD will go away again very soon. It's definitely an important thing to try.
The only thing I'll eat before going to bed is a red apple. I know it sounds odd but I read about this online years ago as it was touted as a brilliant way to get rid of reflux issues. For me, it works. I don't know why, but it does, as long as I chew it well and eat it about an hour before lying down. Apparently the redder the better but I eat Pink Lady's because I like the taste. Weird I know but it's not going to do me any harm anyway. Again, an easy thing to try.
I also take slippery elm powder because I'd often seen it recommended for reflux problems. I put half a teaspoon in a cup with an inch or two of warm water, stir it then drink it down. It's not the best of tastes so some people mix it with things like powdered nutmeg or cinnamon. This needs to be done about half an hour before a meal. I only do it at breakfast as a maintainence dose but I suppose how often you take it may depend on how bad your reflux issues are. Some people take it half an hour before each of the three main meals. Again, it may be worth checking it out.
I know that I now have my reflux issues well under control whereas some years ago I was at my wits end with them and it went on for three or four years. I got very near to having surgery I was suffering so badly. If you're taking the PPI's already, if possible, I'd suggest you try some of the safer and easier alternatives (such as those above that I've found have helped me and apparently others too) rather than thinking PPI's are all you have left or possibly surgery further down the line. Many people get over GERD and reflux issues, or at least get them well under control without PPI's and such meds. I should think we'll never get rid of the problem totally and forever simply because the fault is a mechanical one within the digestive tract, but it's definitely possible to get it to a point where it's no longer a big issue if you're prepared to take a few logical and simple steps that also have no horrific side effects. And, if you're in luck, it may only need a few weeks to get it under control. Better to try than take more drugs anyway.
Than k you so much. This is brilliant. You have made me see that there is a light at the end of the tunnel by giving me such practical advice and for taking the time to do it. I am taking on the pramazole medicines, which I assume is a PPi. I will check this and come off it gradually. It is affecting the efficiency of my Parkinson meds so will be glad to do this. Thanks again.
I forgot to mention that some painkillers can also aggravate reflux problems, some are even thought to be a cause of reflux and GERD if taken over a long period of time. These are the family of NSAIDS (Nonsteroidal Anti-inflammatory Drugs) such as ibuprofen, naproxen, advil and even aspirin. Your doctor should have advised you never to take them once you've been diagnosed with GERD. Paracetomol is less effective for pain but won't do the damage that NSAIDS do. Check "NSAIDS and GERD" online and you'll see more detailed info on that.
Another couple of things that also help at times are chewing gum (sugar free) or, as already posted, mastic gum. They increase levels of saliva in your mouth which helps lubricate things further down.
Bending over, and working in that position will also move acid up towards your throat so do that as cautiously as you can for a while (I know, what else can you not do?) In general, you've just got to think about the mechanics of the problem and avoid doing anything that will make things worse.
Hi Court this may seem pretty simple but I've had great success with taking half a teaspoon of bicarbonate (get the one without aluminium in it) and mixing in a little fruit juice it goes all fizzy and makes you burp some I take it before a meal and I always squeeze lemon juice over my dinner or have water with lemon juice in it will settle your stomach pretty quick I've chosen not to take any meds instead I get success with this home remedy try it keep positive and I wish you all the best
Thank you to everyone who has posted in reply to my question on GERD. I am really surprised and delighted to get so many replies. I take Esomeprozone, but will come off it as I gather I should be able to control my symptoms in a more natural way.
I have another question. My mouth and especially my lips, are covered in ulcers. These burst frequently and are most unpleasant. I assumed they are linked to GERD and was hoping the Consultant would offer advice on how to get rid of them. But no such luck. If anyone suffers from ulcers, I would be grateful on ideas on how to get rid of them.
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