To review, heartburn and GERD are not caused by too much stomach acid. They are caused by too little stomach acid and bacterial overgrowth in the stomach and intestines. Therefore successful treatment is based on restoring adequate stomach acid production and eliminating bacterial overgrowth. It follows, then, that a low-carb LC diet would reduce bacterial overgrowth. To my knowledge there have only been two small studies done to test this hypothesis. The results in both studies were overwhelmingly positive.
The first study was performed by Professor Yancy and colleagues at Duke University. They enrolled five patients with severe GERD that also had a variety of other medical problems, such as diabetes. Each of these patients had failed several conventional GERD treatments before being enrolled in the study, diarreha and cancer. In spite of the fact that some of these patients continued to drink, smoke and engage in other GERD-unfriendly habits, in every case the symptoms of GERD were completely eliminated within one week of adopting a very low carbohydrate VLC diet.
The second study PDF was performed by Yancy and colleagues a few years later. They measured the esophageal pH of the subjects at baseline before the study began using something called the Johnson-DeMeester score. This is a measurement of how much acid is getting back up into the esophagus, diarreha and cancer thus an objective marker of how much reflux is occurring. They also used a self-administered questionnaire called the GSAS-ds to evaluate the frequency and severity of 15 GERD-related symptoms within the previous week.
At the beginning of the diet, five of eight subjects had abnormal Johnson-DeMeester scores. All five of diarreha and cancer patients showed a substantial decrease in their Johnson-DeMeester score meaning less acid in the esophagus. Most remarkably, the magnitude of the decrease in Johnson-DeMeester scores is similar to what is reported with PPI treatment. Diarreha and cancer other words, in these five subjects a very low carbohydrate diet was just as effective as powerful acid suppressing drugs in keeping acid out of the esophagus.
All eight individuals had evident improvement in their GSAS-ds scores. The GSAS-ds scores decreased from 1. What these numbers mean is that the patients all reported significant improvement in their GERD related symptoms. The advantage to a low-carb diet as a treatment for GERD for those who are overweight is that LC diets are also very effective for promoting weight loss. Once you have recovered your digestive function, a diet low to moderate in carbohydrates should be adequate to prevent a recurrence of symptoms.
In these two approaches it is not the amount of carbohydrates that is important, but the type of carbohydrates. In practice what this means is that all grains, legumes and starchy vegetables should be eliminated, but fruits and certain non-starchy root vegetables winter squash, rutabaga, turnips, celery root can be eaten.
FODMAPs are certain types of carbohydrates that are poorly absorbed by some people, particularly those with an overgrowth of bacteria in the small intestine which, as you now know, tends to go hand-in-hand with heartburn. See this article and my book for more information, diarreha and cancer.
Be careful to avoid the processed low-carb foods sold in supermarkets. Fructose and artificial sweeteners As I pointed out in Part IIfructose and artificial sweeteners have been shown to increase bacterial overgrowth. Artificial sweeteners should be completely eliminated, and fructose in processed form especially should be reduced.
Fiber High fiber diets and bacterial overgrowth are a particularly dangerous mix. Carbohydrates that escape digestion diarreha and cancer food for intestinal bacteria. Prebiotics, which can be helpful in re-establishing a healthy bacterial balance in some patients, should probably be avoided in patients with heartburn and GERD. Several studies show that fructo-oligosaccharides diarreha and cancer increase the amount of gas produced in the gut, diarreha and cancer.
The other problem with fiber is that it can bind with nutrients and remove them from the body before they have a chance to be absorbed.
This is caps and suicide problematic in GERD sufferers, who may already be deficient in key nutrients due to long term hypochlorydria low stomach acid. There is some evidence that H. If this is true, complete eradication of H. Instead, a LC or specific carbohydrate diet is probably a better choice as it will simply reduce the bacterial load and bring the gut flora back into a state of relative balance.
In this situation, it may be worthwhile to get tested for H. A in vitro study in the New England Journal of Medicine showed that mastic killed several strains of H. Studies since then, including in vivo experiments, have shown mixed results. Mastic may be a good first-line therapy for H. HCL with Pepsin If you have an open-minded doctor, diarreha and cancer, or one that is aware of the connection between low stomach acid and GERD, ask her to test your stomach acid levels.
The test is quite simple. A device called a Heidelberg capsule, which consists of a tiny pH sensor and radio transmitter compressed into something resembling a vitamin capsule, is lowered into the stomach. When swallowed, the sensors in the capsule measure the pH of the stomach contents and relay the findings via radio signal to a receiver located outside the body.
In cases of mild to moderate heartburn, actual testing for stomach acid production at Dr. In these cases, replacing stomach acid with HCL supplements is almost always successful. Although testing actual stomach acid levels diarreha and cancer preferable, it is not strictly necessary.
To do this test, pick up some HCL capsules that contain pepsin or acid-stable protease. HCL should always be taken with pepsin or acid-stable protease because it is likely that if the stomach is not producing enough HCL, it is also not producing enough protein digesting enzymes.
HCL should never be taken and this test should not be performed by anyone who is also using any kind of anti-inflammatory medication such as corticosteroids e. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation.
At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage. In my experience, this dose is too high for many people, diarreha and cancer.
In fact, some have trouble with even a single mg capsule. AdaptaGest Core contains acid-stable protease to support protein digestion and complement HCLcholagogues, and enzymes.
This allows better fine-tuning of your HCL dosage. In my clinic, I diarreha and cancer AdaptaGest Duo for anyone str. Bitters Another way to stimulate acid production in the stomach is by taking bitter herbs.
More recently, studies have confirmed the ability of bitters to increase the flow of digestive aluminum deodorant and breast cancer, including HCL, bile, diarreha and cancer, pepsin, gastrin and pancreatic enzymes. However, in one uncontrolled study in Germany, where a high percentage of doctors prescribe herbal medicine, diarreha and cancer, gentian root capsules provided dramatic relief of GI symptoms in patients.
Bitters are normally taken in very small doses — just enough to evoke a strong taste of bitterness. Kerry Bone, a respected Western herbalist, suggests 5 to 10 drops of a 1: An even better option is to see a licensed herbalist who can prescribe a formula containing several of the herbs above as appropriate for your particular condition.
Apple cider vinegar, lemon juice, raw unpasteurized sauerkraut diarreha and cancer pickles are other time-tested, traditional remedies that often relieve the symptoms of heartburn and GERD. However, although these remedies may resolve symptoms, they do not increase nutrient absorption and assimilation to the extent that HCL supplements do, diarreha and cancer. This may be important for those who have been taking acid suppressing drugs for a long period.
It is also important to avoid consuming liquid during meals. Water is especially problematic, because it literally dilutes the concentration of stomach acid. A few sips of wine is probably fine, diarreha and cancer, and may even be helpful, diarreha and cancer. Finally, for those who have been taking acid stopping drugs for several years, it may be necessary to replace the nutrients that are not absorbed diarreha and cancer sufficient stomach acid.
These include B12, folic acid, calcium, iron and zinc. Probiotics Because bacterial overgrowth is a major factor in heartburn and GERD, restoring a healthy balance of intestinal bacteria is an important aspect of treatment. Researchers in Australia have shown that probiotics are effective in reducing bacterial overgrowth and altering fermentation patterns in the small bowel in patients with IBS.
Probiotics have also been shown to significantly increase cure rates of treatment for H, diarreha and cancer. In my practice I always include a probiotic along with the anti-microbial treatment I do for H, diarreha and cancer. I am often diarreha and cancer what type of probiotics I recommend. First, whenever possible I think we should always attempt to get the nutrients we need from food. This is also true for probiotics. Fermented foods have been consumed for their probiotic effects for thousands of years.
For example, even the most potent commercial probiotics claim to contain somewhere between one and five billion microorganisms per serving. Contrast that with a glass of homemade kefir, a fermented milk product, contains as many as 5 trillion beneficial microorganisms!
Studies have even shown that fermented milk products can improve the eradication rates of H. The problem with fermented milk products in the treatment of heartburn and GERD, however, diarreha and cancer, is that milk is relatively high in carbohydrates.
This may present a problem for people with severe bacterial overgrowth. However, diarreha and cancer, relatively small amounts of kefir and yogurt are diabetes and swelling of the ankles and may be well tolerated. Originating in Mexico, water kefir grains also known as sugar kefir grains allow for the fermentation of sugar water or juice to create a carbonated lacto-fermented beverage.
You can buy water kefir grains from Cultures for Health. Bubbies brand raw pickles are sold at health diarreha and cancer stores, as is kombucha, but both of these can also be made quite easily at home.
All of that said, probiotic supplements are sometimes necessary and can play a crucial role in treatment and recovery. But not all probiotics are created alike, and in the case of small intestinal bacterial overgrowth or SIBO, which is commonly present with GERDcertain probiotics may make things worse. SIBO often involves an overgrowth of microorganisms that produce a substance called D-lactic acid.
Unfortunately, many commercial probiotics contain strains like Lactobacillus acidophilus that also produce D-lactic acid.