|Flower in NYC park -- how can you be stressed out looking at this?|
As promised, here is a summary of my follow up with Dr. C. This report is well overdue, but it's been a busy few days!
We talked about the past months and what has worked for me, and what are still issues. Dr. C. wonders if I am experiencing bile reflux, not acid reflux, based on my symptoms and my experience with acid medicine last year, which did not work. He seemed concerned about my ongoing "food stuck in throat" feeling and chronic sensation of wetness in my chest, as well as fullness after eating and overall sensitivity to an unhappy gut.
As for belching, Dr. C. thinks this is due to the high fiber content of my diet -- it's just another form of "gas."
BILE BINDING -- THE SOLUTION?
I emphasized while my symptoms aren't pleasant, I can certainly "live with" them, but I was most concerned about long-term effects and risks (i.e. Barrett's esophagus). Dr. C. agreed my symptoms are something to watch, and try to get under control for long-term health. So, we talked more about bile reflux, and trying medicine which "binds" to the bile, suppressing the reflux action. He prescribed for me a bile acid sequestrant -- specifically, cholestyramine. I am still processing information about this drug, but so far, I am not thrilled to take this and have not yet picked up my prescription.
It affects liver function and is often prescribed for high cholesterol. I don't have any concerns with cholesterol, and would hate to mess around with something already functioning well. Who knows what this med would do?
I also don't like the side effect of the med "binding" to everything -- other medications, nutrients -- it is contraindicated for people with vitamin deficiencies. My recent annual blood test indicates some low calcium/Vitamin D and with my vegetarian/near-vegan diet, getting my B vitamins is a concern, too. I don't want to compromise nutrition because of this drug. Bile acid sequestrants also have a side effect of constipation -- and we know that is not an issue I need to complicate!
I asked Dr. C. how long he thinks I would need to be on a bile-binder regimen, and he suggested if it works, until I moved out of NYC. He thinks -- and I agree -- it is the stress of living in New York City that is triggering my GERD/bile/acid reflux. (We briefly talked about my age, and how this might be a factor as well -- I am pre-menopausal.)
MY COUNTER-PLAN: OPERATION DE-STRESS
So, after considering the medicine option, I am deciding to give a non-medication route another try. I have successfully minimized some symptoms with mindful eating. Why not give mindful de-stressing another attempt? I'd rather tackle the cause than the effects for long-term relief. I have also looked into natural medicine approaches, and discovered chamomile tea is an alternative medicine remedy for bile reflux. I am going to see how a non-drug regimen works; if things don't improve in several weeks, I can rethink the cholestyramine. (Dr. C. says I have very minimal damage according to the upper endoscopy we did, and suggested there is time to figure out a treatment -- there will not be more substantial damage "overnight," so I feel confident that I can give my body time to find a way to heal.)
- Get out of New York City more often via day-trips and overnight mini-vacations. I should leave the city at least once a month.
- Get into nature more via the parks that are all around me. One thing about NYC -- the city respects its residents' need for greenery. From Central Park to the "Greenstreets" program, there is no shortage of trees and grassy areas to recharge. I aim to take more advantage of the wonderful park opposite my apartment building. (How easy is that?!)
- Continue exercising, including the stationary bike. Since February, I've been climbing six stories in my work building twice a day, and I've noticed it's an excellent de-stressor. I am committing myself more fully to doing my core workout (necessary for a hip/back issue) and stepping up my time/effort in Tai Chi.
- Natural reflux remedies/bile sequestrants such as chamomile tea and licorice. (Slippery elm and marshmallow are also noted to be bile reflux remedies, but I need to read more about this more potent herbals…)
- Self-talk/self-hypnosis. The other day in the shower, I meditated on my body, and "told" myself to just pull myself together. My job, activities and overall life is good! Stop being so stressed out! Relax, body! NYC is fantastic! And so on, in a mantra kind of way. It helped. I did self-talk again later in the day during a GERD episode, imagining my body healing and sphincters returning to normal, imagining my pink stomach and guts working together, peacefully. Moments later, my symptoms had subsided. Self-talk can't hurt -- it's something to explore.
BILE REFLUX LINKS
When Your Stomach Hates You: Living With Bile Reflux Disease is a fantastic first-person account of BRD by DragonLady. The comments are a good follow up discussion, too.
And then check out When Your Stomach Hates You, Part 2. I love her attitude -- you are in charge of your health!
A thorough resource is the excellent Bile Reflux Disease Support Group -- a web space for discussion, information, stories.
And the Mayo Clinic's article, Distinguishing Between Bile Reflux and Acid Reflux Can be Difficult
CNN's Health Library entry for bile reflux. Mentions alternative medicine therapies.