Happy Tummy: Found and Lost (or, Remembering to Slow Down)

Storefront, Metro Drugs (Upper East Side, NYC)

Something has happened over the past few months to re-ignite my GERD symptoms:  the clenched throat, nausea, fullness and regurgitation episodes.   Since I've mostly had this under control the past year (!) this is surprising and frustrating.  "Oh no, not AGAIN."  

Why?

• Have I been eating too fast lately?   (Yes.  For some reason, I'm inhaling my meals.)
• Eating too late? (Definitely.  Late hours at work.)
• Eating too much?  (Calorically, I think I'm okay, but I do think I'm eating too much bulk-wise.  Because I'm eating too quickly.)
• Eating too much chocolate?  (Most likely.)
• Not enough Tai Chi or breathing exercises?  (Blame the hectic work schedule and falling out of the habit.  I've recently returned to this wonderful stress reliever.)
• Too much black tea?  (I bought some high quality Darjeeling and other black tea, which I've been enjoying alongside the usual oolongs and puehr -- have I overestimated my ability to easily tolerate this again?)  
• Not enough vegetables lately?  (My hectic schedule the past 4-5 months has definitely impacted my capability and desire for home-cooking, especially my greenmarket produce.)
• Not enough sleep?  (If I'm being honest, yes.  See all of the above.)
• A compromised immune system (Due to not enough vegetables or sleep?  I just got over a 2-week cold -- my first in years.)   
• Too stressed out (leading to a compromised immune system, leading to the return of my GERD/gastroparesis) (See above, again, most likely yes yes yes?!!??!)

Sigh! 

Just around this time, I noticed this elaborate chalk drawing in a storefront in Manhattan promoting probiotics for a "happy tummy."  

Maybe I'm easily impressionable, but this drawing reminded me to take a step back -- take ten steps back -- and BREATHE and put my body first.   More and more studies are showing the strong connection between gut health and overall health, especially the immune system.  (I have some new links to share, stay tuned, future post!)

RESOURCE:  2016 GUT MICROBIOTA FOR HEALTH WORLD CONGRESS  

I was excited to come across a link for the Gut Microbiota for Health World Congress meeting taking place March 5-6, 2016 in Miami, Florida with panels such as Gut Microbiota as Therapeutics, Life Events that Alter Gut Microbiota, and other timely titles.   See the whole program here.

The meeting site includes a link to this excellent academic site for gut microbiome news:

• Gut Microbiota for Health: Public Information Service from European Society of Neurogastroenterology and Motility

Report From My Gut: Let's Talk Motility!

This blog entry is not for the faint of heart!

Time to talk "motility."   For people with GERD, gastroparesis, and other GI conditions, "not going" is not just uncomfortable -- it's a crisis.   One "slow" day can easily spiral into a few days, making my already challenged intestines and slow stomach even more cranky.   And, I have found that when I am constipated, nausea often follows.

This morning, I am on day three of feeling not my best.  

I do all the advised things.  I've done most of these in the last 24 hours:

• Eat plenty of vegetables and fruits (Veggie diet -- check!)
• Eat more fiber (that's ALL I seem to eat some days…)
• Take probiotics (done -- in the form of pickles and Puehr tea…)
• Exercise (stair-climbing daily, a few big walks each week, Tai Chi, stationary bike…)
• Drink more liquids (water, non-caffeinated tea, caffeinated tea, more water)
• Relax (trying!!  trying!!  trying!! but easier said than done when the clock is ticking and I need to leave the house for work -- bloated, again!)

Now it's less than 40 minutes to my departure time and I need to shower, get dressed, pack my lunch, and head out -- but who wants to schlep to work feeling like you've got an extra 29 pounds in your gut?  Gassy.  Crampy.  Psychologically bloated.   I don't like using public restrooms (who does?) and with "gut issues" it's just better dealing with things at home, trust me.

So, this remains an ongoing issue for me.  For months, I had somehow settled into a routine and constipation was occasional.  It is upsetting to be back in this situation, worrying where and when my next bowel movement will be!   If I "take too long" in the morning, that can prevent me from meeting my exercise goals -- a 45 minute walk before work, or my Tai Chi class.   It's a daily struggle.

One comfort:  If you are reading this and experience the same issues, you are not alone.  Constipation is one of the most common concerns, and one of the least discussed.  It may not be "life threatening" but it is definitely life-impacting.


WHAT OTHERS ARE SAYING -- LINKAGE 

A few interesting and helpful online resources:

Silent Struggles: The Ugly Truth about Gastroparesis and Constipation

Gastroparesis FAQ:  Constipation Causes & Remedies.  Video from Living With Gastroparesis blogger Crystal Saltrelli, Certified Health and Nutrition Counselor

Excellent graphics and information are included in this Constipation Fact Sheet by the Bladder and Bowel Foundation 

Australian Government Initiative: Looking After Your Bowel -- A Guide to Improving Bowel Function.  A whole government-issued document on the subject!  More good graphics here.

Report from my Gut: Getting GERD Flare-Up Under Control with a Counterattack!

Did too many tomatoes do it?

What happened??!

The past few weeks, all of a sudden, my GERD symptoms rallied and returned, five-fold.  This, after months of feeling much better, no "clenched throat," no reflux episodes, little or no nausea, even my constipation had been resolved for the most part.   Now, constipation has returned.  Bloating, nausea, consecutive days of acid reflux shooting up my esophagus, rare for me even in my GERD flare-ups -- a daily occurrence.  

What caused all of this?  I'm still trying to figure it out.  Too many tomatoes?  Exceptionally stressful (good and bad stress) weeks?  A few constipated days too many?

After a week of chewing on TUMS and feeling miserable and demoralized, I had to take action.  Several days into my "GERD Flare Up Counterattack," I am getting back on track, and the symptoms are subsiding.

Here's the strategy I used to get myself back on track:

• Eliminated my daily caffeinated tea and chocolate intake for a few days, choosing to drink chamomile-lavender and chamomile-vanilla, or lemon verbena, herbal teas.   When I resumed caffeinated tea, I selected pu-ehr and dark oolongs.
• Mindful eating, focusing on GERD-friendly foods (I tend to do this as a matter of course, but made a particularly strong effort to focus on stomach-friendly ingredients): lentils, sweet potato, kale, chard, pasta.  I also re-incorporated greenmarket (pastured) eggs as meals, having hard-boiled eggs and sauteed kale for breakfast and a scrambled egg for dinner.   For lunches, I brought soup or an Amy's frozen meal. I tried to eat slower and smaller meals, noticing I'd been lapsing about this.  
• Avoided tomatoes/tomato-based meals.  Was this the trigger for my reflux spell?  I bought two pints of sweet cherry tomatoes at the greenmarket -- the first of the season!! -- and gobbled them down, on their own, and in a salad.  I also had been increasing my tomato sauce intake, with more veg lasagnas and other dishes.  Usually, I'm lucky and can eat tomatoes without concern.  But maybe this was a case of too many, too soon, too fast.  I've also been eating a lot of strawberries, and tried honey with bee pollen -- a tiny taste that triggered an oral allergic reaction for 15 minutes.
• JUST SAY NO policy at work.   I refused birthday cupcakes, leftover pizza, free chocolate, and other office treats.   (Frankly, I should maintain this policy, which is, overall, the best way to manage my GERD, diet, health.)
• Tums.  Lots of Extra Strength TUMS.  I admit, they helped and I was determined to keep reflux away while I adjusted diet and other factors.
• Engaged in "self talk," trying to calm my mind and coach my body into relaxing, feeling better, getting back in control.  Reminding myself "the nausea will pass" and just don't worry about the constipation, this will resolve as well.  

Slowly but surely, returning to "my normal."

GERD Update: Follow Up Visit with my Gastroenterologist

What a busy January!  I can finally sit and write a "gut update."

Since October, I've noticed an increase in bloating, nausea, constipation, and unusual motility issues (stomach pain, diarrhea, and one case of greasy stools -- whoa).   I also lost five pounds, probably due to increased exercise (Hurricane Sandy caused my commute to involve massive miles of walking when the subways were down) and diet changes, but this concerned me as a "symptom."  What if there is another, more serious, reason?   I decided a follow up visit to Dr. C., my gastroenterologist, was warranted, and met with him before the holidays in December.

We discussed my symptoms, looked at my blood panel (normal), and Dr. C. reconfirmed his thought that I have a sensitive gut, that my pathology is caused by stress.   For the first time, he mentioned the possibility of my having Irritable Bowel Syndrome.   (See the National Digestive Diseases Clearinghouse's good intro to IBS.)

We also talked about constipation as a cause of many of my symptoms, including the nausea  (I agree -- I have definitely noticed a link between the two in my experience) and "stress" is still a prime suspect in triggering the whole cycle.  (I agree with this as well.)   Dr. C. notes I could also be suffering from the horrible sounding condition,"fecal retention" -- my brain/muscles become conditioned to "holding it in" for whatever reason, and this becomes a bad habit, translating into chronic constipation or the equally hideous term, "incomplete voiding."  It's especially irritating because my diet is very high in fiber -- I shouldn't have this problem!

At some point soon, I am supposed to schedule my first colonoscopy.   (For a good "first time" story, see CNN correspondent Lisa O'Neill's account.)  I'm fascinated by the thought of seeing my guts -- but the process upsets me -- ingesting that substance, spending 24 hours "prepping" for the procedure, getting to the doctor after 24 hours of fasting and exuding.  And the colonoscopy itself is a little scary and overwhelming, let's face it.  In Lisa's account, Dr. Anthony Kalloo at Johns Hopkins admits "It's a potentially embarrassing procedure. It's not like an eye exam in terms of personal exposure."  But wondering if "anything else" is going on aside from IBS and bile reflux makes me want to bear it.  I'll be less stressed after a good diagnosis.  (And if the results are not good -- then we can tackle something specific, right?)

MOTILITY ON THE CLOCK

Let's talk motility.  I know I am having major timing issues.   In the morning, I exercise, eat breakfast, shower, get dressed, and head to the subway to get to work.   I'm supposed to fit in my bathroom hygiene in there somewhere.  As the clock ticks, I get more and more anxious -- "I need to use the bathroom" vs "But I have to get ready to leave!" -- and I can literally feel my bowels stop and contract.  "Time's up!!"  I have not mastered the art of using public bathrooms for complex tasks, so the anticipation of feeling bloated and full all day creates additional stress.   My mornings and days escalate into panic mode.   I become fixated on "using the bathroom."  What a cycle!

Ideally, I'd just remedy anything in the evening, but the timing issue returns.    The best plan for managing reflux involves cooking my own food, and eating early.  I don't get home until around 6:15 or 6:30 PM due to my commute, so I need to get into the kitchen right away.  Once again, rushing around means no attention to my bowels.

There are solutions:

• I could eat out or get take out, but that compromises my nutrition -- restaurant food is (almost) always going to be more fatty, too meat-centric, more salty, more spicy, and overall not-as-healthy as home cooking.  
• What about places that are healthy?  There is the Whole Foods salad bar fare, but how many gigante beans and macrobiotic dumplings can one eat?  (If I lived above Angelica Kitchen or Souen, I might have a different point of view.)  I suppose I can explore this more. 
• Bring prepared food home.  A variation on eating out -- I could pick up brown rice from the Whole Foods hot bar and mix it at home with greens.  (But this seems silly to me -- why not just there, why bother half-cooking?)
• Cooking in batches.   I usually make a few dishes at once on Sunday so the first few day of the week are less hectic.  I make pots of beans and freeze them, cook up soups, bake casseroles, and make my own "frozen lunches."  
• Take Miralax or a similar "gentle" medication.  I don't like this idea.  This addresses the symptom but is, in my mind, a temporary solution.   I need to address the cause.  I'm not going to rely on medication every day.
• "Retrain" my schedule to a later hour -- see if my bathroom hygiene can take place post-dinner.

It's all easier written/said than done.  Freshly prepared food is just so much BETTER.    Isn't it?   I love to cook, even if I'm a little bit tired.  It's de-stressing, creative, and the results are usually worth it.   And after a long day, the whole bowel issue is tiresome - I just want to relax, not worry about my body again!

The Plan for now:  book the colonoscopy, try to relax about the whole "going to the bathroom" issue and make time/experiment with new timing, and continue to eat well and mindfully.

MORE MOTILITY READING

• Merck Manual, Irritable Bowel Syndrome
• In Potholes in Your Colon, Dr. Chutkan talks about diverticulitis and how that can affect bowel movements.
• Read a recent peer-reviewed article on the subject:  Leung, Riutta, Kotecha and Rosser, Chronic Constipation: An Evidence-Based Review.   J Am Board Fam Med July-August 2011, vol. 24 no. 4, pp.436-451.  
• The Bristol Stool Chart
• WebMD's The Scoop on Poop

Detox Recipe for the New Year: Carrot, Fingerling Potato and Parsley Soup

Carrot, fingerling potato, and parsley soup

Happy New Year!   I took a few weeks away from my blog to immerse myself in the Christmas season, with all its busy-ness, festive obligations, and visits with family and friends.    

THE HOLIDAYS AND MY CRANKY GUTS: SHORT UPDATE

Like many people, I veered away from my usual diet during the holidays -- more cheese/dairy, more sweets, less locally sourced foods, more food overall -- and had a few moments of extreme nausea and bloating, and constipation followed me into the new year.  I'm still experiencing occasional vomiting episodes -- scary! -- that seem to be related to eating too much, or eating too late.   I have to be vigilant about this.    I've not yet scheduled my first colonoscopy -- suggested by Dr. C. even though I'm not quite at the "colonoscopy age" yet, just to be sure nothing concerning is going on.  We're both convinced most of my issues are related to "stress" but if there is a pathological reason, we need to address it.   I'll deal with scheduling something after mid-January, when work deadlines subside; right now, it is a madhouse (which of course is probably contributing to my cranky guts - the circle continues!).

Soup underway!

BACK ON TRACK:  CARROT, FINGERLING, AND PARSLEY SOUP

After Christmas, I was eager to get back to cooking, and the greenmarkets.  I regularly shop at two greenmarkets that are open year round.  I'm fascinated by cold weather produce, and the challenge of cooking seasonally.  There's the occasional bag of frozen spinach and imported citrus, but mostly we rely on the winter root cellar: carrots, potatoes, turnips, apples, pears, and the rest of winter's pragmatic tubers and other produce.    Craving lots of vegetables and something easy to digest, I came up with this  tasty, GERD-friendly, nourishing blended soup (one of my New Year's Resolutions -- to use my immersible blender more often!).  I had this four four days in a row -- a great "detoxing" start to 2013!

Ingredients:

Sourced from your local greenmarket or farm

4 large cloves garlic (if you have small cloves, use more), pressed or finely chopped 

1 small onion, chopped 

4 medium to large carrots, sliced and chopped 

5-6 fingerling potatoes, quartered 

1 generous handful fresh parsley, chopped 

Olive oil

Water

1. Heat olive oil in soup pot and add garlic.  Cook over low heat until fragrant and softened.
2. Add onion.  Cook until softened.
3. Stir in carrots.  Cover with lid and cook until just softened.  Stir to prevent sticking/burning.
4. Add water to cover vegetables by about one inch.  Add potatoes and a few tablespoons of parsley.
5. Bring to boil and then simmer, uncovered, until vegetables are soft.
6. Add remaining parsley and cook for a few minutes.  Using immersible blender, blend until desired consistency.
7. Before serving, sprinkle with a few parsley leaves.

Variations:  I'm going to try this recipe again, varying it with celeriac, sunchokes, and other roots, or different potatoes (though the fingerlings are just divine in a soup).   A version of this with acorn or butternut squash might work.  I think turnips or parsnips might be too harsh for the flavor I'm trying to achieve here, and I may omit the onion next time.   I'm always interested in adding apples to savory dishes, and wonder how they would go here? 

Storage:  I divided the soup into portions for two and for one using my new Pyrex storage containers (yay, Santa!).  I did not freeze these, wanting to keep the mellow flavor away from any freezer burn.   

Cooling on the window ledge.

Report From My Gut: Action Plan - Operation De-Stress!

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.  

My concerns:  

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.)

My counter-plan:

1. 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.
2. 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?!)
3. 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.
4. 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…)
5. 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. 

Onward!

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.

The Mayo Clinic's bile reflux page

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.

Report From My Gut: One Year Follow-Up Today!

Today, I am visiting Dr. C. for a follow up!  It's been just over a year since my upper endoscopy and GERD diagnosis.   I am excited to share thoughts about where I am now, and see what Dr. C. suggests for the things still affecting my gut.   Since last year, I've been on three different reflux medications, journaled a few food diaries (and began this blog!), experimented with diet modifications, and have gained much awareness of my gut.  

I no longer get nausea as much as I used to, and I rarely have cases of sleep apnea (though last night, I had a horrible episode, the first one in months).  I almost can convince myself that "wet chest feeling" is subsiding.  I have not had regurgitation or that classic "burning heartburn" in months.

BUT -- I still have a catalogue of symptoms daily.  Every so often, I get startled when I notice I am feeling entirely "normal" with no GERD sensations at all.   The fact this is so rare means I am far from solving how to manage my gut.   Here's what I plan to discuss with my doctor today.


ONGOING GERD SYMPTOMS AND STRATEGIES:

• Wet chest feeling/food stuck in throat feeling:  These are chronic, pretty much 24/7 sensations.   Some days are more pronounced than others, and sometimes I do feel completely free of them, but that does not last long.  (The moment I recognize it's gone, it comes right back.)   When the wet feeling/FIT is gone, this usually coincides with my feeling extremely relaxed or during/after an extremely GERD-friendly meal (small portion, slow eating, easy to digest).

• Belching:  I have not been tracking my belching, but I notice this can occur at any time. I am often belching during and after meals, particularly when I eat fast, too much, or too rich foods.    I also am prone to belching when I wake up.  These are all big airy burps with no regurgitation.

• Nausea/fullness/reflux:   Over the past months, my nausea moments have greatly reduced.  I can hardly recall my last episode.  More often, I experience "fullness" after eating, and not a burning but a "gnawing wet feeling" in my stomach-esophagus.   I think I am becoming better at identifying the source of discomfort (not the referred area).    What can/should I do about these symptoms?   

• TUMS:  I resisted relying on the Tums for symptom relief, but caved in and now use Tums 3-4 x a week, sometimes more, sometimes less.  One Tums provides immediate relief of reflux and nausea.  I'll ask Dr. C. if this is an adequate response, or if I should experiment with prescription meds again.   My thought is I should be stopping the symptoms before they even begin -- by the time I take a Tums, isn't the damage already done?   

• Constipation:  I'll also share an update from my intestines.   I've improved my efforts to keep "regular" and am generally pleased with my lower guts; however, it's a daily challenge and when it doesn't work out, I am anxious, stressed out (because I'm usually running late on top of it, because of it), and uncomfortable.  The correlation between my GERD and constipation is definite -- so when things aren't moving along, everything is a wreck!

A full accounting of my visit will be posted...

Report From My Gut: Stuffed Sinuses and GERD?

Carousel, Cape Cod Mall

Since Saturday, I've been experiencing stuffy sinuses.  It's worse in the morning when I wake up, and I've had the that spongy feeling and intermittent headaches.   It's disappointing, because I have been doing well with controlling my GERD issues.  A quick summary:

For some reason these past weeks, I don't feel as "stressed out" and my GERD seems to be quieting down -- not as much belching, food in throat sensations, and no reflux or apnea.

A long weekend out of the city was relaxing and restorative (and I successfully managed to keep my GERD symptoms in check by eating small portions and eating slowly, even with a few decadent meals and desserts).   I have been keeping up with a daily routine during the workweek by climbing six stories of stairs each morning and on my lunch break -- it is not always easy but I always feel fabulous once done.   I am drinking more tea than usual.   The annual Coffee and Tea Festival takes place in a few weeks, so I thought I'd "prep" by weeding out some of my tea collection by drinking it up, and also get my body ready for more caffeine than usual.  (Crazy but true.  Or, any excuse to drink more tea?)   I've been drinking a lot of Oolong and green teas, including Harney & Son's spectacular Lung Ching.

So, to have to deal with this "sinus" issue is annoying.  It seems like once one body part or condition is mended, another one declines.  (Let's not talk about my new reading glasses, left hip, and chipped tooth.)

Indeed:

A quick search online confirms sinus infections, post-nasal drip, and even pneumonia can be side effects of GERD. 

As usual with so many GERD concerns, it's challenging to find "authoritative" sources about this*, but here is an American Journal of Gastroenterology article about a clinical trial by University of Nebraska researchers exploring GERD and sinusitis.

An e-zine article talks about the connection between mucous production to combat acid reflux and clogged sinuses.

Here's Steve's patient story about the "viscious cycle" of GERD and chronic sinusitis (with some IBS thrown in).

Livestrong addresses the connection between GERD and sinus problems, as well.

*I find most of the GERD lore that is online is generated by lay sources.  But maybe that's because GERD sufferers have such a vested interest in ridding themselves of their symptoms/causes.  And, I find doctor recommendations usually involve some kind of drug regimen, so those of us who would like to find a non-drug remedy need to stay creative and open-minded about what works, and in tune with our own bodies.