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

Digestion Does Not Begin In Your Mouth: Your Brain on Hand Food

Potato-garlic pierogis and spinach.  Applesauce on the side.

I wouldn't call pierogis "hand food."  (Pierogis, if you don't live in parts of Brooklyn or Buffalo or another Polish community, are dumplings filled with mashed potato, or potato plus another ingredient -- common fillings include spinach, mushroom, meat, or, as Veselka has mastered, sweet potato).   They're eaten with forks, slathered in applesauce, sour cream, and/or sauteed onions.   Still, when I cook up a portion, I can't resist eating part of one with my fingers.  It just tastes better.

I'm like that with other non-finger foods, as well.  Roasted potatoes.  Brown rice.   Beans.   Lasagna.   Broccoli.  Most of this is done while cooking just for a taste but sometimes after the meal, too, while putting leftovers away.  And I've been known to outright "eat with my fingers" at my desk at work when no one is looking. :)

I am convinced food really does taste better "from hand" to mouth.  One of my theories is that the food gets closer to your nose, thereby ramping up the eating experience.

Not quite, but almost.   I discovered (after looking into this -- surely I couldn't be the only person willing to admit I'm an enthusiastic hand-eater) scientists are finding a connection between how you eat -- with your hands or with a utensil -- and how the brain responds.   Indeed: the act of picking food up with your fingers triggers a response to the brain and your guts -- your second brain -- to get ready for digestive action.   It's a more "whole body" experience that encourages mindfulness while eating -- you are really engaging with your meal.

Gastro Note:  I've found pierogis are a favorite "easy to digest" food of mine.   When my guts are churning, if I have nausea or other gastro issues, I can always tolerate and enjoy pierogis.  Sometimes it gets crazy -- I've had weeks where I've wanted nothing but pierogis for three days in a row!  (They are insanely delicious, especially in my neighborhood, where they are made fresh just down the street.  The "pierogi factory" -- really! -- makes a few varieties but my favorite is garlic and potato, which are also vegan.  Yeah!)  I eat mine with applesauce -- double points if I've made my own applesauce that week!


SOME LINKAGE ON THE SUBJECT...

NPR's The Salt:  Is Everything More Delicious When You Eat With Your Hands?

Express Tribune:  5 Reasons Why You Should Eat With Your Hands

HinduismToday:  The Ways and Joys of Eating With Your Hands

HinduHumanRights: Vedic Wisdom Behind Eating With Your Hands

Organic Olivia:  How Eating with Chopsticks Massages Your Organs and Stimulates Digestion  An interesting related article...

NY Times:  Mind Your Manners:  Eat With Your Hands

SFGate: A New, Old Restaurant Trend: Eating With Your Hands

Linkage: Mind Over Stomach (and Everything Else)

I heard a story this morning on NPR about how putting different labels on the same milkshake caused different physiological reactions in test subjects' stomach responses.  Fascinating stuff.  See below for the link.

How much of our body's response to food is in "our minds?"   And, if there is a placebo effect, is this a bad thing?  How can we leverage this unreality to our benefit?   I say if it's "just" the placebo effect, well, great!  Feeling better and improving your health without medication side effects -- absolutely!  

But -- as you know if you're suffering gut issues, the stomach IS a second brain -- will this make the expression, "it's all in your mind" even more frustrating when there is scientific evidence to back this up?

LINKAGE:

Mind over Milkshake: How Your Thoughts Fool Your Stomach (From NPR, 4/14/2014)

Placebo Effect in the Treatment of Duodenal Ulcer (British Journal of Clinical Pharmacology, 12/1999)

The Placebo Effect Even Works for Sleep (Salon, 2/2014)

Radiolab: Guts (Season 10, Episode 7)

"Second Brain" Found in Stomach, Intestines, Colon (HeatherDane)

Gut Bacteria Might Guide the Workings of Our Minds (NPR, 11/2013)

Nortriptyline No Better Than Placebo for Gastroparesis Symptoms (American College of Surgeons News, 5/2013)

Homeopathy is Bunk, Study Says (The Guardian, 4/2014)

Placebo Effects Are Not the "Power of Positive Thinking" (Science Based Medicine, 1/2014)

Linkage: More Gut Flora in the News

A few months ago, I posted about the increasing awareness of how the microbiome impacts one's gastrointestinal, and overall, health.   Since then, I've been on the hunt for more microbiome information, and get giddy when I come across new resources.   A few of the recent finds:

• The other morning, I heard a segment on NPR about the American Gut Project and new privacy issues it raises.
• The American Gut Project website.  (Though I'm skeptical about any scientific project that doesn't seem to know the difference between "it's" and "its."  Do I really trust these folks?)
• From NPR: From Birth, Our Microbes Become As Personal As a Fingerprint. 
• Do Your Gut Bacteria Influence Your Metabolism?   Yet another NPR story.   NPR seems to love this topic as much as I do!
• Short article from Time online: You Are Your Gut Bacteria:  How the Microbiome Influences Health
• From NPR's health news: How A Change in Gut Microbes Can Affect Weight.  

Linkage: Gut Bacteria and Gut Health

Another fascinating study of our microbiome was released today by researchers at Washington University School of Medicine.   Apparently, a sample of women's guts over five years showed little change -- indicating our gut microbiome is relatively stable (or stagnant?) over time, and suggesting our guts may carry bacteria from childhood.  Whew!  (For more information, visit Dr. Jeffrey Gordon's Lab Page.)  

I need to explore the microbiome studies more on Cranky Gerd.  I am getting obsessed with this topic and its implications!   Here are a few links to get us going.  I am still comprehending the fact that the human body's bacteria grossly outnumbers our human cells by the millions trillions.  

LINKAGE

NPR All Things Considered, July 4, 2013, Gut Bacteria We Pick Up As Kids Stick With Us For Decades

May 2013, UCLA Newsroom: Changing Gut Bacteria Through Diet Affects Brain Function

An article on the topic in the August 2012 Nutrition Action Newsletter, Living in a Microbial World

US News, September 2012, discusses study: Changes in Intestinal Bacteria Linked to Type 2 Diabetes

Homepage of the National Institutes of Health, Human Microbiome Project

New York Times, May 15, 2013, Some of My Best Friends are Germs, by Michael Pollan

The New Yorker, April 17, 2013, A Roller Derby of Bacteria

Microbiome, a scientific open-access journal

Probiotics, Prebiotics, and the Host Microbiome: The Science of Translation, a June 2013 webinar hosted by the New York Academy of Sciences (the webinar itself is not online but there is a wealth of abstracts, names and references here)

June 2013 Medscape video featuring microbiome researcher Dr. Scott Peterson talking about "The Microbiome: Linking Bacteria, Health, and Disease"

Nature: Human Microbiota special issue

Added 7/12/13:

New York Times, July 6, 2013, Why I Donated My Stool by Marie Myung-Ok Lee

Linkage: A Gutsy Girl

While poking around online today, I discovered this gut-friendly resource:

A Gutsy Girl

Gutsy is a blog/web presence by writer/coach/health mentor Sarah Kay Hoffman, a woman who started dealing with colitis issues after a tonsillectomy/adenoidectomy.  Sarah puts it all out there about living with and managing her colitis in this expansive site and her blog, which is part of the blog challenge, 101 Days of Blogging.   Sarah's posts are full of useful links and insights from her lived experience.  She even bravely shares photos of her bloated belly before she went gluten-free, just so readers can see what she's talking about when she means "bloated."   

I like her food/lifestyle-approach to healthy gut care:

My name is Sarah Kay Hoffman,chief gutsy. (<- Yes, my title.) I am a detective, a food and lifestyle detective that is. I believe we are given things in life so that we can make a difference in the lives of others. I was given Colitis. I was also given the passion to help women around the world heal their guts...Gutsy Girl uses food, fitness, relationships and other holistic “lifestyle” factors to “cure” yourself of the digestive problems you’ve been told only medication can fix. I have mastered these same methods to cure my own Colitis. 

And anyone who can slip in a phrase like "safeguard your juju" when talking about how to start your day has my attention!  

Linkage: Medical Students and GERD, Four Fixes for Acid Reflux,

Some interesting GERD-related items in the news:

• A survey of medical students in a Nigerian medical school revealed 26.3% were suffering from GERD.  Large amounts of cola and coffee are thought to be the cause, according to the GI specialist who discussed the survey.  I'm wondering if the pressure of medical school itself is a contributing trigger in this case -- med school is one of the most stressful training programs around.  

• The July issue of Spry includes "Four Fixes for Acid Reflux" by Dr. Jorge Rodriguez.  This quick list of tips are nothing new, but reminders are always welcome, especially since I am still not abiding by some of my own principles (tonight, I ate too quickly, too much, and finished a bottle of Diet Coke left behind by guests -- you can guess how miserable my esophagus feels right now).  

• And maybe my favorite link of the day -- Certified Nutritional Consultant and alternative medicine practitioner Brenda Watson's recent blog entry, "Part 1 of the Poop Chronicles."  I can't emphasize enough my personal experience regarding the connection between GERD and healthy motility.  Simply, when things aren't moving, I'm a reflux mess!   So, hurray for Brenda, who isn't afraid to put it all out there. There's endless amounts of interesting information on her blog/website overall, presented in a highly readable style.  Sure, some of her site is trying to sell you stuff, but I always learn something here (or am inspired to read more about it).  

Breaking: AGA Survey Reveals Majority of PPI Users Still Have GERD

Street art, Williamsburg, Brooklyn 

An article published in the July issue of Gastroenterology and Endoscopy News reveals over half (55%) of PPI users in one study (1000+ people) still suffer from GERD symptoms.   The study, sponsored by the American Gastroenterological Association, states, " Of those taking a PPI, 55.3% reported that they continued to experience heartburn or other symptoms of GERD that significantly disrupted their life."  

Other doctors question the findings -- all of the people on PPIs may not have GERD.  The may be treated for GERD symptoms but PPIs are not helping because that's not the underlying cause:  "Lack of a symptomatic response to PPIs suggests either poor compliance with the correct dosing or timing of the medication [or] volume reflux, such as in those with regurgitation or non-GERD causes."

A quick search around the Internet demonstrates my own concerns about PPIs -- that, often, they are just an easy "fix" for GI doctors.   Medication is doled out as if that is the only option, and patients and doctors love the convenience --  the"science" -- of it.  Taking a pill or three is a lot easier than adjusting your eating pace and portion size, avoiding or reducing certain foods, and re-training yourself to be more mindful of how things affect your body.    My own GI doctor was quick to write out a slew of prescriptions (which I tried, but to no avail).

Look at this MedicineNet entry for GERD, in which the expert answers the question, "What is a reasonable approach to the management of GERD?":

If symptoms of GERD do not respond to maximum doses of PPI, there are two options for management. The first is to perform 24-hour pH testing to determine whether the PPI is ineffective or if a disease other than GERD is likely to be present. If the PPI is ineffective, a higher dose of PPI may be tried. The second option is to go ahead without 24 hour pH testing and to increase the dose of PPI. Another alternative is to add another drug to the PPI that works in a way that is different from the PPI, for example, a pro-motility drug or a foam barrier. If necessary, all three types of drugs can be used. If there is not a satisfactory response to this maximal treatment, 24 hour pH testing should be done.

Higher and higher.  And a Google search results in numerous threads from GERD sufferers agonizing about their continuing symptoms despite an arsenal of revolving meds.  Insanity!  [Disclaimer: I'm not a frequent medication taker -- I'll avoid all congestion medication, most painkillers, and don't get a flu shot.  So I'm coming into this discussion skeptical of PPIs…]

I'm not saying PPIs aren't valuable -- or critical -- for some people.   I know people who have had GERD resolved after short-term medication courses, and my mom is destined for long-term PPI-driven management due to a hernia complication.  This is just a reminder to "listen to your body," continue to ask your doctor questions, don't second-guess your gut, and STAY MINDFUL of the sometimes subtle things that work /don't work.

    

Linkage: GERD Support Group

I discovered this fantastic resource this morning -- MD Junction's Gerd Support Group:

http://www.mdjunction.com/gerd

This is an active community of people with GERD, from newly diagnosed to acid reflux veterans.   There are forums, videos, online diaries, and more. I love learning about what other people are enduring and doing first-hand and comparing it with my own "lived experience."  

From the video forum -- one woman's road to GERD diagnosis.   (One con of this site - the 60 second ads that precede the videos - but this site is free, after all…)

I'm looking forward to signing up and checking this site out on a regular basis!

LINKAGE: Inspiration!

From Mudmagnetmum's thread, "The Lighter Side of GERD," posted on the HealingWell.com board:

Perhaps it helps to remember the "good" things about GERD, like - 

* Without GERD you'd never have known that you could survive without tea, coffee or alcohol.

* Your GERD has probably brought you new friends, both here and in the outside world. With chronic illness you find out who your real friends are.

* You've probably experimented with some foods you never would have bothered with before, or may even have not heard of!

* Your diet is healthier than it was before, your arteries are whistle clean and you can walk past MacD's with your head held high.

In the same thread, Fireworks shares this INSPIRING video.  I admit, I was pumping the air and crying with joy by the end!

Linkage: Alternative Therapies for GERD

Recipes and a gut update and food diary are on the way!   Meanwhile:

I recently found a thread (started in 2006!) on the Healing Well discussion board about the possibility/value of doing exercises to heal a weak esophageal sphincter.  The logic is that GERD caused by a weakened or loose sphincter can be overcome by restoring the sphincter's functionality.   The "jury is out" about their value, but there are several "firsthand" accounts of GERD and its challenges in the thread, something I always appreciate.  I like to know what lifestyle changes people are trying, and what works for them.

Danie writes:

The DGL licorice and alkaline diet and eating small meals is helping me control symptoms almost all the time and I am definitely healing the esophagus this way. I don't feel the tightness in my chest anymore (I never had pain, just nausea and dizziness).  I hope you can do it too and not need surgery. THE KEY REALLY IS TO CHANGE YOUR WHOLE DIET. IT'S DEFINITELY NOT EASY AND YOU DO HAVE TO DEPRIVE YOURSELF OF SO MANY THINGS.....but isn't it worth it to do so for a while?

Gozer offers this list of GERD-friendly habits:

- I don't over eat
- I eat lots of raw or almost raw vegetables
- Take very good probiotics
- I eat white meats
- I avoid dairy products from cows
- I avoid all the usual acid-reflux causing foods like tomato sauce, chocolate, coffee, soda, etc. Carob is a good chocolate replacement
- Take flax seed oil for good fat
- Take a good multi-vitamin every day
- Walk, walk, and more walking.... helps better and faster digestion
- Avoid processed foods... the closer to natural form is always best
- Avoid too much spices and seasonings in/on my food

Others also write about the use of licorice, the value of yoga, and using visualization and relaxation techniques.   Several weeks ago, during an especially GERD-filled week, I decided I had enough and literally "told" my body to just STOP the reflux and tight throat feeling.  And -- it worked!   All these examples demonstrate, again, how managing GERD requires a lifestyle change, not a diet or specific cure-all.

As for the "walk, walk and more walking" advice:

Here's a study published in a 2011 issue of the Journal of Pakistan Medical Association that concludes walking after dinner correlates with less GERD symptoms:

Regular post dinner walk; can be a useful lifestyle modification for gastroesophageal reflux.  Shahid Karim,Wasim Jafri, Afsheen Faryal, Shahid Majid, Mohammad Salih, Fatima Jafri, Saeed Hamid, Hasnain Ali Shah, Zohaib Nawaz, Usman Tariq. J Pak Med Assoc  Vol 61, No. 6, June 2011

Breaking: New Study Links Barrett's Esophagus to Bile Reflux

Good news and bad news from the Rochester Medical Center.  A new study led by Dr. Jeffrey Peters -- an expert in esophageal and stomach surgery -- indicates a link between the dreaded Barrett's esophagus and bile reflux.   According to the study, published in the Annals of Surgery and summarized in an  April 24th Science Daily article,

Peters' team found that bile that washes up from the stomach into the esophagus shuts off genes responsible for the normal, skin-like lining of the organ, and turns on genes that produce the intestine-like lining that is the hallmark of Barrett's.  While previous research established that reflux components encouraged the development of intestinal tissue in the esophagus that alone was never enough to produce the changes that led to Barrett's.  

"The main leap this study makes is that normal esophageal cell growth must be turned off and intestinal cell growth must be turned on in order for the disease to take hold," noted Peters, who is president elect of the International Society of Diseases of the Esophagus. "We found that bile promotes both processes." 

[Emphasis mine.]

The jury is still out whether treating bile reflux with medication works.  According to the study's co-author, Dr. Tony Godfrey, "the only way to stop all reflux components, including bile, is to surgically reconstruct the faulty barrier between the esophagus and the stomach."


Yikes!


Citation:  Marie Reveiller, Sayak Ghatak, Liana Toia, Irina Kalatskaya, Lincoln Stein, Mary DʼSouza, Zhongren Zhou, Santhoshi Bandla, William E. Gooding, Tony E. Godfrey, Jeffrey H. Peters. Bile Exposure Inhibits Expression of Squamous Differentiation Genes in Human Esophageal Epithelial Cells. Annals of Surgery, 2012; : 1 DOI:10.1097/SLA.0b013e3182512af9


LINKAGE


Mayo Clinic's page on Bile Reflux

Linkage: Videos from the U of Wisconsin's Integrative Medicine Program

Quick status update:  Overall, I am maintaining my lack of the "food in throat/lump in throat" feeling -- and it is encouraging!  It seems the longer I go without this concern, the more I feel this issue may be resolved for good.   However, this past weekend, I ate larger quantities -- knowingly!  (why do I do this?!) -- and I caught myself eating fast a few times.   I've felt some reflux, belching, and overall "bloating" as a result.  It was a second "birthday weekend celebration," so I allowed some indulgence, but still -- is there any excuse for overeating or gulping down food?   I'm not being hard on myself; instead, I'm using the past days as "evidence" that my slow eating/small portions is the right approach.

U OF WISCONSIN'S INTEGRATIVE MEDICINE PROGRAM

Poking around the web, I found a few things of interest.  Here's some useful linkage:

From the University of Wisconsin's Integrative Medicine program, here are two engaging videos featuring Dr. David Kiefer and Dr. David Rakel.   I love their conversational, anecdotal style.  Good reminders for those of us well-versed in GERD, and a great introduction to these topics:

Stress and GERD:  Dr. Kiefer and Dr. Rakel

Discusses stress effects, exercise.

Lifestyle Behaviors and GERD: Dr. Kiefer and Dr. Rakel 

Overall discussion of GERD; excellent introduction and refresher.

Linkage: Mindful Eating as Food for Thought

I was excited to learn the New York Times recently published an article on mindful eating.   As I've mentioned in various posts here, eating slowly is consistently one of the keys to keeping my GERD in check.

The Times piece is a good introduction to the idea, loaded with links and references to some of the leaders of this "new" trend.  (It isn't a trend, nor new, but -- hopefully -- it's getting new buzz.)   One thing I was not pleased by is the writer's emphasis on using mindful eating to achieve weight loss by avoiding binging -- an "anti-diet," something the Huffington Post picked up on in their response, as well.   Isn't this notion of our food intake as something we need to tame, dominate, control, put into "good" or "bad" boxes is contrary to the concept of food as nourishing, healthy, and pleasing?  Food is not the enemy!  Mindful eating is, to my mind, more about connecting your body and your food, allowing your body to go at its own pace, savoring the sensory experience -- improving the quality of your life and by extension, your health.

RELATED POINT:  I always roll my eyes when I read about strategies for weight control and how we need to stop eating with our emotions, replacing "real" needs with food, and so on -- has it ever occurred to these diet pundits that I just LIKE food?  It is not a substitute for anything missing in my life -- it is a sensory pleasure in itself.  My pecan-maple artisanal chocolate bars or slices of good bread dipped in superb olive oil or greenmarket roasted potatoes stand alone.   I've eaten food when stressed, sure -- but, mostly, I eat food because I enjoy it and to nourish myself -- not because it is a security blanket.  I really wish writers would recognize this.

In any case, I think bringing mindful eating into the consciousness of the "average household" is a positive thing!  After you read the Times article, don't miss the follow up piece, Mindful Eating: A Teacher Responds to Readers and the follow up to the follow up: Mindful Eating: More Questions for an Expert.

YET MORE:

Zenhabits' introduction and how-to regarding mindful eating.

A registered dietician at Brigham and Women's Hospital offers mindful eating tips.

Linkage: Livestrong

I confess, I'm in love with the Livestrong website and its elaborate personalized weight-nutrition-fitness calculator.  After realizing those few pounds I gained during the recent holiday are not budging, I decided to take action and get more mindful about losing them.  I should, in fact, lose a few more pounds beyond this to put myself squarely in my "healthy BMI" range instead of being at the higher end of it.

So, I signed myself up on the Livestrong site as an experiment, and am now tracking what I'm eating and what exercise I get each day.  It's motivating me, particularly the exercise bit.  Staying active is not my problem, but having a "desk job" is counterproductive to getting the movement I need.  The site is definitely encouraging me to reach my daily exercise requirements.

And, I love all the charts, databases, bells, and whistles!

livestrong.com

Linkage: Acid Reflux Discussion Boards

One of my "hobbies" is looking around the web for first-hand accounts of acid reflux and other GERD experiences.   There are numerous quasi-medical sites, anti-acid product sites, and advertising sites disguised as blogs.  What about "real people" and their "real life" guts?  (This is one of the goals of the Cranky Gerd blog -- to share my firsthand experience of this tiring condition so people can see what "other people" are going through.)

Here are a few of my latest finds:

The Vegan Forum Discussion Board Acid Reflux Thread 
Thread offering various first-hand descriptions of symptoms, experiences with raw/vegan diets, a few links.

My Kitchen in the Desert
This blog seems defunct (the last post was 2009) but there is some interesting stuff here by an Australian vegetarian foodie suffering from GERD (or GORD).   Food discussion, GERD discussion, recipes.

My Acid Reflux Story
Vegan Wanderer's summary of his GERD issues.

Journey to a Healthy Life
Vegan Wanderer now writes a food/nutrition blog with up to date discussions, links and photos about eating well, food production, and other food/nutrition related topics.

Linkage: New Studies Indicate Rise in Acid Reflux

Will acid reflux be the new "hot" medical condition for 2012?  Maybe.   The year closed with a couple of new studies pointing to acid reflux on the rise:


Eivind Ness-Jensen, a researcher at the Norwegian University of Science and Technology, studied 30,000 Norwegians over a decade and found a 47% increase in people reporting acid reflux symptoms between 1995-7 and 2006-9.  Women are more likely sufferers (and more likely to have it clear up on its own).  The study was published in the December 2011 online issue of Gut.


Another study looking at increased over-the-counter acid reflux medication sales in New York City suggests a link between the high unemployment rate and increased use of heartburn/reflux medicine.


It is interesting that many studies point to obesity or smoking as triggers for reflux.  Both can also be the results of stress -- another GERD trigger. 

Linkage: The Damage of Reflux (Bile, Not Acid)

My doctor wonders if some of my reflux stems from bile, not acid reflux, since none of the reflux medications have helped the situation, and I have had ulcer-like symptoms in the past.  I just came across this 2009 New York Times article about bile reflux, and it's a must-read (largely because so little IS written about this) to stay informed:

Excerpt:

Both acid reflux and bile reflux may afflict the same person, which can make diagnosis a challenge. But the stomach inflammation that results from bile reflux often causes a burning or gnawing pain in the upper abdomen that is not felt with acid reflux, according to experts at the Mayo Clinic. Other symptoms of bile reflux may include frequent heartburn (the main symptom of acid reflux), nausea,vomiting bile, sometimes a cough or hoarseness and unintended weight loss.

While the article notes bile reflux is often linked to gastric bypass or other surgical interventions, it is something to consider if your medication/care plan for reflux is not working.

Linkage: GERD-Friendly Vegetables

My positive experience with our root-heavy Thanksgiving meal, and recent root-laden dinners are reminding me how GERD-friendly roots are to my gut.   I did some online sleuthing and it looks like others have discovered this, too.

I like this at-a-glance listing for "sides," which for vegetarians usually means "main course."  This is admittedly a "commercial diet site," but it's still informative, and gives me ideas -- recipes are provided, too:

Dr. Gourmet's GERD/Acid Reflux/Heartburn Friendly Side Dish, Sauces, Extras and Dessert Recipes

Linkage: East Meets West by Bloggers CAB and TAB

Blog of note:  Mad Silence: Exploring the Ties Between East and West…and Anything Else That Catches Our Fancy. Bloggers and New York City residents "CAB" and "TAB" share photos, esoterica, recipes inspired by their interest in Japanese culture and lifestyles.  

A recent entry provides a recipe for Sweet Potato Cashew Bake.

Lovely, informative, and worth a bookmark.  :)   I am looking forward to browsing their blog often!