Hacker News Reader

Hacker News

Comment by loopdoend | Hacker News Reader

Full thread

loopdoend

How I eliminated GERD:

- Walking after every meal

- Reducing my body weight

- Avoiding food in the hours before bed

YMMV

View on HN

For me: lose weight and take a daily PPI.

"But PPIs have terrible side effects!"

Doing great so far. One esomeprazole a day, 30 mins before I eat breakfast and I'm almost normal. This is with bad GERD, a hiatal hernia and some changes to my esophageal tissue. Oh and schatzki rings. I was in immense pain for years and now I can eat normally and enjoy spicy foods again.

A PPI is preferable to Barret's esophagus secondary to chronic gastric reflux, and certainly sounds reasonable in your case.

There are others who start using omeprazole OTC without understanding the difference between it and Pepcid. Omeprazole (and its enantiomer esomeprazol) can cause rebound heart burn with discontinuation, are not meant to be used "as needed" compared to antacids / H2 drugs due to their slower method of action, nor do we fully understand the long-term risks of PPIs. There have been observational studies which, while not able to show a clear cause and effect, have found evidence of higher risk of fractures among those on PPIs long-term.

> do we fully understand the long-term risks of PPIs

The potential link between PPIs and dementia worries me a lot. I switched to H2 blockers when my symptoms decreased but they're not as good and you need to periodically get your liver function checked.

PPIs can take a (long) while for its side effects to present. Also, not everyone experiences the side effects, though some people definitely do!

My anecdotal study, I had an awful case of reflux, my doctor told me to lose weight. Right after that I moved to a place that was more conducive to outdoor exercise and started walking for miles a day, at least 30 miles a week.

That did it, I didn't lose any weight but the reflux was gone completely.

I moved again and where I live now is not as good for outdoor activity, but it hasn't come back yet. I still walk at least a mile a day, maybe that's enough for me. If not, at least I know the prescription for me if it comes back.

Weight loss did it for me. I was on 40mg Nexium and couldn't survive without the med every day. Then I was on a 3 month trip to Europe during which I dramatically lost weight and also ran out of the med. Quite incredibly, I realized I was fine without the med. The trip was 5 years ago and I've been keeping the weight off, it seem to be holding.

This worked for me, too. Additionally, I reduced my intake of fatty foods, such as fried and buttery foods. I did not completely stop them, but I reduced them greatly. It made a huge difference.

>Reducing my body weight

~10lbs (5% of bodyweight) is the difference between GERD and no gerd for me.

Part of it I assume is increase in viceral fat pressuring stomach. After my threshold weight of 190lbs I have to move up a notch on my lifting belt.

> Avoiding food in the hours before bed

I think another factor is higher BW = more calories = more time for digestion. If I shift meals to 8 hours before bedtime vs 5 hours, GERD also goes away because I have more time to digest.

I also don't get GERD after squat and deadlift days because they reliably make me shit. As an infrequent shitter, GERD is also correlated to how backed up I am.

TLDR is to keep your stomach empty / digestion done before bedtime.

Reply on news.ycombinator.com