Treating GERD with the paleo diet
My story about healing GERD was featured in Marks Daily Apple last year and received a very positive response, but also some comments from people who tried eating paleo for GERD and did not have success. So I thought I'd do a post discussing my experiences further, in the hope that people suffering from GERD can have the same success I did.
I can't really remember a time growing up when I didn't have stomach problems. My diet then was full of Kraft Mac & Cheese, Reeses Cups, and McDonalds. When I got to college it got even worse as I reveled in the dining hall's smorgasboard of ice cream, nachos, fries, and cake. It was that first year of college when I first experienced a terrible unsettling pain radiating from my stomach up into my chest. I stocked up on antacids, but found that they provided only temporary relief. My mother chided me for eating unhealthy and I tried to reform my diet by eating vegetarian and low-fat. I ate Special K with soy milk every day for breakfast, a sandwich on whole wheat bread for lunch, and a pasta salad for dinner. But the pain continued. I booked an appointment at the school doctor and was diagnosed with gastroesophageal reflux disease (GERD).
In many ways I was very unlucky. GERD is among the most common diseases of civilization, but it typically does not strike until people are much older. My father was also struggling with GERD at the same time, so perhaps I have some sort of genetic predisposition to it. Both my parents, who have always been suspicious of medications, discouraged me from treating my GERD with the Prilosec pills my doctor prescribed me.
Prilosec is just one of several proton pump inhibitors on the market, which is a very lucrative market considering the vast numbers of people who are diagnosed with GERD. Proton pump inhibitors function by drastically reducing stomach acid. They are widely considered safe for long term use by doctors. One of my doctors told me I would probably be on proton pump inhibitors for the rest of my life, but assured me that was OK.
At first I was ecstatic that I could enjoy food again, but as time wore on I developed other stomach problems. My doctor said it was just IBS, but one morning I collapsed from dehydration. A test at the hospital revealed I had been harboring salmonella chronically for quite some time. Salmonella is among the most common types of food poisoning, but most infections last only a few days. Apparently my body had been unable to clear my infection, which is not usually the case in most teenagers.
Stomach acid is there for a reason and why doctors prescribe medications that pretty much get rid of it is beyond me. Acid kills germs and while I don't have concrete proof, it's possible my lack of stomach acid predisposed me to food poisoning. They have found in studies that PPIS predispose people to pneumonia and I hope someone will study food poisoning and PPIs in the future.
As I recovered my stomach was pretty battered and my GERD returned with a vengeance. I was lucky enough that I encountered Jared Diamond's The Worst Mistake in Human History in class and also heard a lecture by an anarcho-primativist. At first I was quite offended by both. As an agricultural economics student I viewed agriculture as the cornerstone of man's greatest achievements and that hunter-gatherer life had been "nasty, brutish, and short." Raised to believe in conservative ideals, I had been taught that the "noble savage" was a myth popular among liberals who refused to accept man's true nature and the glories of classical civilization. Turns out that the truth is somewhere between. Hunter-gatherers, both modern and paleolithic, were and are as diverse as any other humans. They tend to have relatively high infant mortality and succumb to accidents and diseases that modern humans rarely encounter. But they live and lived longer and better lives than most people expect, with plenty of leisure time and without modern health problems.
So when I encountered Art De Vany's writings and Gary Taubes though one of my favorite economics blogs, Marginal Revolution, I was ready for a change. The idea that fat was good and that modern foods might be the culprit for modern diseases was new to me and it took me a long time to learn how to eat paleo. I had no idea how to cook meat, I had never eaten fish, and bagged baby spinach was the only sort of vegetable I'd really dealt with. Candy and ice cream were also my essential study buddies and I felt pretty proud about my soy milk and Special K habits.
So things certainly did not get better overnight. I tried to eat healthy and would succumb to eating junk, but over time I learned how to buy and prepare good food and became educated enough about science and my own body to have more incentive to avoid junk.
In the future I think scientists will look back on PPIs as a huge mistake. They are already finding out that GERD is about more than just heart burn, that adysfunctional immune system plays a role. I have a feeling that's just the tip of the iceberg. GERD is not just run of the mill heartburn and it's not just about repairing an injury to the esophagus. Real solutions should address why the heartburn occurs in the first place rather than masking symptoms.
In the past, studies about diet and GERD have been mired in simplistic dietary dogma, typically measuring total fat and fiber intake. Newsflash, there are many ways to get both fat and fiber, and many types of both. Some are probably good, others are bad. A bright spot in the research is this study: A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms.
It took a long time for me to finally rid myself of all symptoms, but it was very much worth it. I'm very happy to be both pain and medication free now. I worry people will think I adopted the paleo diet to lose weight when I mention the word "diet." While I did lose weight, it was about being healthy and the paleo diet isn't a temporary fix, you have to stick with it. I got off the bandwagon last year while traveling and had GERD symptoms for the first time in a long time. It was not pleasant. Besides that, while eating paleo I experienced a cessation of problems I took for granted as just part of life, but which I now recognize as food related, such as heavy periods, constant bloating, headaches, and asthma.
My father is also a follower of the paleo diet now and has also experienced relief from GERD.
Here are my tips for combating GERD
- Don't expect GERD to go away overnight. It took me over six months to completely reduce symptoms.
- Learn how to eat wild fish. Omega-3 fatty acids can combat inflammation very effectively. Farmed fish are unfortunately too high in omega-6 fatty acids to be of much use.
- Buy quality meat and animal fats. Factory farmed meat is much too high in omega-6 fatty acids, which can cause inflammation. Eating out only at restaurants that serve pastured meat and getting to know the farmers at your local farmer's market is a good way to accomplish this.
- Eat nose to tail. I grew up thinking that chicken breasts and steak were all that animals had to offer. I was missing out on the vital nutrients present in the whole animal. Bone marrow, lard, tallow, liver, and all the "nasty bits" should become part of your diet.
- Learn how to prepare nutrient rich stock and make healing soups. GERD can make eating uncomfortable, but nutritious soups usually go down well and provide healing nutrients. I will write many posts in the future about stock, but it's mostly just about putting bones in the crock pot overnight. The resulting stock can be pureed with your favorite vegetables.
- Eat greens and seaweed. These fight inflammation and provide healthy fiber without the carbs.
- Educate yourself both by reading more about the paleo diet and health, and by learning to listen to your own body. I did lots of research about different aspects of diet and trial eliminations for questionable foods like nightshades and dairy to figure out if they had a role in my problems.
- Indulge carefully. Find out by trial and error which foods irritate your gut and look to adopt new occasional indulgences that have at least some nutrients, like coconut milk with berries, coconut water, and raw dairy-free chocolate.
- Fermented foods are a bone of contention in the paleo community. They really aren't paleo, but eating paleo isn't about food reenactment, it's about looking to the wisdom of the past and finding what works now. The problem with life today is that we are exposed to so many antibiotics and an artificially sterile environment. Most of us probably have inadequate bacteria to assist with digestion. Probiotic fermented foods can help augment your own body's bacterial colonies while you heal. I consumed apple cider vinegar tonics, kombucha and probiotic pills while I was recovering. I have since phased them out since my bacteria seem to be doing the job fine on their own now.