My brother in-law was over for dinner, he is a few years older, and he has chronic “heart burn” or GERD, and has for years. I realized that my own esophagus had recently healed and I no longer have GERD pain. (I had stopped taking NoGERD (licorice root) probably a year ago, after all the screwy blood test numbers.)
The following is a copy of an email that I sent him about what I think I know about the condition, and how I dealt with it.
But first, I am angry again! I had reduced my cortisol (methyl prednisolone) to around 2 mg daily. Long time now. Blood sugar around 110. And I felt great for what seems like quite a long time. (And a saliva test supported the fact that my own adrenal function was about 20% below normal during the entire day.) No pain. (I did get a blister on the foot which left a sore that hasn't healed since August, right around the time I started the Lantus/long lasting insulin. That is another story.)
So two weeks ago I had an over night stay, I forgot my cortisol (methy prednisolone) so I missed a day. Next day – no pain, so I thought perhaps my adrenals are working normally, and only took 1 mg the next day. So I was a measly 3 mg short for two days (0, 1, 2 instead of 2, 2, 2) . I paid for that for an extended period, i.e. a week to 10 days! Pain starting in the fingers, typical rheumatoid arthritis pain – all because I missed 3 mg, and then the question become, how much to increase to compensate, given the potential effect on my blood sugar?
I have learned that the pharmacokinetics of methyl prednisolone (as I learned the hard way too for hydrocortisone) are delayed, and not like taking an aspirin for pain (that works in perhaps 15 minutes.) The effect (increase in pain) can take 48 to 72 hours after the dosage is declined, but then restoring the dosage does not apparently affect the inflammation that has begun due to the shortage – for weeks! Ouch!
I am angry because as I feltl the pain again, I think of all the people (including my late mother) who had no idea that medicine had discovered exactly what causes and how to stop the pain - replacement of the body's own hormone cortisol. With this angst off my chest, here is what I sent my brother-in-law about what I did to eliminate my own heart burn/GERD. I now wonder if it would have been possible without cortisol supplementation? And if a slight lack of cortisol might be responsible for the inflammation in the esophagus that causes a lot of GERD?.
I could tell that you are still suffering from "heart burn"/GERD and I know from experience it is like torture. While I may have told you some of this before, I want to review how I cured mine. I hadn't even thought about the fact that I now sleep through the night without any heart burn.
There are two valves or sphincters in the stomach, one to the connection to the intestines, where digested food is supposed to go, and the other at the top of the stomach, connected to the throat/esophagus.
It is the upper sphincter that causes the problem. It is supposed to keep the acid contents of the stomach - in the stomach.
The stomach is designed for high acid. But the throat/esophagus is not. If stomach contents backs up from the stomach, through the open sphincter into the esophagus - it will burn and damage the throat. This is the cause of the pain. And "they" are right in the commercials, in that this must be allowed to heal. (I will get to how I got mine to heal).
There is a book you should read entitled WHY STOMACH ACID IS GOOD FOR YOU by Jonathan Wright and Lane Lenard. Surprisingly, LOW stomach acid often causes GERD, and the fix, if this is the case, is to take stomach acid (Betaine HCL) with meals Not intuitive, so read the book.
What seems to happen when the stomach acid is low - the sphincter muscle relaxes. (This may be why the vinegar fix seems to work - the acid causes the sphincter to tighten. The only problem is - if the throat is already raw and inflamed, Ouch!)
The other thing I learned is that the stomach completely empties six hours after a meal, and when it empties, as the lower sphincter relaxes and opens, the upper sphincter may open too - especially if you are lying down. (You'll note the pain like clockwork six hours after your last meal at night).
One idea that is not always easy, is to eat more than six hours before going to bed and/or lying down. So you are upright when the stomach empties into the intestines. Barring that, don't lie flat 6 hours after the night meal. When I feel the pain at night, I immediately sit up for awhile, then when I lie down, I use enough pillows so I am at a 45 degree angle, allowing gravity to pull the stomach contents down.
I know the throat/esophagus can heal - because mine has, and I now get through the night without any pain, especially if we eat early. But it can take some time, and while it is healing, you have to avoid spicy/acid foods. In fact, in stead of taking ascorbic acid vitamin C (a mild acid) I switched to sodium ascorbate vitamin C which is non acidic.
So you have to avoid acid/irritants going down, and the stomach contents from coming up. You do this by keeping the sphincter tight, and proper acid in the stomach seems to be key to keeping the sphincter tight - unless there is something else going on. (IF you remember our friend C., she had a huge hiatal hernia, which was surgically repaired and now she feels great.)
Now one other factor in the healing may be due to the low dose prednisone (cortisol replacement) I have been taking (since I figured out that low cortisol production by my adrenals caused all those hospitalizations a few years back.) Turns out that if you aren't making any cortisol - you die in 24 hours, so everyone is making some. It is not well recognized, especially by medical doctors, that as we age, like other hormones, we can make less cortisol.
Cortisol is THE steroidal Anti Inflammatory (where aspirin is the Non Steroidal Anti Inflammatyr NSAIDS) It stops and controls inflammation. Since the GERD pain is from inflammation of the esophagus, the reason mine cleared up my have something to do with restoring my levels to normal. It is something you could mention to the doc, because a short course of prednisone during the attempt to heal the throat may make it go faster and easier.
Got that off my chest.
Thank you...thank you ....thank you. Yes, i play hockey........late at night and then come home and eat something. There is my problem.
Good info and I still get heartburn during the upright day so not sure how to handle that. Damn...had chili today.
Gotta knock off those donuts too!
ofonorow wrote:The reason it hurts during the day is that it has been harmed – the botton of your throat near the stomach is raw an inflamed. When both acid intake and stomach backup are controlled, no acid in the throat near the stomach, it will heal.
Again, I am taking the anti inflammatory prednisone.. That may be what allowed my throat to heal.. hadn't really thought about it healing until seeing you last Sunday.
And you should probably have an expert take a look - in case you have a big ulcer/hernia like the friend I mentioned. (She was told hers was "huge" and she feels great after having it repaired.)
And don't forget to read that Jonathon Wright book