Celiac and reflux

[aya]

Hi,

how fast after starting with gluten free diet did you notice any improvement with heartburn or reflux?

I am 4th day of diet and reflux seams to be worse than earlier. So I am a bit concerned.

Please, help!!!

Aya

[cyclinglady]

If celiac disease is the cause of your reflux, it can take weeks, to months or a year for healing on a gluten free diet.    I have celiac disease but only was anemic when diagnosed.  Last year, I developed reflux for the first time.  Another endoscopy determined that I  had healed from celiac disease, but stomach biopsies revealed chronic autoimmune gastritis which slowly went into remission on its own after a many months.   I assume my Gastritis will flare up again in the future.   Unlike celiac disease where gluten is the trigger, the trigger for AI Gastritis is unknown.  

To cope, I would sleep elevated and avoided eating late meals giving my stomach time to empty long before bedtime.  I also reduced coffee and ate a bland diet. 

Reflux is awful.  I am so sorry that you are ill.  

[GFinDC]

Hi aya,

It is possible your gi system is making more gas now.  That could force acid into your esophagus and cause pain.  Just gas by itself can cause pain for that matter.

To reduce gassiness, eat little to no sugar and carbs.  Carbs (rice, white potatoes, cereals, flours etc) can feed the bacteria that cause gas.  Some artificial sweetners cause gas also.  Dairy is also something to avoid when starting the gluten-free diet.  Many of us can't digest the lactose sugar in cow milk until our guts have several months to heal.  This lactose intolerance can cause lots of gas/pain.

Peppermint tea can make it easier to get gas out of the stomach.

A simple diet with few processed foods is best for healing.

Edited June 23, 2018 by GFinDC

[Posterboy]

Aya,

GFinDC has given you good advice.  Watch your CARBS they ferment and can cause bloating.

This can be more pronounced after starting PPIs in some people because you have temporarily lowered your stomach acid which can make things worse for some people.  It is called Acid Rebound when people try to stop PPIs and why (at least) for short period of a couple weeks to a month your body begins to produce it's own stomach acid again.. ..things seem to get much worse.

Here is a research link about it entitled "Gastric hypochlorhydria (low stomach acid) is associated with an exacerbation of dyspeptic symptoms in female patients"

Dyspectic (dyspepsia) is the medical term for indigestion commonly known as acid reflux/bloating etc.

Open Original Shared Link

In fact if stomach acid was not the cause your heartburn  and instead say from stress then taking PPIs can make it worse.

See this fox news article from 5+ years ago that explains it well.

Open Original Shared Link

quoting from the article

"It used to be thought that all GERD was the same—you give patients PPIs and they'll all respond," says Prateek Sharma, a gastroenterologist at the University of Kansas School of Medicine. "But we're finding that a subset of these patients don't have acid as a cause of their symptoms."

and they note this in their article on NERD not GERD.

quoting again.

"Another guess is psychological stress. A 2004 study of 60 patients conducted at the University of California, Los Angeles, found that those with severe, sustained stress in the previous six months were more likely to have heartburn symptoms during the next four months."

the standard treatment for acid reflux is to take PPIs and that is troubling for many who start them and cant' get off of them.

they actually note this fact.

quoting again.

"The ones we worry about are the ones who don't respond to standard therapy," he says. "Then we have to figure out why they don't respond."

and might actually be making thing worse for many people.

quoting again. Aya read the whole article and links provided in this thread when you get  chance.

"One 2004 study cited a 46 percent increase in GERD-related visits to primary-care physicians over a three-year period alone."

sadly if they had just tested your stomach acid levels before putting you on PPIs many of your acid reflux symptom's might of have been avoided.

they are now beginning to realize PPI's don't work for everybody and can make it (heartburn) worse in many patients.

quoting again.

"Gastrointestinal experts now estimate that 50 percent to 70 percent of GERD patients actually have NERD, and studies show they are more likely to be female—and younger and thinner—than typical acid-reflux sufferers. They are also about 20 percent to 30 percent less likely to get relief from acid-blocking drugs. But their episodes of heartburn are just as frequent, just as severe and just as disruptive of their quality of life, studies show."

Ground braking research really but we have a long memory when it comes to treatment regimens.  And it will take a while for the medical field to catch up to this new research.

even though this new research recognizes this is real phenomena doctor's are stumped about how to treat it.

quoting again.

"New research suggests that in many people, heartburn may be caused by something other than acid reflux. But gastroenterologists are often stumped as to what it is and how to treat it."

Because they think it is too high to  begin with it doesn't fit their paradigm to think stress or low stomach acid could really be the trigger and never test your stomach acid before beginning you on PPIs.

If you were tested you would of remembered because it traditionally involved swallowing a pill retrieved with  string know as Heidelberg Gastric acid test or similar test like the EpH test where a thin tube is inserted through your nose for 24 hours.

here is a medline article about the esophageal pH test.

Open Original Shared Link

because it makes or effects our gag reflex most people feel uncomfortable doing it.

so this step (test) is typically bypassed. . . .and the real pH of your stomach is never tested/measured.

But we know it is low stomach acid (being misdiagnosed I think) really because we have studied this phenom before see early link posted  here again for convenience sake entitled "Gastric hypochlorhydria (Low Stomach Acid) is associated with an exacerbation of dyspeptic symptoms in . . . patients"

Open Original Shared Link

the article focuses on the results for women (I am/was not sure (can't remember) if you are women or not but men were also studied in this research.

I hope this is helpful.

***this is not medical advice but I have found often when your stomach acid is truly NOT high enough is when we have most of our/your GI problems.

I just try and encourage others to get tested. . . because if you don't test you'll never know.

We have the endoscopy test for many of our other GI problems we also need to test our pH as well to rule out if is contributing to our other GI problems.

***this is not medical advice but I hope it is helpful.

******Maybe someone else can answer this???

Can you do pH testing with an Endoscopy and if so why is not typically done?? when an Endoscopy is performed thus killing two birds (proverbially with one stone (test).

2 Tim 2:7 “Consider what I say; and the Lord give thee understanding in all things” this included.

Posterboy by the grace of God,

 

[aya]

Thank you all for your help!!! It’s a bit clearer now. 

I had problems with gases and bloating and reflux a year ago and doc prescribed Lansoprazol. He said my lower esophageal sphiincter doesn’ t work properly. 

I was taking lansoprazol 30mg for half a year with huge problems with nausea and even more bloating. Than I lowered the dose to 15 for next half a year and felt better and than stopped taking them. I’ve been off for a months when I started noticing numb tongue and reflux again. So I started taking ppi again. And it’s worse again.

I know I have to stop using ppi, but I think I have underlying condition that is making my bloating and reflux and I have to solve it first so that reflux, which is my biggest concern, will go away.

I have been anemic long years before taking ppi, now I have low vitamin d, and quite high result IGA 16 (celiac is >20). Can be reason for low vitamin d in ppi too or is more likely because of celiac?

Doctors don’t want to make any additional test because they say celiac disease can’t be the reason since this test is negative.

And so I am still searching what could be my primary problem.

They just want to operate my LES and that’s it for them.

But I know this won’t solve my problem since the reason has to be somewhere else.

The problem is that the highest dose of lansoprazole is helping me for 12 hours and not 24 like it should. It’s just making my nausea worse and doesn’t help like it should

I get bloated with reflux gases, burping 1 hour after eating. My last meal of the day is at 8 p.m. And the worst reflux attac is usually around midnight and 1 a.m.

Aya

[GFinDC]

Hi aya,

Maybe you can find a different doctor?  There are often celiac disease support groups around.  They can sometimes suggest good doctors to go to that know about celiac disease.

There is a test called DGP IgG, and DGP IgA and also EMA IgA.   Plus total serum IgA.  Did you have any of those tests?  Some people only show up on one test.  Ask for the complete celiac test panel.

If for some reason you just can't get a doctor to test you, then you can go gluten-free anyway.  You don't need a doctor's permission to eat gluten-free.

You should keep eating at least a little gluten each day until all testing is completed.  Testing usually includes an endoscopy also.