Heartburn - how long to fade

[aya]

How long after starting gluten free diet did you need to get rid of heartburn.

Today it’s my 7th day without gluten, but the heartburn stays the same. 

Am I too impatient or this diet isn’t right for me?

How long did it take in your case? Please share with me your experience, since I don’t know what to expect. Do I need more patience or do I have to test any other thing? 

I read that people boticed difference after few days and I don’t, so this is so discouraging ?

I don’t eat tomato, spicy etc. So there can’t be any issue with classical triggers. I don’t drink coffee dont smoke don’t drink alcohol. I don’t overeat, don’t go to sleep 3 hours after dinner...

I am just below the limit line of celiac iga test, I have low vitamin d, low ferritin, low transferin, low calcium.

I have normal b12.

 

I have problem with LES too, did anyone had the same issue and has solved it with celiac diet?

 

Please help me!!!

[cyclinglady]

The LES is probably contributing to your heartburn.  ?. If your heartburn was ONLY attributed to celiac disease, it can take weeks. Months to years before it resolves.  Everyone heals at a different rate.  On week is not enough time.  

Research LES and figure out if you can apply those suggested remedies (like losing weight, sleeping on a wedge, eating too much at meals, etc).  

[aya]

Cyclinglady,

thank you for your response.

I tried everything that could be connected to LES. I am very thin, sleeping on elevated bed, with 3 pillows, eating only permitted food, no alcohol... But daily dose of lansoprazol isn’t enough... it lasts only 12 hours. 

As I have many signs of celiac disease or intolerance to gluten, I though that this could be the reason. 

Is it possible that the LES that isn’t working properly is  connected also to celiac disease?

 

thank you!!!

[aya]

the problem is that i am on gerd diet, and abide all suggested instructions for gerd but ppi doesn’t work in my case. Not even double daily dose. and doctors suspect that I could have intolerance.

[cyclinglady]

It is possible that the LES could be connected to celiac disease.   Then keep at the gluten-free diet and give it time.  

[Posterboy]

Aya,

2 hours ago, aya said:

the problem is that i am on gerd diet, and abide all suggested instructions for gerd but ppi doesn’t work in my case. Not even double daily dose. and doctors suspect that I could have intolerance.

Going low CARB will help you.

Most gluten free diets still have a lot of Carbs in them unless you go Keto too!

We swap rice or corn etc. for Wheat (gluten etc) or one carb for another carb often.

Carbs ferment and that produces excess gas and bloating and when combined with fats causes delayed stomach emptying --- a lethal combination for most people.

quoting the mayo clinic says " Eat fewer fatty foods. Fat slows digestion, giving food more time to ferment."

Eat either fats in meal or carbs in a meal should help the excess fermenting (bloating) you are noticing unless you also have an ulcer.

The lansoprazol is working against you.  The LES usually doesn't open unless your stomach acid reaches approx. a pH of 4.0 or so causing delayed stomach emptying as I understand it.

Here is a good article about it.

Open Original Shared Link

I will comment/note sections that might help you but read it all when you get  a chance.

It should be noted/notable that the reviewer/writer of this opinion is warning his colleagues (other doctor’s in UK) that not testing first for someone’s stomach acid levels before prescribing PPIs as a front line therapy mask the true cause of the underlying condition.

Quoting

“ The increasing readiness to prescribe PPIs on first presentation with GI symptoms means that an increasing proportion of patients taking PPI therapy are receiving them unnecessarily.2 Approximately 50 percent of upper GI symptoms are of the functional subtype and do not respond to acid inhibition”

This information is over 8+ years old but still doctor’s knee jerk respond to the medical practice of replacing gastric juices (stomach acid) function with medicine that suppresses a natural healthy response to food.

He says concluding “We must resist the increasing trend of reflex prescribing of PPI therapy to patients presenting with uninvestigated upper GI symptoms. We need to return to more rational and thoughtful management. It is important to determine the best management for each individual patient considering both short-term and long-term consequences.”

Advising his colleagues to be more moderate in their practice of prescribing PPIs without  first testing someone stomach acid levels.

He says warns that

“PPI therapy may mask ulcer disease. In such situations, I would suggest that first-line empiric PPI therapy is inappropriate and non-invasive H. pylori testing and treatment, or endoscopy, should (of) be (been) employed." (first my words)

He goes on to say quoting again

“In addition, if acid suppressive medication is considered necessary in first presentation, then antacids and H2 receptor antagonists are more appropriate, as they are quicker in relieving symptoms than PPIs.”

So by starting with PPIs (instead of H2 blockers) many, many people get stuck on PPIs seemingly unable to ever stop them (at least cold turkey).

Unless you use the step down method of two weeks between reduction in doses.

Here is a AARP article about it.

Open Original Shared Link

Here also is a good overview of hypchylorida from the nutrition gang and why there is a "Hole/Blindspot" (my words) they say/ask  why hypochylorida is often overlooked today" when it comes to looking for low stomach acid today instead of the high stomach issues you so often here advertise on TV ads today.

Open Original Shared Link

Here is also a nice overview of supplements that can help celiacs (which can become low too when our stomach acid is too low to absorb them).

Open Original Shared Link

It is kind of deep in the details see the paragraph on gastric complications where they say

A short course of acid

blocking medication has been shown to increase stom-

ach pH from the normal 1.6-2.0 pH (similar to the pH

of battery acid) to a pH of 5.0 (similar to the pH of

table vinegar).

30

I would quote more but the formatting is kind of wonky .. but if you follow their links (footnotes) . .. they answer your Original question.

6 hours ago, aya said:

Today it’s my 7th day without gluten, but the heartburn stays the same. 

They are quoting untersmayr who has done the definitive work on this topic. I hope I am spelling their name right.

For anybody who wants to get down in the weeds a little (Ok a lot) here is the full citation entitled "The role of protein digestibility and antacids on food allergy outcomes"

Open Original Shared Link

where they say even "Five days of PPI intake was shown to increase the gastric pH to an average pH of 5.0.Open Original Shared Link " and that would definitely cause LES dysfunction.

So stopping PPIs should make it better right??

Not always and not as fast you might think.

they go one to note quoting again (for those who don't have the time or inclination to read the full citation) read this paper based on this work.

Open Original Shared Link

Untersmayr etal says quoting

"After a 3-month course of medication with either H2-receptor blockers or PPIs, a boost or de novo IgE formation toward regular constituents of the daily diet was observed in 25% of the followed up patients. Sensitization in these patients could be confirmed by positive skin test results 5 months after discontinuation of antiacid treatment.Open Original Shared Link "

And this work is seminal in my mind because it is not just any old researcher or  (medical journal etc.) but it is actually from the Journal of Clinical Immunology ie. the experts to the experts.

And yet almost 10 years later people don't understand or are unaware of this critically important research.

Heck I research alot -- because I had a LOT wrong with me.  So it was out of necessity on my part and I didn't know about this research until recently (about 6 months ago).

But I think your need to run away from PPIs and never look back if you can.

Stepping down to H2 blocker going low carb then stepping down on them (as laid out in the AARP) is your best chance of getting off the PPIs for good and supplementing with BetaineHCL as needed or until gastric tolerance is achieved (a warm sensation in your abdomen area).  BetaineHCL should always be taking with plenty of water to activate the powdered stomach acid you have just taken. Usually more is better ( 3 or4 capsules) in the beginning tapering back over time as less and less is needed to hopefully it is not needed anymore in 3 to 4 months.

I hope this is helpful.  I must stop for  now.

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

Sorry it was soo long again.  I know that zones most people out but when you get some more time read as many links as you can otherwise I have tried to summarize the research through my/their notes in my thread reply.

You can't do what you don't know. .. I wish I knew these things 10+ years ago.

2 Timothy 2:7 Consider what I say; and the Lord give thee understanding in all things.

Posterboy by the Grace of God,

***one more  note about slow LES function and why your stomach is delaying emptying.

quoting

"When gastric digestion experiments with digestion-labile food allergens, such as fish, milk, or hazelnut, were performed with SGF pH at 5.0, these allergens remained stable, even for 2 hours.Open Original Shared Link^,Open Original Shared Link^-Open Original Shared Link "  and remember that is what your stomach is now out after using PPIs for only a 5 day regimen the strength of vinegar. . .and explains the LES malfunction and subsequent dyspesia/heartburn/bloating etc. in my opinion that follows use of PPIs.

***SGF is short for stimulated gastric fluid see full article for why this important.

"In 1996, Astwood et alOpen Original Shared Link reported in a cutting-edge study that digestion experiments in simulated gastric fluid (SGF) ideally distinguish between potentially allergenic and nonallergenic food proteins". . . and has been in use by the FDA since 2004 to test a food's allergenic reaction. . ..

"Testing proteins for resistance to SGF exposure has since become a tool extensively applied in food allergy research to gain novel insights into food allergen biology." and why this is important.