Questions for Wayne/Tex

Suzy · Post by **Suzy** » Thu Sep 15, 2016 4:42 pm

Hi. I'm hoping you can clarify this for me, because based on what I've read here some concepts are new to me:
1. Does taking Zantac/Pepcid actually make reflux worse in some way (by lowering the stomach ph or making undigested food flow up)? If so, that's even more reason for me to stop the Pepcid.
2. Do you suggest using ACV or Betaine HCI while I wean off Pepcid, and if so, do you know how to use them (before meals? with meals? how much?)

Thanks so much. Suzy

Post by **tex** » Thu Sep 15, 2016 5:32 pm

Suzy,

Any medications you take to reduce stomach acidity will probably have some effect on the clinching strength of the LES, but not as much as a PPI.

The reason for taking Pepcid or Zantac is to reduce the burning sensation (not to reduce reflux). If you don't need to reduce the burning, then you don't need to take them.

Lowering stomach pH increases the acidity. Antacids, H2 blockers and PPIs do not lower the pH — they increase it.

ACV is a very mild acid. There are different approaches on using it, and many websites that describe how to use it. Maybe someone here has a favorite way to use it. I've never tried it.

If you decide to use Betaine HCL, here's how to find the correct dosage:

1) Day one: 30 minutes before breakfast - one tab 650 mg betaine HCL; if burning occurs, stop taking
2) Day two: if no discomfort on day one, take two caps the next day. If there is discomfort, the correct dose is one cap with each meal
3) Day three: if no discomfort with two, take three caps. This will be the dose taken with each meal.

When you take a Betaine HCL tablet, you should notice a warm feeling in your stomach, roughly 15 or 20 minutes after you take it. If you don't notice any change, the dose is insufficient. Increase the dose at the next trial, until you experience a warm feeling after taking it. If you experience a burning sensation instead, that dose is too high. If it happens on the first dose with only one tablet, then you don't need any Betaine HCL — you already produce either plenty, or too much stomach acid.

Tex

Suzy · Post by **Suzy** » Thu Sep 15, 2016 6:06 pm

Thank you Wayne. My chest burning has gotten much better so I don't really need it for that anymore. I continue to have sternum pain but the Pepcid doesn't seem to help that at all. I did notice a slight sore throat though the last two days as I've decreased my Pepcid. Perhaps though if I just gargle with baking soda and use high alkaline water I can alleviate that and continue reducing the Pepcid over the next two weeks. . Does that sound reasonable?

Post by **tex** » Thu Sep 15, 2016 7:52 pm

That sounds like a reasonable plan.

Good luck.

Wayne

nsaidcolitis · Post by **nsaidcolitis** » Sat Sep 17, 2016 6:54 pm

tex am i hurting myself by eating high ph foods(i have gastritis as well) im eating avocados almonds and vegetables eggs and chicken cocout oil and soon olive oil, im avoiding or trying to avoid carbs like the plague but maybe i need more acidic foods to recover i get reflux from these foods as well not untolerable but scary. Wish i could eat carbs to soak up the acid but now that i react to them its hard.

i dont react to sucrose,glucose it seems only to fructose and maltose the worst.

Post by **tex** » Sat Sep 17, 2016 9:39 pm

In general, higher pH foods are less likely to cause reflux than acidic foods. Are you aware that carbs promote reflux/GERD? You're not really missing anything by avoiding carbs.

Heartburn Cured - The Blog of Michael R. Eades, M.D.

No one digests fructose well. Here's a quote from page 52 of the Pancreatic Cancer book:

It's important to note that glucose is the only sugar that triggers an insulin response.
Insulin is produced in response to an increase in the blood glucose level, but an increase in the blood fructose level does not cause an insulin response (Ancira, n.d.).60 This results in a completely different way of handling fructose metabolization.

Fructose can only be metabolized by the liver, and the process requires the enzyme fructokinase. Insulin allows glucose to pass from the blood into the muscles where it can be immediately burned as fuel. But because fructose does not prompt the release of insulin, fructose will not have the opportunity to be transported to cells where it can be burned as fuel, and because of that important difference, fructose digestion tends to result in the formation of more fat deposits.

Here's the reference from that quote:

60 Ancira, K. (n.d.). What is the difference between sucrose, glucose & fructose? Healthy Eating [Web log message]. Retrieved from http://healthyeating.sfgate.com/differe ... -8704.html

Tex