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I've been paleo for a year, but starting last week I get heartburn after pretty much every meal! It's really very painful. I never had it before in my life and actually didn't even know what it was when I first felt it and nearly panicked. Now I sympathize!

Potentially helpful facts: I have been Paleo for well over a year, crossfitting for about 3 months and have never had a problem until last week. I haven't added any new foods recently. I started supplementing with Mark Sisson's Fish Oil/Vitamin D/Gut Flora combo about 3 months ago. I was very sick recently (worst cold I've had since going Paleo) and coughing to the point of losing my voice and abdominal soreness.

-Could the Gut Flora be doing this? Perhaps bacteria built up over time in my lower intestine and that's why I didn't feel it until now? is that even possible?

-Could I have damaged my stomach opening somehow with the coughing?

-Could it be caused by cold meds? The heartburn came on a week after I stopped taking them.

I read some great posts on here about how to treat heartburn, so I'm going to try the apple cider vinegar thing, but I really want to know what's causing it. Paleo isn't supposed to give me health problems I didn't have before! Boo!

What could it be?

UPDATE: Thanks for all your thoughtful responses. I cut out all the supplements and, after a week or so, started feeling relief. I added vitamin D back in without a problem. Two days ago I tried adding the fish oil back in at bed time and about 30 mins later, the heartburn was back! I haven't tried with the probiotics, I have just given up on those. Anyway, I think I found my culprit. It's really terrible, because I don't like anything other than salmon and I get bored of that pretty fast. What to do for those lovely omega-3s...I'm sure PH has a solution for that. Off to search i go, thanks again!

UPDATE 2 (1-31-13): I have stopped all supplements and 9 months later the "heartburn" is worse than ever. Went to a GI and an allergist and no one seems to be able to figure out what it is. I get it at random times throughout the day without any correlation to what I'm eating. It does not cause me to cough, but I do sometimes feel mucus coming up into my throat. I'm not even sure at this point if it's heartburn at all. Anyway, just thought I'd update in case anyone was following this. Hope you find more relief than I have!

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 Did you take NyQuil? I get hearburn for a while after using anything with corn syrup. The coughing could have certainly messed something up in the sphincter between your stomach and esophagus. – Happy Now Apr 6 2012 at 20:00
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 Stop taking all supplements. Fish oil in particular can mess with the stomach lining. Add back in D later since that's unlikely to be an issue. – Bread-Eating Beelzebub Apr 6 2012 at 20:19
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 Fish oil can take a while to imbalance prostaglandin synthesis, which can damage the stomach. NyQuil is going to magnify that. Stop taking both for awhile, see if the heartburn goes away, and then maybe try to add it back in. Or just eat fish. – Bread-Eating Beelzebub Apr 6 2012 at 20:46
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 Fish oil can also lower stomach acid, which can lead to bacterial overgrowth or just digestive issues. Betaine HCL could help, there isn't much evidence for it though, but I've used it with some success. informahealthcare.com/doi/abs/10.1080/… – Bread-Eating Beelzebub Apr 6 2012 at 21:32
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 I have access to the document and have just uploaded it for your viewing pleasure: scribd.com/doc/88341575/… – April S.♦ Apr 7 2012 at 5:33
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5 Answers

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I am no doctor but that coughing fit could have cased a hiatal hernia which can really give you some bad heartburn. Just to be safe take it to your doc if you can. It may not be diet related at all, and a more serious problem.

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Thanks Ender, i appreciate the advice and the concern. I'll check it out with my doc. I wonder if they can do an x-ray to see. – PaleoVenus Apr 6 2012 at 22:09
yeah the use a barium x-ray – Ender Apr 6 2012 at 22:21
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I found that NSAIDS aggravate or even cause GERD. If you used any advil, aspirin, alleve, anything like that, you may have generated the acid.

A few tricks for making GERD calm down when it's super angry. Black licorice is a natural anti-acid, and you can take it in tablet form-I use a product called gastrocare, and if I chew a tab or two, the symptoms go away immediately. Drink a lot of water. Avoid fructose and FODMAPS foods in general.

Do not, repeat, do not go down the road of taking pepcid/prilosec. Stick with natural treatment, rather than monkeying with the balance of acid in your belly.

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Could you be pregnant?

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Haahaa, I hope not. Just thinking about that gives me heartburn. – PaleoVenus Apr 8 2012 at 23:25
Just wondering. I know several ladies who got heartburn almost as soon as they conceived! – DanielleO812 Apr 9 2012 at 0:54
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You could have aspirated stomach acid into your windpipe with your bad cough. Chris Kresser has a series on GERD. He recommends 2 books. Both are helpful. A meat and fat only diet helped me. ZERO carbs and HCL (Twin Labs) also worked. Jonathan Wright recommends pancreatic enzymes for more "mature" sufferers of acid reflux. They were a tremendous help. You can do this. Takes some time, though.

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oh wow. Would aspirating stomach acid have an ongoing effect like this? You'd think I would have felt it immediately when it happened and then it would have subsided when the cough ended. Zero carb is not an option for me as good carbs help me manage depression and without them I get hopelessly down. I'll look into the authors you recommended. Thanks! – PaleoVenus Apr 6 2012 at 23:00
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This happened to me too. I had never had heartburn before paleo, but then started getting serious chest pain. After some trial and error, cutting out olive oil did the trick for me.

Good luck!

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