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Hey guys, I've been paleo for 1+ year, and around the one year mark, I developed GERD/Heartburn. It started after having a weird reaction to a food (i think coffee). In the process of finding out it was the coffee, I must've done something to weaken my lower esophageal sphincter pressure.

It seems like most of the GERD posts are about folks on SAD curing it with a paleo diet.

So what do you paleo folks do when you get heartburn?

Avoid FODMAPS? Fast? Not-fast?

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Hey Lost, me too, right at the 1year mark as well.paleohacks.com/questions/110294/… though I think mine was related to either fish oil supplements or a really severe cold/asthma/allergies. I stopped the supplements and have been doing much better, I plan to work them back in soon to confirm it was the cause. – PaleoVenus Apr 22 2012 at 16:37
FYI, still having severe problems with chest burning. Went to a GI and an allergist and no one seems to be able to figure out what it is. I hope you have found some relief. Let us know! – PaleoVenus Jan 31 at 19:47

15 Answers

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I've been paleo for 3 months now, i do have the odd treat day but primarily paleo. However last week i started getting severe cramps and indigestion, something i've never suffered with before. I don't drink coffee so i know it is not that, does anyone have any suggestions of how to ease it, i have heard peppermint tea is good?

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There's a study suggesting that calcium carbonate (in a quick-acting form like powder or chewable tablets) can raise esophageal PH (potentially fighting GERD) without lowering gastric PH like some treatments do. Also, calcium has been recommended as helping to close the valve protecting your esophagus.

I think it's an easy treatment to try, especially for anyone replacing an existing calcium supplement with a powdered version. I'll be giving it a shot myself.

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Betaine HCL supplements with digestive enzimes and calcium are available from Country Life. – Aston Feb 21 at 18:54
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If you were on a PPI the reason the reflux came back was not because of PALEO while you are on PPI's your stomach produces more acide producing cells in an attempt to counteract the PPI's acid block abilities. So when you stop taking them you will get even more acide production than ever before until your cells normalize which can take several days to several weeks depending on how much damage you did whil using the PPI's.

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Some coffees are more acidic than others, hence the various coffees being produced now that are advertised as "low acid". Different decafs have different levels of caffeine, and ironically most are produced from the most acidic coffee beans because they maintain their flavour better after the decaf process. Puroast has a low acid decaf coffee and for those of us with Keurigs, now have the k cup version.

Caffeine relaxes the LES which is why GERD is worse after drinking it. Black tea is acidic, caffeinated and high in histamine for those people whose GERD may be related to histamine tolerance.

It may be time to find a totally different morning "fix"

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I had been suffering from bouts of GERD on and off for 18 months. Taking betaine HCL supplements helped enormously but it wasn't a solution really. I would be two months on HCL capsules, then be fine for two months w/o HCL capsules until GERD started to return, and the cycle would repeat. Sometime during all this I went full Paleo (, I had been gluten free and dairy free throughout). So no, going full Paleo did not resolve my GERD issues. It did help enormously with another problem I had: IBS.

A couple months back I went to a gastroenterologist. I had a colonoscopy and upper endoscopy done. I had a benign stomach polyp caused by an H. pylori infection. Eliminating this infection, through a horrible course of antibiotics, eliminated both my IBS and GERD. I am SO MUCH better now.

Bottom line: go to a gastroenterologist and get tested for H. pylori. H. pylori causes a lowering of gastic pH as part of its survival mechanism. I can see where a large number of folks with GERD have this bacteria. There are a number of ways to test for H. pylori w/o the need for an endoscopy.

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I'm 9 months into paleo. Just started with acid reflux last week- I never knew it could hurt so much. Based on this thread I'm going to stop drinking coffee. Here's hoping it works. Thanks for everyone's thoughts on this topic.

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Be conscious of EVERYTHING you eat, stop eating anything that gives you an excessive amount of gas. – lostgoonie Oct 7 at 1:13
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I had a similar issue. I think my problem was that I had almost zero stomach acid before going paleo. Once my body started producing it on it's own, I had a lot of acid reflux - until my body adapted and started to deal with it properly. Supplements helped as did appropriate meal times, etc. Check out http://www.ncbi.nlm.nih.gov/pubmed/21577303

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I have a bit of extra detail here regarding coffee. I drank a lot of coffee years ago (I already had a slightly weak LES as a child - I could not run far without getting a 'stitch' or cramping symptoms in the abdominal region) and now I can not drink coffee as it makes me feel quite strange and affects my vision for about two or three weeks. The condition of reflux and later GERD crept up on me despite keeping a very steady healthy diet and weight. I kept away from coffee but liked (at the time) milk and cheese. To cut a long story short I have noticed that I can drink coffee and get rid of my GERD by living at 8,000 feet or above! I visited Ecuador and after a week of high altitude felt 100% and loved their coffee! On returning to sea level (Vancouver Island) my GERD returned within a day.

So anyone got any comments? Is it just an emotional response - Holiday = no GERD, or is this a heart mediated, oxygen mediated, neurological response (as I think it must be)? The LES tone is neurologically controlled. So coffee affects the nerve, as do other specific foods...Now how do we get a recovery? Surely the neural/immune response is the issue here but how do we recover?

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Maybe this might help: http://www.healingnaturallybybee.com/articles/dig14.php

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Coffee just might be the actual culprit: "Cross-reactive substances can comprise other, supposedly gluten-free grains, similar enough in molecular structure or genetics to cause reactivity in those particularly sensitive. Somewhat more mysteriously, they can include entirely unrelated compounds that may have an immunologically associative relationship to casein (actually, surprisingly similar molecule to gluten) AND EVEN COFFEE in some people. Coffee, in fact, according to researchers at Cyrex labs, may be the single most cross-reactive substance of them all." ~ Primal Body, Primal Mind (page 42)

Bummer, though, hope you feel better!

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Coffee had no effect on me, I drink ~4 cups a day and no reflux. Cow dairy, and wheat cause it for me. YMMV. – raydawg Oct 7 at 15:39
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I experienced very similar reactions to food around the 1 year mark too. I began taking a very good probiotic and prebiotic by Quest. It has made a HUGE difference and I can drink as much coffee as I want! Hope this helps x

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I had pretty severe heartburn (never spoke to my doctor about it) before following a mostly strict paleo diet (no dairy except butter, no sugar, no grain, minimal nightshade). In the last few months I've figured out a few things. Coffee: switching to home roasting made a huge difference. Adding copious amounts of Kerrygold might help too. Alcohol: the acids and histamines caused major problems before, but now they are even worse. Tomatoes: should be kept at a minimum now. The heartburn is worse now than it was before when I indulge in general heartburn inducing foods. My reactions to anything unfriendly to my body are generally worse now. This includes second hand smoke, fragrance, alcohol, grain, dairy, and certain cosmetic chemicals. And I thought I was sensitive before.

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oh and sugar...it's my worst offender...I even get heartburn from honey. I can't even have dark chocolate bars now, just baking or raw cacao. I do okay on the 99% bars, but at that point I might as well save the cash and buy baking. – Molly Apr 22 2012 at 16:15
Baking soda or real pickles help. – Molly Apr 22 2012 at 16:20
Sugar is also a culprit for me, even honey and whole fruits cause a big constellation of problems both physiological and psychological. – Canis Minor May 9 2012 at 16:06
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I had GERD before going paleo, but it got worse when I started - I suspect this is because I was using acid blockers, and having gone off of them, going Paleo allowed the proper minerals to be absorbed (zinc, magnesium, potassium, etc.) which produced more acid reflux.

However, the GERD did not go away until I took out all dairy about a month later.

So you'll have to find what triggers it. For me, wheat causes me the runs, but then immediately, acid reflux comes back at night. If I consume a bit of dairy (amount varies, but typically cheese, even raw milk cheese) triggers it. So far the only dairy that doesn't cause it is goat kefir/cheese.

I don't think it's lactose related for me, due to the timing, plus there's not much left after fermentation, so it's something in the proteins, likely the casein. As usual, you're your own n=1 and YMMV.

It might be the coffee, it might be the brand of coffee, or it might be what you put in it. Who knows, maybe they used the same grinder they use for wheat flour to grind your coffee if you picked up some low quality stuff.

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In general, giving up processed foods cured my GERD but I can have mild symptoms if I eat too late in the day or eat a meal with large portions of fat/starch. I've learned to take a stomach acid capsule with such meals and to stop eating by about 6 pm. Since starch is a particular trigger for me I usually only eat starch between noon and 4 pm.

If I notice sensations of possible heartburn, I just sit up and drink a little water and that usually takes care of it as long as I haven't eaten for several hours.

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I got my first round of GERD from over use of advil when I tweaked my back. It comes back to visit when I get any kind of stomach bug, or when I eat fodmaps. I can make it go away, almost like magic with bone broth + probiotic drinks (kefir/kombucha). I can now have a little bit of fodmaps foods, as long as I take in a bunch of probiotic drinks and keep my gut nice and healthy.

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