My struggles with acid reflux (GERD)

I’ve been suffering with acid reflux for almost 2 years now. In reality it’s probably a lot longer however 2 years ago is when it got so bad that I went to the hospital to get checked out. My main symptom was shortness of breathe and a “globus” feeling in my throat. These are classic LPR symptoms and while I was never officially diagnosed with any disorders as I never required (or requested) an endoscopy, I was however prescribed a PPI (Omeprazole) and Gaviscon. As mentioned my symptoms were most closely related to LPR but what I didn’t notice at the time was that I also had acid reflux, it was just less bothersome to me.

I am still not free of acid reflux and suffer with some symptoms daily depending on what and how much I eat. In fact as I’m writing this I have some mild symptoms after eating too much for lunch, but I am on holiday sitting by a river so not all is bad with the world. I don’t want you to think that your problems will never be solved because actually I’m quite positive about my situation which is in part why I’m writing this. If like me though, you damaged yourself badly, it will take a much much longer time than you read online and in all likely hood, it will mean changing your eating habits for the rest of your life.

I want to lay a little background of why I believe I developed the problem in the first place. Unfortunately if you are reading this it might be too late, but you might also have a similar background and find it interesting, so hey ho. I have been overweight for most of my life. I’ve also lost and gained tremendous amounts of weight twice in my life. In my early 20s I had reached 160kg and I was likely even heavier at my biggest, 160kg is after months of dieting and being brave enough to step on the scales, to 95kg. I then moved to Thailand and my healthy eating regime disappeared I rocketed from 95kg to 140kg in a year. I maintained 140kg to 160kg for the next 4 years until my symptoms really kicked in.

Needless to say my eating habits were catastrophic for acid reflux. Being over weight (obese in my case) is a risk factor but I also quite literally did everything I was not supposed to. I would eat two super large meals a day. I would do so, attempting to do a OMAD (one meal a day) diet but failing and binging for a second meal usually right before bed. I would eat generally healthy whole foods but incredibly spicy with a lot of “trigger” foods. Obviously you don’t get to 160kg on sweet potoatoes, salad and chicken breast. I was also eating plenty of calorific curry type foods with a coconut milk base. I did this for several years before I had to stop.

I ended up going to see a doctor at the hospital. As mentioned above, I didn’t have an endoscopy, he didn’t think it was necessary (and I agreed). I told him what my symptoms were and he prescribed some medications and made some comments on how to eat (small meals). I was pretty satisfied, I had a plan of action. I would have loved more information from the doctor on what to eat and what to avoid, but what I later learned after Googling was that the list of foods people can and cannot eat are incredibly personal. As an example, I can eat high fat foods like peanut butter and coconut meat from fresh coconuts but an equal amount of chocolate in weight or calories would give me a lot of mucus in my throat and a slight burning sensation. There are however I believe universals that I will list a bit later on.

Literally the same day of going to the hospital I changed my diet completely. I would eat immediately when waking up, it would be a small portion of anything that was regarded as “reflux safe” so oatmeal, lean meats and fish, salads, vegetables and so on. I would try to eat similarly sized meals every 2-3 hours and fit in pieces of fruit every now and then depending on how I felt. I would also religiously stop eating at 4pm to give my body plenty of time to digest before sleeping.

I played around with this formula a little, mostly reducing the eating window and at one point I reduced it to midday (12:00) and for weight loss this worked great. In a year I went from 148kg to 88kg. When I got into the 80s I decided that I was losing weight too quickly and tried to eat more calories. That didn’t go well. I was better, my symptoms were less and I could eat a bit more. What I noticed though was that often my symptoms accumulated over a period of days. I could eat a slightly larger meal one day, but doing the same thing for 2 or 3 days would mean a fairly painful flare up.

I was also developing an eating disorder, I had begun to become incredibly hungry and would binge eat everything I could see. I did this despite knowing that I would be in pain later and it would ruin my capacity to work. Despite this, I continued to lose weight and reached 79kg at my lowest and maintained 79-83kg for many months going through this cycle of eating safely and then binging occasionally.

It was fairly recently that I made it past this step and finally found the right balance. What I believe is the case is that, when eating from waking up (8am to 12am) I would fit in 3 meals and a piece of fruit. This would equate to a maximum of 1500 calories. Way below my maintenance. That over the period of a few days would build up and the urge to binge would win, where I would eat a lot of very calorie dense foods like cheese. This would keep me around the same weight with perhaps a slight trend downwards.

That brings us roughly to today. I exercise immediately when I wake up, then eat some lean meat or fish topped off with 30-40g of nuts or nut butter. That equals about 200g of food and roughly 400 calories with lots of healthy fats, protein and fibre. I aim to eat a similar meal every 2 to 3 hours and fit in several pieces of fruit throughout the day. So really, the saving grace are nuts. They should be a trigger food but not for me, thankfully.

Now, I want to do further blogs on the specifics but I also want to give you a good place to begin experimenting from. I want to go with things that I think are universals to my recommendations.

(future me) I used the term “large meal” below, I wanted to define what that is for me. A large meal is anything over 350g of food. I aim to eat small meals which I define as 250g or less (200g is ideal). For me, it means that I end up deconstructing a lot of meals and having parts of them. For example I’ll eat a chicken breast with beef liver and a small portion of salad leaves. That totals about 250g of food and is slightly on the heavier side. If I want pasta and cheese, that’s a big no no, so I just eat cheese on it’s own. There are some caveats like watermelon or dragon fruit that I can eat more than 350g without or with minimal symptoms. You might find this to be the case with other watery foods also.

(universal) Avoid large meals as much as possible. This can be so difficult for some of us who like to feel full, but ultimately if you suffer from bad enough acid reflux you know it’s not worth it. (though it took me a very long time to learn that lesson). (universal) Don’t be afraid of eating and exercise. If you are not eating large meals, you won’t be feeling bloated. Exercising an hour or so after eating will be fine. Even if you feel a bit sub par, doing light exercise will make you feel better. I would say this is not true if you have eaten a large meal though. (universal) Drink calories. I personally stay away from sugary drinks, I want to be healthy and I figure fruit juices, or sodas aren’t good for me either but I’m not totally against it. I would say though, just from a health point of view, having a smoothie using whole fruits or nut milks or milk is the superior option and remember that just an extra 200 calories from liquids is half of a meal you won’t need to eat.

  • (universal) Chew your food. Chew as much as possible and try to get into a habit of putting your knife and fork down between bites and also reduce size of each mouthful. It makes food last longer which is a big bonus for me, it means you can eat a smaller portion with other people and not be sitting waiting for them to finish. Supposedly also, chewing your food reduces reflux symptoms. I’m not convinced on the last part, but taking my time to enjoy the smaller portions is worth it on it’s own.
  • (universal) Tell other people. Let others know that you can’t eat certain foods or eat large portions. If you’ve got the right people around you they are going to help you.
  • (universal) Find high calorie foods. Some (I hope at least) high calorie foods will agree with you. Add these into your diet as a staple to avoid having to eat large meals to get your calorie requirements. My current go to are nuts. Specifically homemade peanut butter (just peanuts, a pinch of salt and a food processor). 100g of peanut butter is a whopping 588 calories with 50g of fat, 25g of protein, 9g of sugars and 6g of fibre. It’s almost perfect and for me personally, I think it is perfect.
  • (universal) Time restrict yourself. I should say, this one sent me down a dark path so don’t be stupid like I was. What I will say though, it did and does work for me. Just be sensible. Currently I leave anywhere from 5 hours 30 mins to 7 hours between my last meal and sleep and I’m not crazy strict. Find the right portion size, the right meal frequency, the right snacks and make sure you’re getting enough calories each day. It’s not easy and I’m going to write an article on just this point alone.
  • Drink a lot of water. Try at least, I hear some people suffer with “water brash” but for me with LPR symptoms water clears and soothes my throat.
  • Chew chewing gum. I like to eat and a big part of eating is chewing. I think (bro science) that it helps a little by having more saliva coat your esophagus. (btw in Thailand you can get raw sugar cane which wood like and you can chew it for the sweet nectar, it’s low calories and for me, I can eat it all day long with no symptoms (minus the mouth ulcers from chewing wood lol)).
  • Don’t starve yourself. Not eating works great for me, my symptoms disappear. When I was 140kg+ eating 1200 calories a day worked great to control the symptoms but it didn’t fix the underlying problem and it also give me an eating disorder.
  • Buy a wedge pillow. I don’t know if it really helps or not but i feels like it does. For me it’s a good buy for the placebo if nothing else.
  • Sleep on your left side. Same deal as no.10. It strangely seems to help but I’m not convinced that it’s not just a placebo.
  • Gaviscon or antacids. For me, Gaviscon Advanced definitely works, if I eat a large meal and use Gaviscon the symptoms are reduced. If I binge, Gaviscon can help but it can’t save me. As with all medicines, I use them sparingly when I really need them.
  • PPI’s I used Lansoprazole and Omeprazole. Both seemed to work, I got scared though by some studies linking them to esophageal cancer. I’m also probably stupid. I’ve been thinking recently about using Omeprazole again. My thoughts are that I don’t want to use PPI’s to eat larger meals and damage my body. I want to use PPI’s to give my body time for it to fully heal and continue with a diet that is reflux friendly. I’m not sure that the medication is going to do that. I should give it a try though.
  • Don’t be fooled by herbal remedies. I totally feel that ginger helps with my reflux symptoms, but not even nearly as much as Gaviscon but unlike Gaviscon, I’m not that concerned about consuming too much ginger. I said don’t be fooled though, the fact is, the medicines work and work really well. The so called herbal remedies like ginger or apple cider vinegar etc probably do “help” but none of them have helped when I’m having a flare up. All of that said, I’m not going to tell you not to try them. If they work only as a placebo, that’s great but don’t suffer needlessly by avoiding the medication because you’re drinking ginger tea.
  • Exercise more. I was obese, I needed to lose weight to be physically healthy irregardless of my acid reflux. I also happen to think that exercise has helped reduce my symptoms. The problem is that there’s no way I can say that exercise really did help my reflux symptoms. It could just be losing the weight. Still, exercise is good for you, so definitely recommended but it’s not necessarily going to fix your reflux.
  • Walk after meals. The reason this isn’t a universal is that it doesn’t help me eat a larger meal or reduce my symptoms during a flare up. What I do find though, is when I eat a smaller portion and do 5+ minutes of walking after, I rarely get symptoms and I can eat again in 2 hours. I would very much recommend giving this a try.
  • Distract yourself. If you did eat something that disagrees with you, try your best to do something to keep your mind off the pain or discomfort you’re feeling. Even if it’s just playing a game.
  • Plan your food ahead of schedule. I feel that this might be a negative for me, but I plan the next days food during the previous evening. I’ll get any meat and fish out of the freezer and put it in the fridge to slowly defrost overnight. I like to plan so I know I’m hitting my calorie needs and it actually reduces my hunger by knowing what’s next. I’m not totally convinced that it’s not part of an eating disorder though.
  • Be spontaneous. The opposite 🙂 if someone in your family has made some nice meal or desert then eat some of it. You might be able to say no once, or twice, or 3 times but you get the picture, eventually you’ll give in and eat too much (at least I do).
  • Eat yummy foods. I love ice cream so most weeks we go to an ice cream parlor and I order a small but delicious ice cream. I’m quite lucky because I don’t think ice cream is a bad trigger food for me, so I can do this and have no symptoms. I would recommend that you do have planned cheat foods. Stick with smaller portions but go for it.
  • Live life. Reflux seriously sucks, it’s dominated and dominates my life a lot. I went from being all about food to not being able to eat it. It’s not the end though. Use the tips above like chewing your food and eating slowly, it’s not the same as eating a lot of food but it’s the next best thing. Beyond that though, find more than food. When you go on holiday, make it an adventure holiday where it’s about hiking a mountain and not about going to a fancy restaurant.

Read more about similar things :)

Carpe Diem
2023 — Matt Gould