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GERD/LPR/Acid Reflux: Not getting enough calories

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GERD & Acid Reflux
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Posted 12/19/2016 7:04 PM (GMT 0)
Hello all! Okay, that exclamation point may be misleading...as I am not in the best of spirits due to dealing with GERD/LPR/Reflux combined with sore throat.

Question: How can I get enough calories while I dealing with this bout of GERD/LPR reflux and sore throat?

Losing weight and fast, have low energy, mood is crappy, and I am in isolation-mode because talking hurts. I am severely under my necessary calorie intake right now. The foods I list below are super lean and are so low in terms of calorie count!
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(Here's some background if you would like more information)

2 years ago while teaching yoga I got a sore throat that wrecked havoc on my life. I went to ENT and he said I have GERD. Put me on PPIs (prevacid) and also zantac. Lot of other life stuff happened (such as being diagnosed with testicular cancer and then it metastasized to lymph nodes a year later...so I got radiation therapy...awesome!) and I got out of teaching, and my throat felt a lot better since I wasn't overusing it all the time. Still had reflux, but it wasn't taking over my life. After a particularly bad week of pushing my luck with all sorts of junk food, I have recently entered reflux hell again. I'm losing weight (I'm about 6'3 in height and I usually weigh about 154 lbs, which is still low...but now I am at around 143 and probably dropping). This is because my reflux is out of control and it seems like everything I eat is causing it.

Recently I went to a different ENT (my other one moved) and he wrote LPR as a diagnosis. He ideally wants me to undergo stomach pH testing to determine is surgery is a good idea...and I would love to do those things...only I don't have health insurance currently. (With any luck I will soon, but there's no guarantee it will pan out.) Since I cannot afford the above, he suggested I up prevacid to the max dose of 60mg a day (30mg, 30 min before breakfast and dinner) and then take zantac before I go to sleep. At first it seemed this was helping (-slightly-), but IF there was relief, it was short-lived.

I have read in depth about the effect of long term PPI/H2 use on creating stomach acid, and I would like to get off of them eventually. However, I missed one dinner dose of prevacid and that night and the next day were absolutely horrendous. I think my body's natural ability to create stomach acid is so piss poor right now that even "bland" things like chicken are not being digested efficiently...causing reflux?

Diet (everything is either Trader Joe's or Whole Foods)
Eggs in the morning (2 whites, 1 yolk), salad, cantaloupe slices, cauliflower
Snacks: Cashews sometimes, apples, cantaloupe, gluten-free granola, oatmeal w/ raisins
Dinner: Skinless chicken tenders, salad, cauliflower, cantaloupe, jasmine rice

So desperate for calories that I've even started drinking Slim fast/Ensure shakes, which I'm sure are loaded with a lot of bad stuff. The irony is that my diet seems so healthy, but I'm the unhealthiest I've ever been in my life.

For oils I usually use extra virgin olive oil, but sometimes extra virgin cold pressed coco oil
Spices: Pink Himalayan salt
Supplements I use/have used: Multivitamin, DGL-Licorice tabs, D-Limonene, Slippery Elm powder, Manuka honey, Melatonin 3mg, HCL/Pepsin

I recently ordered Gaviscon Advanced (UK version from amazon) and it seems to be better than the US version, which really just seems to dry my throat out now.

Lifestyle changes/Things I've tried:
Bed elevated 6 inches (may do 8 very soon)
More/smaller meals
Humidifier
ACV
HCL/Pepsin


Looked into the Fast Tract Diet as well as the Dropping Acid Diet. Did some reading on paleo/keto as well.

Any suggestions would be appreciated!!! Thanks so much.

Post Edited (Sonus) : 12/19/2016 12:11:36 PM (GMT-7)

Posted 12/19/2016 9:53 PM (GMT 0)
You should try the low-carb diet. NOT no carbs but low carbs. Also stop eating fried or fatty foods. You should be able to tolerate any NON-fried meat. Chicken either baked or sauted (olive of coconut oil), steak but lean cuts of steak, turkey bacon, turkey. Stay away from pork if at all possible as well as spicy foods. DO NOT DRINK COFFEE OR ALCOHOL on an empty stomach!
Posted 12/20/2016 1:15 AM (GMT 0)
Okay I had gerd for years and I had the same problems in calories.

What I eat for extra calories is:
Organic grass fed butter, Coconut oil, avocados, Grass fed meats w/ no antibiotics like chicken/turkey, and some rice occasionally

these foods is at least 500+ calories added to what ever your eating, I just make sure its natural because for some reason when I eat cured (sugar) meat or high carb foods like bread it gives me acid reflux.
Posted 12/25/2016 5:15 AM (GMT 0)
I recommend getting Gaviscon UK. It actually does something, where the US version does nothing. It's a completely different formua.

It's been getting a little better. I think when you're in sore throat mode/burned esophagus, you can't see past it. It was so bad that I couldn't eat, and basically was starving myself. I think that is much more acidic than just biting the bullet and eating. Here's my current routine (and I'm looking to add good calories to it):

That being said, I've been monitoring my diet pretty well. My diet has been mostly poultry, rice, and fruit. I've been drinking one cup of coffee as my throat allows, and I (stupidly) ate ice cream yesterday (I stayed up a few hours after, in hopes it might not ruin me. Again, Gaviscon is necessary.

Breakfast/staple meal:
2 egg whites + 1 full egg
Jasmine rice
Cantaloupe (hopefully steamed)
Cashews (roasted currently, had been eating raw)
Coffee (low acid, grassfed butter, extra virgin coco oil, a pinch of baking soda)

Dinner:
Steamed veggies (cauliflower, baby carrots)
Skinless chicken breast/tenders
Jasmine rice (low sodium soy sauce)
Cantaloupe
Cashews

Snacks:
Cashews and raisins
Oatmeal (rolled oats, gluten free) with raisins and manuka honey

PPIs: 30-40 min before breakfast, 50 min to an hour before dinner

Supplements:
2-3 DGL licorice tablets before meals
D-limonene after meal(s) (I take it after dinner if I suspect I'll need help digesting)
Melatonin (3 mg) 1 hr before bed
Multivitamin

Zantac 150mg 1 hr before bed, Gaviscon UK

(Gaviscon as soon as I feel any twinge, even after meals)

Trying to wait at least 2 hours before meals before I hydrate (ten big gulps every few min). High pH water

Hope this helps someone!
Posted 12/25/2016 5:17 AM (GMT 0)
QUESTON:

If you had to use/make a calorie shake, which one would you use?

I am looking into finding the BEST "weight gainer" shakes for GERD. I need more calories.

Is whey protein bad across the board?

I bought some egg white protein and tried making a shake with raw almond butter, almond milk, egg white, hemp protein, banana and manuka honey and it was awful. AND it wasn't enough calories. I used 1/4 an avocado today but still need to fine tune.

Thanks!
Posted 12/29/2016 3:51 AM (GMT 0)
For anyone interested in what I'm doing for more calories:

I've been making these shakes!

1 1/2 cup almond milk (unsweetened)
1/2 avocado
1 banana
1 tbsp of manuka honey
2 scoops egg white protein powder
1 scoop hemp protein powder
1 tbsp of rolled oats (gluten free)
pink salt

Blend it up...it's pretty good and pretty filling. The way I've been making it adds up to about 350-430 calories. I think this is a much better alternative than using pre-made shakes that are loaded with sugar and chemicals. I ditched the almond butter because I feel that texture is more likely to cause symptoms.

Still interested in a good weight gain powder. All I seem to find in stores are whey (which is dairy) and plant based protein powder which has pea and soy protein isolates, which I am allergic to. Any suggestions would be welcomed!
Posted 12/29/2016 6:08 AM (GMT 0)
I have no ideas for you protien question, but......

Something to ponder. Often people at this point need to back up and look at the big picture. You kind of did that, but back up again and look more. The big, big picture, as to why this is happening in the first place.

Remember, It is possible to get GERD from things other than over acid production. Yet some Drs assume its too much acid without PH testing to prove it and RX PPI's when that was NOT the answer.

Its obvious many people have weak LES valves, maybe born like that...? Couple that with a bad food experience, gut candida, or SIBO bacterial overgrowth, and it might be enough to cause temporary GERD which the upward acid further weakens the LES. Then its stuck in some evil cycle till the LES heals and closes correctly. If the LES wont heal, they dont get better. It can heal, but is a challenge.

Besides all the healthy eating,......... have you tried digestive enzymes, probiotics, supplemental HCL for meat, or candida diet (no sugar, carbs, grains, booze), these help many people find the real problem. Looks like you beat healthy eating to death and its time for an additional plan.

Unfortunately usually only NP Drs look at alternative causes or solutions to complicated health issues, thus so many post here from people remaining ill from conventional medicines failures.
Posted 3/21/2017 6:54 PM (GMT 0)
In the interest in replying for other people who might be looking at this wanting help and the update.

Yeah, I've tried HCL, digestive enzymes, and Zypan. HCL was about 6 months ago and I found that it didn't help and also made symptoms slightly worse. A week and 1/2 ago I tried digestive enzymes (which contain acid protease) which I believe flared me up again. I tried Zypan a couple of times, but also had a similar response. So these occurrences have convinced me that they are not helpful in my case. I currently believe that because my throat is chronically inflamed, anything with acid is making it worse.

My issue with adopting an outright "low acid diet" is that I will be -severely- under calorie. My meal plan is basically the same as above, with minor changes. Poultry, jasmine rice, steamed veggies, and fruits. I regularly restrict all sugar (except manuka honey) and low quality carbs. The exception to this is when I get so down and apathetic about it all that I drown my sorrows in Ben n' Jerry's, convincing myself that "It's going to suck regardless, and I need the calories." Many will understand this struggle.

Not drinking coffee in the morning makes me legitimately depressed (many times I have chosen not to drink coffee and my mood is just in the gutter all day. I already struggle with severe depression and anxiety. I currently view it as a necessary evil, as I have no substitute for the chronically low energy problem I have. aka fatigue)

At the time of the earlier posting, I was on PPIs and H2. Max dose. I had to do the pH test so I got off them, and my test indicated that I was refluxing within the normal amount and surgery wasn't needed. It also indicated there were 2 instances of non-acid reflux, which indicates LPR if I am correct. After a month of this, and attempting to gain weight back, I had another flare up and am now back on PPIs, at least for the morning dose. Zantac at night with melatonin to sleep through the night. Gaviscon Advanced 4x daily, which is my main defense against the reflux.

When it gets bad, I dream of having surgery. I have terrible luck and I am quite sure that the Nissen surgery would just cause more problems. I've been thinking about Stretta.

I'm still here, although the struggle continues! Thanks for reading.
Posted 8/9/2017 4:57 PM (GMT 0)
Hello Sonus,

Curious. When you tried HCL, digestive enzymes, and Zypan, where you taking PPIs and H2 blockers?

Hang in there! changes in dietary habits, primarily restricting the amount I eat has given me the best results.
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