Really sorry, more questions after discovering some things :(

I'm sorry about the number of similar posts I've been making here lately. Reflux has really played havoc with my daily life; it's constantly on my mind as soon as I wake up, and I've been struggling to get a handle on it as my thoughts have become progressively darker. I'm posting on forums like these more often (no offense!), and cry every week. How am I expected to face 60+ more years of life like this? People keep saying it's all in my head, and because of getting 5 negative (and 1 positive) spit test samples, I keep trying to think it is. It really hurts to be told it's "all in my head" and that I'm "faking it for attention." Today however I figured out some reasons why my reflux flares up sometimes. I think so anyway, but I need some help about it. Hang in there, I've got a lot to say...

First, I considered my diet. What's weird is that sometimes I can eat things you can easily say are bad for reflux. Angel Cake and Swiss Roll are notable examples. I ate some before Chrimbo and experienced no burning, and only a little more burping probably because of their airy texture/filling. That felt good, and it seemed like I was improving at last. A few days later, all I ate was a bread salt-pretzel, lettuce a banana and a glass of water and my throat was aflame. At the time I was sat enjoying myself with my best friend and for once reflux wasn't on my mind so much, so it really pushed my anxiety levels up. One day in the same week I felt so bad I only ate bread and chicken soup (with as little "cream of" as possible) and washed it down with skimmed milk (0.5% fat). It was like a wildfire in my esophagus, and every belch made it worse. I kept wondering why the whole time, until I looked back and considered what I was doing.

In the 2nd and 3rd examples, I was sitting down. I was switching between sitting back or leaning slightly forwards, but never enough to be too far hunched over or too far back like reclining or lying down. I still had both feet on the floor, so there wasn't much pressure on my ribcage/stomach, but I still think it's significant. If I sit like that anywhere at all - in a car, at a computer, at work - I sometimes get the burning, forced burping or at least the feeling of what I last ate/drank in my throat. Even if I didn't eat or drink anything, or if I follow the Kouffman reflux diet, it still happens. Standing up at work all day doesn't cause me symptoms very often, even if I bend over to pick something up, or feel anxious thinking about my reflux ordeals.

But it's far from consistent. Today, I experimented to see if I could force the burning sensation by hunching over on purpose and occasionally pressing my knees up to my ribcage. At one point, I couldn't get anything to happen until I stood up, THEN the burning occurred. My throat felt sore too, so I took a mini-jar of honey. The burning only occurred when I was standing, and disappeared when I sat down. Weird. On the other hand, yesterday I was offered a small slice of birthday cake at a party. Depressed by how I'd missed out on all my favourite foods anyway, I tried it thinking the Mirtazapine would stop the burning. Incorrect..! Sitting down, or a while after standing up made me burn. Once I got rid of the burning by simply tilting my head down (without moving the rest of my body) to look at a book. Confused yet? XP

Furthermore I've been monitoring my fluid intake to see if that affects anything. If I drink less than 1.5L of water or milk a day (the expected amount in the average lad of 22) I experience more burning burps and sore throats. If I drink more than 1.5L, I get more burping, but less burning unless it's been a while since I last had a swig of water.

Sorry this has been a lot to consider. Here's one more thing. Last year, I was suffering from anxiety related to my heart. You see heart conditions tend to run in my family, and when my arm felt sharp pains and my chest felt tight, I thought for sure I was next. These symptoms tended to be posture-related too. I could be lying in bed and getting the pains, but as soon as I sat up in bed they would mostly vanish. I've proved beyond a shadow of a doubt my pains last year were stress related, and I'd like to think my symptoms this year are too.


So to summarise, here's a question. Is it possible for my reflux symptoms to still be caused by stress and anxiety, even if things like posture and some foods make them worse? Also, can something as simple as worrying about if I'll get symptoms or not cause hidden stress in any way? If at all possible, I'd like to avoid medications and surgery, but even if anxiety is causing my problems, does the posture-making-it-worse thing mean I'll have to get surgery anyway to keep it away?

Thank you for any help you can offer, and once again I apologise for either being bloody confusing or persistent!


EDIT: One thing I considered is that I'm making my throat sore myself from clearing my throat all the time, and that the burning is actually soreness made worse by my posture. The honey making me feel a little better - despite being an acidic food - made me think this. Is this a valid theory?

Post Edited (Daxter) : 12/30/2013 2:10:19 PM (GMT-7)

Daxter, your story is so similar to mine we could almost be the same. Hopefully you will be relieved to hear that while I was once where you are now, I am now doing ok and the symptoms have really settled down.

Firstly note that it isnt all in your head, reflux tests arent perfect and quite often show things as fine when they arent. Secondly anxiety and stress does have an effect on reflux, not only by increasing its likelihood and acidity, but it also makes your esophagus more sensitive so it feels more painful. At least thats what I find. The symptoms you are experiencing and very real, they arent in your head and will likely continue even when your not stressed. It isnt just caused by stress, althougt that makes it worse.

reflux has a lot of effects on my heart, probably because I have a hiatus hernia. My heart frequently skips beats, and feels like it stops beating for a while. I have also had sharp stabbin pains in my heart before, but these stopped once I went on PPIs to reduce stomach acid.

Hunching over will tend to push acid up from the belly into the esophagus, it will also put pressure on your heart so dont be surprised if you get strange symptoms when you do it.

I also find that standing can make my reflux worse. try not to lie flat but lie at an angle, or sit, I found this the best position for me.

Also take real care with not only what you eat, but the volume. For example having a huge glass of water or milk with a meal is going to fill your stomach and because its all liquid it will easily flow out into the esophagus. but if you just have a piece of cake, it will likely absorb any liquid and probably stay in your stomach.

if you have reflux during or after a meal then my best advice is dont eat or drink anything else. Try and relax your body and just wait for it to subside, it will, but it takes some time.

Post Edited (Andy1986) : 12/31/2013 3:32:47 AM (GMT-7)

Hi Daxter

Firstly, be assured that it's not in your head and what you are experiencing is very real and very common. GERD symptoms can be very distressing, I ended up in the ER twice before I was diagnosed as my heart felt like it was going to burst out of my chest and my heart rate was over 220 beats per minute. I have now found out that this happens as one of our central nerves runs very close to the oesophagus (the Vagus Nerve) and so when your oesophagus is upset it can impact on your heart rate in various ways. Stomach acid is powerful stuff and it can cause some very painful symptoms.

I had severe chest pain as well because my oesophagus wasn't functioning properly and would sometimes go into spams. This also caused other symptoms like headaches, nausea, pain in my arm, tingling in my fingers etc.

Before I was diagnosed I was told by medical professionals that it could be due to "stress" or that it was psychological - when in actual fact the distressing nature of the symptoms and not having a diagnosis was what was creating my anxiety and stress - i was completely miserable. Once I had the diagnosis the anxiety went away.

I also get what's known as positional reflux, especially when driving long distance, or where I am sitting forwards for any period of time - this is due to the upward pressure on the stomach and oesophagus, once I walk around a bit it gets better.

I was on Pantoprazole, which is a Proton Pump Inhibitor drug, for over 4 years. This really helped, along with dietary control. There were a number of foods I couldn't eat and the main problem was limiting both food and drink intake to small amounts.

I live in New Zealand and six months ago I agreed to be part of a medical trial my local hospital is doing for a new treatment for GERD. I have a small device implanted just below my ribs which sends light electrical stimulations to my lower oesophageal sphincter to retrain it to operate normally. The device is made by a company called Endostim and it works brilliantly - without any of the complications that other surgical treatments seem to create. I still get minor symptoms and I watch how much I eat and drink, but the improvement is amazing and I can eat virtually anything now and don't take any medication anymore. The recovery time was only a few weeks and I can't feel the stimulations happening - i sometimes forget it's there!

Hang in there - make sure you keep asking your doctors for answers and don't be put off by unhelpful medical professionals, as many of us in this forum have been. There appears to be a global lack of understanding within the medical fraternity about the severity of this disorder and the major impact it has on our daily lives, and what treatment options are out there. Keep asking until you get the help you need.

Remember, you are not alone as there are millions of suffers around the world, this forum is a great place to get support, ask questions and to share your experiences.

Best wishes and keep posting with your progress to let us know how you are doing.

Rebecca