For the past few months, I’ve been engaged in a pesky war with my stomach. Whenever I’m considerate enough to send down some tasty food and drinks, it decides to act like an ungrateful brat and spit my offerings back up, with a little additional bilious acid for good measure.
Yep, I’ve been diagnosed with GERD (gastroesophageal reflux disease), the digestive disorder commonly associated with heartburn and acid reflux. Apparently I’m not alone, with around 20 to 30 percent of the U.S. population recorded as having GERD issues, often on a daily basis. So what’s going on? Well, in medical terms, it’s when your lower esophageal sphincter decides it cannot be assed to do its job properly, gets lazy, and allows acid to splash back up from the stomach. Cue the heartburn, the associated ailments, and, if left untreated long enough, the more grisly complications.
In my case, GERD appeared to manifest itself in an increasingly severe sore throat and what seemed like chronic hoarseness that lasted over a month. I remember spending my girlfriend’s birthday in a Mexican restaurant, nursing a paltry bowl of black bean soup, unable to talk because of the hurt. After seeing a doctor, I was told it was likely reflux causing the sort of sore throat that physically made eating a pain. An optical camera device was shoved up my nose and down my throat for good measure; I was sent home with some Nexium pills meant to re-balance the acid in my stomach and restore a state of stomach serenity.
Unfortunately, the first doctor I saw told me that I could continue to eat and drink whatever I wanted—so for the first month, I carried on bombarding my delicate esophagus with unwanted pizza and beer treats. The sore throat persisted, and nothing much improved.
At this point, I began to do a little research for myself. It seemed sensible to conclude that diet hugely impacts GERD. I rationalized it with the common-sense idea that if your stomach is not happy with the food you are sending it, you might want to try offering it something different. Drugs like Nexium (which are called Proton Pump Inhibitors) are not something you want to be on for the long term—at least if you’d prefer to minimize side effects like osteoporosis and heart attacks. Nor is GERD a curable condition in the traditional medical sense—PPIs only control the condition, and the surgery option, fundoplication, has a ridiculously low success rate—so making an attempt to switch up your diet and lifestyle to knock this ailment into shape seems like an endeavor you owe yourself. Here’s how I went about doing it.
(Disclaimer: Let the record show that my formal expertise is in cats and rappers, so, you know, definitely still talk to your doctor about what’s going on, even if you suspect they’re just trying to push prescriptions on you.)
The best way to get your GERD under control is through diet changes. The bad news is there are foods you probably regularly enjoy that you need to banish from your meals entirely.
The common list of foods that can aggravate GERD usually reads like this:
- Citrus fruits
- Carbonated drinks
- Deep-fried food
- Spicy foods
- Dairy (although feta and goat cheese usually get a pass)
So, the trusty pizza and beer combo is out—at least for the immediate future.
The safest way to ensure you avoid the common GERD trigger foods is to commit to cooking all your meals yourself for the first couple of weeks. Sure, it’s a lot more work, but if you’re serious about beating this, you’d better do it, because whenever you eat out, you lose control over exactly what is in your food. (Additionally, with GERD affecting everyone in slightly different ways, it’s best to be draconian about cutting out the usual suspects, so you can suss out exactly what you can and cannot tolerate as you later try to reintroduce foods from the hit list.)
While certain devilish foods like tomatoes and chocolate have been proven to aggravate GERD, other less-heralded foods can become your allies. These foods are often alkaline in nature, so I suppose the assumption is that they help to balance out the acid you’re combatting.
The list of friendly foods plays out like this:
- Fruits like apples, bananas, and melons
- Fish and seafood
- Skinless chicken breasts
- Green vegetables like celery, green beans, broccoli, and asparagus
- Fermented foods like sauerkraut
- Probiotic yogurts (kefir is king)
Okay, that might not sound like the most exciting grocery list to build your new diet around, but it’s easy enough to work them into regular rotation without feeling like you’re beholden to some oppressive feeding regime.
I’ve been sticking to a weekday breakfast of granola with kefir topped with apples, bananas, or melon. It’s actually a pretty great breakfast (and a cinch to prepare). You can also add a dash of cinnamon or a swirl of honey (locally produced if possible), should you find the taste of kefir a little too tart. At the weekend, I bring out the home-cured gravlax salmon with poached eggs, which I fancy up with some fennel pollen (it’s cheap, easy to order online, and makes a great addition to your spice rack).
Making a quick tuna or chicken salad with bits of apples, celery, parsley, dill, and apple-cider vinegar (more on that little genius later) works for lunch, and it’s easy enough to make a side salad by simply slicing some fennel and dashing it with your oil of choice and a few seasonings. Pro GERD tip: caramelize a batch of fennel slices and use them throughout the week as an onion substitute on things like burgers.
For dinner, lean proteins and vegetables are a solid choice, often paired with something like wild rice, quinoa, or beans (of the dried heirloom variety, not those nasty, metallic-tasting things slopping around in cans). Most root vegetables are GERD-compliant, too, so just roast them up in some coconut oil (which some people allege can help sooth a sore throat as well).
You can get your daily ginger fix by pouring boiling water over small pieces of ginger root and either sipping it hot if you can tolerate it like that, or letting it cool for later. You can also repeat the same trick with fennel fronds (those scraggly bits at the top of the stalks).
When beginning to monitor your diet to combat GERD, some people recommend keeping a food diary that logs everything you eat and how you feel afterwards. I’ve never bothered with that, being that I’m quite capable of remembering what I ate for lunch, and whether or not I was fine with it. But, you know, embrace whatever works for you.
Okay, now you’ve started to take control of what you’re eating, but the next step is changing the way you eat. In short, there’s a good chance you’re scarfing down your meals too quickly.
To help your GERD-afflicted stomach cope with digesting food, you need to concentrate on something as elementary as chewing: Ideally, you’ll want to chew each small mouthful around 20 to 30 times. The more liquified the food gets, the easier it is on your stomach.
Also, take time between mouthfuls.
Let me repeat: take time between mouthfuls.
Put your fork down between mouthfuls, if that helps.
Your goal is to slow your whole world down when you’re eating. Wolfing down a sandwich at lunch while feverishly checking Twitter and Instagram on your phone does nothing to bring respite to your GERD. You need to take a moment to sit still and let your food settle before getting back to work. If possible, try and incorporate a short walk around the block into your post-eating routine. The idea is to calm yourself and your stomach down during mealtimes, because it’s all too easy to get caught up in the momentum of stuffing your face.
Here’s another new rule for your mealtimes: because your stomach is pretty much the size of your fist, you’ll want to think about ditching the classic breakfast, lunch, and dinner setup and instead eating a larger number of smaller meals. This helps give your stomach time to recover between bouts.
I’ve read that five to six meals a day is ideal, although that’s obviously not really practical for most people. I’ve settled on four meals a day, with the main difference being that I follow a smaller-than-usual lunch with a decent afternoon snack. A granola bar and a banana works, nuts are great (especially tamari-roasted almonds), and at home, some sort of nut butter with an apple and some crackers seems to do the trick. (I’ve been going with sunflower-seed butter lately, just because almond butter seems to cost about $20 a jar these days.)
Did I mention the GERD dress code, too? Yep, try and avoid wearing anything too tight around the waist while you eat, as it can put extra physical pressure on the stomach. So ditch any skinny-jeans goals and proudly pop open that top pant button when feasting. Sweatpants are also a GERD classic.
One more thing: You’ll want to become the shy, introverted type during mealtimes and try to avoid talking to anyone while eating. Apparently, some people are very prone to swallowing air while they talk—I’m not making this up—which can increase the burden on stuff traveling down your esophagus, and add to the ills of your stomach.
More bad news: beer is really not going to do much to help with your GERD. Not only is it carbonated, but with beer, you’re usually drinking a large volume of liquid. When I first tried to reintroduce alcohol to my lifestyle, I plumped for Guinness. (Hello darkness, my old friend.)
While it’s carbonated with a nitrate mix—so it’s not as fizzy as your fashionable IPAs—a righteous imperial pint of Guinness is a hell of a lot of liquid for your stomach to deal with. Obviously, you’re probably not just drinking the one beer, too, so bestowing on your insides a steady stream of heavenly black liquid manna might not exactly be the smartest move.
I’ve fared better with red wine, or whiskey and water. Why not white wine? Because it’s usually chilled, and there’s a theory that very hot and very cold drinks can make GERD worse. From experience, ice water in a restaurant definitely does not sit well with my stomach. Keep your liquids room temperature if possible.
Finally—and this is a really key point—it’s imperative to avoid drinking at the same time as you eat. It’s simply too much for your stomach to cope with. So try and leave a good half-hour between bouts of eating and drinking.
You don’t have to delve into the depths of the Dark Web to come across a host of touted miracle cures for GERD. Feel free to buff up on them, but remember that oftentimes, the people advocating for them are in some way involved with selling the product (either direct or through affiliate links). Artisanal snake oil will not cure GERD.
If you do decide to dip into the miracle cures, it’s preferable to limit yourself to one or two at a time. That way, you can work out if anything you’re taking is actually having any sort of positive effect, while also not breaking the bank as you buy out the health food store.
To date, I’ve run through licorice (nope); aloe vera juice (a funky taste that possibly has a soothing cooling effect); alkaline water (you can buy special filters or droplets); eating a tablespoon of coconut oil (this just did not seem like a smart thing to do every day); sauerkraut (and fermented foods in general, although avoid kimchi, as it can contain garlic and chili); and a wedge pillow (I bought the $30 one from Bed Bath & Beyond, and while I’m not sure if it actually works, it’s comfortable, and the cat seems to have no interest in repurposing it into a nap spot).
I was about to try mastic gum, which people recommend chewing either before or after eating, but it was $40 for what would have been two weeks’ supply at my local overpriced health food store, so I skipped on that. Ditto probiotic supplements—natural probiotics in yogurt seem a more sensible route—and something called Betaine HCL, which came up when I was traversing down one particular online GERD wormhole.
Having said all that, there is one urban-legend GERD cure that might actually work...
Granted, at first, the idea of using this stuff to alleviate your ills seems silly. If GERD is caused by your stomach producing too much acid, why will drinking an acidic vinegar help you out?
Well, apparently it just does.
Of all the anecdotal accounts of home remedies, the one about taking a couple of teaspoons of apple-cider vinegar (the organic one with the “mother” in it) with a glass of water a couple of times a day seems to come up regularly. There’s a theory that in some cases, GERD is actually caused by a lack of stomach acid, and this stuff is full of the good sort of acid to help get the internal flora of your stomach back in perky shape.
I’ve yet to come across any scientific studies to back this up, but in my experience, I’ve found there’s something in it. Apple-cider vinegar definitely helps me out, plus it’s cheap (about four bucks a bottle), and if you lace it with honey, it kinda tastes like a more natural sports drink.
So yeah, try drinking vinegar.
Like many ailments, avoiding stress and participating in a sensible amount of exercise can help out with GERD. I’ve noticed that it’s all too easy to get caught up in a perpetual stress loop: You realize you’re getting symptoms, so you worry about it, and soon you’re looking up cures on the internet, which only makes you more consumed with it.
Enjoyable exercise certainly helps keep your mind off your symptoms. I’ve ditched incorporating any sort of sprinting intervals in my running in favor of taking longer, more scenic routes. Avoid lifting weights (too much stress on the core area), and go for a long walk or a bike ride instead. It really helps with giving you a mental break from the terror and all-consuming nature of this thing.
Ideally, after a month or so of diligently sticking to your new routine, you’ll start feeling as though you’re getting your diet and lifestyle in check. Your symptoms are waning. You’ve actually managed to be vaguely social and eaten out in a restaurant without feeling the need to rush home and don the sweatpants. You know you can beat this thing on your own. That’s when you decide it’s time to get off your GERD medication (which you should always do under your doctor’s supervision). You do so gradually, and things are going great—until you come up against a little something called reflux rebound.
Yep, you guessed it: this is when your symptoms return, and often worse than ever.
In my case, I think the reflux rebound kicked in about 10 days after finally coming off my Nexium pills. I started to get the ol’ chronic sore throat and hoarseness of voice. It was getting to the point where even being in a fairly quiet restaurant or bar was demoralizing, being that no one could really understand a word I was saying. It was beginning to affect my work, too, as I’d try and switch phone interviews with rappers and cats to email exchanges. The condition was not improving, and I found myself doing irrational and desperate things, like spending nighttime hours researching a whole new set of miracle cures that I was convinced I needed to purchase immediately.
But just as I was considering going back to popping the purple pills, things seemed to magically improve. I’d like to think it was down to endurance and waiting out the reflux rebound. During this phase, I was extra vigilant about my eating habits: sitting very still and staying calm for about 15 minutes after eating even-smaller-than-usual portions seemed key. Then one day I woke up and felt the ebullient lightness of being that comes when you’ve recovered from an illness.
That was about six weeks ago. Since then, I’ve stuck to the basic tenets of the GERD diet and lifestyle, and even started to eat and drink out on occasion. It seems to be working, although I still have an upcoming hospital appointment booked to monitor the condition. Good riddance, GERD—I hope.
Phillip Mlynar lives in Queens, NYC. When not writing about rappers for Red Bull Music Academy, NYLON, and the Village Voice, he muses on the feline form for Catster. His Twitter claims he’s the world’s foremost expert on rappers’ cats.