Heracles’ labours were getting further and further away from home. For his next task, he had to cross the Libyan desert to get to the other. The following is an alphabetical list by title of some of the songs. I will keep updating every couple of weeks. Added 27 New or Revised MIDI. President Trump's lawyers on Friday said that the commander in chief is immune from civil lawsuits accusing him of inciting violence during Trump rallies.“Mr. According to Mother Teresa, “If you judge someone, you have no time to love them.” I first saw this quote when it was posted on my sixth-grade classroom wall, and. Get rid of heartburn and GERD forever in three simple steps. Note: this is the sixth and final article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II, Part III, and Part IVa, and Part IVb before reading this article. In this final article of the series, we’re going to discuss three steps to treating heartburn and GERD without drugs. These same three steps will also prevent these conditions from developing in the first place, and keep them from returning once they’re gone. To review, heartburn and GERD are not caused by too much stomach acid. They are caused by too little stomach acid and bacterial overgrowth in the stomach and intestines. Therefore successful treatment is based on restoring adequate stomach acid production and eliminating bacterial overgrowth. This can be accomplished by following the “three Rs” of treating heartburn and GERD naturally: Reduce factors that promote bacterial overgrowth and low stomach acid. Thank you for your continued support of Deadspin. Call your senator, she misses you. Disclaimer: You are leaving a Gizmodo Media Group, LLC website and going to a. Let me share my story, I’m sure it’s very similar to yours. My name is Alain Gonzalez and I’m a lot like you. Ever since I was in high school I was always the. Replace stomach acid, enzymes and nutrients that aid digestion and are necessary for health. Restore beneficial bacteria and a healthy mucosal lining in the gut. Reduce factors that promote bacterial overgrowth and low stomach acid. Carbohydrates. As we saw in Part II and Part III, a high carbohydrate diet promotes bacterial overgrowth. Bacterial overgrowth – in particular H. This creates a vicious cycle where bacterial overgrowth and low stomach acid reinforce each other in a continuous decline of digestive function. It follows, then, that a low- carb (LC) diet would reduce bacterial overgrowth. To my knowledge there have only been two small studies done to test this hypothesis. The results in both studies were overwhelmingly positive. The first study was performed by Professor Yancy and colleagues at Duke University. They enrolled five patients with severe GERD that also had a variety of other medical problems, such as diabetes. Each of these patients had failed several conventional GERD treatments before being enrolled in the study. In spite of the fact that some of these patients continued to drink, smoke and engage in other GERD- unfriendly habits, in every case the symptoms of GERD were completely eliminated within one week of adopting a very low carbohydrate (VLC) diet. The second study (PDF) was performed by Yancy and colleagues a few years later. This time they examined the effects of a VLC diet on eight obese subjects with severe GERD. They measured the esophageal p. H of the subjects at baseline before the study began using something called the Johnson- De. Meester score. This is a measurement of how much acid is getting back up into the esophagus, and thus an objective marker of how much reflux is occurring. They also used a self- administered questionnaire called the GSAS- ds to evaluate the frequency and severity of 1. GERD- related symptoms within the previous week. At the beginning of the diet, five of eight subjects had abnormal Johnson- De. Meester scores. All five of these patients showed a substantial decrease in their Johnson- De. Meester score (meaning less acid in the esophagus). Most remarkably, the magnitude of the decrease in Johnson- De. Meester scores is similar to what is reported with PPI treatment. In other words, in these five subjects a very low carbohydrate diet was just as effective as powerful acid suppressing drugs in keeping acid out of the esophagus. All eight individuals had evident improvement in their GSAS- ds scores. The GSAS- ds scores decreased from 1. What these numbers mean is that the patients all reported significant improvement in their GERD related symptoms. Therefore, there was both objective (Johnson- De. Meester) and subjective (GSAS- ds) improvement in this study. It’s important to note that obesity is an independent risk factor for GERD, because it increases intra- abdominal pressure and causes dysfunction of the lower esophageal sphincter (LES). The advantage to a low- carb diet as a treatment for GERD for those who are overweight is that LC diets are also very effective for promoting weight loss. I don’t recommend VLC diets for extended periods of time, as they are unnecessary for most people. Once you have recovered your digestive function, a diet low to moderate in carbohydrates should be adequate to prevent a recurrence of symptoms. An alternative to a VLC is something called a “specific carbohydrate diet” (SCD), or the GAPS diet. In these two approaches it is not the amount of carbohydrates that is important, but the type of carbohydrates. The theory is that the longer chain carbohydrates (disaccharides and polysacharides) are the ones that feed bad bacteria in our guts, while short chain carbohydrates (monosacharides) don’t pose a problem. In practice what this means is that all grains, legumes and starchy vegetables should be eliminated, but fruits and certain non- starchy root vegetables (winter squash, rutabaga, turnips, celery root) can be eaten. These are not “low- carb” diets, per se, but there is reason to believe that they may be just as effective in treating heartburn and GERD. See the resources section below for books and websites about these diets, which have been used with dramatic success to treat everything from autism spectrum disorder (ASD) to Crohn’s disease. Another alternative to VLC that I increasingly use in my clinic is the Low FODMAP diet. FODMAPs are certain types of carbohydrates that are poorly absorbed by some people, particularly those with an overgrowth of bacteria in the small intestine (which, as you now know, tends to go hand- in- hand with heartburn). See this article and my book for more information. Be careful to avoid the processed low- carb foods sold in supermarkets. Instead, I suggest what is known as a “paleolithic” or “primal” approach to nutrition. Fructose and artificial sweeteners. As I pointed out in Part II, fructose and artificial sweeteners have been shown to increase bacterial overgrowth. Artificial sweeteners should be completely eliminated, and fructose (in processed form especially) should be reduced. Fiber. High fiber diets and bacterial overgrowth are a particularly dangerous mix. Remember, Almost all of the fiber and approximately 1. Carbohydrates that escape digestion become food for intestinal bacteria. Prebiotics, which can be helpful in re- establishing a healthy bacterial balance in some patients, should probably be avoided in patients with heartburn and GERD. Several studies show that fructo- oligosaccharides (prebiotics) increase the amount of gas produced in the gut. The other problem with fiber is that it can bind with nutrients and remove them from the body before they have a chance to be absorbed. This is particularly problematic in GERD sufferers, who may already be deficient in key nutrients due to long term hypochlorydria (low stomach acid). H. While I think it’s a contributing factor in some cases, the question of whether and how to treat it is less clear. There is some evidence that H. If this is true, complete eradication of H. Instead, a LC or specific carbohydrate diet is probably a better choice as it will simply reduce the bacterial load and bring the gut flora back into a state of relative balance. The exception to this may be in serious or long- standing cases of GERD that aren’t responding to a VLC or LC diet. In this situation, it may be worthwhile to get tested for H. Wright, author of Why Stomach Acid is Good For You, suggests using mastic (a resin from a Mediterranean and Middle Eastern variety of pistachio tree) to treat H. A 1. 99. 8 in vitrostudy in the New England Journal of Medicine showed that mastic killed several strains of H. Studies since then, including in vivo experiments, have shown mixed results. Mastic may be a good first- line therapy for H. The test is quite simple. A device called a Heidelberg capsule, which consists of a tiny p. H sensor and radio transmitter compressed into something resembling a vitamin capsule, is lowered into the stomach. When swallowed, the sensors in the capsule measure the p. H of the stomach contents and relay the findings via radio signal to a receiver located outside the body. In cases of mild to moderate heartburn, actual testing for stomach acid production at Dr. Wright’s Tahoma clinic shows that hypochlorydria occurs in over 9. In these cases, replacing stomach acid with HCL supplements is almost always successful. Although testing actual stomach acid levels is preferable, it is not strictly necessary. There is a reasonably reliable, “low- tech” method that can be performed at home to determine whether HCL supplementation will provide a benefit. To do this test, pick up some HCL capsules that contain pepsin or acid- stable protease. HCL should always be taken with pepsin or acid- stable protease because it is likely that if the stomach is not producing enough HCL, it is also not producing enough protein digesting enzymes. Note: HCL should never be taken (and this test should not be performed) by anyone who is also using any kind of anti- inflammatory medication such as corticosteroids (e. Motrin, Advil, etc.) or other NSAIDS. These drugs can damage the GI lining that supplementary HCL might aggravate, increasing the risk of gastric bleeding or ulcer. To minimize side effects, start with one 6. HCL w/pepsin in the early part of each meal. If there are no problems after two or three days, increase the dose to two capsules at the beginning of meals. Then after another two days increase to three capsules. Increase the dose gradually in this stepwise fashion until you feel a mild burning sensation. At that point, reduce the dosage to the previous number of capsules you were taking before you experienced burning and stay at that dosage. Over time you may find that you can continue to reduce the dosage, or you may also find that you may need to increase the dosage. In Dr. Wright’s clinic, most patients end up at a dose of 5- 7 6. In my experience, this dose is too high for many people. In fact, some have trouble with even a single 6. It's Nice And Quick And Clean. Thank you for your continued support of Deadspin. 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