50 replies to this topic

[j03]

What are some drug or supplements that tigthen the LES spincter? I tried baclofen, and I don't think that helped much. My doctor won't prescribe a prokinetic, he says there's too many side effects like tardive dyskinesia, etc. I just started taking glutamine as i read it could tighten it. I also tried 6MG of melatonin, and ashwaganda but they did nothing. Anymore options?

Background: I have treatment resistant GERD, and I've tried all acid reducers, and every supplement, but i am certain it's a sphincter issue, rather that an acid one. That's why I'm not interested in acid reducer right now, just things to tighten the sphincter. I don't have a hiatial hernia, and also no hy pylori.

[OneScrewLoose]

What brand of Ashwagandha did you use? It tends to work for me.

[Jay]

Anything that effects neurotransmitters in the Vagus nerve has the potential to help, or hurt, (but be careful because, as your doctor said, anything that works really well is likely to have side effects elsewhere, some of them potentially dangerous). Theanine and glutamine should yield more GABA and might help (doesn't help me). Marijuana helps too, but has obvious side effects. Ashwaganda is another possibililty (doesn't help me). Melatonin maybe. Taurine? Calcium carbonate maybe. Based on your post, my guess is that none of these things will help you enough however. Swallowing an ice slushy helps me a little.

You might want to start by avoiding things that weaken the LES. Chocolate, caffeine, alcohol, peppermint oil, stomach distention (too much food and drink), sugar, garlic/leeks/onions, etc. Some people find fat is a problem as it does delay gastric emptying. I only find it to be a problem if I have done something that weakens the LES in the first place. In fact, a very high fat diet helps me quite a bit.

Are you sure you don't have h pylori? You could try d limonene- anti-bacterial properties and may provide a physical barrier against acid in the upper stomach. Manuka honey, ACV, kombucha, sulforaphane, etc.

Do you have Barrett's esophagus?

Edited by Jay, 23 October 2009 - 01:21 PM.

[Lufega]

Try using glutamine with B6 to favor the productin of GABA. Any GABA agonist will increase the tonicity of the LES.

[lynx]

D-Limonene

[j03]

Thanks for the responses! I'm going to try a few of these suggestions. To answer the few questions:

-I was taking the Now brand ashwaganda.

-I did both an endoscopy and a barrum swallow test, and no h pylori, hiatial hernia, or barrets.

-I tried manuka honey and limonene. Limonene works as a mild acid reducer, but that's not my problem. My sphincter is really weak I believe!

My problem with GERD is mostly at night! I wake up with sore throats. My bed is raised, and I try to fast a few hours before, and I am taking a h2 blocker Fametidine (proton pump inhibitors give me terrible headaches, so I can only use h2 blockers), and sucralfate (it's supposed to coat the esophagus), but i still wake up with a sore throat.

Edited by k4t, 23 October 2009 - 04:17 PM.

[Jay]

I think Zantac (ranitidine) works better than famotidine, especially at night. The OTC dosages were too low for me, and likely will be for you. I used to take 300mg per doctor's instructions and it worked reasonably well if taken an hour or two before bed.

Edited by Jay, 23 October 2009 - 04:57 PM.

[FunkOdyssey]

I have this problem too (nighttime-only GERD, wake up with sore throats + hoarse voice + lump feeling in chest). I haven't found anything that reliably fixes it yet, but eliminating chocolate and alcohol seems to have reduced severity as well as avoiding meals near bedtime.

I wonder if valerian root would be effective for increasing LES pressure due to its interactions with the GABA system? I haven't tried it yet but I may this weekend.

Edited by FunkOdyssey, 23 October 2009 - 05:08 PM.

[ajnast4r]

I have this problem too (nighttime-only GERD, wake up with sore throats + hoarse voice + lump feeling in chest). I haven't found anything that reliably fixes it yet, but eliminating chocolate and alcohol seems to have reduced severity as well as avoiding meals near bedtime.

i have this problem too... its pretty much solved by eating my last meal 3 hours prior to bed, to ensure near complete gastric emptying by the time i lay down. i also never lay down after a meal.

[OneScrewLoose]

How many PPIs have you tried? When might not have the side-effects of the other.

Also, I find that if I take the Ashwagandha to frequently for my problem, it makes it worse when I don´t take it. Downregulation methinks.

If you still can´t find anything, there´s always Reglan, but taking that in the long term can cause tardive dyskensia. It´s rare, but it can happen. Also, there is cisapride. It was pulled from the market a few years back because of a few cases of long QT syndrome, but it can be special ordered by a doctor if worse comes to worse. My physician told me that a lot of cases of the long QT syndrome happened because doctor´s weren´t aware of possible effects when prescribed with the wrong medication, namely certain antibiotics.

I would exhaust other options first, but these are possiblities at your disposal.

[presently]

My severe GERD was permanently eradicated by sipping on 1/4 teaspoon of l-glutamine in about 2 oz. of water and not taking any food or liquids for 1/2 hour afterwards to let the l-glutamine solution soak into the lower esophageal sphincter and strengthen it. I did this as needed for about a week, and my GERD has not returned for years. I had tried everything under the sun prior to this, and had been suffering terribly for over a year, but relief was quick. A friend suggested it, and she was right, at least in my case.

I should add that by the time I tried this (in late 1999), I had given up all alcohol and caffeine for several months, which in itself didn't fix the GERD problem, but probably helped the l-glutamine do its job so well.

[tunt01]

has anyone tried PepZinGI (zinc-carnosine)? it's in a lot of formulas like this:

http://www.swansonvi.../ItemDetail?n=0

supposed to coat the stomach ... ?

[warner]

Try Gaviscon, bought from canadadrugs.com, without aluminum (just alginic acid + magnesium carbonate). The US version (discontinued?) never had enough alginic acid to be effective. The gaviscon (alginate foam) will block reflux with minimal effect on stomach acidity.

[lynx]

My severe GERD was permanently eradicated by sipping on 1/4 teaspoon of l-glutamine in about 2 oz. of water and not taking any food or liquids for 1/2 hour afterwards to let the l-glutamine solution soak into the lower esophageal sphincter and strengthen it. I did this as needed for about a week, and my GERD has not returned for years. I had tried everything under the sun prior to this, and had been suffering terribly for over a year, but relief was quick. A friend suggested it, and she was right, at least in my case.

I should add that by the time I tried this (in late 1999), I had given up all alcohol and caffeine for several months, which in itself didn't fix the GERD problem, but probably helped the l-glutamine do its job so well.

This is interesting because glutamine is the preferred fuel for GI tract cells, so I guess this extends to the esophagus.

[Jay]

My severe GERD was permanently eradicated by sipping on 1/4 teaspoon of l-glutamine in about 2 oz. of water and not taking any food or liquids for 1/2 hour afterwards to let the l-glutamine solution soak into the lower esophageal sphincter and strengthen it. I did this as needed for about a week, and my GERD has not returned for years. I had tried everything under the sun prior to this, and had been suffering terribly for over a year, but relief was quick. A friend suggested it, and she was right, at least in my case.

I should add that by the time I tried this (in late 1999), I had given up all alcohol and caffeine for several months, which in itself didn't fix the GERD problem, but probably helped the l-glutamine do its job so well.

This is interesting because glutamine is the preferred fuel for GI tract cells, so I guess this extends to the esophagus.

Glutamine is also a presursor to GABA, which can tighten the lower esophageal sphincter.

[tunt01]

is there increased cancer risk with taking glutamine?

[FunkOdyssey]

For people that have tried glutamine for this purpose, how much have you dosed? Because I often hear people taking about 1-2 grams of glutamine, when 100g of whey contains almost 18g of glutamine (for perspective).

I imagine larger amounts of glutamine could make the difference if you've only experimented with low doses.

Edited by FunkOdyssey, 26 October 2009 - 07:10 PM.

[Jay]

For people that have tried glutamine for this purpose, how much have you dosed? Because I often hear people taking about 1-2 grams of glutamine, when 100g of whey contains almost 18g of glutamine (for perspective).

I imagine larger amounts of glutamine could make the difference if you've only experimented with low doses.

I used 2 grams of powder on several occasions when I had reflux and did not notice any effect at all.

[FunkOdyssey]

See, I think if it was going to work, it would be via a long-term healing-of-tissues mechanism, not as an acute treatment. So that may be another factor besides dose in glutamine failures: lack of consistent long-term use.

[Jay]

See, I think if it was going to work, it would be via a long-term healing-of-tissues mechanism, not as an acute treatment. So that may be another factor besides dose in glutamine failures: lack of consistent long-term use.

I thought glutamine works because it is a precursor to GABA and GABA activates the GABA-B receptor which tightens the LES (link). If that's the theory, shouldn't glutamine have an acute effect?

Edited by Jay, 27 October 2009 - 12:20 AM.

[Jay]

There's some speculation that ketones may activate the GABA-B receptor too (link)(and link to pdf), which would be nice because I'm pretty sure they're safer than baclofen.

This comports with my experience being in ketosis -- did NOT have reflux then. At the time I chalked it up to carbs causing my reflux (link) (and link) via bactreial fermentation, but maybe it was the ketones...

I plan on experimenting with coconut oil at night to see if it helps my current reflux. I doubt it will be enough but we'll see...

Edited by Jay, 27 October 2009 - 12:24 AM.

[OneScrewLoose]

For people that have tried glutamine for this purpose, how much have you dosed? Because I often hear people taking about 1-2 grams of glutamine, when 100g of whey contains almost 18g of glutamine (for perspective).

I imagine larger amounts of glutamine could make the difference if you've only experimented with low doses.

Is that as glutamine as a consituent of the whey protein, or mixed in?

[j03]

The last few nights I took 300 mg's of Ranitidine, about 3 g's of glutimine, and limonene before bed, and I have woken up with marginally less reflux that before. There's still reflux, and my throat is raw, but that's a positive I guess.

I think I might add baclofen with the above regimen, hopefully that will make a difference.

[FunkOdyssey]

For people that have tried glutamine for this purpose, how much have you dosed? Because I often hear people taking about 1-2 grams of glutamine, when 100g of whey contains almost 18g of glutamine (for perspective).

I imagine larger amounts of glutamine could make the difference if you've only experimented with low doses.

Is that as glutamine as a consituent of the whey protein, or mixed in?

As a constituent of the whey protein.

I haven't read TOO many accounts of glutamine curing reflux, but those I have described taking glutamine daily for a period of time after which the reflux disappeared. If glutamine -> gaba conversion was the mechanism of action, the reflux would never resolve on its own and glutamine would be required indefinitely.

[smithx]

What are some drug or supplements that tigthen the LES spincter?

Triphala.

I was diagnosed with chronic GERD and told that it would be with me for the rest of my life. I had horrible symptoms and tried all sorts of products with no relief.

I started taking triphala (Planetary Ayurvedics Triphala Gold from iherb) and after about 3 weeks my GERD was gone. I still get a little heartburn from time to time, but it's basically non-existent.

Triphala contains astringent fruits which apparently tighten the LES sphincter, but it also helps tonify the digestive tract and move things along. GERD can be caused by or exacerbated by constipation or slow movement, which increases back-pressure. Triphala deals with that too.

Triphala is one of the really fundamental treatments in Indian Ayurveda and is recommended widely for chronic use. It's also been found to have anti-cancer and other benefits (on the skin, for instance). But I'm just glad it got rid of my GERD.

You may also want to experiment with eating less in a single sitting, so that you don't induce spasm in your intestinal tract by overloading it, and so that food can move through without backing up. If you do eat a lot and want your stomach to empty faster (to reduce back pressure), try Shatavari (see http://www.jpgmonlin...4;aulast=Dalvi).

But what worked for me was Triphala. Good luck!

[ajnast4r]

funny you say that... i had a bit of heartburn the other night and popped a triphala pill before and after my meal and it helped a lot

[tintinet]

Sorry to report Planetary Ayurvedics Triphala Gold from iherb did nothing for me. Same for various brands of Manuka honey. Limonene does help.

Edited by tintinet, 30 October 2009 - 03:11 PM.

[Jay]

What are some drug or supplements that tigthen the LES spincter?

Triphala.

I was diagnosed with chronic GERD and told that it would be with me for the rest of my life. I had horrible symptoms and tried all sorts of products with no relief.

I started taking triphala (Planetary Ayurvedics Triphala Gold from iherb) and after about 3 weeks my GERD was gone. I still get a little heartburn from time to time, but it's basically non-existent.

Triphala contains astringent fruits which apparently tighten the LES sphincter, but it also helps tonify the digestive tract and move things along. GERD can be caused by or exacerbated by constipation or slow movement, which increases back-pressure. Triphala deals with that too.

Triphala is one of the really fundamental treatments in Indian Ayurveda and is recommended widely for chronic use. It's also been found to have anti-cancer and other benefits (on the skin, for instance). But I'm just glad it got rid of my GERD.

You may also want to experiment with eating less in a single sitting, so that you don't induce spasm in your intestinal tract by overloading it, and so that food can move through without backing up. If you do eat a lot and want your stomach to empty faster (to reduce back pressure), try Shatavari (see http://www.jpgmonlin...4;aulast=Dalvi).

But what worked for me was Triphala. Good luck!

Is there any evidence that triphala tightens the LES? Or promotes motility? I've been looking and can't find anything. Since there are multiple causes of GERD symptoms, the fact that it helps some people doesn't mean it actually tightens the LES. It may for instance just kill off some of the h pylori in the stomachs of those infected.

[smithx]

Is there any evidence that triphala tightens the LES? Or promotes motility? I've been looking and can't find anything. Since there are multiple causes of GERD symptoms, the fact that it helps some people doesn't mean it actually tightens the LES. It may for instance just kill off some of the h pylori in the stomachs of those infected.

There's ample evidence that it promotes motility. Just take 4 of them at once and you'll get more motility than you ever wanted.

I know it wasn't h.pylori because I had been tested for that and was negative.

As for tightening the sphincter, it's astringent, so it would tend to do that, but I don't know of any studies.

On the other hand, the stuff's cheap and has other reputed health benefits, so if you're suffering from GERD, why not take it for a few weeks and see if it helps you or not.

[FunkOdyssey]

Is there any evidence that triphala tightens the LES? Or promotes motility? I've been looking and can't find anything. Since there are multiple causes of GERD symptoms, the fact that it helps some people doesn't mean it actually tightens the LES. It may for instance just kill off some of the h pylori in the stomachs of those infected.

There's ample evidence that it promotes motility. Just take 4 of them at once and you'll get more motility than you ever wanted.

I know it wasn't h.pylori because I had been tested for that and was negative.

As for tightening the sphincter, it's astringent, so it would tend to do that, but I don't know of any studies.

On the other hand, the stuff's cheap and has other reputed health benefits, so if you're suffering from GERD, why not take it for a few weeks and see if it helps you or not.

I actually started taking triphala a few days ago (triphala gold, 2 tabs at 10:30am between breakfast and lunch, 2 tabs at 10:30pm before bed) and it is definitely doing something good for my digestion. I haven't had any nighttime reflux the last two nights. I will be so happy if this continues.