Tuesday, January 4, 2011

The Triple Crown: Solving Three Problems in One Stroke

The readers of this blog have spoken: a lot of you are suffering from bloating and acid reflux and want to know what to do about it. At least, that's what my statistics tell me: the top two posts for the past month are Gas Bloating: The Incredible Shrinking Waistband and Exploding Intestines and My GERD is Cured: Low-Carb Hits the Mark. If you're like a lot of people, you might also have made a resolution to lose weight. I sympathize with all these problems: I used to suffer frequently with gas pain and acid reflux and a year ago I set out to lose 20 pounds.

Why do so many people have bloating and acid reflux this time of year? Too many Christmas cookies, too much stuffing and mashed potatoes, too many holiday potlucks with dishes made of cheap, high-carb food, and too much dessert. In other words, too many carbs. That's the short answer.

What do Carbs Have to Do with It?
Dietary fat doesn't give you gas. Protein gives you very little gas, and it's farther along in your digestive system. Carbs, however, do create gas when they're consumed by your digestive bacteria.(1) Certain carbs are worse than others. Wheat and apples are the worst two for me; others are bothered by lactose and certain vegetables like broccoli and cauliflower.

In susceptible people, that gas pushes up the stomach acid into the esophagus, causing acid reflux. At least, that is Norm Robillard's theory as he's described in the book Heartburn Cured. His theory also squares better with reality than conventional wisdom on avoiding onions, coffee, spicy food, dietary fat, and so on. I had acid reflux so severe that it gave me an esophageal ulcer. Once I cut down on the carbs, to about 50 grams per day, I could have all the coffee, fatty meals and spicy food I wanted. My theory of why these foods are associated with acid reflux is that dietary fat makes your stomach acid stick to your throat and the spicy, acidic foods make it more painful on your delicate esophagus, which was never meant to come into contact with stomach acid.

What to do? You can take a product like Gas-X for bloating, but I never found it very helpful when I was so bloated I looked pregnant. You can take medicines for acid reflux, but beware: they're expensive, they disable the first line of defense in your immune system (most germs die in your stomach acid unless you've neutralized it), and they interfere with absorption of vitamins and minerals. (See this post; scroll down to Antacids.) Going off proton pump inhibitors can give you a nasty bout with acid rebound, which I suffered mightily with. (See this and this.)

What if you could solve both problems--and possibly lose weight--in one stroke? You can: cut down on the carbs. A low-carb eating plan is a time-honored way of slimming down. Before the low-fat craze, our great grandmothers knew that if they wanted to lose weight, they cut back on the bread and potatoes and skipped dessert. Long before Great Grandma was around, our stone age ancestors lived almost entirely on meat, eggs and plants, not fat-free bagels. Paleontologists say they were stronger and healthier than their agricultural descendants.

There's no one diet that's right for everyone. Look into some low-carb diets like Atkins, Protein Power, South Beach and various paleo diets, and see which one you think you could live with best. Commit to a two-week trial--that's about how long it takes for your body to adjust to using fat for fuel. (Yes, I said fat: by all accounts, you'll have a rough time trying to live mostly on protein.) Consult some other low-carbers if you run into problems; we're a supportive community (see blog roll on the right). And have a healthy, happy new year.

(1) Heartburn Cured by Norm Robillard. 2005.


Anonymous said...

Hi Lori
My n=1 experiment may not generalize very well but it may be of interest. I reduced fibre to 12gm/day average and significantly (estimate 2lb min.) reduced the colonic population (polite euphemism). I also fasted one day/week. It took 6 weeks to produce results. No bloating and I can pack away huge meals without any distress. The happy sounds of a well functioning intestines, just like in my youth, have returned.

Lori Miller said...

I'm glad you're feeling better. There are those who say that fiber isn't really necessary for good bowel function. I can't say from experience; my GI problems were mostly farther up.