I know there are wide range or issues under the GERD banner, but I thought I'd post my experience on the off-chance it helps anyone with a similar problem.
It all kicked off during a period of stressful events. I would typically wake up at 2am with acid in my throat, vomit, then lie awake uncomfortable, restless and sweating until the alarm went off.
* Avoiding stress - helped
* Meditating - helped a bit
* Regular exercise - helped a bit
* Drinking decaf green tea (L Theanine is supposed to be good for stress) - helped
* Cutting out spicy/tomatoey/rich foods - helped a bit
* PPIs - helped a little bit
* Cutting out alcohol - helped a little bit
* Cutting out caffeine - helped a bit (via reducing stress, I reckon)
* Avoiding foods for 3/4 hours before bed - helped a bit
* Sleeping on a GERD bed wedge - helped
* Supplements (magnesium, B12, B-complex, C, D) - no help
Eventually, I was as chilled out as I'd ever been. The source of stress was gone. And I was doing everything I could to avoid reflux. But I was still waking up at 3am - 4am feeling a little queasy, and completely unable to get back to sleep. On a bad day I'd still vomit in the morning. I had blood tests - normal. I was tested for H pylori - negative. I had a gastroscopy - normal. By this stage my doctor basically just said "live with it".
I had a feeling my problem may have something to do with excess bile, as the vomit was sometimes quite a lurid yellow, and PPIs didn't really help.
Then, after battling with my body for about a year, I stumbled upon the paper "Regulation of bile acid synthesis in man. Presence of a diurnal rhythm." (google it if you want, it's free) which told me two things:
* Bile production varies throughout the day. It starts ramping up at about 4am, peaks at about lunch time, then drops off heavily after lunch
* The paper also makes fleeting reference to the way bile production is regulated by bile acids returning to the liver after being reabsorbed in the intestines.
Then I figured it out. I like a decent breakfast - some protein and carbs to keep me going through 'til lunch. Maybe I was producing excess bile? Maybe my healthy breakfast was 'using up' all that bile so there was no negative feedback?
Well, I tested it out. I replaced my balanced breakfast with a meagre bowl of cereal, followed by cups of green tea and feeling hungry until about 11am (when I'd relent and have a snack). The mornings were a little unpleasant for a few days as all that excess bile was swept through to my intestines, but the feedback was almost immediate. After a few days I was sleeping through the night and the bed wedge had been relegated to the cupboard. I've had no problems since.
I'd had lots of advice to watch what I ate before bed. No one had ever mentioned breakfast. If you think bile might be your problem, it might be worth a try.
Post Edited (Keith29) : 5/26/2011 5:29:30 AM (GMT-6)