Is stress the ultimate root cause of my GERD?

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WJF
Regular Member


Date Joined Sep 2011
Total Posts : 273
   Posted 10/27/2011 10:05 PM (GMT -6)   
I read
www.healingwell.com/community/default.aspx?f=45&m=1525051
and feel enlightened like never before.

It tells when a person is under stress, the pylorus shut tight, and the stomach content has only one outlet, goes up. I have never taken stress as the primary cause, I have always been looking for solutions to food intolerance, insomnia, stomach acidity, etc....


before onset of my first symptom:
I was in a highly stressful job. I sometime felt nausea in the morning before and after breakfast. I often felt nausea before meetings where I could be repeated grilled by my boss.

I then had gastric attacks, heartburn before meals and grumbling stomach 2hours after breakfast. doc prescribed me acid blockers. I have then changed my job to a less stressful one.

1st onset of symptoms of GERD: heartburn, I felt terribly bloated and gassy after eating certain food (I have eliminated and avoided them one by one). I felt reflux at night and I couldn't sleep. I was diagnosed with hiatal hernia, GERD and esophagitis.

My prescriptions Nexium and later Pariet help, but could not alleviate the heartburn/reflux completely. I then tried to stop it and tried to control my GERD in a natural way, I attempted 3 times without success. It did work for at most 2 weeks in each try, during which I was symptom-free, and then I fell back to GERD again.

A review of my diary (I kept detail records of daily activities) showed stressful events from life, intolerance to food, indigestion, bloated, gassy stomach, insomnia, withdrawal rebound (usually happened in 1 week after I stopped the meds) are most closely linked to my relapses.

What do you think?

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 10/27/2011 10:45 PM (GMT -6)   
wjf

funny you should mention the pyloric sphincter

ive been thinking a lot lately about how reflux is not necessarily just a function of how tight the les (lower esophageal sphincter ) can remain closed...but...reflux might also be a function of... if, and when, and how much the pylorus opens when the stomach contracts to push digested food into the duodenum

im sure smarter people than me thought about this a long ago

when the stomach contracts, if the pylorus remains clamped tight, then there is big pressure up and against the LES and into the esophagus

i guess that stress plays a role in gerd for people who do not have anatomical dysfunctions nor deformities

of course,some people have a non functioning or virtually no les...or a huge hiatal hernia. no amount of stress reduction is going to counter these physical problems

but

some people have no discernible anatomical problems and have neurological- signaling problems and i bet for these people stress and emotions play a big role in the functioning of the pyloric sphincter as well as the lower esophageal sphincter

can i prove any of this.................no, sorry , i cant

but i do know that when i stress a lot i reflux a lot more

hang in there
best wishes
mock turtle

WJF
Regular Member


Date Joined Sep 2011
Total Posts : 273
   Posted 10/27/2011 10:59 PM (GMT -6)   
have I come to know this a little bit too late?

I should not have stopped the meds then, instead should have worked on my stress problems.
After a stressful day induced reflux. It didn't stop. Now I have reflux day and night. The pain is unbearable, antacid relieves only a short while, I double on my PPI for now. PPI only lasts for 10hours or so. I eat little. I fear my gullet has turned ulcerative. What should I do?

opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 10/27/2011 11:04 PM (GMT -6)   
I sure wish this was all my GERD was from. Unfortunately my stomach empties rather quickly and my LES was wide open. I cab see where stress could cause some severe issues with this though. If people can cause problems with their jaws and teeth from clenching during stress it seems logical that other parts of the body are doing the same.


Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 10/28/2011 1:28 AM (GMT -6)   
wjf

have you been seen by a doctor for your reflux issues?

your concern that you have injured your esophagus should be investigated given the collections of symptoms you indicate.

when you are steadily taking your medication are your symptoms controlled?

if you have been experiencing reflux for years and or if you are middle aged you are probably over due to get 'scoped" (esophagoscopy)

i hope you have been seen by your doctor regarding these issues, if not, i would recommend you be seen soon.

best wishes
mt

WJF
Regular Member


Date Joined Sep 2011
Total Posts : 273
   Posted 10/28/2011 1:55 AM (GMT -6)   
yes, I have seen a doc, and done a endoscopy before - GERD, hiatal hernial, mild esophagitis. In the most recent appointment, he have asked me to take pariet once per day for 8 weeks and see him again. It's me who deviated from his instructions and stopped taking the pill, thinking that I was GERD-free after monitoring myself symptom-less for 3 weeks and able to control with natural methods. I feel guilty now, have only myself to blame.

That being said, I accept where I am now and want to move on. I am still pondering what to do. I am now taking the pill twice per day, and taking some antacid on and off moderately. I feel pain after the effect of the drugs wear off, 3-4 hours after the PPI, 30mins after antacid. pain level is about 7 out of 10 when sitting upright. I do feel lesser or no pain when I am moving or doing other stuff. I am not sure if the pain is a just residual pain after a reflux attack (like an ulcer in mouth that aches when nothing is in contact) or if the acid is constantly attacking my gullet. I couldn't tell. My stomach is calm. I don't have fever.

Should I endure the pain see if it improves tomorrow or the day after? or should I see A&E immediately?

Post Edited (WJF) : 10/28/2011 12:58:33 AM (GMT-6)


mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 10/28/2011 12:53 PM (GMT -6)   
wjf

first dont feel guilty. we all struggle with this ugly disease and sometimes make turns in the decision making tree that turn out not to work out. many of us are desperate for answers and solutions, so dont beat yourself up... seems to me ive been where you are and it hurts bad...you are not alone

second...you said, "I feel pain after the effect of the drugs wear off, 3-4 hours after the PPI,..." just to be clear PPIs have a long period of onset for effectiveness and a long "effective" half life. while it is true the body eliminates the PPI from the system fairly quickly, the effect on the parietal cells (where acid in produced in the stomach) is long lasting.

i am not a doctor nor a medical professional of any kind so you should not take my words for granted as true...always check out everything with your doctor. but from what i have read and been told by authoritative sources is that PPIs shouldnt be "wearing off" three hours after last dose.

talk to your doctor, it may be that a different PPI or a different dose or the addition of an H2 may be appropriate...or some other solution. the best way to approach this is to be an informed patient AND to take that to your doctor and discuss and make a "team" decision

i would definitely put guilt behind me, go see the doc and tell the truth.

any doc that judges a patient harshly because of human frailty...well... i would change doctors because it is important for people in the helping professions to avoid being "judgmental.

please see your doctor

hang in there, and stay in touch, people here will help

best wishes
mock turtle

ps

i want to recommend a strategy that you may or may not have heard about

for several days,eat small meals...eat the same amount of food you usually do, or if overweight, a little less, but divide your daily intake into smaller amounts so that you eat no more food in volume than the size of your fist...and then wait at least two hours for the next meal

also during this time eat just skinless white chicken meat, steamed broccoli, brown rice, egg whites, mashed boiled carrots, light white fish (not oily...for example no salmon etc) water melon or other highly recommended foods that are helpful for people with gerd

(avoid all foods that are notorious for opening the lower esophageal sphincter.... that is... no chocolate, mint of any kind, no tomatoes nor potatoes (nightshade vegetables), and no alcohol) (check to see if you are taking other drugs that "open" the LES- talk to doctor if so)

then after 3 days of this see how you feel?

Post Edited (mock turtle) : 10/28/2011 12:04:43 PM (GMT-6)


WJF
Regular Member


Date Joined Sep 2011
Total Posts : 273
   Posted 10/28/2011 2:58 PM (GMT -6)   
:-) thank you for the encouraging words. it really soothes a tormented soul.

I went to the A&E of a nearby hospital. The doc and nurses ran some tests quickly and cleared me of all emergency conditions. They gave me a "cocktail" of PPI, antacid to neutralize the acid completely, an injection of Maxolon and painkiller (he then prescribed both meds for me). I asked the doc about Maxolon, he said it's a drug that was conventionally used to treat nausea and vomitting, in my case it has been used as a pain relief because it can shut my upper sphincter tight. How creative he is! I wonder, couldn't Maxolon be used for reflux relief because of this excellent property? I was discharged later and asked to rest and monitor for pain. So far so good.

You are right about the efficacy of PPI. That is what I had experienced since the very beginning. What happened in the past 36hours puzzles me. The more I think about it, the more question marks I have in my head. I am only sure of one thing. I must have taken something that relaxes my sphincter so much.

A review of my diary reveals one plausible explanation. I was on the 8th day off-PPI where rebound is still very likely. I pasted a plaster containing various herbal medicines on my back to treat a sore muscle the night before. Substances that could relax the sphincter could have been absorbed. The next day I worked more stressfully than other days and drank avocado juice in the afternoon, a non-GERD safe food, something my stomach has tolerated for a long time. I have been overeating out of anxiety to get well fast. My abdomen was quite full. All these may have led to the disaster.

Now I will start from square one, and make things right, slowing down to give myself 2 months time to heal and stabilize. Not going to stop the meds until then.

P/S: I drop potato now, I have put it on my menu without knowing what you said... sigh....

Post Edited (WJF) : 10/28/2011 2:01:55 PM (GMT-6)


mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 10/28/2011 5:59 PM (GMT -6)   
wjf

you are welcome!

may i suggest you test to see if you can eat potato after you stabilize with the most medically conservative diet that reasonable...

then add foods one by one testing that one food for a few meals in a row and making no other changes, so you know for sure

i cant eat tomatoes but i believe one of our moderators here at HealingWell- gerd, can eat tomatoes all day long...we are individuals

best wishes
mt

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 10/29/2011 3:30 AM (GMT -6)   
"Also, it is not a specific psychiatric disorder that may be responsible for gastrointestinal distress but the presence of psychological distress that predisposed a patient to have clinical manifestations of GERD"

This is an extract from an article that discusses stress and GERD, which you may find interesting. Both my episodes of GERD (of which the current one seems to have no end date!!) occurred within six months of stressful events and I sometimes wonder that even if the stress has gone you are then stuck with being unable to withdraw the ppis, because of acid rebound and also the concern of inflicting further damage to one's oesophagus . .

Link to the article coming up .....
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 10/29/2011 3:31 AM (GMT -6)   
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2008.03883.x/full

There it is. Knowing what switched it on, however, isn't necessarily any help in switching it off!!

MMM
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 10/30/2011 12:35 PM (GMT -6)   
Still doesn't explain my good friend's two children who were born with GERD problems one of which is still in the hospital as we speak. Her third child is fine. Neither of those two children born with the GI problems which manifest themselves as GERD had any stress the day they were born. The only stress they have now is learning how to live after their NF surgeries. The baby underwent her 3rd surgery to correct post-NF surgery problems last week and her mom is doing the best she can.

I think we can get to a point we think we "did something" to cause these problems when maybe the truth is we just live in an imperfect world where things happen even to innocent little kids like my friend's two children. They did nothing.

And, I know people with GERD and Barrett's who are calm relaxed people and I know people who are an emotional mess who have no reflux or GERD at all. One personal friend didn't even know he had Barretts until a routine EGD. He had NF and went on with his life after the surgery which probably saved his life. His GI sought out the best Barretts surgeon he could locate for him because he was so close to cancer. He was not "nervous" before and he isn't nervous now.

I too have fallen at times into the trap of believing I "thought" myself into GERD. I did not. I was acidic and bilious from the time I can first remember. I will never believe that anyone does this to themselves or even has the capacity to do so.

I do believe we can be born with physical deficiencies that can bring us down just as a heart attack in a 16 year old can do who did nothing to bring on a heart attack.

Stuff happens . . . just my opinion.

Post Edited (halloweenbaby) : 10/30/2011 11:45:00 AM (GMT-6)


mudmagnetmum
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Date Joined Apr 2011
Total Posts : 1604
   Posted 10/30/2011 4:56 PM (GMT -6)   
GERD in infants is different, and very much structural weakness combined with completely liquid diet!!

Sixteen year olds who have heart attacks usually have adult sudden death syndrome - a heart defect that never gets detected before they drop dead.

But it is reassuring, to me, that you know of relaxed folk with GERD. I guess what bugs me most is that my run in with GERD 4 years ago lasted six months and cleared up totally of its own accord. Three years later it came back, more or less overnight and just won't get back in its box!!

MMM
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 10/30/2011 10:28 PM (GMT -6)   
halloweenbaby

are you saying that because some young children and infants have GERD that therefore psychological stress in adult onset of gerd can never be a cause?

can there be only one cause of a disease?

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 10/31/2011 4:17 AM (GMT -6)   
I think our lounge carpet will bear testimony that every baby has an element of reflux ;-)
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

WJF
Regular Member


Date Joined Sep 2011
Total Posts : 273
   Posted 10/31/2011 8:13 AM (GMT -6)   
I have started a stress relief therapy - meditation, listening to music, occasional PC gaming, talking to people, exercise, walking, breathing, slowing down my rhythm, etc. I have been eating carefully, avoiding all pitfalls as best as I can. I will not deal with drug withdrawal rebound at the moment, so I am taking 1 Pariet pill every night. Let me see how it goes.

GERD@youngAGE
New Member


Date Joined Apr 2013
Total Posts : 2
   Posted 4/23/2013 10:44 PM (GMT -6)   
Hi,
I have very bad similar situation for about 6 months of severe stress event where I constantly worried every day hour and minute of my stressful event for six months straight until I was relieved. But in the mean time I have developed Gerd. All off a sudden I started having reflux symptoms. I then went to my doctor and he sent me to the G.I. doctor for an endoscopy. The G.I. doctor diagnosed me with grade B esophagitis and Gerd. He then put me on PPI's every day and my symptoms went away. But then after three months off taking PPI's I tried to stop, and then my symptoms came back within two days off stopping medications. Currently I am taking 40 mg all PPI every day and I feel better once in a while in a day but my symptoms are even worse. I went to my G.I. doctor again and he just told me to keep taking PPI's and see him in a year.

My symptoms are like feeling Fullness of stomach after eating small meal and stomach is not emptying fast enough. It feels like my stomach stays full for longer period of time and I cannot lie down right away if I wanted to.
Do u think that I have bad pyloric sphincter which is causing delayed emptying of stomach and may be my LES is fine.

Any help would be really appreciate. I can't sleep due to this GERD. It is really stuck in my kind and feel totally depressed. Please help.
Thanks.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 4/24/2013 2:19 AM (GMT -6)   
GERD@youngAGE

Welcome to Healing Well.

You have posted on an old post. I started a new thread for you.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

Post Edited (opnwhl4) : 4/24/2013 1:24:17 AM (GMT-6)

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