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Traveling with Heartburn (GERD)

traveling with heartburn
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I’ve told you about my heartburn, right? Yeah, I have. I mentioned it in this post about doxycycline. You see, I took doxycycline for 6 months as a malaria prophylactic and subsequently developed gastroesophageal reflux disease (GERD). It has been debilitating in many ways.

Symptoms of GERD can include heartburn, a cough, and miserably, the taste of stomach fluid in your mouth. When I first starting showing symptoms, I didn’t know what I had. I found myself waking up abruptly 20-30 minutes after laying down to sleep, clutching my chest, thinking I was having a heart attack.

This was alarming. I thought there was something wrong with my heart. Maybe I had a palpitation or an arrhythmia? Searching on the internet didn’t help. If you’ve ever tried to self-diagnose a malady on the internet, you know about the anxiety-ridden rabbit hole that you will descend on the way to what will most likely be a mis-diagnosis.

Several doctor visits later, including one trip to a cardiologist, and I was diagnosed with GERD and given a prescription for 40mg of omeprazole, commonly known by its brand name, Prilosec. Two years later and I am still dealing with GERD, although I have learned to manage it to some extent. But how do I manage it when I travel? I am abroad for most of the year, often in West Africa. Travel presents many challenges to the GERD sufferer. New foods, drinks, sleeping environments. In this post, I explain how I cope.

Sleeping

I used to always look forward to sleep. But for a time, sleeping become a chore, and one that brought me much dread. I learned that I can no longer sleep on my back and that eating a late meal would lead to violent waking 30-40 minutes after laying down. Now I have learned how I have to sleep: on my left side, with my head propped up more than usual, and I know that I can’t eat right before sleeping.

On the road, this can become a more difficult task. You might not know what kind of sleeping arrangement you’ll find yourself in and late meals are always a possibility. If I find myself in a hostel or hotel, or staying at someone’s house, and there isn’t a good pillow option for propping my head up, I will create my own pillow using my bag or by folding up a bunch of my clothes. This improvised pillow has saved me on many occasions. I try to steer clear of late meals, but sometimes they are unavoidable. In those cases, I will take an antacid after eating and I won’t lay down right away (I’ll stay up and read or listen to music instead).

Eating

chili_pepper_gerd_heartburnEveryone knows that some foods stimulate acid creation. Alcohol, tomatos, orange juice, etc. But few people know that there are also other foods that can cause heartburn not by stimulating more acid, but by relaxing the muscle that connects the stomach to the esophagus, allowing acid to creep up. These foods include mint and chocolate.

I do make a conscious effort to limit the amount of food I eat from these two categories, but I’ll be honest with you, there’s no way I’m cutting them out entirely — I enjoy them too much and I’ve been able to manage my GERD while keeping them in my diet. I monitor my heartburn and if things flare up, then I will temporarily avoid these foods. Otherwise, I will eat them in moderation. I try to avoid overeating and I always try to chew a stick of bubblegum after I eat (mint gum can irritate GERD as I mentioned above, but otherwise, gum helps to stimulate saliva and saliva is basic, which can help limit the acid in your stomach).

UPDATE: I strongly checking out the gum linked right above this paragraph. XyloBurst is sugar-free, but it does not contain aspartame or any of the other bizarre ingredients that you find in Trident etc. Good for your heartburn and your teeth!

Medication

I no longer take the 40mg omeprazole that I was originally prescribed. I still do take 20mg omeprazole, however, though not on a daily basis. I would say I take it 75% of days. I keep antacids on hand and I will use them if my heartburn flares up and I need quick relief. However, I try to avoid them as much as possible as they can cause your stomach to overcompensate in the end, creating more acid and exacerbating the problem. I take omeprazole rather than other medications such as Zantac, because my doctor told me that proton-pump inhibitors like omeprazole are better for long-term use. Some people dispute this and clearly there is more work that needs to be done to determine the safest long-term medication for heart burn sufferers.

When it comes to travel and heartburn medication, I’ve found that it’s very easy to find both antacids and omeprazole in any country I’ve visited. In fact, in West Africa, I can purchase omeprazole for a fraction of the price that I can in the United States. For 20 pills of 20mg omeprazole, I pay $2 in West Africa.

If you are thinking about taking a medication for heartburn on a long-term basis, do not simply start taking something over the counter. Visit your doctor. Better yet, make an appointment with a gastroenterologist and have a full exam. I actually ended up getting an endoscopy to rule out more severe causes of heartburn.

Recently, I’ve been reading about this magnetic bracelet that has been FDA approved for the treatment of GERD. While I would wait to see how things play out on the long-term with such an implanted device, the preliminary results are so far very encouraging and it looks like it may be a good option for severe heartburn sufferers. Here is an article on it if you are interested.

If you have any tips to share when it comes to travel and heartburn, please drop some knowledge on us in the comments below.

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{ 3 comments… add one }

  • Matt May 4, 2013, 12:04 pm

    Having been diagnosed with GERD I spent considerable time researching what could be the cause. Dr’s like to say it’s too much stomach acid and then prescribe PPI’s indefinitely. I didn’t like the idea of taking a PPI long term.

    What I found is that the problem isn’t with stomach acid, it’s with the lower esophageal valve. It malfunctions and opens at the wrong times allowing acid to come up. Any amount of acid is bad for the esophagus so simply reducing the amount of acid still doesn’t resolve the problem.

    What causes the valve to malfunction? An increase in intra-abdominal pressure. What causes an increase in intra-abdominal pressure? Malabsorption of carbohydrates and bacterial overgrowth (SIBO – small intestinal bacteria overgrowth). This condition can be compounded by the use of PPI’s which reduce stomach acid and set an environment for the proliferation of bacteria growth. And of course use of antibiotics can indiscriminately wipe out the good bacteria and allow the bad to grow.

    I too took lots of antibiotics to rid myself of a parasite picked up through International travel as well as doxycycline for malaria prevention years ago. What developed as a result was SIBO. I’m now treating that and have seen a reduction in GERD symptoms already. The SCD diet has also helped considerably.

    This article was a great help in identifying my issue with GERD.

    http://chriskresser.com/the-hidden-causes-of-heartburn-and-gerd

    A hydrogen breath test can quickly determine if SIBO is the underlying issue. It’s interesting the role that our GI flora play in so many different aspects of our health.

    • phil May 4, 2013, 5:32 pm

      Hey Matt,

      Thanks for your comment. I think we’ve talked a bit before about the effect of antibiotics and I remember talking to you about the long-term parasite that you were dealing with. This is all very interesting and I’m inclined to get this breath test now. My gastroenterologist didn’t bring it up with me and perhaps he is way off the mark on the reasons for my GERD. It’s worrying to me that I could possibly be making the issue worse by taking PPI’s. Are you treating your GERD through diet alone?? Thanks a lot for the comment and I hope you are well. Still in Indonesia??

  • Travelwedge November 16, 2015, 8:38 pm

    Hi, very common to struggle with sleep if you have acid reflux. We developed an inflatable bed wedge designed to offer relief from acid reflux while sleeping at home or on the road. http://www.travelwedge.com

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