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Are there any safe foods?

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Printed Date: 27 May 2019 at 9:43am


Topic: Are there any safe foods?
Posted By: Lucylou
Subject: Are there any safe foods?
Date Posted: 19 Oct 2012 at 10:13am
Hi I'm Lucy, waiting for confirmation of barretts after a lovely gastroscope in September.
This has all come as a bit of a shock to me as the first signs I ever got was back in early August and since then I have gone from acid reflux symptoms to the constant chest pain, and only feel symptom free in the morning before I eat.
When I saw the red area on the screen during the scope, and was then told it was barretts, I got quite scared because of things I'd read.

I've tried omeprazole, then lansoprazole and now esomeprazole, but they don't seem to prevent the chest pain, which I presume is the acid on the reddened cells.

I thought barretts was the result of long term acid reflux, how have I jumped over the oesophagitis stage and arrived here so quickly?

I'd be grateful if anyone can tell me what I can eat that will go past the barretts without flaring it up? Even oatmeal with slippery elm is making it sore now and I'm feeling very low.
Given up tea coffee wine chocolate tomatoes, practically everything, only occasionally do I have some Guinness but losing interest in that too..

I have so many questions, about the rapid progression I seem to have, but will wait until I've seen the specialist for my results, most likely in November .
Thanks for listening/reading



Replies:
Posted By: Lucylou
Date Posted: 23 Oct 2012 at 11:48pm
Okay, and one question I do have is about alkaline foods, the pH diet and whether anyone has been able to see a link with body pH levels and gastro issues/disease.
I've heard of a book called 'alkalise or die' amongst others, and that they state if your body is alkaline then you will not be getting ill or diseased.
Have scratched the surface of this, it promotes a largely vegetarian/vegan diet, even chicken and fish is out, as acid, or acid forming, (all meats, in fact) and the aim is to get a ratio of 80:20 alkaline/acid foods in your diet to start to alkalise.
Am I barking up the wrong tree here?
Things like licorice, watermelon, miso soup are highly alkaline. Things like fast food, beer, wine, tea, coffee etc all acid.

Please can anyone offer advice? I have bought the cool food cookbook and will be trying the recipes (arrived in 24 hours, amazing) but would like to hear people's experience of the alkaline diet


Posted By: chrisrob
Date Posted: 24 Oct 2012 at 8:34am
Hi Lucy,

Sorry to hear of your diagnosis. Join the club.
Apparently only about 50% of those with Barrett's actually report heartburn symptoms. It's possible their oesophagus was less sensitive than some others.
But your Barrett's was caused by acid and bile refluxing and attacking the oesophageal epithelium.
Barrett's itself is asymptomatic and the Barrett's cells less sensitive than squamous (normal) epithelium: the pain you are now experiencing is due to acid reflux.

You will find much conflicting advice regarding diet.

Trigger foods differ from person to person. It may be something we learn: one theory is our stomachs may produce less acid when we recognise we are about to eat acidic foods.

But it's not necessarily the acidity of the food that matters. And there are a number of myths:

Many people will say to avoid spicy food. We instinctively imagine they will burn our oesophagus as we experience a burning sensation in the throat but its acidity is noting compared with acidity of the stomach acid.
(The regional patient support group I chair will be enjoying our annual curry evening in a few weeks that was initiated by our senior consultant gastroenterologist advisor.)

The fat content is a bigger issue. Fat does not dissolve in acid. It requires the bile it will meet in the duodenum. In the stomach, fatty foods remain longer - being churned and sprayed with acid that is not neutralised. Many fast foods are high in fat.

People may suggest milk is a good drink as an alternative to other, acidic, drinks. However, milk is a foodstuff that contains fats.

Drugs including nicotine, alcohol and caffeine can relax the lower oesophageal sphincter facilitating reflux.

Fruit is acidic but produces an alkaline ash when digested so is good.

You will find much on the internet that is best avoided. There are charlatans selling their cures for acid reflux. Like the snake oil peddlers of the wild west, they prey on the gullible and make their money telling them to eat apples.
Beware also of those who tell you to get some universal indicator paper to measure your body pH. Acidity of saliva or urine (or even blood) is not an indicator of the acidity of the stomach. (That is actually something Theo Baroody says in his book.)

http://heartburn.about.com/cs/dietfood/a/heartburnfoods3.htm - This link will take you to a reasonable (free) website with suggested foods to avoid.

It may take time for you to get the right balance - of drug dosage and recognition of your personal food triggers to control acidity and any adaptation of lifestyle to reduce reflux.

In the meantime, it is very unlikely your Barrett's will get any worse. And you should be scoped every couple of years to check.

All the best

Chris

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk


Posted By: Lucylou
Date Posted: 24 Oct 2012 at 4:09pm
Thank you for replying Chris, I had worked out that spices didn't bother me, it's the normal things like vegetable soup (shop bought) that I would have thought okay that give me the acid/chest pain. I guess the fat content was one thing I didn't check. I've lost a stone in weight since mid September just by cutting fat out, (edited to add, and eating bland food and cutting right back on my lovely glass(es) of white wine in the evenings)- surely the body needs some fats?
As I said I have 1,000 questions to ask, hope you don't mind me asking some of them here?
Will domperidone help the symptoms to go? I have a prescription ready to go, and with nearly constant discomfort (except for early mornings) I'm keen to get some relief. I believe this drug is also meant to stimulate the LOS? Is this true? What research has been done regarding the weakening of this sphincter and why? Can it be exercised, strengthened (have read about linx magnets, but I mean naturally, without surgery) and also have read about the vagus nerve being responsible, any definitive research on this?
PPI long term medication -which is what I face, I hear can lead to anaemia and other mineral deficiencies, will this be monitored by health service or is it down to me to get supplements? Will I get blood screens or do I have to push for those myself?
Sorry, too many what ifs, but as you can tell I have been turned upside down by this diagnosis and the prospect of dysplasia & procedures.

Many thanks for any replies, just the useful links will do instead of trying to match my essays!


Posted By: chrisrob
Date Posted: 24 Oct 2012 at 6:40pm
Hi again,

Yes, some fats are necessary in your diet. But too many processed foods have too much fat in them. As I said, you'll need to experiment and find what foods cause you problems and which ones you can tolerate.

Please do feel free to ask all the questions you want. That's what this forum is for. Be advised we are not doctors (though can access them if necessary) but between us we have a wealth of experience and there's usually someone who can answer your queries.

Domperidone is an anti-emetic / pro-kinetic agent that is meant to help peristalsis to assist the passage of food through the digestive tract. You may or may not find it helpful. It is best not to take too much too often as our bodies become used to it and it loses its effectiveness.

A weak LOS may result from many things. Hiatus Hernia is a common cause. But there's also recently been shown to be a genetic link.
Presently the best known way to strengthen the LOS is with a fundoplication operation. There are, and have been, other treatments and devices to tighten, or provide an alternative to, the LOS. http://www.aetna.com/cpb/medical/data/200_299/0213.html - This link will take you to a paper where different devices were evaluated.

The Linx device with a ring of titanium magnets is not recommended for Barrett's patients.

A new treatment that looks promising is http://www.endostim.com/international/ - Endostim, described as a pcemaker for the LOS, which works by providing small pulses of electricity to the muscles to tighten or relax them.
https://docs.google.com/viewer?url=http%3A%2F%2Fd2j7fjepcxuj0a.cloudfront.net%2Fwp-content%2Fuploads%2F2012%2F10%2F2012ACGRelease-Electrical-Stimulation-of-LES-for-GERD-2.pdf - The American College of Gastroenterology issued a paper about it this week.

There is much on-going research into all aspects of this condition and its best treatment etc. A recently introduced page on Barrett's Wessex website is attempting to flag new research as findings are released. https://sites.google.com/site/barrettswessex/news/research - It may be accessed here.
(I also have a vast back library of abstracts saved on my computer.)

Long term high dose PPIs can result in poor mineral absorption. You will need to check (or ask your doctor to test) for signs of osteoporosis through calcium deficiency and anaemia through iron deficiency - and you can also experience problems through deficiencies in magnesium, zinc, etc. You won't be offered blood tests automatically but if you start noticing symptoms you can ask your doctor.

The side effects may worry but most are not bothered by them. It does require high dose PPI over a long period. (I was on 80mg omeprazole for a few years: aneamia was my main problem.) But the side effects are probably better to the possible alternative.

All the best

Chris


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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk


Posted By: Suzy
Date Posted: 25 Oct 2012 at 9:35pm
Hi Lucylou

You asked about alkaline diet books. I have bought the Energise For Life book "Alkaline Diet Recipe Book" by Ross Bridgeford and have found it really useful, however it is a whole new way of eating/cooking but there's something in it. He also recommends a ratio 80:20 alkaline/acidic foods. It's not something you can achieve over night but can gradually change over time. I find you have to work at it and the rest of the family won't necessarily be in favour!

Many of us experience chest pains but hopefully when you get the acid reflux under control the pains will ease. It takes time in the beginning until the drugs begin to work and you slowly make changes to your diet. Everyone's different and what works for one will not necessarily work for someone else. It's very much trial and error. Beats me how so many can go to the annual curry evening that Chris mentioned - I couldn't cope with a curry, no matter how mild!

Interested to see you feel your oatmeal and slippery elm irritate. I find oats in any form make me very unwell now even though they are such a good source of energy being low GI. I avoid oats completely now. I take my slippery elm as a "tea" just before going to bed as I find it very soothing. I'm also a big fan of Aloe Vera but check my posts for what to look for when buying it.

If you haven't already found it the energise for life website is quite useful. You will be inundated with emails if you sign up for their newsletter, but there's always the delete button! They provide weekly alkaline recipes so no need to buy the book, if you don't want to.

Just as an aside for everyone if you're looking for something new for breakfast I came across this in the Gluten Free section at Sainsbury's ~ "Nature's Path Gluten Free Mesa Sunrise". It's a multigrain cereal with organic corn, flax, quinoa and amaranth (whatever that is!). I find myself snacking on it during the day too - much healthier than crisps!

All the best

Suzy


Posted By: Suzy
Date Posted: 25 Oct 2012 at 9:56pm
Following on from previous post I just googled Amaranth and up popped no end of very healthy looking recipes. Will be off to the health food shop tomorrow to see if they stock it - does anyone else cook with it?

Suzy


Posted By: Lucylou
Date Posted: 25 Oct 2012 at 10:21pm
Hi Suzy
Thanks for your replies, I get so confused because on one website oatmeal is 'safe' on another its acidic, same with honey! Miso soup is highly alkaline, but tofu is acidic. Confused.com
Can you believe I already bought the Mesa sunrise cereal, enjoyed it but think the milk set me off.
I sent off for energise for life food charts, and get emails daily from Ross, but again, not all items are okay to eat.
I bought 'dropping acid' book too, again it has an induction diet for initial 2 weeks to calm things down, in it, oatmeal is a staple food! Along with camomile tea, chicken stock and green veg and root veg.
Just get so cheesed off with the whole concept, I have eaten home made curry tonight, and last night! Sod the consequences!
My partner is trying very hard to get things right when cooking, but its hard when even I don't know what I can eat and what needs to be left out.
Have you tried 'taifun' tofu with basil? Delicious, one of the few things I can tolerate, along with 0% fat Greek yogurt and beetroot ( not at the same time)
Camomile tea and water are the only things I can drink it seems
Ho hum


Posted By: Suzy
Date Posted: 26 Oct 2012 at 10:00am
Hi Lucylou

As I said before it's very much trial and error. I can't tolerate honey either along with a zillion other things! There will probably be recipes in any of the alkaline recipe books that you won't be able to tolerate. It takes time to work out what works for you.

If you think the milk upset you it probably did. Have you thought about avoiding dairy for a bit and see what happens? I've given up dairy altogether and really like Alpro Soya milk (original) and Pure Soya spread, miss cheese though. Alpro is a good brand and available in most supermarkets.   There's several different flavours so it might be worth a try.

Haven't tried the taifun tofu but will give it a go.

If it's any consolation the only thing I drink, apart from the soya milk, is water and it's been like that for years, so at least you know you're not alone. Things may change for you though, this is a condition that seems to flare up and then calm down.

All the best

Suzy


Posted By: Lucylou
Date Posted: 08 Dec 2012 at 11:25pm
Just a quick update.....
Have given up milk of any sort, found a drink called 'oatly' which works well when making porridge.
Slippery elm sold boxed in shops apparently is produced with cornflour cut into it, but have found proper slippery elm sold in infinity foods (pricy) but these 3 things together for breakfast seem to hold off the reflux symptoms til lunchtime.

Am working on a safe lunch now.
I have also found a Japanese store which sells soup base granules that produce a clear soup in which I can add rice noodles and thinly sliced vegetables, which also doesn't set me off, so things are looking up a little....
Still making mistakes, and when the acid is there I tend to think what the hell and have a treat or two, am hoping this wont do any harm, but it keeps me from going totally mad as always loved my food and drink so much ....... I MISS IT!!!!!!!!
Oh and Christmas is coming, good luck everyone


Posted By: chrisrob
Date Posted: 09 Dec 2012 at 8:34am
Hi Again, Lucylou,

Thank you for the update.
I'm glad you are finding which foods work for you and managing a healthy, relatively problem free diet.

About three years ago I put together the top ten tips for surviving Christmas, with the help of one of my gastroenterologist colleagues.

That may be seen on here: https://sites.google.com/site/barrettswessex/tips - Barrett's Wessex / Tips (scroll down the page) if it's helpful.

Happy Christmas.

Eat (carefully), Drink (carefully) and be merry.

Chris

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk


Posted By: Lucylou
Date Posted: 09 Dec 2012 at 3:07pm
Thanks Chris for all your sensible advice.
I have no malignancy, found out last week, but am going back to see consultant as GP was unable to answer my 1,004 questions on the subject!
Happy Christmas all !



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