What Helped My GERD and LPR

This is a personal account, not medical advice. Reflux has several possible underlying causes and some of them need a doctor to rule out. See the note at the bottom before you take anything here as a plan.

It started with late night pizza and beer, followed by going straight to bed. For the next week or two I had chest pain that I was convinced was my heart. A friend was the one who finally suggested it was heartburn.

It got worse before it got better, mostly because I had no idea I was making it worse. Spicy food and coffee were doing real damage and I kept eating both. Once I understood what was happening I cut every classic trigger food at once and ate baked chicken, potatoes, oatmeal, and not much else. I was in a lot of pain for several days regardless. A doctor put me on a prescription PPI, and I started sleeping on a wedge pillow.

The worst of the pain eased over about two weeks, but constant reflux and heartburn stuck around. An endoscopy turned up H. pylori. I took the course of antibiotics and cleared it, confirmed with two separate tests. I am still not convinced H. pylori was the cause. My honest read is that the cause was bad eating habits: eating right before bed and eating too much.

Recovery from there was slow and unglamorous. Over several months to a year I noticed small improvements every one or two weeks. Slightly less pain. Able to add fruit back. Then I would eat something that turned out to be a trigger and pay for it with a flare up for a couple of days.

At around ten months I was able to come off the PPI, but only by tapering slowly. Stopping quickly brought the flare ups right back.

By the two year mark I was mostly fine with occasional flare ups, and I had a routine for them: treat the symptoms and find the actual cause. One flare up traced back to heavy work travel with frequent cocktails and restaurant food. That stretch also left me asthmatic after eating and took a couple of months on a prescription inhaler to settle.

Four years out, I eat almost anything. The permanent exclusions are short: coffee, grapefruit, and anything aggressively spicy. I tried reintroducing coffee more than once and always paid for it, so I switched to black and green tea for caffeine. My mood is better for it, mostly because there is no crash. Thai, Mexican, BBQ, all fine in moderation and at a sensible hour.

Affiliate links. We earn a commission if you buy through one, at no extra cost to you. Nothing on this page is medical advice.

What Actually Helped

Four things did the heavy lifting. Two are habits and two are products.

» A bland diet at the start, then systematic reintroduction – Cutting everything at once is what breaks the cycle. The real work is adding foods back one at a time so you learn your own triggers instead of guessing. Mine turned out to be a much shorter list than the internet's.

» Eating three to four hours before bed – Longer is better. This one change probably did more than any medication, and it costs nothing.

» ⭐ Budget Wedge pillow – Gravity does the work overnight. Stacking regular pillows does not achieve the same thing because your torso bends at the waist and the pressure gets worse. Use it until things calm down, and longer if you can stand it.

» Budget Bed risers – The alternative if a wedge is uncomfortable or you share the bed. Raising the head of the frame a few inches tilts the whole sleeping surface, which some people find easier to live with than a wedge.

For Flare Ups

» Budget Gaviscon Advance – Worth being precise here, because the name is misleading. The product that works is the UK formulation, which is an alginate. It carries 1000mg of sodium alginate per 10ml dose and forms a floating raft over the stomach contents rather than neutralizing acid. The Gaviscon sold on US shelves is a conventional antacid with a fraction of the alginate and it is not the same product. If you are in the US you are looking for imported UK stock, and it goes out of stock often. Check the label says Advance, not Double Action or plain Gaviscon.

» Budget Famotidine – An H2 blocker, useful during a flare rather than as a daily habit. Sold as Pepcid AC and as generic famotidine, which is the same thing for less.

A note on Zantac, since I mentioned it when I first wrote this up. The original Zantac was ranitidine, and the FDA requested that all ranitidine products be pulled from the US market in April 2020 after finding NDMA, a probable carcinogen, at levels that climbed during storage. The product on shelves now called Zantac 360 is famotidine, the same active ingredient as Pepcid. So if you read older reflux advice recommending Zantac, the drug being described no longer exists in the US and the box with that name on it is something different.

Coming Off a PPI

The single thing I would tell anyone still on one: taper, do not stop. Coming off quickly triggered flare ups every time. It took me around ten months to get off mine and the last stretch was the slowest. Do this with the doctor who prescribed it, not on your own timeline.

Get Checked Out

I am not a doctor. Work with yours to confirm there is no other underlying cause, because most of the time reflux is just reflux, but occasionally it is not, and the things it occasionally is are worth finding early. The endoscopy was genuinely an easy procedure and it is what turned up the H. pylori in my case.

Everything above is what worked for me over four years. It may not work for you.