How to live with GERD
Getting my prokinetics won't be easy, but it will be necessary. Not sufficient, however, because living--and getting a completee night's sleep--with GERD caused by intestinal dysmotility requires following two rules:
1. Digestion takes time
2. Don't eat napalm.
1. With prokinetics, and for people with a normal digestive system, breaking down food takes approximately 3 hours. Thus you have to stop eating solid foods three hours before bedtime or you won't be getting any meaningful sleep. Stay up, walk around (it helps to move your middle), and then go to bed. Not before.
However, if you stop eating too much before that--say another three hours--you have a different problem. Ever go to bed hungry? Hard to sleep then too. I get a burst of energy at that point which doesn't allow me to sleep at all. What do I do?
Drink milk, eat a little ice cream, even drink a protein drink. Since intestinal muscle is the issue, liquid nutrition is basically safe inside of those three hours. I can even get away with a glass of milk right before bed, for my Nexium.
2. Napalm, as I understand it, is a mix of laundry detergent (or some other gel-like substance) and gasoline. One sticks to you, the other burns you.
Think of the gel as fatty foods. You can have fried food--i certainly do. Sangyeopsal aka Korean barbecued pork belly? I eat it all the time. Bread dipped in olive oil? Bread is slow to digest, but as long as I don't eat it too late I'm fine. Greasy hamburger? Oh yeah.
You can have spicy food. Chicken habanero that sets your face on fire? Oh yeah--as long as I have plenty of tortillas and water--I love it, but I'm a bit wimpy that way. Pineapple or tangerines, those acids? No problem, especially early in the day. Kimchi? Sure, why not?
Utterly off-limits, however, is chili. Spice + fat = culinary napalm. Curry will tear up my insides for days. Pizza--provided it's not particularly spicy, and as long as it's washed down with Diet Coke or Pepsi. Not sure why the strong acid cuts through the cheese and dough, and I won't guarantee that one. Chocolate ice cream? A little iffy.
This brings me to another oddity (besides pizza + cola). I'm a coffee addict, the type of person you just don't talk to until I've had my daily mocha. The rule of napalm is very important in this one, because coffee itself is a strong acid. So no milk, right? Au contraire, the milk buffers you from the acids. Dilutes them? It's coffee's native oils that tear my gut apart. I can't have drip coffee because of those oils, and I don't even risk cold brew. Espresso, however, does not let most of those oils through. With milk, I can drink that all day.
Two simple rules, and two simple medications, are what's between me and a normal life vs constant heartburn and lost sleep. Thank you Korea for teaching me that.