{"id":292,"date":"2013-08-25T17:12:18","date_gmt":"2013-08-25T21:12:18","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=292"},"modified":"2020-07-11T10:43:02","modified_gmt":"2020-07-11T14:43:02","slug":"gastroesophageal-reflux-disease-gerd-2","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/gastroesophageal-reflux-disease-gerd-2\/","title":{"rendered":"Gastroesophageal Reflux Disease (GERD)\u00a0"},"content":{"rendered":"<div id=\"attachment_3161\" style=\"width: 235px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/GERD-image.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3161\" class=\"size-medium wp-image-3161\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/GERD-image-225x300.png\" alt=\"GERD Gluten Celiac Disease\" width=\"225\" height=\"300\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/GERD-image-225x300.png 225w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/GERD-image.png 600w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-3161\" class=\"wp-caption-text\">Arrows Show Abnormal Movement of Gastric Acid in Gastroesophageal Reflux Disease.<\/p><\/div>\n<h2>What Is Gastroesophageal Reflux Disease (GERD)?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">G<\/span>ERD is an upper digestive disorder that is characterized by a decrease in lower esophageal sphincter pressure (LES,) which allows the abnormal reflux or backflow of stomach contents into the esophagus. It is also called erosive esophagitis or reflux esophagitis and\u00a0is the most common disorder of the esophagus.<\/p>\n<p style=\"text-align: justify\">The esophagus is a muscular tube that transports swallowed substances to the stomach. It begins at the cricoid cartilage (Adam&#8217;s apple) as a continuation of the pharynx and ends at the lower esophageal sphincter (LES).<\/p>\n<p style=\"text-align: justify\">The\u00a0lower esophageal sphincter is located at the junction of the esophagus and the stomach. It functions like a circular band to tighten after food is ingested in order to prevent its going back up the esophagus.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: How does reflux damage the esophagus?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: Damage to the lining of the esophagus is induced by the caustic, chemical action of acid and pepsin in gastric juice and, in severe cases, also\u00a0bile salts, that back upwards from the stomach through an impaired LES.\u00a0Gastric acid combined with pepsin or bile salts seems to be more harmful to the esophageal epithelial layers than gastric acid alone.<a href=\"#footnote_1_292\" id=\"identifier_1_292\" class=\"footnote-link footnote-identifier-link\" title=\"Chen X, Oshima T, Tomita T, Fukui H, Watari J, Matsumoto T, Miwa H. Acidic bile salts modulate the squamous epithelial barrier function by modulating tight junction proteins. Am J Physiol Gastrointest Liver Physiol. 2011 Aug;301(2):G203-9. doi: 10.1152\/ajpgi.00096.2011. Epub 2011 May 26.\">1<\/a><\/p>\n<p style=\"text-align: justify\">Pepsin is normally produced by the stomach to dissolve protein in swallowed food.\u00a0Unfortunately, when the esophagus is inflamed, pepsin will act on it to break down the protein in its sore wall. These sores are called erosions.<\/p>\n<p style=\"text-align: justify\">Importantly, refluxate to the esophagus in patients with acid suppression therapy is different from those in patients without. Higher levels of secondary bile acids are detected in patients with acid suppression therapy. Even if acid suppression is successful, weakly acidic reflux with bile acids can damage the esophagus.<a href=\"#footnote_1_292\" id=\"identifier_2_292\" class=\"footnote-link footnote-identifier-link\" title=\"Chen X, Oshima T, Tomita T, Fukui H, Watari J, Matsumoto T, Miwa H. Acidic bile salts modulate the squamous epithelial barrier function by modulating tight junction proteins. Am J Physiol Gastrointest Liver Physiol. 2011 Aug;301(2):G203-9. doi: 10.1152\/ajpgi.00096.2011. Epub 2011 May 26.\">1<\/a><\/p>\n<p style=\"text-align: justify\">Damage starts at the luminal surface (inside where food passes through) of the squamous epithelium (tough surface cells) and progresses through the underlying layers into the submucosa.<\/p>\n<p style=\"text-align: justify\">One of the primary functions of the esophageal epithelium is to protect the underlying tissue from mechanical and chemical damage by acting as a barrier. The epithelial layers of the distal esophagus need to withstand reflux from the stomach and its contents. When the epithelium fails to protect the underlying tissue from this damage, it leads to erosions, esophagitis, and may lead to Barrett&#8217;s esophagus.<a href=\"#footnote_1_292\" id=\"identifier_3_292\" class=\"footnote-link footnote-identifier-link\" title=\"Chen X, Oshima T, Tomita T, Fukui H, Watari J, Matsumoto T, Miwa H. Acidic bile salts modulate the squamous epithelial barrier function by modulating tight junction proteins. Am J Physiol Gastrointest Liver Physiol. 2011 Aug;301(2):G203-9. doi: 10.1152\/ajpgi.00096.2011. Epub 2011 May 26.\">1<\/a><\/p>\n<p style=\"text-align: justify\">Barrett&#8217;s esophagus and esophageal small cell cancer are severe complications of GERD that can be fatal.<\/p>\n<p style=\"text-align: justify\">GERD can result from too much, or more commonly, too little stomach acid.<\/p>\n<h2>What Is Gastroesophageal Reflux Disease (GERD) In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li><strong>Relationship between GERD and celiac disease.\u00a0<\/strong>Gastroesophageal reflux disease (GERD) is an atypical symptom of celiac disease.<\/li>\n<\/ul>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between GERD and gluten.\u00a0<\/strong>Research shows that a gluten free diet significantly decreased the relapse rate of GERD symptoms suggesting that celiac disease may represent a risk factor for the development of reflux esophagitis.<a href=\"#footnote_2_292\" id=\"identifier_4_292\" class=\"footnote-link footnote-identifier-link\" title=\"Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet.&nbsp;Gut. Apr 2003;52(4):514-7.\">2<\/a><\/li>\n<\/ul>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between GERD and gluten free diet.\u00a0<\/strong>A study investigating\u00a0the prevalence of GERD symptoms at diagnosis and the impact of the gluten-free diet found that GERD symptoms are common in classically symptomatic untreated celiac disease patients and that the gluten free diet is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population. At baseline, 30.1% of celiac disease patients had moderate to severe GERD (score more than 3) compared with 5.7% of controls. Moderate to severe symptoms were significantly associated with the classical clinical presentation of celiac disease (35.0%) compared with atypical\/silent cases (15.2%). A rapid improvement was evidenced at 3 months after initial treatment with a gluten free diet\u00a0with reflux scores comparable to healthy controls from this time point onward.<a href=\"#footnote_3_292\" id=\"identifier_5_292\" class=\"footnote-link footnote-identifier-link\" title=\"Saad R, Bellec V, Dugay J, Blanchi A,Nachman F, V&aacute;zquez H, Gonz&aacute;lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S&aacute;nchez IP, Mauri&ntilde;o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017.\">3<\/a><\/li>\n<\/ul>\n<h2>How Prevalent is GERD In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_bullet black\">\n<li style=\"text-align: justify\">Celiac patients have a high prevalence of reflux esophagitis. Retrospective study shows 19% in patients undergoing endoscopy for biopsy.<a href=\"#footnote_4_292\" id=\"identifier_6_292\" class=\"footnote-link footnote-identifier-link\" title=\"Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. Gut. Apr 2003;52(4):514-7.\">4<\/a><\/li>\n<li style=\"text-align: justify\">At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls: 30.1% of celiac disease patients had moderate to severe GERD (score &gt;3) compared with 5.7% of controls. Moderate to severe symptoms were significantly associated with the classical clinical presentation of celiac disease (35.0%) compared with atypical\/silent cases (15.2%).<a href=\"#footnote_3_292\" id=\"identifier_7_292\" class=\"footnote-link footnote-identifier-link\" title=\"Saad R, Bellec V, Dugay J, Blanchi A,Nachman F, V&aacute;zquez H, Gonz&aacute;lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S&aacute;nchez IP, Mauri&ntilde;o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017.\">3<\/a><\/li>\n<li style=\"text-align: justify\">Of 212 patients undergoing upper endoscopy for dypepsia, 3.3% of patients showed histopathological changes typical of celiac disease on duodenal biopsy. 8.5% of patients had gastric reflux.<a href=\"#footnote_5_292\" id=\"identifier_8_292\" class=\"footnote-link footnote-identifier-link\" title=\"Piatek-Guziewicz A, Przybylska-Felu\u015b M, Dynowski W, Zwoli\u0144ska-Wcis\u0142o M, Lickiewicz J, Mach T. Endoscopic and histopathological findings of the upper gastrointestinal tract in patients with functional and organic dyspepsia. Przegl Lek. 2014;71(4):204-9.\">5<\/a><\/li>\n<\/ul>\n<div id=\"attachment_13298\" style=\"width: 265px\" class=\"wp-caption alignright\"><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-13298\" class=\"wp-image-13298\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis-300x294.jpg\" alt=\"IMG_1008a esophagus lower 3rd esophagitis\" width=\"255\" height=\"250\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis-300x294.jpg 300w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis-1024x1006.jpg 1024w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis-70x70.jpg 70w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/IMG_1008a-esophagus-lower-3rd-esophagitis.jpg 1948w\" sizes=\"auto, (max-width: 255px) 100vw, 255px\" \/><\/a><p id=\"caption-attachment-13298\" class=\"wp-caption-text\">This Video Photo is From Cleo&#8217;s Gastroscopy Procedure. Two Weeks Gluten Free Stopped this Damage. Esophagitis, Which is Inflammation of the Esophagus, Results from the Burning Effects of Stomach Juice Abnormally Contacting Tissues of the Esophagus. The Cause Was Low Stomach Acid Which is Why Prilosec Did Not Help.<\/p><\/div>\n<h2>What Are The Symptoms Of GERD?<\/h2>\n<p>GERD is marked by these symptoms:<\/p>\n<ul class=\"cp_bullet red\">\n<li>Chest pain that may resemble angina in half of patients.<\/li>\n<li>Dysphagia (difficulty swallowing)<\/li>\n<li>Fullness under breastbone.<\/li>\n<li>Heartburn (burning sensation behind the breastbone).<\/li>\n<li>Regurgitation of bitter tasting fluid.<\/li>\n<\/ul>\n<p>However, reflux can occur without symptoms.<\/p>\n<h2>How Does GERD Develop\u00a0In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li>GERD results from gluten exposure and increased abdominal pressure in active celiac disease against the lower esophageal sphincter.<\/li>\n<\/ul>\n<h2>Does GERD Respond To Gluten Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Gluten free diet significantly decreases the relapse rate of celiac disease-related GERD symptoms.<a href=\"#footnote_4_292\" id=\"identifier_9_292\" class=\"footnote-link footnote-identifier-link\" title=\"Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. Gut. Apr 2003;52(4):514-7.\">4<\/a><\/p>\n<p style=\"text-align: justify\">The gluten free diet is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population. A rapid improvement was evidenced at 3 months after initial treatment with a gluten free diet with reflux scores comparable to healthy controls from this time point onward.<a href=\"#footnote_6_292\" id=\"identifier_10_292\" class=\"footnote-link footnote-identifier-link\" title=\"Nachman F, V&aacute;zquez H, Gonz&aacute;lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S&aacute;nchez IP, Mauri&ntilde;o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.&nbsp;Clin Gastroenterol Hepatol.&nbsp;2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017.\">6<\/a><\/p>\n<h2>6 Steps To Improve GERD In Celiac Disease and\/or Gluten Sensitivity:<\/h2>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both GERD and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li style=\"text-align: justify\">Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_7_292\" id=\"identifier_11_292\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">7<\/a><\/li>\n<li style=\"text-align: justify\">The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify;padding-left: 30px\">Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types<\/strong>:<\/p>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\"><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_12_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li style=\"text-align: justify\"><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_13_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Bad Fats.<\/strong>\u00a0Includes deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_14_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a>.<\/li>\n<li style=\"text-align: justify\"><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_15_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li style=\"text-align: justify\"><strong>Hot Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_16_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Alcohol and Caffeine<\/strong>. Relax the lower esophageal sphincter and disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_292\" id=\"identifier_17_292\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\"><strong>Fruits.\u00a0<\/strong>Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li style=\"text-align: justify\"><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.<\/li>\n<li style=\"text-align: justify\"><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li style=\"text-align: justify\"><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li style=\"text-align: justify\"><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li style=\"text-align: justify\"><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li style=\"text-align: justify\"><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 for examples such as calendula.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>3<\/strong><\/span>\u00a0<strong>Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p>Click here.<\/p>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>4<\/strong><\/span><\/span><\/em><em><strong><span style=\"color: #800000\">Manage Your Medications <strong>\u00a0Safely<\/strong>:<\/span>\u00a0<\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Certain prescription drugs that are commonly prescribed for GERD deplete nutrients. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.\u00a0<strong>Do not stop prescribed medications without supervision.<\/strong><\/p>\n<p>\u00a0This is not a complete listing.<\/p>\n<table style=\"height: 246px\" width=\"512\">\n<tbody>\n<tr>\n<td width=\"300\"><strong>\u00a0<\/strong><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong> <strong>\u2013<\/strong><\/p>\n<ul>\n<li><em>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae, <\/em><\/li>\n<li>Magnesium and Aluminum Antacid preparations (Gaviscon<em>\u00ae<\/em>, Maalox<em>\u00ae<\/em>, Mylanta<em>\u00ae<\/em>).<\/li>\n<\/ul>\n<ul>\n<li><em>Prevacid\u00ae, Prilosec\u00ae.<\/em><strong>\u00a0<\/strong><\/li>\n<\/ul>\n<ul>\n<li>Alka Seltzer<em>\u00ae<\/em>, Baking Soda<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/td>\n<td width=\"276\">\u00a0<strong>DEPLETE THESE NURIENTS &#8211;<\/strong><\/p>\n<ul>\n<li>Calcium, Chromium, Folic Acid, Iron, Vitamin A, Vitamin B12, Vitamin D,\u00a0\u00a0\u00a0\u00a0\u00a0 Zinc, Magnesium, Copper, Potassium.<\/li>\n<\/ul>\n<ul>\n<li>Vitamin B12.<strong>\u00a0<\/strong><\/li>\n<\/ul>\n<ul>\n<li>Folic Acid, Magnesium, Proteins, Potassium<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><b>5<\/b><\/span><\/span><strong><span style=\"color: #800000\">Nutritional Supplements To Help Correct Deficiencies:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\">\n<li style=\"text-align: justify\">L-glutamine 250 to 500 mg \u00a0just after eating has been shown to heal the esophagus.<a href=\"#footnote_9_292\" id=\"identifier_18_292\" class=\"footnote-link footnote-identifier-link\" title=\"The Herbal Drugstore. Linda White, M.D and Steven Foster. 2000. Rodale Inc. USA.\">9<\/a>This is a safe dose,\u00a0but always check with your doctor to avoid interactions with medications or if you are on a low protein diet since this is an amino acid. L-glutamine is a natural fuel for the cells that line the intestines.<\/li>\n<li style=\"text-align: justify\">Multivitamin\/mineral combination that provides 100% once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><b>6<\/b><\/span><\/span><strong><span style=\"color: #800000\">Manage Natural Remedies:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Carminatives are plant sources that tone muscle and improve peristalsis, and thus aid in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort. However, some carminitives\u00a0 relax the lower esophageal sphincter thus aggravating GERD. DO NOT use these carminitives: fennel, lemon balm, peppermint and spearmint. The same goes for cigarette smoke, alcohol, high fat foods, mints, chocolate, onions, and caffiene.<\/p>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets stimulate and improve digestion and are easily digested.<\/li>\n<li><em>Cabbage stimulates and improves digestion and is also a liver decongestant. Proven to help GERD.<\/em><\/li>\n<li style=\"text-align: justify\">Lettuce stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Dandelion is a digestive and liver tonic, bile stimulant, and mild laxative.<\/li>\n<\/ul>\n<p><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li>Parsley relieves colic, gas and indigestion.<\/li>\n<li>Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li>Thyme is a soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<li><em>Calendula is also an astringent and anti-inflammatory that makes it an effective remedy for GERD. Use as a tea. (Steep a teaspon of flowers in a cup of hot water for 10 minutes.)<\/em><\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are antispasmodic.<\/li>\n<li>Nutmeg is also useful for abdominal bloating, indigestion and colic.<\/li>\n<li>Ginger also supresses inflammation.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2>What Do Medical Research Studies Tell About GERD In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;Endoscopic and histopathological findings of the upper gastrointestinal tract in patients with functional and organic dyspepsia.&#8221;<\/strong> This retrospective study investigating the frequency and type of the macroscopic and histopathological changes in the upper gastrointestinal (GI) endoscopy in patients with symptoms of dyspepsia verified that regardless of the severity of lesions of the upper GI endoscopy in patients with dyspepsia, it is advisable to biopsy from both the gastric and duodenal mucosa, which allows for an individualized management of these patients. Celiac disease should be considered in the diagnosis of the causes of dyspepsia.\u00a0Reflux esophagitis was found in 8.5% of patients.<\/p>\n<p style=\"text-align: justify\">Included in this study were 212 patients with dyspepsia, at the age of 18-84 years, including 60 patients to 45 years of age (group I) and 152 patients older than 45 (group II) who underwent gastroscopy. The severity of esophagitis was classified according to the Los Angeles Classification and gastritis according the updated Sydney system. Biopsy specimens were taken from the gastric and duodenum for histopathological examination.<\/p>\n<p style=\"text-align: justify\">Reflux esophagitis was found in 18 patients (8.5%), slightly more common in people over 45 years of age (group I&#8211;5%, group II&#8211;9.2%). The mild forms of esophagitis occurred most frequently. A more advanced form of inflammation and Barrett&#8217;s esophagus was found only in patients over 45 years of age. Normal gastric and duodenal mucosa was revealed in 30% of patients in group I and 9.2% in group II. The most common endoscopic disorder was gastritis, mostly erythematous-exudative and less often atrophic.<\/p>\n<p style=\"text-align: justify\">The majority of patients had normal duodenal mucosa. In 3.3% of patients (group I&#8211;8.3%, group II&#8211;1.3%), who had not previously been diagnosed celiac disease, histopathological changes typical of celiac disease has been shown. In all patients, in whom biopsy specimens were taken from normal duodenal mucosa (14% of patients), histopathological examination revealed the presence of non-specific inflammation, regardless of the coexistence of H. pylori infection.<a href=\"#footnote_5_292\" id=\"identifier_19_292\" class=\"footnote-link footnote-identifier-link\" title=\"Piatek-Guziewicz A, Przybylska-Felu\u015b M, Dynowski W, Zwoli\u0144ska-Wcis\u0142o M, Lickiewicz J, Mach T. Endoscopic and histopathological findings of the upper gastrointestinal tract in patients with functional and organic dyspepsia. Przegl Lek. 2014;71(4):204-9.\">5<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cGastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.\u201d<\/strong> This study investigating\u00a0the prevalence of GERD symptoms at diagnosis and the impact of the gluten-free diet found that GERD symptoms are common in classically symptomatic untreated celiac disease patients and that the gluten free diet is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population.<\/p>\n<p style=\"text-align: justify\">Subjects consisted of 133 adult celiac disease patients evaluated at diagnosis and 70 healthy controls. Fifty-three patients completed questionnaires every 3 months during the first year and more than 4 years after diagnosis. GERD symptoms were evaluated using a subdimension of the Gastrointestinal Symptoms Rating Scale for heartburn and regurgitation domains.\u00a0At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls.\u00a0At baseline, 30.1% of celiac disease patients had moderate to severe GERD (score more than 3) compared with 5.7% of controls. Moderate to severe symptoms were significantly associated with the classical clinical presentation of celiac disease (35.0%) compared with atypical\/silent cases (15.2%). A rapid improvement was evidenced at 3 months after initial treatment with a gluten free diet\u00a0with reflux scores comparable to healthy controls from this time point onward.<a href=\"#footnote_10_292\" id=\"identifier_20_292\" class=\"footnote-link footnote-identifier-link\" title=\"Saad R, Bellec V, Dugay J, Blanchi A,Nachman F, V&aacute;zquez H, Gonz&aacute;lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S&aacute;nchez IP, Mauri&ntilde;o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017..\">10<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cReflux esophagitis in adult coeliac disease: beneficial effect of a gluten free diet.\u201d<\/strong> This study evaluating whether untreated celiac patients had an increased prevalence of reflux esophagitis and, if so, to assess whether a gluten free diet exerted any beneficial effect on GERD symptoms demonstrated celiac patients have a high prevalence of reflux esophagitis. That a gluten free diet significantly decreased the relapse rate of GERD symptoms suggests that celiac disease may represent a risk factor for the development of reflux esophagitis.<a href=\"#footnote_11_292\" id=\"identifier_21_292\" class=\"footnote-link footnote-identifier-link\" title=\"Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. Gut. Apr 2003;52(4):514-7.\">11<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_292\" class=\"footnote\">Chen X, Oshima T, Tomita T, Fukui H, Watari J, Matsumoto T, Miwa H. Acidic bile salts modulate the squamous epithelial barrier function by modulating tight junction proteins. <em>Am J Physiol Gastrointest Liver Physiol. <\/em>2011 Aug;301(2):G203-9. doi: 10.1152\/ajpgi.00096.2011. Epub 2011 May 26.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_292\" class=\"footnote\">Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet.<em>\u00a0Gut<\/em>. Apr 2003;52(4):514-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_292\" class=\"footnote\">Saad R, Bellec V, Dugay J, Blanchi A,Nachman F, V\u00e1zquez H, Gonz\u00e1lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S\u00e1nchez IP, Mauri\u00f1o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. <em>Clin Gastroenterol Hepatol<\/em>. 2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_292\" class=\"footnote\">Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. <em>Gut<\/em>. Apr 2003;52(4):514-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_292\" class=\"footnote\">Piatek-Guziewicz A, Przybylska-Felu\u015b M, Dynowski W, Zwoli\u0144ska-Wcis\u0142o M, Lickiewicz J, Mach T. Endoscopic and histopathological findings of the upper gastrointestinal tract in patients with functional and organic dyspepsia. <em>Przegl Lek.<\/em> 2014;71(4):204-9.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_19_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_292\" class=\"footnote\">Nachman F, V\u00e1zquez H, Gonz\u00e1lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S\u00e1nchez IP, Mauri\u00f1o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.\u00a0<em>Clin Gastroenterol Hepatol.<\/em>\u00a02011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_292\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_292\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_17_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_292\" class=\"footnote\">The Herbal Drugstore. Linda White, M.D and Steven Foster. 2000. Rodale Inc. USA.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_18_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_292\" class=\"footnote\">Saad R, Bellec V, Dugay J, Blanchi A,Nachman F, V\u00e1zquez H, Gonz\u00e1lez A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, S\u00e1nchez IP, Mauri\u00f1o E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. <em>Clin Gastroenterol Hepatol<\/em>. 2011 Mar;9(3):214-9. doi: 10.1016\/j.cgh.2010.06.017..<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_20_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_292\" class=\"footnote\">Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet.<em> Gut<\/em>. Apr 2003;52(4):514-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_21_292\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Gastroesophageal Reflux Disease (GERD)? GERD is an upper digestive disorder that is characterized by a decrease in lower esophageal sphincter pressure (LES,) which allows the abnormal reflux or backflow of stomach contents into the esophagus. It is also called erosive esophagitis or reflux esophagitis and\u00a0is the most common disorder of the esophagus. The &#8230;<\/p>\n","protected":false},"author":29,"featured_media":3346,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,155,782,65],"tags":[1851,1852,1855,562,565,1933,799,776,800,1853,1850,1854,1256],"class_list":["post-292","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-esophagus","category-atypical-symptom","category-digestive","tag-atypical-disorder","tag-barretts-esophagus","tag-bile-acids","tag-dysphagia","tag-esophageal-small-cell-carcinoma","tag-esophagus","tag-gastroesophageal-reflux-disease-gerd","tag-health-conditions","tag-heartburn","tag-hydrochloric-acid","tag-les-lower-esophageal-sphincter","tag-pepsin","tag-regurgitation"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/292","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=292"}],"version-history":[{"count":33,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/292\/revisions"}],"predecessor-version":[{"id":16980,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/292\/revisions\/16980"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/3346"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=292"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=292"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=292"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}