Wednesday, September 16, 2009

Oatmeal and Ayurveda

Recently I posted on colonic fermentation induced reflux. If you followed the links, you saw that the idea seems to be that the bacterial fermentation of carb by-products (what's left over after your digestive system absorbs what it can) produces something (maybe just gas, maybe something more complicated) that causes reflux.

One thing I discovered on my own is that if you go very low carb for a while (say 80% fat) and then have a bunch of carbs for lunch one day (oatmeal in my case), you might have a very burpy night. In my case, the experience went well beyond what I would normally expect from oats. So what happened?

I think that some of the good bacteria inside of me (probably the bifido ones) died of starvation during my 4 day long whipping cream binge. Then, when I ate Irish steel cut oats for lunch, the only thing left to ferment them were the more gas-producing bacteria. I guess the moral of the story might be to not eat whipping cream for 4 days straight. Or if you do, take a probiotic while you do it and introduce the carbs back gradually. I'll let you know if that works.

As a side note, after my oatmeal lunch, my reflux was so bad at night that I thought I should try to shut it down. I tried some strong decaf green tea, but that didn't help enough. So, I resorted to ashwaganda, an Indian herbal supplement known as an adaptogen (anti-stress medicine). In addition to promoting sleep, ashwaganda also inhibits acetylcholinesterase, an enzyme that degrades the neurotransmitter acetlycholine. Turns out, more acetycholine around (as a result of disabling that enzyme that degrades it) means less reflux because acetycholine helps to keep the LES closed.

It would be so perfect, but playing around with neurotransmitters makes me a little nervous because not enough is understood at this point. What's good in the short term may be very bad in the long term, especially in this area. Acetylcholinesterase inhibitors may have short term side-effects as well. In particular, acetylcholinesterase inhibitors can contribute to cardiac arrhythmias in some people. Likewise, Cisapride (a drug approved to treat GERD by increasing LES pressure) was pulled from the market over similar fears -- it's not an acetylcholinesterase inhibitor but does increase acetylcholine nonetheless via agony of 5HT4 (serotonin) receptors. So, can ashwaganda also contribute to cardiac arrhythmias? I have no idea, but I would guess it's unlikely as most of these things are dose dependent and I don't think ashwaganda is a particularly potent inhibitor of acetylcholinesterase. Also, people take ashwaganda and it's not known as the drop dead supplement. So, long story short, I took it and slept like a baby, without reflux.

EDIT: I tried Ashwaganda again and do not think it helped my reflux. In addition, it might have given me heart palpitations. Maybe psychological, maybe not. I have had palpitations before, but mostly after a hard night of boozing... The point of the update is to record that my ashwaganda experiment is officially over.

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