<<Disclaimer: Verify this information before applying it to your situation.>>

I note that some celiacs who are new to the strange rites and sensations of
our exclusive club sometimes have trouble distinguishing between gluten
reactions, reactions to lactose intolerance, and more frequently, acid
reflux (which celiacs are far more prone to that others because of the
frequency of World War One type gas attacks after eating suspect foods).

First, it's often very hard even for the most experienced to distinguish
between a gluten reaction and a reaction to diary. And remember half of us
are permanently lactose intolerant; and most newbies are lactose intolerant
for the first  year or two till they learn to eat right and their gut has a
chance to heal thoroughly. What's more, many don't know they are lactose
intolerant. I thought my doc was crazy when he tested me and told me I was
intolerant. I had been drinking a quart of milk a day because I was
laboring under the distinct misapprehension that milk settled my stomach,
for decades. So you don't know till you avoid all dairy for two or three
weeks, then challenge with normal helpings for a day or so. You'll know in
a hurry if you have problems then.

But mainly, it's the acid reflux that many mistake for a gluten reaction. A
burning sensation in the chest is not a gluten reaction, and a bloated
feeling also may not be. But the acid reflux often presents as something
resembling what most would think was hypoglycemia. My doc told me it can
make you feel queasy and kind of nauseous for days, as if you were having a
low blood sugar reaction. That's what it did for me. Before I learned to
control it I took Prevacid for a couple of weeks to allay that feeling and
get my system working right again.

But acid reflux also often causes chest pains that are hard to distinguish
from Angina -- this comes especially after going to bed at night, and/or
after light exertion. The worst offenders for reflux that causes chest pain
are (in order): alcohol, fats, decaf (worse than real coffee for many),
coffee, then the well known acidy foods, especially canned tomato products.
The alcohol and fats are the worst because they relax the esophageal
sphincter just above the stomach. This relaxed sphincter then allows acid
from the stomach to back up into the esophagus, which in turn causes the
sphincter to spasm and cramp causing pain like any cramped muscle will do.
This pain at the bottom of the sternum can be very strong and feel exactly
like angina. Hence you often hear of people ignoring heart attacks because
they thought the pain was just indigestion.

So if I know ahead of time I will be having a drink for dinner, or steak
(especially prime rib, the fattiest of all), or even a fatty fish such as
Chilean Sea Bass (damn that stuff's good) I take a couple of O/C Zantac
75's (Axid and Pepcid are also good -- all GF) half an hour before dinner.
If I have both the drink and the steak then I also follow  up by taking two
more about two hours before bedtime.

If you have problems bad enough that your doc puts you on a proton pump
inhibitor like Prilosec (or preferably Prevacid since it's safer), they
will often tell you not to take any acid inhibitors with it, like the
Zantac, Axid, or Pepcid. But you should know that Medscape just reported on
a study that demonstrated that patients healed much faster when taking a
proton pump inhibitor if they also took an acid inhibitor with it. Your doc
may not know this.

Also, I might mention that I think it's bad practice to take antacids alone
for reflux. Antacids, like Tums or Maalox, only dilute the acid in the
stomach, causing your system to secrete even more acid in what's called a
"rebound effect." Neither the proton pump inhibitors nor the acid
inhibitors seem to cause the rebound according to the literature. So if I
need an antacid for immediate relief, I also take an acid inhibitor with it
so my system doesn't produce more acid to compensate for the dilute.

Aside from that, Mrs. Lincoln, how did you like the play? -vance