The big hand on the clock had not yet passed the number twelve. It was not yet seven a.m., early for breakfast, according to some standards. I had barely taken off my parka when the kimchi jjigae started to boil, simmering atop the makeshift butane gas burner. “Aged” kimchi, fatty morsels of pork, fish cake, and in spectacular fashion, instant ramen noodles. This was the most memorable meal in my trek through Korea, and a worthy champion of all breakfasts of champions, a mesmerizing symphony of hot, spicy, sour, fatty and nutty.
Eating through Korea, and much of Asia, one inevitably encounters levels of heat and a variety of spices. They are what make the dishes unique, that “bang” effect when you pop that first spoonful in your mouth. Meat from all parts of the animal (and from all kinds of animals) smeared in deliciously mysterious blends of red chilies, fish from all depths of the ocean simmering in heat-infused cauldrons, and the freshest produce with nothing else but touches of sesame oil and mother loads of garlic. Personally, anything in soup form turns my head; alongside coffee, things boiling in savory broth are my favorite psychoactive drugs. What can I say, doctor’s orders. Soup fetish is shared amongst many travelers, writers and eaters alike. Fellow non-lawyer lawyer Jodi Ettenberg, travel writer and author of the blog Legal Nomads, knows a little something about eating through Southeast Asia, and has professed her love for all things soup in a beautiful piece about the gastronomy of Mekong (read it here).
One problem. I have gastroesophageal reflux disease, or GERD. According to the renowned Mayo Clinic, “Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms. Signs and symptoms of GERD include acid reflux and heartburn. Both are common digestive conditions that many people experience from time to time. When these signs and symptoms occur at least twice each week or interfere with your daily life, doctors call this GERD.” In food terms, anything flavorful and exciting will cause stomach acid to shoot up my esophagus. No good.
Thankfully, my case is not that severe, nothing that cannot be treated or controlled with “healthy” eating habits and Prilosec OTC (and my condition has improved significantly within the past year). Nevertheless, eating my way through Korea was not always easy with GERD, especially when I was treating every meal (starting with breakfast, and often more than three times a day) as if it was my last. But I wasn’t about to settle for salads and bland rice porridge. So over the years, I have developed a list of sorts, comprised of tips to control and minimize the level of discomfort. Every street I strolled down, something was boiling to my left, something steaming to my right, the soondae lady calling for me, the catfish stew guy grabbing my arm. As Oscar Wilde once said, “I can resist everything, except temptation.” Ah, the temptation. Ceaseless. Having GERD could be a death sentence to a traveler, a crippling Achilles heel. While shitting like a mink and crawling on all fours after eating bad crab is probably worse, GERD still impacts your eating routine. So awareness and precaution is critical. That is why I share this list with you, in hopes that, if there are any travelers out there suffering from this annoying-as-hell disorder, they will still manage to conquer the gastronomical path without a trip to the emergency room.
With that, here is some non-medical advice from a non-lawyer lawyer.
* * *
1. Take Prilosec OTC (or equivalent) Religiously
I cannot emphasize this enough, for I once too underestimated its usefulness. Prilosec should be taken once a day, and it essentially blocks the release of excess stomach acid. Better than Tums. One doctor recommended I take it right before bed, because, theoretically, acid is more likely to travel upriver (meaning up the esophagus) when one is reclining. Makes sense. Another doctor told me I should take it about an hour before an anticipated “big meal,” so when this anticipation comes to fruition, my stomach is not freaking out, spewing acid like a frightened sea squirt. Personally, I think taking it at night before bed has worked better, but I cannot say that for others. Try both and see for yourself.
2. Stay Away from Aspirin
Down all the gochoojang you want, chomp on all the chilies you want, drink that late night coffee (ok, these are bad, too, for GERD). But whatever you do, don’t take aspirin, especially when your GERD symptoms seem to be on the rise (trust me, you know when things are about to get worse). I cannot explain why this is, and my med student brother told me some gibberish at some point, which I rarely comprehend. Bottom line, aspirin makes your symptoms worse. If you need pain medication or a fever reducer, try other drugs that do not contain aspirin.
3. Carbohydrates are Your Friend
You should eat your bland carbs (often meaning bland rice) to balance out the spice and heat of the other foods. In addition to all the grilled meats, fish, and stew, a bowl of rice or a slice of bread goes a long way, in my opinion, absorbing excess acid generated from the fiery pork belly and raw garlic that just went into your mouth.
4. Breakfast Does a Body Good
This isn’t your mom nagging you through grade school. Yes, breakfast is good for you, especially if you have GERD. In my experience, an empty stomach is ripe for acid action, especially if that empty stomach is blitzed with heavy, fatty, spicy, delicious creations without notice. Wherever your current destination is, the locals probably know where the best breakfast grubs are. You don’t really know a culture until you sit down with locals for breakfast. So for everyone’s benefit, search for breakfast and enjoy it, regularly.
5. Snack Away in the Streets
For true travelers, I do not have to emphasize the thrill and joy of street food. Street food is not a fad, it is certainly not a “hipster” thing. It does not spring up by every John Doe crowing every street corner with a truck or cart. While they may be serving ridiculously good food too, “street food” is a time-cultivated, history-tested tradition. Folks eating on the streets – while selling and bartering whatever they could find to earn very little – is what created street food. This is certainly the case in Korea, where outdoor markets were (and still are for many) the very source of livelihood. People had to eat while working, and voila, street food. In any event, an empty stomach is bad for GERD. So while you are exploring the explorable (by foot, wherever possible), snack and snack often. Control the acid with regular food intake, and really learn the streets and the people that inhabit them. Tough to learn that in front of tablecloth.
6. Tums for Your Tummy
While drugs like Prilosec are better for long term treatment, Tums can save your ass in an emergency. Carry some with you at all times. But a word of caution: do not rely on them. For me, there were days when each meal was a grand slam; hearty kimchi jjigae for breakfast, spicy monk fish casserole for lunch, snacks, snacks, more snacks. Ah, and dinner was something grilled, intestines perhaps with a little skirt steak on charcoal. Having forgotten to take Prilosec the night before, I took some Tums before dinner. No good. It didn’t seem to work as quickly as I thought it would. But that was one particular day with meal after meal after meal. Tums would have worked wonders on any other day, and if I had taken them earlier.
7. Raw is Good, but Not Always
Sashimi is sexy. It just is. Raw fish in any form – also, beef tare-tare in any form – is plentiful throughout the Korean shores and elsewhere in Asia. But, unfortunately, raw things do not seem to be best for GERD people. My most memorable sushi experience to date has been at Sushi Sunsoo in Seoul (which I wrote about in this post). Cruelly, I was fighting off a nasty cold, and my GERD was acting up again, thanks to many fantastic meals preceding Sunsoo. Sashimi, oysters, nigiri sushi, maki, tempura – divine. But that night, I almost crawled into the ER. Raw fish plus cold plus that mysterious medicine the pharmacist gave me (which I stupidly consumed without reading the labels for aspirin) did not please the GERD gods. So if you are in a region prone to magnificent uncooked foods, schedule your meals accordingly.
* * *
There it is.
Travel is meaningless without food. The essence of travel is the acquaintance of and interaction with the people that make up the destination, and food happens to be the universal language spoken across all continents. To reach a soul, the stomach is the quickest route.
Don’t let that acid get in your way.