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Digestion Part 2 – Acid Reflux & GERD

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In our last digestion post, we went over what happens when everything works as it is supposed to, but what happens when things go wrong?

Since we have already learned that digestion is a North to South process, I’d like to start with what can go wrong in the stomach. The stomach is all about acid. If you have been suffering from heartburn, acid reflux, or ulcers, you’ve most likely been told that your problem is too much stomach acid and been instructed to take an H2 Blocker like Zantac or a PPI like Prilosec to reduce the amount of acid, but the real problem is not enough stomach acid!

What?! I know, on the surface it doesn’t make sense. You’re asking me: “but if I don’t have enough stomach acid then why is it burning my throat every night?” This post will break it down, and tell you how to start getting relief!

The Importance of Stomach Acid

Your stomach needs acid to properly break down food and protect you from pathogens. Stomach acid is our first line of defense against yeast, bacteria, and parasites, and when our pH is correct these microorganisms will be killed. When the pH is not correct, these organisms get the chance to thrive in the stomach.

The other reason that the stomach is so acidic is so it can efficiently break down food. By the time food exits the stomach it should be fully broken down into a paste called chyme. When stomach acid is low, that food isn’t fully digested or acidic enough to trigger its release into the small intestine. The result of this is that the food sits in the stomach and ferments.

This fermentation causes gas and pressure to build up, and ultimately the pressure is enough to cause the contents of the stomach to reflux into the esophagus, which burns because even though there isn’t as much acid in the stomach as there should be, it is still far too acidic for the esophagus.

So what is the ultimate result of all of this?

  • Fermentation of food causes gas, burping, bloating, and reflux
  • Acid reflux into esophagus can cause ulcers
  • Food sits in the stomach for too long and damages the lining of the stomach and can lead to ulcers
  • Low stomach pH allows pathogens into the immune system, and bacteria like H. Pylori can begin to thrive and cause harmful effects

Traditional Treatment for Acid Reflux

As mentioned above, the typical treatment for acid reflux is an H2 blocker like Zantac or a Proton Pump Inhibitor (PPI) like Prilosec.

H2 blockers work by interfering with the histamine receptors in the stomach that produce acid to create less stomach acid. PPIs work by disabling the chemical system in the cells of the stomach that produces stomach acid. PPIs are much stronger than H2 blockers and significantly decrease stomach acid.

These drugs were designed for the treatment of peptic ulcers and are only supposed to be used for 6 weeks, but many people are on them long term and have been instructed to take them indefinitely. Since the drugs significantly deplete stomach acid, they can cause long-term side effects like decreased resistance to pathogens, and further maldigestion and fermentation of foods.

Also, a proper stomach pH must be maintained in order to trigger Pepsin, an enzyme which breaks down proteins into smaller peptides and essential amino acids. Studies have also shown that PPIs can impair our ability to absorb iron, Vitamin B12, folate, calcium, and zinc. So even if you are eating the most nutrient dense foods (and most of us aren’t) you may be deficient in vitamins and malabsorbing your food if you are on a PPI.

Alternative Treatment to Acid Reflux

Instead of taking the traditional acid reflux medication which can exacerbate the side effects of low stomach acid and interfere with nutrient absorption, we need to focus on increasing stomach acid with either apple cider vinegar or HCl tablets before meals.

However, it is very important that you work with a qualified functional practitioner before trying this, especially if you are currently experiencing symptoms of acid reflux, or on acid reflux medications or steroids. In these cases you will need to focus on healing and repairing the stomach mucosa before supplementing with HCl or trying to come off of your medication.

Making lifestyle changes such as avoiding acidic foods, moving to a whole foods, nutrient dense diet, stopping NSAID use, and quitting smoking can also be extremely helpful in correcting acid reflux and helping the gut heal.

The next post in this series will cover leaky gut. Have questions about digestion? Let me know in the comments!

Resources 

What Everyone Ought To Know (But Doesn’t) About Heartburn & GERD



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