Between 20 and 30% of Americans have gastric reflux, also known as GERD. This means that food and/or stomach acid flows backward up the esophagus. The typical treatment in conventional medicine is to give drugs that shut down stomach acid. Stomach acid is there for a reason. First, it is necessary to digest your food. 50% of patients put on stomach acid blockers eventually get bacterial overgrowth of the small intestine.
“Stomach acid is a necessary and vital part of digestion.Yet, stomach acid has become enemy number one in the United States. We are a nation reliant on our proton pump inhibitors (PPI), acid reducers and antacids. Many think they cannot live without these medications but many of the symptoms of low stomach acid actually mimic those of excessive acid or Gastroesophageal Reflux Disease (GERD). A very common misunderstanding is if you have GERD/acid reflux, you have too much stomach acid. Quite the opposite is true. Low stomach acid will cause the lower esophageal sphincter to remain open, causing stomach acid and contents to reflux into the esophagus.”
It’s almost incredible to me how conventional medicine gets this one wrong. I have seen many cases of GERD – gastric reflux helped or fully reversed by adding small amounts of stomach acid, as Betaine HCl. Of course, this needs to be done carefully and with supervision. And then it becomes important to ask why? Giving Beatine HCl is only symptomatic treatment. I think of it as a temporary solution until we can fix the underlying problem. There are a very few patients who cannot tolerate Betaine HCl and must first go through some healing of the stomach lining.
There are several common causes.
1. INFECTION. Most commonly due to a bacteria called helicobacter pylori, or H. pylori. About 50% of the world is infected. Many people have few symptoms but this bug likes to shut down stomach acid production for it’s own benefit. There are drug and herbal remedies. Occasionally there is some other infectious process such as Giardia which is usually picked up in wilderness areas. I have seen patients with severe disruption of the whole digestive system often due to something like a gut based yeast infection. But the most common cause by far is H. pylori.
2. AUTOIMMUNE. Patients who are producing antibodies to wheat (gluten) often also produce antibodies to the part of the stomach lining which produces stomach acid. This can produce severe problems like pernicious anemia because you need stomach acid to absorb vitamin B12. And vitamin B12 is necessary for red blood cells to mature normally. This will usually show up on a routine blood test. We have protocols for managing such autoimmune conditions
3. STRESS. It’s folk knowledge that stress interferes with digestion. Now I think we know why. The whole of the digestive system is under the control of the vagal nerve. This nerve is comes out where the spine becomes the lowest part of the brain. It is concerned with “rest and digest.” It is shut down by any sense of unsafety. This could be actual real world fear, or fear of a boss, financial fear, or fear of getting sick. It can also be shut down by old fears due to things like past trauma. There are many strategies to stimulate the vagal nerve in a positive way to restart digestion.
4. DRUGS. I have seen patients who have been on proton pump inhibitors for 20 years and it may take a long time for their stomach to heal. Proton pump inhibitors like Prilosec have been shown to cause acid painfor weeks after withdrawal even in healthy volunteers. Even though many of these drugs are available over the counter, even at your local gas station, they can have serious consequences. Up to 50% of patients on long-term acid blockers develop significant upset in the gut microbiome – the community of healthy bacteria normally living in the intestines.
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