Does that heartburn really need a purple pill?

GERD

Do you have "acid-reflux" or GERD and reach for that purple-pill or antacid occasionally?  Do you get bloated and gassy after eating?  Do you have to make a quick trip to the bathroom after eating?  Do you feel stuffy, swollen, and allergic when you wake up in the AM?  Do you have allergies, asthma, eczema, psoriasis, unexplained diarrhea, achy joints, chronic sinusitis, chronic fatigue, crampy muscles?

Would you believe all these symptoms-and more, can be due to malfunction of your gastrointestinal tract?  (PS, the answer is yes)

Undiagnosed food allergies, lack of adequate stomach acid, undiagnosed celiac disease, parasite infections, overgrowth of intestinal yeast and "bad" bacteria, and the resulting intestinal inflammation and malabsorption of important nutrients can cause all of the symptoms listed above.

The good news is that gastrointestinal malfunction can be diagnosed and permanently treated by physicians such as myself who employ the latest technologies to identify the problem and then use the principles of functional medicine to fix it.

I am going to cover a series of gastrointestinal problems that I routinely treat in my practice in my next few blog postings.  Today I'll cover stomach acid and acid-reflux symptoms.

One problem with the gastrointestinal tract (GI tract) that is commonly left undiagnosed by conventional medicine is a deficiency of HCl (stomach acid).  Many people who have GERD symptoms actually have LOW stomach acid-not too much.

Here are some causes of low stomach acid:

1.  Stomach inflammation caused by an infection by a bacteria called H. Pylori or by gluten-sensitivity.

2.  By a deficiency of energy-producing B vitamins.

3.  An autoimmune attack on the acid-producing parietal cells.  This is often associated with other autoimmune diseases.

4.  Consumption of foods one is allergic to.  80% of people with documented food allergies have low stomach acid when it is tested.

5.  A major cause is simply the aging process.  The elderly frequently have low HCl, while children make plenty of it.  The acid-producing cells require a lot of energy to make stomach acid; as the cells age, they become less energetic and fewer in number and acid production declines.

6.  Hypothyroidism.  Inadequate thyroid hormone production can decrease the energy production in the cells; stomach cells need lots of energy to make acid.  Treatement of hypothyroidism, particularly with T3 can often improve acid production.

7.  Viral illness (cold/flu)

Why do we need stomach acid?  Why are those "purple-pills" so damaging?

1.  Acid is needed to sterilize the food we eat.  If there is no acid, the worm eggs, yeast spores, bad bacteria, and parasites that are always on our food and in the air and water we consume, can enter our intestines and start to proliferate, causing disease.

2.  Acid is needed to start the protein digestion process.  It activates an enzyme called Pepsin which chops up the protein we eat.  Without it, we don't fully digest the protein we eat leaving it as food for bacteria who turn it into gas (bloating and diarrhea).  More important, our bodies are literally starved for protein and amino acids despite eating plenty of it.

3.  Acid is needed to dissolve the minerals such as iron and magnesium, calcium and zinc from the proteins in our foods.  No acid means no absorption of these minerals.  This causes osteoporosis in our bones and muscle cramping and weakness, loss of taste and smell, weakened immune systems, fatigue, etc.

4.  Acid is the signal to our small intestine to secrete it's own digestive enzymes to process our food.  If we don't make acid, or we suppress it with medicines, we won't digest our food at this secondary site either.

So, you can see why a normal level of stomach acid is important and why shutting off acid production with a pill can cause problems.

Now what about "heartburn"?  Isn't that a symptom of too much stomach acid like they say on the TV commercials?

Think about who gets "heartburn"... Is it a child or an aging adult?  Right, the adults, who have lower stomach acid due to aging get heartburn...So why do we reach for anti-acid medicines when we really don't have enough acid in the first place?  It turns out that most people who suffer from GERD or "heartburn" actually have LOW stomach acid!  It is the reflux of undigested food into the esophagus that causes irritation to the esophagus and the "feeling" of heartburn.  There is really very little acidic damage going on-just inflammation from the undigested food particles.   It is counterintuitive, but commonly the solution to fixing "GERD" or "acid reflux" is  to increase the amount of stomach acid-not reduce it-to improve digestion.  Other factors are also important, such as removing allergy-causing foods, eliminating infections such as H Pylori, removing gluten from the diet, restoring nutrient levels, optimizing hormones.

Unfortunately, although one can suspect that a patient has low stomach acid by their symptoms, the only way to be sure is to do the proper testing.  Some physicians will advise you to take a product called betaine in increasing doses until you get stomach heat or pain and thereby determine if you need additional stomach acid.  This is a crude way of figuring out if you need additional HCl.  There is a better way.  In our office, we use the Heidelberg pH probe, a tiny electronic device that is swallowed like a vitamin pill.  It goes to the stomach where it measures the ph (acid level) in the stomach.  This is a painless, inexpensive, and risk-free test.  It takes about 30 minutes and then you know for sure.  In addition, we can monitor the response of your stomach to various treatments designed to improve the production of stomach acid.

I find that one of the best ways to improve digestion is to simply clean up the diet.  I usually start my patients on a "paleolithic diet."  I find that after 8 weeks on this diet, about 80% have no more acid indigestion or bloating.  For the others, I then move to further testing such as the Heidleberg capsule or a complete digestive stool analysis (CDSA).  I'll discuss this in my next blog.  The paleolithic diet works because it eliminates the common allergy-producing foods like dairy and grains, including the gluten that aggravates many people.  It is also highly nutritious and starts to restore the nutritional deficiencies these patients suffer from.  Of course, I start them on a potent blend of nutritional supplements, such as DGL which helps heal the stomach lining,

as well. With the inflammatory allergens removed, the stomach can heal and start making acid.  This kills off bad bacteria or yeast hanging around in the stomach and upper small intestine, which improves the bloating and diarrhea.

OK, now you know more than most people about stomach acid and digestion.  If you have more questions or you wish to schedule an evaluation, you can contact my office or submit a comment.

Dr. Kaye

300Trade Center, Suite 4410

Woburn, MA 01801

781-933-4200

www.optimalwellnessmd.com

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