Tuesday, April 28, 2009

Acid Reflux

Acid blocking drugs are some of the most prescribed medications in the country. Aside from those using prescription medications, forty percent of adults self-medicate with antacids and other OTC medications.

But inhibiting stomach acid may not be such a good thing.

Hydrochloric acid (HCl) plays many important physiological roles. Aside from its obvious role and breaking down solid food that can be passed into the small intestine, HCl also assists in protein digestion, facilitates the absorption of minerals and B-vitamins, and stimulates pancreatic enzymes and bile secretion. HCl also protects against orally-ingested pathogens and is the first line defense against infections, helping prevent bacterial and fungal overgrowth of the small intestine.


In short, blocking acid production can set the stage for a variety of maladies related to nutrient deficiencies and bacterial infestations. Yet these drugs are first line therapy for acid reflux and represent the third highest selling category of OTC medications. Thus, exploring alternative methods is paramount.

Understanding Stomach Physiology
When food is present in the stomach, the parietal cells go to work to secrete pepsin and HCl. The stomach then proceeds to gently churn up the mix until the food is pulverized into a soupy consistency that can be passed into the small intestine for extraction of nutrients into the bloodstream. During this process a signal is sent to the esophageal sphincter muscle at the top of the stomach and it closes tight, preventing access of the stomach contents into the esophagus.

The length of time that this process takes will vary depending on the size of the meal, but even with larger meals it usually takes a couple of hours at the most if everything is in order.



When Things Go Awry
A number of different factors play into why stomach function goes awry and people begin to experience acid reflux.


For one, the quality of nutrition is huge. The parietal cells of the stomach are very dependant upon certain nutrients, especially zinc, for their normal function, and when nutrient deficiencies are present the production of stomach acid can be affected.


Stress is also a factor, as chronic stress has been implicated in causing sometimes catastrophic changes in various functions of GI health.


Additionally, sometimes there is literally a structural malfunction of the esophageal sphincter muscle that sometimes requires surgery to repair.


For this post we’ll focus our attention on stomach acid production.



Is the Burning Because of Too Much Acid, or Too Little?
The common medical mindset pertaining to acid reflux is that too much stomach acid causes acid reflux. I suppose sometimes that is true, but more often than not it probably isn’t true. The reason is that if there is a malfunction in the stomach acid secretion process such as a nutrient deficiency, then two things can happen: 1) The mechanism that is supposed to signal the esophageal sphincter to close off after the parietal cells begin secreting acid is weak or sometimes broken altogether since there is too little stomach acid to initiate it. Thus, the sphincter remains relaxed and acid can backwash up into the esophagus, which of course is very uncomfortable. 2) Because of too little stomach acid to break down food properly, food can sit in the stomach for hours and putrefy, thus causing build up of gases in the stomach that pushes the acids to the top of the stomach and causes reflux.


In short, acid reflux can very often – perhaps more often than not – be caused by not enough stomach acid, not too little of it.



An Alternative Solution
A simple solution to the problem of acid reflux is to give MORE acid, not suppress what little you have. HCl and pepsin can be provided in tablet form and can be used to supplement one’s own production of stomach acid so that food is broken down properly, gas and bloating is reduced, and reflux is controlled.


Given the current trends in the reduction of stomach acid production with age, it stands to reason that most people suffer from having too little instead of too much. Research shows that by the time the average person is 40, stomach acid production is reduced by 50% compared to age 20. And by the age of 60 the production is reduced by two thirds as compared to age 20. Timiras PS. Aging of the gastrointestinal tract and liver. In: Timiras PS, ed. Physiological basis of aging and geriatrics. 2nd ed. Boca Raton: CRC Press1994:247-57.

Likewise, the use of a novel agent known as zinc-carnosine has been shown to be remarkably effective in treating acid indigestion and diminishing the presence of a bacteria called, Helicobacter Pylori, which has been implicated in stomach ulcers.


Symptoms of Low Stomach Acid
-Bloating or distention after eating
• Diarrhea or constipation
• Indigestion
• Excessive belching, burping and/or bloating
• Flatulence after eating
• Sense of fullness during and after meals (prolonged)
• Poor appetite, disinterest in food
• Offensive breath
• Bad taste in mouth
• Partial loss of taste or smell
• Difficult bowel movements
• Difficulty swallowing
• Unintentional weight loss
• History of anemia, unresponsive to iron
• Spoon shaped nails
• Sores in corner of mouth
• Smooth tongue

Section 1, Part A of the Health Appraisal Questionnaire is a quick and easy way for practitioners to diagnose possible stomach acid issues.
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Related formulas:
Metagest
Zinlori 75