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Hidden Gut Dysfunctions Part 2: Stomach Acid Insufficiency

The acid that begins the process of protein digestion in the stomach is Hydrochloric acid (HCl). Within the health industry I have noticed the abuse of supplementary HCl in a hope to improve digestion. The use of non-scientific methods of testing HCl are commonly used and if truth be told are more a method of selling supplements than addressing gastrointestinal dysfunction. All that being said though the prevalence of sub-optimal stomach acid and pancreatic insufficiency could be something that in the general population is being severely underestimated.

In my forth-coming online health questionnaire you will be able to assess possible dysfunctions with regards to stomach acids and pancreatic enzymes that may at least lead you to scientifically validated lab assessments to determine if this is an area that might need to be addressed.

What do these acids do?

The normal resting pH of the stomach is around 1-3 (very acidic), and upon digestion is more around 0.8-1.5. The HCl itself is produced by the parietal cells within the stomach, and is vastly dependant on the optimal function of the mitochondria within those cells to help with the production of these acids as the process is very energy demanding. So long as HCl secretion has been sufficient, pepsin is then secreted, and it is the job of pepsin to breakdown the large protein molecules into smaller molecules that can be further broken down in the small intestine by other digestive enzymes. Intrinsic factor is also released by the parietal cells which is crucial for the absorption of vitamin b12.

Within the small intestine the foods are further broken down into more and more simple forms that can then be absorbed into the blood stream and sent to the liver for processing as amino acids, fatty acids and the simplest sugars. Along with the digestion and absorption of these macronutrients we also absorb most of our minerals and vitamins at this point.

One other crucial role of HCl is the first step in fighting invaders from the outside environment, thus helping prevent food poisoning and infections from parasites, yeast/fungal and bacterial.

Signs and Symptoms of Insufficiency

Using quality symptom analysis we can start to pick up possible signs of dysfunction with stomach acid secretion. This will make up part of the forthcoming online health assessment questionnaire I have in development at the moment. This is not a diagnosis, but merely a way to help steer us in the right direction to optimise our healthcare.

Stomach Acid Deficiencies

  • I find I get constipated regularly
  • My breath is often smelly
  • I experience a sense of fullness during and after meals
  • I see undigested food in my stool
  • I burp or belch regularly
  • I experience gas/wind after meals
  • I use laxatives frequently
  • Heartburn/Acid Reflux

The general medical model usually focuses on acid excess, assuming that the heartburn/reflux symptoms you might experience are caused by too much acid, hence the success of antacids/acid blocking drugs. It has been proposed however that in many of these cases the issue may not be excess acid, but more an inadequate acid production or most commonly acid simply being where it does not belong, such as back up into the oesophagus. The most common issue being a dysfunction with the lower oesophageal sphincter (LES), that stops acid spilling into the oesophagus.

As we age it is said that the LES works less effectively, which would explain why more people get acid reflux as they get older, rather than we start producing more acid as we get older which simply does not make sense. There are certain triggers as well which can cause dysfunctions with the LES, these include nicotine, alcohol, orange juice, tomatoes or tomato based products, spicy foods, food sensitivities (commonly gluten and cow’s milk), high processed fat and peppermint and spearmint teas may also relax the sphincter and cause reflux symptoms.

I recall the only time I have suffered acid reflux was at Glastonbury festival one year. Excess alcohol, yes, excess caffeine, yes, dirty high fat meals, sure thing. Was it my body responding by making more acid or was it a relaxation of the LES?

As we know the conventional treatment is antacids in most cases of acid reflux/heartburn, but is excess acid the most likely cause? Knowing this, what are the potential side effects of antacid consumption?

Conventional treatment for heartburn and reflux is the use of acid neutralisers and acid suppressors. Whilst the neutralisers and suppressors work entirely differently the end result is pretty similar. The most common form I see being prescribed is the acid suppressor group.

The most common are proton pump inhibitors such as Omeprazole, Lansoprazole & Esomeprazole. These work by directly inbibiting the proton pump, part of certain cells in the stomach that produce HCl. They do this with drastic effect, dropping stomach acid secretion by up to 95% for the best part of a day!

Noted side effects include, skin reactions, headache, hormonal imbalances, increased small intestine bacterial overgrowth, decreased B12 and folate absorption, reduced mineral absorption, higher risk of food poisoning and so on. But if you then actually consider symptoms associated with mineral deficiencies, B12 and B9 deficiencies, increased possibility of infection, you can see how simply blocking or reducing acid levels can have a host of systemic effects on the human body.

We should also consider the possibility of a digestive infection or overgrowth with matters like this as well. Commonly a H.Pylori overgrowth can cause these symptoms and further lab testing I think should always be considered in these cases. One group of acid blockers was actually formulated as a drug for people with peptic ulcers, which later was proven to be caused by the bacteria H.Pylori.

Testing for Low Stomach Acid

There are numerous so called measures of stomach acid and digestive enzymes. Truth be told though, to measure these levels is extremely difficult if not impossible to get exact readings. There are some useful tools though. I have found a good comprehensive stool assessment will provide a lot of indicators that along-side symptom analysis work well as a predictor. For stomach acid one of the only valid tests, but one that is extremely unlikely you will be able to get done is the Heidelberg capsule test.

Natural Solutions to Low Stomach Acid Levels or Reflux Symptoms

  • Fat Loss – Those suffering with reflux that are overweight often benefit from dropping their body fat levels down
  • Reduce or stop smoking
  • Try HCl supplementation to see if it helps (anything from 200mg-1500mg may be of benefit)
  • Osteopathic/chiropractic adjusts are said to help in some cases of LES dysfunction
  • Be careful of late night feeding
  • Stay hydrated
  • Drink ginger tea
  • Use a gastrointestinal formula to help with repair of the oesophagus. Good products include glutamine, zinc carnosine, aloe, liquorice root, N-Acetyl Glucosamine, slippery elm bark, marshmallow root.

For further information on one-2-one consultations and lab testing for gastrointestinal dysfunction please don’t hesitate to contact me using the form below.

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