The Heartburn Return

If you experience recurrent heartburn, you may have to do more than stop having pizza and beer.  Gastroesophageal Reflux Disease, or GERD, is a potentially dangerous condition affecting 18% of people worldwide.  Untreated, acid reflux can lead to esophageal stricture, ulceration, hemorrhage, bleeding, Barrett’s esophagus (pre-cancer), dysphasia, choking, and weight loss. 

What can I do?
The majority of cases are caused not by too much acid but rather not enough.  What we often feel is the acid of incomplete digestion.  The answer is to support the function of the body.  The parietal cells (stomach acid producing cells) are located in the gastric mucosa.  Diminished secretion of stomach acid is called atrophic gastritis or gastric atrophy.  There is no disease known for inducing gastric hyperacidity (too much acid).  Antacids provide temporary relief, but medications that suppress digestive acids (when the body is already deficient) can cause long term health complications such as: poor absorption of vitamins, minerals, amino acids, poor digestion of proteins, allergies, bronchial asthma, bacterial overgrowth in stomach and small intestine, pernicious anemia, depression, stomach cancer, skin diseases (acne, dermatitis, eczema, urticaria), gall bladder disease, lupus, grave’s disease, ulcerative colitis, chronic hepatitis, osteoporosis, diabetes, and arthritic conditions.  Stomach acid, or hydrochloric acid (HCI), is crucial for complete digestion of food and absorption of nutrients.  Digestion involves a highly complex and well-coordinated interaction of many different acids, enzymes, alkaline substances, hormones, and many other mechanisms.  When these are produced in just the right amounts at just the right times, digestion is efficient.  Indigestion happens when something upsets the balance, like a stomach acid deficiency.  The mechanism within the parietal cell responsible for secreting HCI is called the proton pump.  Drugs called proton pump inhibitors work by turning off this pump.  Suppression of digestive acids can cause states of malnutrition and disrupt the natural gastrointestinal environment.  These drugs make the body produce more gastrin, a hormone related to the production of HCI.  Chronic over production of gastrin (hypergastrinemia) can lead to gastric adenocarcinoma - a form of stomach cancer.  A common prescription of 40 to 60 mg of Prilosec will typically produce gastrin levels to be ten times the normal level. 

What do I do first?
Foods that aggravate and weaken the lower esophageal sphincter and should be limited are: fried or fatty foods, coffee, caffeinated  drinks, alcoholic beverages, chocolate, peppermint and spearmint, garlic, onions, citrus fruits, tomato products, chili peppers, pepper, and all carbonated beverages.  Eat small amounts and chew carefully to ensure complete breakdown of food before passing to the stomach.  Lying down after we eat creates pressure from gravity that pushes acid back towards the esophagus.  Emotional stress will also limit the body’s ability to fully digest food.  Eating on the run or under emotional pressures disrupts digestion.  Once the offensive aspects of our diet and lifestyle are eliminated, a program of restoration and healing can be considered.

What supplements can I take?
Even if we are consuming all the right foods, we may not be able to absorb them if we are lacking crucial digestive enzymes and acids.  Nutrients such as peptide and amino acid components of proteins, minerals, B vitamins, and other nutrients all depend on adequate amounts of stomach acid to be digested and absorbed.  The stomach achieves this by regulating the gastric pH (acidity level) and by producing a digestive enzyme called pepsin when acid is increased.  Pepsin is essential for the initial digestion of protein.  If acid levels are depressed then so are pepsin levels and proteins will not be broken down into amino acid components and peptides.  HCI and pepsin supplements can be very effective on problems of indigestion but have some risks.  Supplementation should be monitored by a Clinical Nutritionist.  Enzyme therapy is also used when our own levels are found to be deficient.  Enzymes are protein catalysts that are needed for digestion and absorption of fats, proteins, and carbohydrates.  The most common supplements are bromelain (from pineapple), papain (from papaya), and pancreatin (from animal tissue).   They are fairly safe and inexpensive.  Other herbs and agents that stimulate production of digestive juices include: yellow dock, wormwood, milk thistle, hops flowers, goldenseal root, globe artichoke, ginger, gentian root, fennel, dandelion, caraway, and barberry bark.  It is best to stay with recommended doses and receive guidance from your nutritionist. 

In Summary
By understanding the relationships between what we eat, how we eat, the drugs and supplements we take with how our bodies respond we can make choices for a long term solution to the problem of acid reflux instead of short term relief of symptoms.  With help from your nutritionist you can then restore imbalances and increase absorption of all nutrients.  Awareness of toxicity and deficiency is crucial to improving the quality of our lives.

John C Cassone MS, CNC is a Clinical Nutritionist and Homeopath.  His office is located in Old Town Temecula.  951-837-9013.  TemeculaHomeopathy.com