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GERD

GERD, or Gastro-Esophageal Reflux Disease, is a digestive disorder, in which partially digested food from the stomach, along with Hydrochloric acid (HCl) and enzymes, backs up (or regurgitates) into the esophagus.

Some facts about GERD:

In the medical profession, it is commonly accepted that heartburn and GERD are caused by high stomach acid.  Progressive doctors, who venture beyond the mainstream, as well as alternative health care providers, understand that the problem more often lies in a lack of HCl, rather than an excess of it.  In fact, though we may think of this approach as progressive, it is not new at all; as early as 1966, the Merck Manual stated that “[heartburn] is not due, as formerly believed, to excessive gastric acidity per se, as the same symptoms often occur in achlorhydria [absence of stomach acid].” 

The bottom line is that heartburn and GERD are more often caused by deficiency of HCl than by too much of it.  The stomach is supposed to have a highly acidic environment.  The problem comes in when acidity from the stomach enter the esophagus, in which the environment is normally more alkaline in healthy individuals.

Dr. Jonathan Wright (a pioneer in holistic medicine) has found in his clinical practice that 90% of his patients with GERD showed hypochlorhydria (too little HCl) when HCl production was measured.

Inhibiting stomach acid production can have detrimental effects on the body in the long run. Low HCl leads to electrolyte deficiency, which inhibits enzyme production.  This, in turn, leads to poor nutrient absorption, which can cause many kinds of chronic conditions, including Rheumatoid Arthritis, Asthma, Chronic Fatigue, Depression, etc.

Causes of GERD:

  • Estrogens can weaken the lower esophageal sphincter (LES) - the sphincter that separates the stomach from the esophagus, and, in healthy individuals, ensures that there is no backflow.  If functioning properly, the LES prevents food, acid, and bacteria from backing up into the esophagus once it has entered the stomach. Pregnant women, women on birth control, and women on estrogen replacement therapy (ERT) are more likely to experience heartburn due to elevated estrogen levels.
  • Studies show that 25% of pregnant women experience daily heartburn, and more than 50% experience occasional distress.  The great news is that Acupuncture can help!
  • Obesity is another possible cause of heartburn, although causative role and benefits of weight loss have not been proven.

Causes of low HCl production may include:

  • Vitamin A and B deficiency
  • Low protein intake
  • Chronic stress
  • Zinc deficiency
  • Low-salt diets  > may be a factor, because Sodium and Chloride are needed for HCl production. 

(Note: our bodies cannot utilize the inorganic sodium from table salt. Although a good quality sea salt is much better than table salt, it is best to get most of your sodium from organic sources – i.e. fruits and vegetables.  Good sources of organic sodium include celery, beets, carrots, dark leafy greens, okra, and black mission figs.)

HCl challenge test: 

The HCl challenge test is an easy way to find out if your hydrochloric acid level is low.  For this test, the patient supplements with HCl capsules at mealtimes.  If symptoms occur or are aggravated, the capsules are discontinued immediately.  It is an indication that stomach acid levels are, indeed, in excess.  If no symptoms occur, or improvement is experienced, it tells us that acid levels are low.  

Please talk to your practitioner before taking this test!

Antacid drugs:

Antacid drugs are given to suppress or neutralize stomach acid production.  The idea is to minimize irritation of the esophagus.  While patients may experience relief in the short term, this may have long-term adverse effects.

There are two categories of antacid drugs: acid neutralizers and acid suppressors.

Acid-neutralizing drugs:

  • These are extremely alkaline (high) pH mineral salts, e.g. Calcium, Sodium, Aluminum, or Magnesium.  Their effect is temporary and does not shut off the body’s acid production, but rather neutralizes acidity temporarily by introducing a buffering agent.
  • Examples are Rolaids, Tums, Alka Seltzer, Maalox, and Mylanta.
  • These drugs are available over the counter and used daily by many GERD sufferers
  • Long-term use can lead to excess calcium in the blood.  The excess alkalinity can bring on a state of ‘alkalosis,’ which may lead to kidney failure.

Acid-neutralizing drugs, such as Tums, are often advertised as beneficial source of supplemental Calcium – however, the form of Calcium contained in these products is Calcium carbonate, which is poorly absorbed by the body.  Additionally, Calcium requires an acidic environment for proper absorption, and acid-neutralizing drugs aim to create a more alkaline environment.  You can see how this would make it difficult to absorb Calcium from this source.  The conclusion is that Tums are a very poor source of supplemental calcium, and certainly not a good way to prevent osteoporosis!

Another concern is that some acid-neutralizing drugs contain Aluminum, which has been linked to incidences of brain dementias, such as Alzheimer’s.

Acid-suppressing drugs: 

H2-receptor blockers:

  • Examples include: Tagamet, Zantac, Pepcid, and Axid.
  • These can shut off acid flow for hours at a time.
  • They may have serious side effects, including GI disturbances such as constipation, diarrhea, nausea, vomiting and heartburn – incidentally the very condition they are prescribed to treat!

Proton-Pump Inhibitors (PPI) 

  • These are the strongest of the acid-suppressing drugs; they can reduce acid secretion by 90-95% for the better part of the day.
  • Higher doses totally eliminate HCl; this causes achlorhydria (complete lack of stomach acid).
  • Side effects include diarrhea, skin reactions, headaches, impotence, breast enlargement, and gout.
  • Examples are Prilosec, Prevacid, AcipHex, Nexium, and Protonix.

Problems associated with antacid use:

  • If your stomach acid is low to begin with and you are treated with antacids, hypochlorhydria will be exacerbated, effectively making your problem worse.
  • Habitual use of antacids blocks natural production of HCl.
  • Stomach acid serves to sterilize food before it enters GI tract. Without this protective mechanism, growth of microbes may result, including yeast and H. pylori - the bacteria associated with gastric ulcers.
  • HCl is one of nature’s most essential antibiotics!  Without stomach acid, the body cannot neutralize the bacteria present on all raw vegetables, and we end up with a perfect breeding ground for many other health problems!
  • Alkalinizing the lower part of the stomach (called Antrum) causes the hormone Gastrin to be released; this leads to a huge rebound output of acid; more antacids are required, leading to eventual malfunctioning of HCl production; the patient develops hypochlorhydria, or, worse, achlorhydria (no stomach acid).  

The Chinese perspective:

Each organ’s Qi flows in a particular direction when healthy.  The Stomach’s Qi is designed to flow downward.  When it runs upward instead of down, we have a pathological condition, which we call ‘counterflow Qi.’  Resulting symptoms include nausea, vomiting, gastric reflux, hiccup, and belching.

Acupuncture can help to regulate the proper flow of Qi; in this case, re-direct the Stomach Qi downward.

Fear tends to deplete circulation in the stomach lining.  The body goes into fight-or-flight mode when we are in fear, and blood is circulated to the large muscles in the body, so that we can either run for our life or fight whoever may be attacking us.  As blood is shunted away from the digestive organs, HCl secretion is shut down and the digestive process is put on halt.  

Chronic fear or anxiety leads to chronic lack of HCl; this, in turn, leads to chronic poor digestion, along with all the accompanying symptoms, which may include acid reflux, heartburn, belching, bloating, etc.

Anger is likely to inflame the lining by activating excessive Histamine release and secretion of excessive acid; this may lead to Gastritis and stomach ulcers.

Stress lowers mucous secretions; this results in thinner mucous lining and less protection, which, in turn, causes poor absorption of proteins and lays the possible groundwork for an ulcer.

Acupuncture helps to clear stuck emotions, calm the nervous system, and balance and ground you, so that your body may function more optimally and produce the proper amount of HCl for healthy digestion.  Healthy digestion is the basis for greater health in all areas of life.

A few tips:

  • Slow down when you eat!  
  • Eating too quickly causes the stomach to become distended > food is pushed against top of stomach, forcing open the LES, and washes into esophagus > the result is heartburn.
  • Create a calm and comfortable environment at mealtimes.  
  • Eating in an anxious state makes you more likely to swallow air with your food > air warms to body temperature, expands, and is belched forcefully enough to push stomach acid into esophagus, resulting in heartburn.
  • Avoid charged emotional topics or excessive mental activity while you eat.
  • If you work, read, or watch TV while you eat, or if you eat during a business meeting, the blood flow in your body will be shunted to your brain and away from your digestive tract, allowing you to focus on the task at hand, but preventing your body from properly digesting the food you are feeding it.  Additionally, you are less likely to pay attention to chewing your food properly.  Remember, digestion begins in the mouth!  Our saliva is full of beneficial enzymes, which start to break down our food before it travels further down the GI tract.