Shutting off stomach acid…what could go wrong?
Patients often request “Don’t set the chair back too far Doc, I have reflux.” Millions of people suffer from dyspepsia. It’s a catchall phrase describing heartburn, gas, indigestion, abdominal pain, bloating, belching, and reflux. Absent an ulcer, patients are most often prescribed proton pump inhibitors (PPIs) to reduce or eliminate stomach acid production. To someone suffering from the regurgitation of stomach acid (GERD), PPI’s eliminate the acid, and patients feel better. Unfortunately this doesn’t solve the problem.
At NYU, my physiology professor referred to the G.I. tract as ”Merely an appendage of the oral cavity.” To a first year dental student, it struck a chord. Maybe there was more to this dentistry thing than met the eye. Aside from speed eating or food gulping, many people experience dyspepsia as a result of excessive intake of refined carbohydrates, especially high fructose corn syrup (HFCS). It’s hard to find a processed food that doesn’t contain this cheap synthetic sweetener. Friendly Lactobacillus bacteria located in the small intestine help digest carbohydrates and starches but not completely. These undigested carbs are fertilizer for gas producing bacteria responsible for GERD. They invade the small intestine when acid production is lowered. Additionally, a large segment of the population can’t absorb fructose in the small intestine at all. These undigested carbs essentially become fertilizer for the gas producing bacteria responsible for GERD. They invade the small intestine when acid production for the small intestine is lowered. Why does this happen?
Moving south, the bacteria in the large intestine don’t need oxygen; they’re anaerobes and survive by fermentation, a process which produces gas. The politically correct term is flatulence. When this socially unacceptable wind leaves the rectum it’s not painful, except to innocent bystanders. On the other hand when the intestinal gas gets released through the stomach into the esophagus it can lead to I which can be quite painful. How on earth can this happen?
Shutting off acid production seems reasonable enough, but it creates serious side effects. Acid keeps the gas producing bacteria confined to the large intestine. Reducing the acid shield allows them to migrate north, invading and inflaming the walls of the small intestine. They feast on the undigested starches and carbohydrates like HFCS. Fermentation produces enormous amounts of gas in the small intestine (where it doesn’t belong). The amount of carbohydrates in one slice of bread results in the formation of 1.5 gallons of gas. A slice of cheese pizza about 3 gallons. As this gas exits the small intestine and moves up through the stomach, acid is forced out of the stomach and into the esophagus resulting in GERD. When we cut off or neutralize stomach acid, it allows more potentially harmful bacteria to survive. This bacterial invasion from the large intestine overwhelms the indigenous, protective Lactobacillus. PPI’s reduction of stomach acid also allows pneumonia organisms to overgrow and colonize the upper small intestine. As gas is released through the mouth, pneumococcus bacteria are inhaled and colonize in the lungs. A study reported in the Journal of the American medical Association (JAMA) showed patients using PPI’s (Nexium, Prevacid, or Prilosec) were 89% more likely to develop pneumonia. Those taking acid reducing drugs such as Tagamet or Pepcid, 63%. FDA recommends no more than two weeks of continuous PPI use or 42 days annually. Both guideline are routinely violated. Acid is necessary to digest protein. Vitamin B12 and Iron assimilation require an acidic environment. Lacking acid, calcium and magnesium absorption are impaired, leading to an increased risk of hip, wrist, and spinal fractures. JAMA reports taking PPI’s for more than a year results in a 44% greater hip fracture risk.
What to do: 1. Increase the surface area of your food. In other words make a conscious effort to chew food longer. If you can’t chew, blend your food. This ensures more food particles coming into contact with digestive enzymes. As we age we produce fewer enzymes and produce less stomach acid. By age 50 the stomach releases only 15% of the acid of a 25-year-old. Good news: fermented beverages such as beer and wine have been found to stimulate gastric acid production by as much as 60 to 90%. Raw apple cider vinegar has a long history as a digestive aid. A teaspoon added to a small glass of water is often an effective remedy for dealing with low stomach acid. 2. Take digestive enzymes with meals. Be sure they contain papain and bromelain which are derived from papaya and pineapple respectively. Both contain powerful proteolytic enzymes that help digest meat or other forms of protein. If vinegar and enzymes aren’t doing the job, one or two tablets of betaine, a hydrochloric acid supplement should help. Other natural digestive aids you may want to explore are 3. Artichoke extract (5% cynarin) which increases bile secretions and accelerates transit time in the G.I. tract which alleviates bloating fullness and spasms. Studies report after six weeks of treatment, vomiting/nausea were reduced 83%, abdominal pain 76%, loss of appetite 72%, constipation 71%, flatulence 68%, and fat intolerance 59%. Nature’s Way, Jarrow Formulas, and Now Foods all carry the extract. 4. Melatonin. Research shows that 95% of night shift workers suffer from G.I. problems and peptic ulcers are five times more frequent in this group compared to the general population. Staying awake at night reduces melatonin production. This not only impacts sleep negatively but also impacts metabolism, blood-pressure, hormone levels, and blood sugar regulation. One study of over 3000 male night shift workers show they had triple the rate of prostate cancer doubled the rate of bowel cancer a 79% increase in lung cancer and 70% increase in bladder cancer. Research links dyspepsia and GERD to a disruption of melatonin levels and poor sleep habits. 2 to 3 mg. taken an hour before bedtime works for most people.
Remember, all synthetic drugs have side effects some of which can be devastating and actually make the condition being treated worse. Poor digestion of food creates a cascade of negative events. Check with your healthcare provider. Discuss implementing some of the above suggestions. Try a natural approach. You may be pleasantly surprised.
Stay well…Bill Ardito, DDS – Sunshine Dentistry AZ