GERD, Reflux and Low Stomach Acid

Do you suffer from heartburn? How about acid reflux? If you’re one of the 10-20% of Americans with gastroesophageal reflux disease (GERD) who endure weekly episodes, these painful symptoms, don’t be fooled into thinking your condition is something you need to live with.

When the lower esophageal sphincter (LES), which separates your stomach from your esophagus, relaxes inappropriately, stomach acid “refluxes,” or comes back up, into your esophagus. Unprotected from the acid, the fragile esophageal tissue burns and ruptures. Most people feel this as heartburn, without realizing that there is actual, lasting damage being done.

GERD is one of the most common digestive diseases in the United States, with a much higher prevalence here than in the rest of the world. It is so commonplace that culturally we treat it as completely normal, the expected aftermath of indulging in a rich meal.

Most people think that GERD is caused by excess stomach acid. While doctors may warn you of GERD risk factors, such as being overweight, smoking, and overeating, the conventional treatment is medication that soothes GERD symptoms, either by neutralizing stomach acid or blocking its production. Billions of dollars are spent on these medications. They account for over 50% of the cost of all prescriptions for digestive disorders. Unfortunately, most people don’t realize that these acid-blocking drugs are only meant to be taken for about three months and are not safe for long-term symptom control.

Causes of GERD and How to Combat Them Naturally

1. Food sensitivities – especially to things like gluten or dairy, inhibit your digestion. When your body can’t digest its food, the food sits in your stomach and can’t pass through the rest of your system. This excess of food in your stomach can cause acid reflux. I recommend that you remove gluten and dairy from your diet.

2. Poor Diet – GERD is a modern day disease. Certain foods aggravate the symptoms of GERD, especially alcohol, caffeine, and fried foods. Additionally, overindulging in these foods leads to weight gain. Excess weight pushes up against your stomach, causing your LES to spasm and let stomach acid spill out. Forego processed food for real, whole foods. Try an elimination diet to see which foods exacerbate your symptoms.

3. Not Enough Stomach Acid – Contrary to popular belief, GERD is often not caused by an overproduction of stomach acid. Stomach acid doesn’t wind up in your esophagus because it spills out due to excess. It spills out because the LES relaxes when it shouldn’t. Too little stomach acid however is a large contributor to GERD, as it prevents digestion. Stomach acid has an important role in the body. Not only does it break food down into amino acids, it also kills bacteria, yeast, viruses, and parasites that enter our digestive tract. Low stomach acid is linked to yeast overgrowth, B12 deficiency, parasites, and even anxiety and depression. Try supplementing with hydrochloric acid (HCL), which is the main digestive acid in the stomach.

4. Stress – Often overlooked, stress has a profound effect on the body. It manifests in physical symptoms such as an erratic, racing heartbeat, muscle tension and twitches, and digestive issues like diarrhea and reflux.

5. Small Intestinal Bacteria Overgrowth (SIBO) – An imbalance in the types and quantities of certain bacteria within our digestive tract can lead to all kinds of gastric complications. It has long been understood that H. pylori bacteria is the major cause of peptic ulcers.

Stomach acid is critical for disinfecting and killing off bad microbes and for optimizing protein digestion in the body. When the body is unable to produce enough stomach acid, inadequate digestion and microbial overgrowth occurs. One of the most important and underappreciated health principles is taking time and creating rituals to improve stomach acid levels.

The Normal volume of the stomach acid fluid is 20-100mL with a pH range from 1.5-3.5. For healthy protein digestion, the pH should be in the 1.5-2.2 range.

Major Functions of Stomach Acid

1. Sterilizes the Food: Whenever we consume food, bacteria and other microorganisms come in with the food (even if it was cooked or pasteurized). The stomach acid helps to neutralize the bad invaders we don’t want in our system.

2. Protein Digestion

3. Activating Pepsin: Pepsin is a proteolytic enzyme that is necessary for our body to effectively metabolize protein.

4. Stimulating the Delivery of Bile and Enzymes: Stomach acid helps to stimulate the release of bile from the liver and gall bladder and digestive enzymes from the pancreas.

5. Closing the Esophageal Sphincter: Stomach acid is an important trigger for the contraction of the esophageal sphincter to protect the soft, delicate tissue of the esophagus from the harsh acids in the stomach.

6. Opening the Pyloric Sphincter: Stomach acid helps to activate the pyloric sphincter which allows food to move from the stomach to the small intestine.

The Problem with Low Stomach Acid

When the body is unable to produce enough stomach acid, it is unable to digest protein molecules and key minerals. These partially digested protein molecules get into the small intestine and create significant stress on the pancreas to produce adequate enzymes to metabolize the protein effectively. This can cause stress and irritation to the intestinal lining.

The large protein molecules and incomplete digestion irritates the gut lining, leading to leaky gut syndrome. This process can trigger the development of auto-immune activity in the body. Poor digestion also creates an environment suited for the development of small intestinal bacterial overgrowth (SIBO), Candida overgrowth and parasitic infections.

When we digest our food poorly it leads to increased inflammatory activity which depletes key minerals and antioxidants throughout the body. This mineral depletion leads to an inability to form stomach acid and the vicious cycle of poor digestion and chronic inflammation continues.

12 Signs that You Have Low Stomach Acid

1. Gas and Belching: With low HCL, this usually comes on shortly after a meal, within 60 minutes.

2. Acid Reflux: This is most caused by low acid (not too much acid)

3. Bloating and Cramping: The gas production from the bacterial fermentation in the stomach produces this.

4. Chronic Bad Breath: This is due to the toxic metabolites produced through bacterial fermentation in the stomach

5. Bad Body Odor: Poor stomach acid production leads to an overall microbial overgrowth throughout the body.

6. Undigested Food in Stools: This is obvious, you are not able to completely metabolize the food you are consuming.

7. Aversion to Meat: Many people with low stomach acid desire to avoid meat and have digestive problems when they eat it.

8. Tired After Meals: If the digestive process has to work twice as hard, it will cost us a lot of energy, leaving us tired.

9. Feeling Full But Still Hungry: You are full because food isn’t leaving your stomach, but you are hungry because you are not absorbing nutrients effectively.

10. Chronic Anemia: You aren’t having excessive bleeding, you are consuming enough iron in your diet (or even in supplements), yet you still have a non-responsive anemia.

11. Weak Fingernails: If your fingernails break, chip, or peel easily it is a classic sign of nutrient deficiencies, especially protein, minerals and B12.

12. Frequent Nausea: Because your stomach gets full quickly, it can often trigger a nausea reflex.

The Baking Soda Stomach Acid Test

Ingesting baking soda has been a natural remedy used for many years to help settle an upset stomach. Baking soda contains a sodium bicarbonate which has hydroxide ions that reduce acidity. Since reducing acidity can create more comfort in someone with acid reflux, baking soda developed this reputation.

There is a simple test you can do at your home in order to see if you have enough stomach acid. This involves drinking baking soda in order to create a unique chemical reaction within your stomach. This reaction happens when the (OH-) ions of the baking soda (sodium bicarbonate) and the hydrogen (H+) ions within the hydrochloric (stomach) acid (HCI). This should naturally result in carbon dioxide gas production and a resulting burping effect.

This test is virtually free (excluding the cost of a ¼ tsp of baking soda).

Do the test on 3 consecutive mornings in order to find an overall average.

Dissolve 1tsp baking soda in 4oz. of water. Drink on empty stomach.

Early and repeated belching may be due to excessive stomach acid (but don’t confuse these with small little burps from swallowing air when drinking the solution). Any belching after 3 minutes is an indication of low stomach acid production.

The Betaine HCL Challenge Test:

This is a very reliable test you can perform if you have the symptoms above and failed the Baking soda test. It will cost you a bottle of Betaine HCL, which you will probably need anyways if to help you restore HCL levels if they are truly low.

To perform the test do the following:

1. Buy some Betaine HCL with pepsin

2. Eat a high protein meal of at least 6 ounces of meat

3. In the middle of the meal (never in the beginning) take 1 Betaine HCL pill

4. Finish the meal and observe what you notice.

Outcomes

1. You don’t notice anything. If you do not notice any difference it is likely that you have low stomach acid levels.

2. You notice indigestion: if you notice a burning, hotness or heaviness in your chest then these are signs you have adequate stomach acid levels.

It is best to do this test 2-3 times in order to make sure you aren’t getting a false positive.

10 Ways to Improve Stomach Acid Levels

1. Use liquid nutrition throughout the day. You should make at least half of your meals in a liquid form such as a protein shake or green smoothie. Protein shakes are pre- metabolized and very easy to digest and do not depend upon HCL production. If you have low HCL it is wise to have 1-2 protein shakes each day to enhance amino acid absorption and reduce stress on the GI system.

2. Use Ginger: Ginger is one of the best things for improving digestive juices. You can put ginger essential oil in water (2-3 drops in 8oz. of water), juice a ½ inch of fresh ginger root in a green juice each day and use ground ginger on your foods.

3. Hydrate Outside of Meal Times: I am a huge advocate of optimal hydration and it is especially important if you have low stomach acid. Good hydrating will help activate bowel motility and push contents through the digestive system which will reduce microbial fermentation and toxicity in the body.

4. Drink Very Little With Meat Containing Meals: Anytime you are going to have meat or any sort of heaver food (not a smoothie or a veggie salad), you should cut off drinking water at least 30 minutes before the meal apart from perhaps 2oz for taking a supplement. This will reduce any potential dilution of the gastric juices and allow for better digestion.

5. Hold Off On Water After A Meal: To allow for optimal digestion, I recommend abstaining from water of liquids until at least 30 minutes after a meal. This allows for proper stomach acid activity, sterilization, protein metabolism, etc.

6. Use Lemon and Apple Cider Vinegar: Squeezing fresh lemon or using lemon juice or apple cider vinegar on your meat and veggies helps to pre-metabolize the food. This allows for better digestion and nutrient absorption. You can either marinate foods in a lemon or ACV base or just add them as a dressing right before you consume them.

7. Eat Protein Foods at the Beginning of the Meal: The stomach will begin churning out its stomach acid when you begin eating, especially when you are consuming protein.

8. Use Fermented Veggies: Pickled ginger, etc. all contain organic acids, enzymes and probiotics which help to improve digestive juice secretions.

9. Use Fermented Drinks: Fermented drinks such as ACV, coconut water, kefir, and lemon water (not fermented) contain organic acids that have an anti-microbial effect. So these help to reduce the bacterial load, especially the bacteria in the stomach such as H Pylori. Keeping H Pylori levels down is important for the body to be able to produce enough stomach acid.

10. Eat Your Largest Meal When You Are Most Relaxed.: In order to produce adequate stomach acid, you body needs to activate the parasympathetic nervous system. If you are busy and, on the go, you will be in fight or flight sympathetic mode. If you struggle with low stomach acid, this is not going to allow you to produce anywhere near enough.

Keep Moving Forward 😊 Sarah