How many of you get a burning stomach or throat after you eat or just randomly through the day? I see it more and more commonly with my patients. Most of them are already on acid blocking medications, either prescription or over the counter. The problem obviously is not much fun, but the pill popping remedy is much worse than the symptom. The problem is nobody seems to know this.
The proton pump inhibitors such as Prilosec, Prevacid, and Nexium are well documented to produce a 50% increase in death over 5 years (compared to H2 blockers like Tagamet or Zantac), a 44% increased risk of dementia, 16% increase in heart attacks, double the risk of death by any cardiovascular incident, kidney disease, increased hip fractures, the list goes on and on. Link
When used for only a few weeks and then stopped, these drugs can be lifesavers for someone with a bleeding ulcer. The problem is people use these things for years just to make themselves more comfortable. These are not safe drugs to use for this purpose. Proton pump inhibitors are not for your comfort. They are to keep you from developing a perforated ulcer and dying. If you do not have a bleeding ulcer that is at risk of perforating then you should not be on these meds. They are not even approved for their most common use – GERD. They are not a reflux drug because they are too dangerous – but that is precisely the reason people I have talked to are using them.
So what is this reflux really about? For most people the assumption is that they have an acid stomach because they burp up stomach acid. For 90% of people this assumption is wrong, in fact the exact opposite is the problem – not enough acid. How can that be if you are burping up acid? The answer is all in the degree of acidity. Real fresh stomach acid is about 100,000 to 500,000 times more acid than plain water. It is really intense and will dissolve steel. The stuff you are burping up is only 1000 to 10,000 times more acid than water – about 1-2 % as strong as real stomach acid. The valve at the top of your stomach shuts tightly closed when it is exposed to the strong stuff, but does not close tightly when your stomach acid is weaker. Because of this the weaker acid can escape up into your throat. It is still strong enough to burn and cause distress, but it is nowhere near as strong as healthy stomach acid. It is vinegar strong compared to laboratory hydrochloric acid strong.
So for most people the real problem is weak stomach acid. Do you want to test your stomach acid levels? Remember mixing baking soda with vinegar as a kid and watching it bubble up? We can use this reaction to test our levels of hydrochloric acid in our stomach. First thing in the morning before eating or drinking anything take a
cup of cold water and mix in 1 teaspoon of baking soda. Drink this down and start timing how long it takes for you to burp. The soda will mix with your stomach acid and form CO2 gas. If you burp in the first 2 minutes than it means you have a lot of stomach acid. Burping between 2 and 3 minutes is normal, and 3 to 5 minutes is low acid levels. If you burp after more than 5 minutes or not at all then your stomach acid is really low.
What causes low acid levels? Age is number one – over 45 years of age we start to form less stomach acid. H Pylori infections of the stomach shut down acid production as can low zinc levels. Food allergies and plant lectins such as found in grains, nightshade veggies, legumes, and squash-family veggies inhibit acid production, as does most dairy. And very commonly stress triggers tension in your diaphragm producing a sliding hiatal hernia that forces open the valve at the top of the stomach allowing stomach acid to get squeezed up into the throat.
What can we do about this problem? If the problem is age then we need to supplement our acid levels by taking betaine hydrochloride plus pepsin tablets with any meal that has protein or minerals in it. Protein includes meats, fish, fowl, seafood, nuts, legumes, and dairy while minerals refers to any mineral tablets you may be taking. Cabbage juice has something called vitamin U (for ulcer) in it that heals ulcers nicely. Aloe Vera and DGL (deglycerized licorice) are my favorites for taming acid stomach. A recent study found the combination of melatonin 6 mg, 5-hydroxytryptophan 100 mg, D/L-methionine 500 mg, betaine 100 mg, L-taurine 50 mg, riboflavin 1.7 mg, vitamin B6 0.8 mg, folic acid 400 microg, and calcium 50 mg worked 100% – much better that PPI drugs. The most effective component was the melatonin as they got almost as good results when it was used alone. Here is the study.
If the trigger is food sensitivity then obviously avoid the offending foods. If the trouble is stress then actively activating your vagus nerve several times a day will counteract the negative effects of the stress on your stomach. Here is an excellent article on how to do this: Vagus
Don’t try to go off your PPI’s cold turkey – use the above suggestions and lower your dose slowly, then switch to an H2 blocker like Tagamet, Zantac, or Cimetidine for a few weeks and wean off them. By then you should be able to make do with natural alternatives.
We really need our stomach acid to be strong. It sterilizes the food we eat and is required for breaking down protein and absorbing minerals like calcium, magnesium, and zinc. If you are having problems with sagging skin or hair loss, these are common issues with poor protein digestion. Osteoporosis begins with poor mineral absorption and lack of weight bearing exercise. The undigested proteins end up feeding nasty gut bugs we don’t really want living inside us. Good stomach acid is vital to our health, so shutting it off so we can be more comfortable when we eat pizza is a quick road to serious health problems.
What if you are in the 10% that does have too much acid? Neutralize the acid with bicarbonate of soda and calm the stomach with the strategies mentioned above. If that does not work then you may need an H2 blocker plus supplementing with betaine HCl plus pepsin at every meal that has protein or minerals to replace the acid you are turning off with the drugs.