Gastric Reflux or Heartburn

Like so many other chronic health problem gastric reflux seems to be increasing in its incidence.  The problem seems to affect people in their 40’s and beyond although there are some younger people who have this condition. Many people think this disorder is caused by the body producing too much stomach acid whereas in fact it is generally caused by five things

1. Failure of the lower oesophageal sphincter (which sits just above the stomach) to remained closed when the stomach is churning,
2. Low levels of a hormone produced by the stomach called gastrin,
3. Low stomach acid known as hydrochloric acid,
4. Low levels of zinc, vitamins B₁, B₆, and zinc, and;
5. Unrelenting and unresolved stress.  Other factors such as a hiatus hernia (primarily a stress based disorder) can be a major contributor to the problem because the lower oesophageal sphincter is prevented from closing.

The lower oesophageal sphincter is supposed to remain closed except when food is passing through to the stomach.  This prevents food which has been exposed to stomach acid (pH of between 2 and 3) from going back up the oesophagus.  Unlike the stomach the oesophagus is not lined with mucus cells that protect the underlying soft tissue from being burnt by the acid.  It is failure of this protective mucus layer in the stomach that leads to stomach ulcers.

When we get hungry, think about eating something, smell food or start eating our stomach starts producing a hormone called gastrin.  In turn the gastrin stimulates cells called parietal cells to produce hydrochloric acid and something called pepsinogen which helps break down protein.  The more gastrin produced the more acid that is produced.  The other roles of gastrin are to contract the lower oesophageal sphincter during the digestion phase of the stomach and increase the churning motion of the stomach[1].

The connection between gastrin and hydrochloric acid levels in the stomach appears to be a two way street.  I have seen quite a few people with gastric reflux and just by increasing the acidity of the stomach the reflux disappears.  Taking a table spoon of apple cider vinegar before a meal can have this affect in mild cases of gastric reflux as can taking betaine hydrochloride which is a stomach acid substitute.  This should not be done if you have or suspect you might have a hiatal hernia.

There have been studies which show that stomach acid levels decline with age being at their peak around 30 years of age and declining to less than half that level by age 50.  Why should that be when the basic ingredients of hydrochloric acid are hydrogen and chloride both of which should be abundant in our body especially chloride if we eat salted foods.  The answer lies in the fact that in the process of making and releasing hydrochloric acid the body needs vitamins B_1, B₆ and zinc[2].  When we are stressed we use a lot of B vitamins particularly vitamin B_6.  If we add to that the effect of diuretics like tea, coffee and alcohol it is not surprising that many people in their 40’s and beyond are having trouble with gastric reflux.  Diuretics make us urinate more and because B vitamins are water soluble we tend to eliminate them more easily than fat soluble vitamins.

Many people are zinc deficient.  Henry Oseicki in his book the Nutrient Bible says that 47 percent of people are at risk of zinc deficiency.  The reasons are that a lot of foods do not contain zinc and the ones that are supposed to have zinc often don’t have sufficient levels because zinc is not in our nutrient poor soils.  In addition many people do not and cannot afford to eat fish and shellfish which are a good source of this mineral.  Prolonged unresolved stress not only leads to B vitamin deficiency but affects the body’s ability to retain magnesium and zinc.  It is interesting to note Oseicki’s observations that 49 percent of the population is at risk of magnesium deficiency.

The answer for many people is to take antacids[3] and prescribed drugs like proton pump inhibitors. Brand names of these proton pump inhibitor drugs include Zoton, Acimax, Losec, Klacid Hp 7, Maxor and Somac.  They are to treat stomach and duodenal ulcers and Zollinger-Ellison syndrome a condition in which the stomach produces too much stomach acid.  Many people are taking these products when they do not have Zollinger-Ellison syndrome but cases of mild to moderate gastric reflux.  The effect of these drugs is to completely stop the production of hydrochloric acid.  The body produces hydrochloric acid so that proteins can be broken down sufficiently. When protein matter enters the small intestine other enzymes will break them down further into amino acids and allow the body to absorb them.  Stomach acid levels determine the level of bicarbonate ions released by the pancreas and these pancreatic juices contain the enzymes required to break your food down further so that it can be digested.  The whole cascade of digestion requires good stomach acid.

Long term use of these drugs for gastric reflux is not a great idea. In my view taking pancreatic enzymes as a supplement when on these drugs will not markedly improve digestion. It’s a bit like taking a chisel to a log when you really need a chainsaw (stomach acid). The answer in many cases is to take zinc and B vitamins and probably a separate B₆ supplement, apple cider vinegar before each meal or betaine hydrochloride tablets (available for most nutrient vendors) and to steer clear of diuretics such as tea, coffee and alcohol.  Taking digestive enzymes in these circumstances may also help with problems associated with poor digestion such as bloating, flatulence, burping and irritable bowel. In addition you need to look at your stress levels and make attempts to deal with what is causing that stress.  See my previous article on How Kinesiology can Help Me.

If you suffer from gastric reflux and you have little white flecks on your finger nails you have a relative zinc deficiency.  This means that the levels of zinc antagonists in the body particularly copper, iron and molybdenum maybe high compared to zinc and block the action of zinc to a greater or lesser extent.  Copper tends to accumulate in the body when there is chronic stress and poor adrenal and liver function.  High copper levels can lead to gut dysbiosis (poor gut function such as bloating, flatulence and constipation) and hypothyroidism.  You may still be zinc deficient but not have the outward signs.  Poor immunity can also be an indicator of zinc deficiency.  Amino acids are required to make insulin (17 of the 20) and for the production of neurotransmitters such as serotonin, melatonin, dopamine and GABA to name just two important reasons to maintain good protein digestion.

For many years I had this condition.  I would go to bed at night and wake with acid coming up my throat.  The bigger the meal I ate at night the worse it became.  The condition started in my late 40’s and didn’t go away immediately I gave up practicing law.  The reason was that the physical imbalances were still there.  I had white flecks on my finger nails and didn’t know what that meant.  When I found out and started taking zinc and a B complex the symptoms became less.  I then tried taking betaine hydrochloride for a short period and the symptoms disappeared and have not returned although I continue to take zinc and B vitamins to counteract my high copper levels.  Many of my clients have had the same experience.  My overall digestion has improved considerably.