Digestive Health Part 12: More Acid

Written by Dr. Claire Arcidiacono, ND acid

For further questions or concerns email me at [email protected]†

Continuing our topic from last week let’s cover the risk factors for acid based digestive concerns. The number one risk factor for GERD is H. Pylori. In fact, up to 40% of GERD cases is associated with an H. Pylori infection. (1) Other risk factors include gallstones or as we say in the holistic community “sluggish gallbladder,” obstructive sleep apnea, obesity has also been found to be associated with more severe GERD. 13% of changes in esophageal acid exposure is attributable to an increase in body mass index (BMI). (2) A hiatal hernia can also increase the risk of GERD. Holistically, food allergies/sensitivities can also increase the risk of GERD. Pathogens can increase the risk of certain gastrointestinal concerns leading to GERD. Stress has a huge link to the digestive tract and is therefore a big risk factor for GERD. Certain medications including NSAIDs as well as smoking are also risk factors for GERD. Lastly as anyone who has ever been pregnant, the likelihood of GERD is increased. (3)

Stomach Acid

The conditions related to stomach acid are very closely related, so some may sound familiar. Just like with GERD H. Pylori is a major risk factor for peptic ulcers. NSAIDs are a risk factor for ulcers. Stress is such a huge risk factor for peptic ulcers. Ulcers brought on by stress are usually called “stress ulcers.” Just like with GERD, pathogens and food sensitivities can increase the risk of peptic ulcers. IBD, specifically Crohn’s disease, increases the risk of developing an ulcer. Systemic concerns such as vasculitis, Zollinger – Ellison syndrome, certain tumors as well as gastric ischemia. (4)

The risk factors for Gastritis will sound very familiar to you. In addition to the previous risk factors such as H. Pylori, NSAIDs, pathogens and food sensitives, other risk factors more specific to gastritis includes the use of cocaine, long term severe illness, and autoimmune illness. (5)

Last but not least low stomach acid or hypochlorhydria. This can also be caused by H. pylori, a very interesting bacteria that can either increase or decrease the amount of stomach acid produced. Other risk factors for low stomach acid include atrophic gastritis, which can be a result of alcoholism and autoimmune conditions. Pathogens, stress and food sensitives are all risk factors. (6)

Long term complications caused by an increase in stomach acid include but are not limited to cancer. Any time cancer or other serious illness is a possible complication it is important to take this issue very seriously. In some cases this means using certain medications even if it’s only for a short period of time. Other complications for GERD can include Esophagitis, esophageal strictures, and barrettes esophagus. (7) Complications resulting from peptic-ulcers include bleeding, perforation, stomach blockage and in my clinical experience, I’ve seen an increased risk of GERD.  Systemically whenever there is bleeding as a complication, there is also the risk of anemia and all of the complications that long term anemia can cause.(8) The long term complications to gastritis also include bleeding and anemia as well as increasing the likelihood of developing both peptic-ulcers and GERD. (9) Last but not least low stomach acid can lead to all the forenamed conditions – GERD, peptic-ulcers, and gastritis! It can also lead to problems digesting proteins and absorption of B12 as well as certain vitamins and minerals. Long term calcium deficiencies can lead to osteoporosis while long term stomach acid deficiency can even lead to next week’s topic – SIBO. (6)

One of the first questions I ask people who have GERD or any of the other concerns mentioned in this blog is have you been tested for H. Pylori?? H. Pylori is a bacteria that I’ve mentioned over and over again in this blog. Eliminating H. pylori is an important step to reducing any symptoms caused by high or low stomach acid. Now on to some things that have been found to help with stomach acid.

• To start with its important to neutralize the acid to both listen the symptoms and reduce any damage/ repair the damage:
  • DGL has been found in studies to help reduce the effect of stomach acid and promote the healing of tissues (10). Please see Invite’s DGL, Min acid and GI Maintain!
  • Marshmallow has been found to help form a barrier that protects tissue against irritants such as stomach acid. It also has been found to reduce inflammation in the tissues. (11) Please see Invite’s Min acid and GI Maintain!
  • Aloe Vera has been found to help with the symptoms of GERD (12) and Ulcers as well as Gastritis. It also helps promote healing of the tissues. (13) Please seer Invite’s Min acid
  • Slippery Elm has been found to help soothe and heal the effects of too much or too little stomach acid (14) please see Invite’s Min acid and GI Maintain!
  • Other Demulcents are also very helpful but I’ll be concentrating on these 4 since they are the most common.
• Next we want to concentrate on actually healing the tissues:
  • L-Glutamine has been found in studies to promote healing in the digestive tract (15) See Invite’s GI Maintain and L-Glutamine
  • Nucleotides while not usually a supplement with associate with the gut has been found in studies to be very helpful in working with any sort of wound healing. (16) Please see Invites Nucleotide complex!
  • Collagen has been found in studies to help with wound healing. (17). See Invites Collagen Hx, Collagen Tablets, Collagex HA and True Beauty!
• While working on eliminating the signs of too much acid/or too little acid we also want to eliminate any pathogens as well as repopulate the digestive tract with good bacteria. I have covered this topic in detail in the blog regarding diarrhea. Feel free to take a peak!
• In the case of low stomach acid there has been found to be a correlating low level of zinc as well as B vitamins. Correcting these deficiencies will eliminate the underlying cause of the low stomach acid (18). Please see Invite’s Zinc products as well as our line of B vitamins!
• Lastly digestive enzymes can help to break down the food and also help to replace the acid that is missing in the case of low stomach acid. (19) Please see Invite’s Digestive Hx and Prozyme digest.

As sad as it is we are quickly approaching the end of our digestion series. We will be talking about SIBO next week and then a quick overview (don’t worry there isn’t a test) and we will be moving on to our next topic! While I know some people might be asking about topics that weren’t addressed I just wanted to say that in this series of blogs, I wanted to discuss the most common concerns regarding the digestive tract. Feel free to reach out with other digestive health concerns.

Sources

1. El-Omar EM, Oien K, El-Nujumi A, et al. (1997). “Helicobacter pylori infection and chronic gastric acid hyposecretion”. Gastroenterology. 113 (1): 15–24. doi:1016/S0016-5085(97)70075-1. PMID 9207257.
2. Ayazi S, Crookes PF, Peyre CG, et al. (September 2007). “Objective documentation of the link between gastroesophageal reflux disease and obesity”. American Journal of Gastroenterology. 102: S138–S9. doi:14309/00000434-200709002-00059.
3. Sontag SJ (1999). “Defining GERD”. Yale J Biol Med. 72 (2–3): 69–80. PMC 2579007. PMID 10780568.bo
4. Lanas A, Chan FK (August 2017). “Peptic ulcer dMayo Clinic Gastroenterology and Hepatology Board Reviewisease”. Lancet. 390 (10094): 613–624. doi:1016/S0140-6736(16)32404-7. PMID 28242110. S2CID 4547048.
5. Hauser, Stephen (2014). . Oxford University Press. p. 49. ISBN 9780199373338. Archived from the original on 2016-03-05.
6. Guilliams TG, Drake LE. Meal-Time Supplementation with Betaine HCl for Functional Hypochlorhydria: What is the Evidence? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238915/) Integr Med (Encinitas). 2020;19(1):32-36. Accessed 6/27/2022.
7. “Acid Reflux (GER & GERD) in Adults”. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 5 November 2015. Archived from the original on 22 February 2020. Retrieved 21 February 2020.
8. Cullen DJ, Hawkey GM, Greenwood DC, Humphreys H, Shepherd V, Logan RF, Hawkey CJ (October 1997). “Peptic ulcer bleeding in the elderly: relative roles of Helicobacter pylori and non-steroidal anti-inflammatory drugs”. Gut. 41 (4): 459–62. doi:1136/gut.41.4.459. PMC 1891536. PMID 9391242.
9. Varbanova, M.; Frauenschläger, K.; Malfertheiner, P. (Dec 2014). “Chronic gastritis – an update”. Best Pract Res Clin Gastroenterol. 28 (6): 1031–42. doi:1016/j.bpg.2014.10.005. PMID 25439069.
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928719/
11. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hn-2128005
12. https://pubmed.ncbi.nlm.nih.gov/26742306/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087681/
14. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hn-2167004
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146642/
17. https://www.wnyurology.com/content.aspx?chunkiid=21721#:~:text=Other%20sources%20of%20bioflavonoids%20have,symptoms%20as%20compared%20to%20placebo.
18. https://www.clinicaleducation.org/resources/reviews/the-role-of-hcl-in-gastric-function-and-health/
19. https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements

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