In part 1 of Acid Reflux – What’s Really Going On? I talked about how reflux is often a result of low stomach acid levels, contrary to popular belief. * I shared how one of my clients had been treating her reflux the way conventional medicine tells us to: by suppressing stomach acid levels with antacids and proton pump inhibitors (and a whole bunch of other self-help remedies that didn’t quite work). And as you will see later on, chronic low stomach acid levels can have a serious ripple effect on our digestion and nutrient absorption. Seemingly unrelated health issues had started popping up for my client and she was dealing with low energy levels, poor quality sleep and low appetite.
Here are some important facts about stomach acid that help to explain why low stomach levels can cause such a ripple effect in different areas:
Compromised Protection:
- Stomach acid is an in-built protection mechanism against pathogens that can’t survive a low pH. Low stomach acid levels can therefore fail to provide that protective barrier and contribute to an increased risk for bacterial or parasite infections (including travel belly or food poisoning). (1) (2)
Compromised Digestion
- When stomach acid levels are adequate, they trigger the release of pancreatic enzymes as well as pepsin further on in the digestive tract, which is essential for the breakdown and digestion of food. Low stomach acid levels can therefore lead to a compromised digestion, malabsorption and improperly digested food.
Mood issues
- Improperly digested protein can cause malabsorption of amino acids (the building blocks of protein). Certain amino acids are precursors for neurotransmitters, such as dopamine, serotonin and norepinephrine and a deficiency in these amino acids can therefore cause neurotransmitter imbalances. This can cause common mood related issues like anxiety, depression, mood swings, etc.
Bacterial overgrowth
- Improperly digested carbohydrates can cause the overgrowth of bad bacteria in the gut. (3) Bad bacteria feed on carbohydrates and produce gas in the process, which causes the bloating that can contribute to intra abdominal pressure.
Intestinal Hyperpermeability
- Bad bacterial overgrowth in the gut also contributes to intestinal permeability (4), which has its own slew of related health problems including chronic inflammation, allergies, brain fog, autoimmune conditions, skin problems, fatigue and more.
Reduced Nutrient absorption
- Low stomach acid levels, through all of the mechanisms explained above, can affect nutrient absorption and may affect levels of iron, B12, folate, calcium and zinc in the body. (5) (6)
As you can see, low levels of stomach acid create the perfect setting for poor digestion and bacterial overgrowth, all of which can contribute to bloating, increased intra abdominal pressure and therefore acid reflux. Now that’s a vicious cycle that’s hard to break!
Before going into the root cause approach to dealing with acid reflux, let’s have a quick look at some of the factors that can contribute to low stomach acid levels:
- Food sensitivities or allergies, which can contribute to leaky gut and chronic gut inflammation. (7)
- An overuse of antibiotics, which affects the microbial balance in the gut and promotes inflammation. (8)
- Histamine intolerance can cause acid reflux (plus a whole bunch of other symptoms).
- Chronic stress in any form affects the body’s ability to produce HCL and other digestive secretions. When we are in a continuous “fight or flight” state, our body is more concerned with putting out the “fires” and less concerned with digestion.
- H Pylori infection. H Pylori is a bacteria that is a normal part of our gut flora. However, it can overgrow as a result of the same factors mentioned above. H Pylori targets the stomach parietal cells and interferes with their ability to produce HCL. Besides symptoms of heartburn and reflux it can cause ulcers and is a known cause for gastric cancers. In 2015 4.4 million people worldwide were estimated to be positive for this infection with a whopping 54.7% of the population in Asia. (9)
- Aging: as mentioned earlier stomach acid levels tend to decline as we grow older.
A root cause approach to resolving acid reflux and GERD therefore takes into account all these different factors and that is exactly what I focused on with my client: identifying and eliminating problem foods, eating a nutrient dense diet that reduced internal inflammation, rebuilding the microbiome with the help of pre- and probiotic foods and bringing in some targeted measures to boost stomach acid levels.
While you work on underlying imbalances it may be important to rule out an H. Pylori infection, which can get aggravated by increasing stomach acid levels. Secondly, if there is a lot of inflammation in the stomach it may be necessary to soothe and heal the stomach lining first before actively boosting stomach acid levels. In this particular client’s case we had to bring in some healing herbs such as slippery elm powder, deglycyrrhizinated licorice (DGL) and marshmallow root before moving on to the next step.
Provided that all this is looked at, here are some ways to naturally boost stomach acid levels:
1. Drinking a glass of water with the juice of ½ a lemon about 20 minutes before a meal. This can help stimulate the flow of digestive secretions.
2. Drinking a glass of water with 1 tbsp. of apple cider vinegar 20 minutes before a meal has the same effect.
3. Chewing on some ginger “pickle” before eating can help too. Simply grate some ginger and mix with a pinch of Himalayan salt and lemon juice and keep it in the fridge. Chew on ½ a tsp. 20 minutes before a meal helps to boost stomach acid levels.
4. Activate your senses before eating helps to trigger the chemical reactions necessary to kick-start the digestive process. This includes being involved in food preparation, creating a relaxed and positive eating environment and taking a moment to see, smell and appreciate your food before starting your meal.
5. Chewing your food properly: the action of mindful chewing alerts your digestive system to get ready to receive the food that you are eating.
6. For some it may be necessary to take it a step further and supplement with actual hydrochloric acid in the form of Betaine HCL with pepsin during meals. It’s always best to introduce this under the supervision of a health practitioner. I must say that this was an absolute game changer for me and some of the clients I have worked with.
These steps are potentially very helpful as an intervention for people who are dealing with acid reflux but they can be useful for anyone who is looking to boost his or her digestive health.
This is what my client had to say after going through the step-by-step root cause approach: “I had been suffering for almost a year from nausea, fatigue and indigestion. After 10 weeks my quality of life has improved a lot. My digestion is much better, I no longer have acidity, nausea or fatigue and my energy levels are steady. Your program really changed my life!”
If you would like to learn how to resolve your digestive symptoms in a truly personalised manner and by addressing your unique root causes, please book a free strategy call here.
Be well!
* Important note:
My purpose is to educate and shed light on some common misconceptions regarding acid reflux and some of its underlying causes but please note that there are definitely situations, where intervention with acid reducing or acid blocking medication is required. If you are on prescription medication or you are dealing with a medical diagnosis such as Zollinger-Ellison syndrome, peptic ulcers or esophagitis you need to consult with your doctor before making any changes.
