More on GERD

Since I posted on GERD several times, it behooves me to inform you about a wonderful series of blog postings that I discovered recently on the subject of acid reflux and GERD that have some very interesting new insights and helpful, step-by-step solutions to the problem. The name of the blog is The Healthy Skeptic and it is written by Chris Kresser. Chris is not a medical doctor but has studied Chinese medicine and acupuncture, and is currently studying to pass the California licensing exams. Because of his own health problems he has done a lot of research and writes in a clear way to explain what he has found. He recommends all the things that I have been recommending with regards to diet (low-carb) and digestive health. The series on GERD begins here. There are six main entries and two supplemental. The comments are very helpful, too.

Even though I had read all the books and blogs, I was still having stomach problems in May. It was Kresser's posts that got me to finally try the one thing I had been afraid to try, HCl Betaine with Pepsin. It worked like a charm and is still working. Jonathan Wright in his book, Why Stomach Acid is Good For You, stated that the majority of people with GERD have low stomach acid, not too much stomach acid. Without enough acid in the stomach, the lower esophageal sphincter muscle (LES) doesn't stay shut like it should. Taking HCl with meals solves this problem and also helps you to digest the food you are eating. It makes things work like they should. What I discovered in reading Kresser is that it may not be true that as we age we naturally produce less acid. He suggests that it is an overgrowth of the H. pylori bacteria that causes the acid to be reduced. That is how H. pylori can survive in our stomachs, by stopping the production of acid that would kill it and other bacteria.

The role of H. pylori in GERD

I believe that H. pylori infection plays a significant role in the pathogenesis of GERD and other digestive disorders.

H. pylori is the most common chronic bacterial pathogen in humans. Statistics indicate that more than 50% of the world population is infected. Infection rates increase with age. In general, the prevalence of infection raises 1% with every year of life. So we can expect that approximately 80% of 80 year-olds are infected with H. pylori.

Second, we know that H. pylori suppresses stomach acid secretion. In fact, this is how it survives in the hostile acidic environment of the stomach, which would ordinarily kill all bacteria. Treating an asymptomatic H. pylori infection with antibiotics increases stomach acidity and eradicating H. pylori with antibiotics improves nearly all patients suffering from hypochlorhydria.

Although it is commonly assumed that stomach acid production declines with age, recent studies suggest that the secretion of stomach acid doesn’t decrease with age and that the trend is actually to increase, especially in men.

However, this tendency for acid secretion to increase with age is completely nullified by the corresponding increase in H. pylori infection. Since the incidence of H. pylori infection increases with age, it follows that hypochlorhydria also increases with age.

The reason I had been afraid to try supplementing with HCl is because if you have an ulcer, the added acid can make it worse. Also, the few times I had tried it in the past, I had had worse reflux. What I discovered was that I was taking it the wrong way. Kresser suggests taking it at the start of a meal not at the end as it says on the bottle. He also suggests gradually increasing the dosage until you feel a slight burning sensation, and then backing off one pill. That is your dosage. I am up to four pills per meal (1200mg) and still have not reached that limit.

I am finding that I have no more cramps, no more heart-pounding after meals, less congestion, and I even sleep better because a sour stomach is not waking me up. And I feel like I am getting the full nutritional benefits of all the healthy foods I am eating. The third step in alleviating GERD (the first being to reduce the factors that cause bacterial overgrowth and the second being the replacement of aids to digestion) is to replace the bad bacteria in your gut with the good guys. That has been the focus of my health concerns recently and will be the subject of my next post.