real causes of GERD (heartburn)
knows that our stomachs produce gastric acid. But many people
associate this acid with the bothersome sensations of heartburn
or acid reflux disease. No wonder that so many of us are
eager to neutralize our stomach contents with medications.
But can it really be done? Can we "turn off" gastric
acid production and magically get rid of heartburn?
stomachs naturally produce a hydrochloric acid. If we don't
make enough of this acid, a dangerous and potentially pre-cancerous
condition called hypotrophic gastritis can develop.
acid is essential for normal digestion. It helps process
and neutralize meat, so that it can then be digested by
enzymes. Hydrochloric acid also signals the gastric glands
to produce important digestive enzymes, which break down
complex protein molecules into simpler and easier-to-digest
substances, such as peptides, peptones and so on.
even these smaller substances are still too large to be
assimilated by our bodies. They need to be even further
broken down by the enzymes of the small intestine and pancreas
into amino acids. Unlike large molecules, amino acids can
be used by our bodies for tissue regeneration. Unfortunately,
without gastric acid, our bodies can't fully process protein.
As a result, nutritional deficiencies can develop. Even
worse, molecules that haven't been properly broken down
can enter the bloodstream. Since they're too large to be
used by our bodies, they can actually become allergenic
or cause headaches and inflammation of the joints.
does "too much acid" mean?
other bodily functions, there can be too much or too little
gastric acid. Acidity is typically measured by pH. Neutral
pH is 7.3. Anything above 7.3 is alkaline and anything below
is acidic. The higher the pH number - the more alkaline;
the lower - the more acidic.
what's the normal pH for gastric acid? 1 - 3. That's
a very acidic environment - similar in its strength to the
acidity of a car battery. So where does the concept of "too
much acid" come from? It doesn't appear to make physiological
sense. Only 0 is less than 1. In the case of "high
acidity of stomach fluids," our stomachs make more
hydrochloric than necessary for the digestion of the particular
foods we're eating (the acid pH may still be higher than
heartburn is indisputably a real and uncomfortable occurrence.
But treating it has to begin with a good understanding of
its true causes.
sensation of heartburn - burning in the esophagus - is the
result of stomach juices flowing backwards (reflux). The
pH doesn't matter - it can be 2 or 8. The esophagus lacks
the same protective coating the stomach has. Any gastric
juices - whether acidic or alkaline - can cause a strong
irritation in the esophagus. This gastroduodenal reflux
- or flow backwards - is what's commonly called "heartburn"
or "acid reflux."
why does reflux occur? There can be many reasons. Overeating
can cause the stomach to stretch, causing the air trapped
in the stomach to rise into the esophagus together with
some gastric fluids. Eating too many sweets can also be
a factor. Sweets stimulate the production of gastric acid,
but unlike other foods, they don't neutralize these secretions.
Ironically, lower hydrochloric acid production can actually
contribute to heartburn. Without enough hydrochloric acid,
meat proteins can't be properly digested, which stresses
the entire digestive system. Yet another factor is dyskinesia
(improper movement) of bile ducts, which can cause bile
to be transported to the stomach, and later, the esophagus.
can also be the result of something as simple as swallowing
too much air while eating and talking - known medically
as aerophagia. Another more serious cause could be a hiatal
hernia, which can loosen the muscles of the esophageal sphincter,
normally responsible for keeping the entrance to the stomach
closed. In this case, gases and drops of digestive fluids
can make their way inside the esophagus.
of low gastric acid
simply taking an acid reflux medication won't solve most
cases of heartburn. Instead, medications can actually mask
the real problem and can even worsen digestion. For example,
if your stomach has a normal pH (1 - 3), the pH of your
intestines will be almost neutral (pH 5-7). If you eat too
much of an alkaline product, such as meat, or if your hydrochloric
acid secretion is lowered, your intestines can quickly become
too alkaline. This over-alkaline state can last for a while,
since your normal intestinal functioning will be weakened.
intestinal pH of more than 8 signals your intestines to
"rest" and stop contracting. Since your intestines
are already full of alkaline food, they don't receive a
signal to start working again, so they can continue to be
filled with more food. This can lead to serious and painful
gastic acid is lowered, certain digestive enzymes, such
as pepsin and trypsin, can't be synthesized. As a result,
proteins move into intestines before they're properly digested.
Once in the intestines, the food starts to rot, which begins
a "poisoning" process. One of the functions of
gastric acid is to neutralize bacteria digested with food.
If this didn't occur, the food reaches the intestines together
with various bacteria. Inside, the bad bacteria starts to
multiply rapidly, damaging the normal intestinal flora.
The bacterial rotting process can lead to the secretion
of active toxic substances, such as methane, hydrogen sulphide
and so on. This can result in localized problems, such as
colitis, hemorrhoids, polyps and even cancer.When the same
rotten products seep into the bloodstream, they move quickly,
poisoning the main organ systems: endocrine, immune, cardiovascular
and so on. They are most harmful, however, to the nervous
system - particularly the human brain.
addition to everything else, lowering the production of
gastric acid changes our vitamin profile and acid-alkaline
balance. This can lead to numerous problems outside the
digestive system, including allergies, memory difficulties,
hypertension, sleep disturbances, arthritis and so on. The
synthesis of the intrinsic factor responsible for assimilation
of vitamin B12 stops together with the production of hydrochloric
acid. When our body doesn't get enough B12, numerous problems
can arise, including anemia, irreversible nerve damage and
increased levels of homocysteine - a risk factor for heart
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of continuing to mask the cause of your heartburn, it makes
more sense to find out where the problem is coming from
and how it can be treated.
we can help:
first goal is to figure out what's causing your acid
reflux. Dr. Koles is an experienced diagnostician
who can direct your search for the real cause.
the cause has been established, we can devise an individualized
diet and supplementation program.
note that we strongly caution our patients against
stopping your acid reflux medications without consulting
with a physician. An abrupt change can lead to a "rebound
effect," where your stomach over-produces hydrochloric
acid. Any change in medication should always be supervised
by a doctor.