Stomach Acid confusion!

Answered on August 19, 2014
Created February 27, 2012 at 12:54 AM

Okay, so I have been reading the articles (Kresser: http://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd) and all the posts here that seem to tell me that my gastritis/heartburn is largely due to low stomach acid. Kresser describes that anti-acid medications treat the symptoms not the cause- they prevent the acid from refluxing into the esophagus but do not treat the "underlying problem".

One of the main causes of GERD he says to be bacterial overgrowth, due to the pH being as high as 5. From my biology classes, I recall that a "resting" pH for the stomach is normally 4-5, while a "digesting" pH is typically buffered to around 2-3. So wouldn't saying that a stomach pH resting at 4-5 be totally normal? In microbiology we discussed that the tricky aspect of living as a bacterium in the stomach is not just the pH- it is the frequent movement, mucosa lining (which is not very good for starting a colony), etc. Wouldn't all those aspects together make bacterial overgrowth in the stomach unlikely? Isn't H. Pylori really the only bug that does well in there anyways (which so many of us have as is, but is also easily treatable with a short course of antibiotics)?

I have gastritis, and took a course of antibiotics many years ago to get rid of an H. Pylori infection, and have tested negative for it ever since (usually have to get tested for something or other at least once a year, so it has been checked on a annual to biannual basis). I have had 3 ulcers previously, all of which were related to the H. Pylori infection, and I haven't had any ulcers since treating the H. Pylori. I used to get a lot of gas trapped in my stomach, but that has gone away with the wind (pun intended) since I switched to a paleo diet. So between no bacterial infection and very little gas, you'd think my gastritis would have totally gone away, right? The thing is, I still get "flare ups" around the same times I used to pre-paleo. Typically when I'm stressed, lie down too soon after eating, exercise too close to eating etc. To manage these I take a Zantac or a Tecta, and they both really prevent any acid reflux (take one or the other probably 1-3 times a month). I am still young (20 years old) and do not want to cause any acid damage on my esophagus that could put me at any cancer risks later in life. Since I don't have problems with gas or bacterial overgrowth anymore, wouldn't it be more important to manage the associated symptoms because they pose a risk in damaging the tissues in my esophagus? Is it worth it for me to still use these medications to prevent the symptoms of gastritis?

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1 Answers



on February 27, 2012
at 11:45 AM

I find those PPIs and antacids tend to cause more problems than they fix.

Before I went paleo:

In my own case, I had nightly GERD issues, I took Zantac every night. I had previously skipped dinner because it would reflux, but, I'd get acid anyway, or even bile reflux since I had my gallbladder removed about 10 years ago. So I used to just eat a few slices of cheese before bed to counter the acid/bile.

I noticed that when I took Zantac or antacid at a certain time each night, if I skipped the pills one night, I'd wake at the same exact time with reflux. It's as if I was training my stomach to create more acid at a specific hour to counter the PPI/antacid! So as I realized this, I started to chop the Zantacs in half, then quarters and gradually wean myself off. (After Paleo, I learned that the term for this is "titrate down".)

The GERD actually got worse the first month of going Paleo, but after that they went away. The big issue for me turned out to be getting rid of all dairy. Once I did that, no more reflux at all. So you might still have some exposure to an allergen that's causing you issues.

Now as I did the transition, I suspect I had leaky gut and all the usual problems such as malabsorption and lack of things like magnesium, potassium, etc. Some of these minerals are required for proper stomach acid. So as my gut healed and I started to absorb, and supplemented with magnesium and other minerals, it completely went away once I took out the dairy.

Dairy is weird for me. Small amounts of cow dairy trigger reflux. Even raw milk cheese. But I've no problems at all with goat dairy. I think it's something in the protein, as I've had reactions to whey protein shakes as well. It seems to be dose dependent, and it doesn't matter how early in the day I'm exposed to the stuff, the reflux happens at night. No cow dairy, no reflux. I've had one or two exposures to wheat after Paleo, and one of the numerous effects was reflux.

So I think the key is to find out what triggers it for you and avoid those foods. Supplementing minerals, especially magnesium and potassium, and getting probiotics, things like sauerkraut, kefir, and the like may help.

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