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GERD treatment with Betaine HCL - chicken or egg?

Commented on February 24, 2014
Created February 23, 2014 at 8:13 PM

I am very familiar with Chris Kresser type approach to GERD, namely that it's generally caused by hypochloridia. This makes sense. What doesn't make sense is that the treatment he (and others) suggests is to take HCL pills in a gradually increasing dose until you feel warming in the stomach - basically until you feel heartburn. If I HAVE heartburn and I'm taking pills to relieve it, how do I know how to distinguish between my actual GERD and the "warming" from the HCL pills?!!

96440612cf0fcf366bf5ad8f776fca84

(19413)

on February 24, 2014
at 06:05 PM

Sorry. A damaged LES usually requires surgery to fix. :( It's possible that obesity is an issue, but I was obese before paleo and post paleo all reflux went away- then again, that's my symptom for getting glutened or exposed to cow-dairy, so as soon as I took out grains and dairy, no more reflux. If you don't find an urge to burp after eating carbs, you probably don't have SIBO.

38023e37dbe3408746d6ed1dc198945c

on February 23, 2014
at 08:19 PM

Oh and just to add: could it be that my GERD is not hypochloridia but rather just from leaking normal stomach acid due to pressure from obesity? And maybe it won't resolve until I lose some weight in any event?

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2 Answers

0
38023e37dbe3408746d6ed1dc198945c

on February 24, 2014
at 01:20 PM

I did try it for a week, and the near constant heartburn after meals got unbearable. No matter what the dose. The other possibility is that my acid is normal but my obesity is causing opening of the LES. In which case, no amount of supplementation would make a difference. (Another issue that Kresser doesn't directly address.) I don't have any bloating or gas that I am aware of, though I realize that I could still have SIBO.

96440612cf0fcf366bf5ad8f776fca84

(19413)

on February 24, 2014
at 06:05 PM

Sorry. A damaged LES usually requires surgery to fix. :( It's possible that obesity is an issue, but I was obese before paleo and post paleo all reflux went away- then again, that's my symptom for getting glutened or exposed to cow-dairy, so as soon as I took out grains and dairy, no more reflux. If you don't find an urge to burp after eating carbs, you probably don't have SIBO.

0
96440612cf0fcf366bf5ad8f776fca84

(19413)

on February 24, 2014
at 10:57 AM

You can always try it and see if it makes a difference. I take Now Super Enzymes caps (the tablets aren't as effective) which contain ox bile and Betaine HCL, usually 3-4 caps before each meal, but not for hypochloridia, but rather because I've had my gallbladder removed.

It's the same protocol as Chris Kresser describes, however, I heard it from Robb Wolf (actually one of his helpers.)

Hyperchloridia is highly unlikely, and Mr. Kresser does know what he talks about - most cases of GERD is caused by hypochloridia and things such as antacids make life much worse for those taking them, because it then prevents absorption of the very minerals that allow the stomach to produce proper levels of HCL (potassium, zinc, magnesium, etc.).

Best thing to do, is to just try it for a week. At worse, your GERD will not go away, at best, it will work.

The point of the test (take upto 5 pills until you feel heat, on an empty stomach, if you don't feel heat, use 5 pills) is to measure how many pills you'd need before each meal. You'd of course immediately eat something containing both fats and protein right after ingesting the pills to prevent damage. The betaine itself is known to help, so it's not just the HCL.

Stomachs have muscles around them that contract, and a sphincter muscle that senses HCL which closes when HCL is high. As part of their normal operation they squeeze and churn their food contents in order to digest the food. The sphincter muscle at the top of the stomach that allows food to enter from the esophagus should remain closed as long as it's not damaged, and as long as it senses high acid levels in the stomach. It is unlikely to relax and open just from simple pressure.

There is a case where if you have SIBO (Small Intensite Bacterial Overgrowth) that the excess bacteria in the small intestine would cause a lot of gas and pressure to push the stomach contents back up, and thus cause reflux, but if this is the case, it will likely cause gas and bloating immediately after eating, and would usually only do so with higher carb meals, in which case avoiding foods that feed them will get rid of it. There is a hydrogen breath test that measures the type of gasses that can say whether you have SIBO or not.

That website has a lots more stuff on SIBO:

http://www.siboinfo.com/

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