In the next few articles, I’ll be writing about the epidemic of gastroesophageal reflux disease (GERD) and its mismanagement by the medical establishment.
In this first article I will present evidence demonstrating that, contrary to popular belief, heartburn and GERD are caused by too little (not too much) stomach acid. In the second article I’ll explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. In the third article I’ll discuss the important roles stomach acid plays in maintaining health and preventing disease, and the danger long-term use of acid suppressing drugs presents. In the final article, I’ll present simple dietary and lifestyle changes that can eliminate heartburn and GERD once and for all.
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Heartburn and GERD Are No Joke
According to the National Institute of Diabetes and Kidney Digestive Diseases, sixty million people experience heartburn at least once a month and twenty five million experience symptoms daily.
Gastroesophageal Reflux Disease (GERD), a more serious form of acid reflux, is the most common digestive disorder in the United States. Studies show that 10-20% of individuals experience symptoms at least once a week, and prevalence of GERD is increasing steadily.
Drugs for acid reflux and GERD are cash cows for the pharmaceutical companies. More than 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium, the most popular, brought in $5.1 billion alone – making it the second highest selling drug behind Lipitor.
As sobering as those statistics are, it’s likely that the prevalence of GERD is underestimated because of the availability of antacids over-the-counter. This permits patients to self-medicate without reporting their condition to a doctor.
Up until fairly recently heartburn wasn’t taken too seriously. It’s primarily been the butt of bad jokes about Grandma’s cooking. But we now know that heartburn and GERD can have serious and even life-threatening complications, including scarring, constriction, ulceration, and ultimately, cancer of the esophagus.
Problems with the Conventional Theory
If you ask the average Joe on the street what causes heartburn, he’ll tell you “too much stomach acid.” That’s what most of the ads seem to suggest too. I’m sure you’ve seen pictures like the one at the top of this post in ads for acid suppressing drugs on TV and in magazines.
But there’s a big problem with this theory: the incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age (Fig 1).
Numerous studies have shown that stomach acid secretion declines with age. In one study researchers found that over 30 percent of men and women past the age of 60 suffer from atrophic gastritis, a condition marked by little to no acid secretion. Another study found that 40% of women over the age of 80 produce no stomach acid at all. 1
Figure 1. Mean stomach acid secretion from the second to the eighth decade. (from Wright, 2001 p.20)
Just as studies show acid secretion declines with age, it is also well established in the scientific literature that the risk of GERD increases with age.
If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see.
In fact, according to Jonathan Wright, MD of the Tahoma Clinic in Washington state, when stomach acid is measured in people suffering from heartburn and GERD it is almost always low, not high. In his book Why Stomach Acid is Good For You, Wright explains:
When we carefully test people over age forty who’re having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach.
In Wright’s 25 years of conducting these tests, he found very few people with excess stomach acid. Excess stomach acid is only found in a few rare conditions like Zollinger-Ellison syndrome), and GERD is hardly ever associated with too much stomach acid.
What’s more, Wright and other clinicians have found that giving hydrochloric acid supplements to patients with heartburn and GERD often cures their problem:
In 24 years of nutritionally oriented practice, I’ve worked with thousands of individuals who’ve found the cause of their heartburn and indigestion to be low stomach acidity. In nearly all these folks, symptoms have been relieved and digestion improved when they’ve taken supplemental hydrochloric acid and pepsin capsules.
My own clinical experience confirms this. So far every patient I’ve had with heartburn or GERD has responded well to hydrochloric acid supplementation. We’d expect just the opposite to be true if these conditions were caused by too much stomach acid.
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A Symptom Is Not a Cause
When I explain to patients that GERD is caused by not enough stomach acid, rather than too much, they are initially doubtful. “If that’s true”, they say, “then why do my antacid drugs provide relief?”
I’m not denying that the symptoms of heartburn and GERD are caused by stomach acid refluxing into the esophagus. Nor am I arguing that reducing or eliminating stomach acid with drugs doesn’t relieve those symptoms.
What’s crucial to understand is that any amount of acid in the esophagus is going to cause problems. That’s because its delicate lining isn’t protected against acid like the stomach lining is. You don’t have to have excess acid in your stomach to have heartburn.
The misguidedness of this approach is clearly demonstrated by the use of acid inhibiting drugs to treat heartburn and GERD – problems which are caused by not enough stomach acid!
The Consequences of Ignoring the Cause
As I wrote above, Americans spend more than $13 billion on acid stopping drugs each year. This expense might be justified if antacid drugs were actually curing heartburn and GERD. But just the opposite is true. Not only do these drugs fail to treat GERD, they will make the underlying condition (not enough stomach acid) worse. This virtually necessitates the lifelong use of these medications for anyone who takes them.
While this is a nifty sales strategy for the drug companies, it’s a bitter pill to swallow (yes, pun intended) for those suffering from heartburn and GERD.
Curing a disease means eliminating its cause. When a disease is cured, the symptoms don’t return once the treatment is removed. This of course is not the case with drugs for heartburn and GERD. As soon as the patient stops taking them, the symptoms return. And often they’re worse than they were before the patient started the drug.
Unfortunately, pharmaceutical companies aren’t interested in cures because they aren’t profitable. It’s much more lucrative to sell drugs that people have to take for the rest of their lives than it is to promote dietary or lifestyle changes that would cure the problem.
Therefore, although the drug companies are well aware that GERD isn’t caused by too much stomach acid and that low stomach acid causes serious health problems and complications, they continue to sell billions of dollars worth of antacids to an unsuspecting public. Even worse, these powerful drugs are now available over-the-counter with no warnings about the dangers they present.
Note: if you think this sounds strangely like the situation with the #1 selling drug, Lipitor, you’re correct. Lipitor arbitrarily lowers cholesterol across the board, even though evidence clearly indicates that high LDL cholesterol is not the cause of heart disease. What’s more, low cholesterol is associated with greater risk of death in the elderly population. Something is definitely wrong with our “healthcare” system when the #1 and #2 medications are actually contributing to the conditions they’re supposed to treat. But I guess if you’re looking at it from the standpoint of the drug companies, who are in business to make a profit, it’s the perfect business model.
In the Part II I explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. We’ll also look at the primary causes of low stomach acid, and how you can prevent this condition from occurring. Read on!
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- Sharp GS, Fister HW. The diagnosis and treatment of achlorhydria: ten-year study. J Amer Ger Soc 1967;15:786-791. ↩
Dear Chris Kessler,
Do you know of a doctor in the South Orange County, Calif. area that treats Acid Reflux the same way that you recommend?
I have a hiatal hernia which probably aggravates my acid reflux. Right now the medical doctor I go to prescribed pantoprazole, 40 mg, which I take every day. If I miss taking it even one day I get intensely painful heartburn and have to chew on tums several times throughout the day.
I’ve been on this medication for about six months. I’m worried about the long term effects of staying on this medication such as not being able to absorb calcium or Vit B12, not to mention not being able to absorb other nutritients. I’d like a doctor’s help getting off of the pantoprazole if you know a doctor in my area or anyplace in Orange County, preferably one that will take Medicare.
Thank you,
Rhonda
I have a small hiatel hernia, I have been overweight since having my twins 8 years ago even though I do not eat big meals. I have been taking Omeprazol usually only when I felt ill with the acid and the hunger pang type feeling. For the past 4 months I have felt awful. Severe hunger pang feeling, wake up in the night with acid in my throat, I snore terribly apparently, I felt like I had lumps through my digestive system, excessive swallowing and thick saliva. I get a crackling sound like the space dust sweet that we ate in the 70s that popped in your throat whenever I swallow. When it was really bad my neck and throat felt sore and chest bones hurt. im very worried that I will get throat cancer and cant understand why the symptoms are carrying on the Omeprazole doesnt seem to make a difference,
Hi Lynda,
I too worry about throat cancer.. though the docs keep telling me that my throat can be sore for ages before it could get to that stage.. My throat has been sore non stop for four months.. and when I tried Omeprezole it got even worse.. I had never really burped hardly ever until I took those horrific tablets! My digestion has been completely ruined and it is taking a long time to re-build.. I now eat a very simple basic diet, with small frequent meals.. I am taking pro-biotics with digestive enzymes, L-Glutamine and slippery elm.. Things have improved a lot using these natural things.. I do wonder if I knew about these things to start with rather than trying the PPI’s whether I may have got better sooner.. It is a tough call when there is the scary prospect of cancer.. and I do not blame so many people continually trying to resolve things with PPI’s.. it takes a lot of courage to try and work it out and go against what you have been told to do.. and I guess everyone is different.. I wish there was a magic pill, but I now do not believe there is.. I am convinced it is about getting the digestive system working properly so the rest can function.. This site is very helpful and it is great that there are some people who have the courage to say what they believe!
Hi There, Four months ago out of the blue I developed chest pains and a very strange sensation when I tried to eat anything.. I could not understand what it was, but I would start to eat and suddenly my heart was beating really fast and I thought I would pass out.. After many tests I had a diagnosis of Esophogitus Grade B shown by an Endoscopy.. I was amazed.. I have never had heartburn in my life and my diet is organic and not junk food.. The Doc gave me PPI’s Omeparazole.. As soon as I took them I was very il.. Burping at least 300 time probably in one day.. having never been a person who burps a lot.. Nausea, headaches and undigested food in pale stools, severe stomach aches all over.. Also had never experienced any stomach issues before.. The day before all this started I was out on my Mountain Bile for hours and thought I was in the peak of fitness.. When I stopped the PPI’s then I found out what Acid was like.. and it took 2 months to settle down.. but my stomach issues have not! My digestion is impossible and also my abdomen aches after each B/M.. The Doc keeps telling me to take Antacids but I cannot digest any food when I do.. As I have inflammation in my Esophogus I worry about trying HCL tablets as I fear they may make the inflammation worse..The other evening I read an article which said try drinking Sprite after you eat if you are too scared to try other options.. I found this helped a lot almost immediately.. This makes me think that maybe stomach acid is low.. but then I think how did I get inflammation in the Esophogus.. Could it be that due to such a lot of strenuous exercise my Esophogus has become loose? I am at my end with all of this.. it has been four months of hell!! Any advice would really be appreciated.. anyone else had anything like this? Thank you
Pavla, I have had the same symptoms that you described! I’ve been on PPIs for 3 months and now I have the heartburn sensation frequently and the feeling that food sits in my stomach for hours. I have been so depressed and frustrated because symptoms have only gotten worse. And I fear that my doctor will follow conventional methods and not help me find what the actual problem is.
I was diagnosed about a month ago with mild asthma. I was put on advair 1 puff, twice a day. I was also given albuterol for rescue inhaler. Last week I was eating any food from cereal to yogurt to bananas, and every time I put food into my mouth, I would have an asthma attack and need to use my inhaler. I went to the doctor and he told me I have GERD and prescribed omeprazole 40 mg once a day. Ever since then, I have not had an attack after eating. I feel fine, except I do have stomach aches occasionally. Does this mean I am going to be stuck forever on this drug? When I was having those episodes, I never experienced heart burn. I don’t want to be on this drug forever but like people were saying before, if I come off, then the symptoms might come back.
Is pepcin over the counter or prescription? I was told to take Pepcid daily and it ended up causing a B12 deficiency, so an alternative would be great!
Also, what tests should one ask for at the doctor to make sure there isn’t too much esophogeal damage?
I’m a 55 year old male, suffering from acid reflux disease/gerd. I started taking Nexium until my insurance stopped covering it, so my dr. prescribes me omeprazole, think its 20mg, 2 X a day. He told me that I’d be a life long taker of this med. I’ve had a few scopes and the only thing I’ve been told that I may be a candidate for Barrett’s Esophagus. I’ve been getting scoped about once every 5 years to check on it. Anyway, lately I’ve been experiencing other abdominal problems. My Dr. was concerned with possible other issues, so he ordered me a stress test and a breathing test, which both came back okay. I suggested Candida bacteria, but he just shunned it off. I had what I thought were a few of or similar symptoms of it, but still not sure. What I have going on is occasional bloating, almost constant belching, and more than normal flatulence. Along with that, I get short of breath, and it is difficult to catch my breath. That is the part that made my dr. have the stress test. These symptoms have been bothering me for about four months now, and just I’m just getting tired of it. It makes me not want to do stuff I normally want to do, sometimes I will nap when I get home from work, something I never did before. Here’s something else, I have constant throat clearing, which drives me crazy…but when I get sick, ie, cold, bronchitis, flu, the throat clearing goes away, and since I started with the breathing thing, that goes away for the most part when I get sick. I’m sick of being sick, and started to think, maybe the medicine I’m taking is what is causing it.
Hi Dano, A lot of what you are going through sounds similar to me.. Since I took the PPI’s my stomach has been completely messed up.. I am too scared to go anywhere as I cannot eat properly.. I have been having Scans and Tests for a stomach problem which appears I only have due to the PPI’s.. It all seems crazy! My Doc refuses to acknowledge that these problems actually started when I took the tablets.. every few weeks he thinks I may have a different decease.They have scanned my Pancreas, Liver Tests, MRI’s Ultrsound Scans of Abdomen.. etc etc etc all normal! but I am in pain and cannot digest food anymore.. now I am due for a Colonoscopy! I have never had any issues with my stomach ever.. now it is a disaster!
Hi Chris! I need your help! I have heartburn daily and also an impaired ability to burp particularly after eating. All I eat right now is boiled chicken soup with carrots and squash. I just started hcl betaine but have to go slowly because the first time I took it I got a thunderclap headache and yet normal brain scan. I also started a probiotic and milk thistle. I still cannot burp well. It feels like my esophagus is pushing the soup up into my throat. When I used to take prilosec, it masked the heartburn pain but did nothing for the dysfunction of the belch reflex…if that is a correct diagnosis. I do need to see a dr this week to rule out some things before assuming I simply cannot burp efficiently. Do you have any thoughts for me? Anyone? [email protected]
I’m confused. You say,
“heartburn and GERD are caused by too little – and not too much – stomach acid. ”
If there is too little acid, how can acid reflux exist then?
I’ve been diagnosed with the earliest stage of GERD but I suffer everyday with symptoms such as discomfort after eating even half a slice of bread. My weight dropped by 10kg. I can’t eat anything!
I’ve been taking PPIs and antacids but they don’t help much. The weird thing is that after taking my first set of PPIs my heartburn went down to zero. I have no pain. I only have this weird tightness feeling in my chest and throat and feel that food is stuck in my oesophagus.
Is my problem an acid reflux problem? Will taking HCL supplements help?
I been treated for acid but belive I low acid can you get excess nose mucus through this I had it for more than 2yrs ended up on life support an have discoverd I have mysenius gravis its driveing me mad gp keep passing the book dont no what causeing the .mucus its like haveing flu all the timevx
After reading ur web pg I’m sure my heart burn is because I’ve been taking tums almost every night for years 🙁 Going to stop as of now and reading your articles on Gurd and acid reflux IBS, so but I’m still wanting to know what does HCL mean? Thanks Sharon
Greg,
Don’t panic. Find an ENT that has some experience with GERD and do what they suggest. They can easily look into your upper air way in the office with a nasal scope which is very simple and easily tolerated.( Nexium 40 mg timed release before your biggest meal of the day. What I was prescribed and seems to be working well.)
Also one never knows if there is esophagus damage without a scope of the esophagus/stomach/lower intestine. Also easy to tolerate but without insurance. . . probably not possible as it is expensive. I had one and a small Barrett’s esophagus was indicated – so I will have another scope in a year to see if there is change. Watch the diet as instructed but again don’t go overboard as there are lots of opinions tossed around as to what to eat and what not to eat. It does seem we are all different as to what works and what doesn’t. I know one person who was on Nexium for 4 months and no longer has reflux. I have a friend who was on Prilosec for 8 years who is now weening off as his reflux seems to be gone. Just met someone who has had reflux for 10 years and takes over the counter Prilosec – twice as much as recommended – still eats what he wants without care, drinks whiskey heavily, eats late dinner and then goes to sleep sitting up in a chair and is very overweight. He commented that “you have to live your life” I see him as having a horrible life and is well on his way to early exit.
Do what a GOOD doctor recommends and then live your life well and see what you can do to get control of that awful feeling. My doctor told me to close my computer and stop reading everything and let him be the doctor. That I was not educated enough to really understand all the information out there! So I’m giving it a try! Good luck.
PS. The different diets that you read about can be effective as well as the supplementation with HCL. I am a little confused about the pepsin need as Dr. Jamie Kaufmann says that it is Pepsin that causes the actual damage to the esophagus and not the acid – and that even with acid reducers the pepsin is not much suppressed but stays around in the gut and migrates to the esophagus.
Really nice to read this comment. I’ve had GERD for years and all the suggestions I read about low stomach acid, paleo, take HcL/enzymes, etc. make it SO much worse it’s ridiculous. Perhaps a large majority of people diagnosed with heartburn have low stomach acid and this info is useful for them, but for those of us who seem to have the opposite problem, reading article after article that implies ‘if you just take this supplement, oh, that didn’t work, then you need to do this’ and ignores that some people actually are not doing well doing it ALL with these protocols, is very frustrating and a bit condescending. I challenge Chris Kresser and others to provide suggestions to people with ACTUAL high stomach acid . These guys spend their lives gathering information, they must have ideas. Since high stomach acid does exist as a problem, I’d love to hear their ideas on how to help that so the small percentage of us for whom adding acid is a nightmare can get some healthy natural relief as well (if possible) without just killing all our stomach acid entirely.
HI there
I have had reflux symptons for just over a year now. Its mainly been a sore throat but the other day after a stupid tomatoe pasta which i should have known not to have i started getting pain in my stomach.
I am going crazy. I have just started taking some ppis which i really dont want too but nothing else has helped. I dont know where to turn. The only thing that helped was a low carb diet but then i messed up a few days and it seems to have really hurt me. I have had scans on my thyroid my kidneys my upper throat was slightly enflamed by caid reflux but she didnt look down my eosophagus.
Im really nervous about cancer. Everyone tells me not too. I could live with the pain if i didnt think it would lead to cancer. Can anyone please tell me if they have cursed their reflux (esecially if they have had it everyday) Or how lon g it také sbefore the freaded c sets in. I am only 35 and really cant put up with this forever. Also i hear conflicting stories about alkaline and acid. All answers would be gratfully recieved 🙂
I cannot thank you enough for all this information. I recently had a virus where I was vomiting anytime I tried to swallow food or water regularly for 2 months. Of course my esophageal endoscopy came up normal but based on my symptoms I was diagnosed with GERD. Just diagnosed, but no treatment. Thankfully I was already seeing a homeopath and he was able to treat it enough so I was able to eat and drink again within 3 weeks, fairly certain it was H. Pylori. However now I get this incredible heartburn, it feels like a heart attack, regularly, so I’m so thankful I stumbled upon this website. I have something I can start to work with: taking HCL, low-carb diet, herbs, and even not drinking water with meals. Thank you!!
I recently had an esophagectomy due to cancer. About 1/4 of my stomach was removed also, and the remaining stomach was used to reform an esophagus. If i lay flat in bed i get acid reflux symptoms. I sleep on a wedge but i find that i scoot down in my sleep. This causes me to wake up from the acid reflux. I have been taking Prilosec to prevent the symptoms. Since I can no longer develop Barretts Syndrome, is there another malady that I should be concerned about that taking acid suppressants can cause me specifically?
Hi Chris: I have been getting heartburn for a couple of months survere. I have been take 650mg of HCI with pepsin. I am taking 3 at the begining of each meal also take a digestive enzyme half way thur my meal. This does seem to help for a little bit but about 2 or 3 hours later I start getting heartburn. Then I take 1/2 tsp of baking soda in water & this helps out quite a bit. I doesn’t seem to mater what I eat I still get heartburn a few hours after I have eaten. I do not eat a huge amount of food. I am trying to find out what else I can do to get rid of this problem. I did break my ankle 4 months ago and had surgery & they put me on antibiotics during surgey & some pain pills to take at home. I did not notice heartburn until about 2 months after the surgery. Do you think this has somthing to do with me taking the antibiotics & pain pills. Also have you heard about taking matula tea for h-plyori & if it works. I am thinking that is what I may have. Any advice or help is very much appriciated. Thank you
My son was born 7 weeks premature and is now almost 2months 8days adjusted and was diagnosed with acid reflux/gerd by pediatrician over the phone with no exams performed. He was put on Zantac twice a day .. I was extremely hesitant to give him medicine so young since I don’t even take medication for anything. I told ped that I didn’t want to give it to him and dr got mad at me. I cave and I have been giving for 2weeks now but I’m not sure that’s the problem . I cut all dairy , wheat, nuts soy and eggs out of my dietcause I think that’s what’s bothering him sincehe drinks formula 30% of thw time and breast milk 70% I noticed he gets a rash around his neck and on his eyelids. His ped GI also saw him and said that dairy cannot be problem since it’s rare to pass it down via breastmilk. I want to stop giving him medicine but don’t know what to do. He is so little and I don’t want him to suffer.
Hi Sujey,
Were you able to get a 2nd opinion from a specialist/ENT or GI doc? Another possibility is to see a D.O., instead of an M.D. b/c they often balance treatment, and don’t rush to taking the drugs. I don’t know your situation, but I would suggest seeking out a few specialists, and maybe an allergist as well.
Best wishes for your son,
alanna
Hi Alanna,
I did see a pediatric GI for another opinion, he is the one who told me about dairy not being a problem bit he also didn’t performed any test on him just prescribed a stool softener . I’m feeding him Alimentum formula he seems to be doing a little better but he is soo gassy still and it bothers him.
Sujey,
It’s heartbreaking when this is happening with your baby. I feel for you. I do not know what to recommend, other than what I would do. That is, maybe seek out D.O., naturopath – as they will look at less invasive remedies/root cause. Allergist., and perhaps further pediatric specialist (GI, or ENT). I hope you get answers and relief for baby.
Best to you,
alanna
Milk products alway gave me gas and in some cases diarrhea. My Naturopathic Dr ran some tests and determined I had two issues. The first was with lactose (which I was aware of) and the second was the inability to digest the protein. My GI Dr (gastroenterologist) confirmed this. Said I’d have issues w/ goats milk also and soy. Below is a good article on this and tests to run.
http://kidshealth.org/parent/medical/allergies/milk_allergy.html#
Hope that helps.
I would guess it being the soy in the formula. I’m horrified by the ingredients in all the store bought baby formula, filled with frankenfood & gmo soy etc.
Reading a lot of the comments here if it were me, in my opinion I would try probiotics & cut the junk formula.
The put my 16 year old kid on 80mg Omeprazole now. 40mg in the morning and 40mg at night. Reluctantly, I agreed to a 4 week trial. In addition, she’s been given a steroid inhaler to take twice a day and another steroid to add to warm water for a saline nose rinse twice a day. My daughter has a dry cough all the time for the past 3 months at least and constant throat clearing for the past year!
They had tried her on 40mg Omeprazole for 3 months and it did nothing! No relief. We have already changed her diet, no more dairy, now doctor wants grains out too. Its so hard for a teen to live this way. I hardly know what to cook anymore. We have not notices any change of symptoms with diet whatsoever. Ice cream or bowl of salad, she feel the same!
its so frustrating, doctors don’t know.. we’ve seen about 5 different ENTs in New York City including Laryngologists, vocal cord specialists, sinus specialist, we’ve had her tested for allergies, all did nothing. I hate the meds and I do NOT want her on it for more than 4 weeks!
Why does not one doctor know how to tell me what causes this??
Daniela
Unfortunately, from what i know there is very little help out there for LPR and there is no understanding in medical community why PPIs of no help. Perhaps, some doctors know something that other do not, they do not always agree with each other and often sceptical of one over another treatment. It is very frustrating!
I know people who work and live happily on PPIs for 20 years…Does it mean it is good? No one knows. But I am all into medical treatment now as there is no black and white thing. If all would be that easy then pharma already would have come up with the drug that promotes production of the stomach acid…So, it might be a combination of two worlds – diet/stress management and medical treatment. Once you know your diet 9only you could figure this out), treatment may gradually be taken down to a minimum or none.
HCI did not help me at all…neither enzymes, nor the diet alone with pribiotics.
Please, send me an email if you like to chat about this more: [email protected]
Hi Daniela, Why not try something natural as well as change of diet.. How about looking at your daughter’s digestion.. make sure it is working well.. I would guess it is suffering with such a large dose of PPI.. It may help to take Digestive Enzymes with each meal.. Also try Slippery Elm which can be put into a drink if preferred.. You could also try DGL chewable tablets.. all these things are available at the health store.. Hopefully you can work hard on these alternative therapies as you gradually pull away from the PPI’s.. Be very careful not to just stop the PPI’s, just lower the dose gradually. or you may get rebound..
try a gluten free diet- some people I know who are gluten intolerant have the same symptoms. Since dairy free didn’t change the symptoms, add dairy back in.
Guys, this is great stuff. But I haven’t seen on here (altho admittedly I haven’t read EVERY comment!) anyone addressing the actual MECHANICS of acid reflux: namely the esophagus/sphincter muscle being OPEN, which ALLOWS the acid to come up in the first place! So how do we get this thing to close???
I have recently weaned myself off the troublesome PPI’s (in my case, Omeprazole), but now have been REALLY SUFFERING from heartburn (acid buildup)! (I’m a 54-year-old, so maybe most bets are off, anyway…)
I’ve tried the bed elevation trick (set that way for years), and have recently tried the ‘drink-quart-of-warm-water-at-once-and-jump-up-and-down’ trick, but to no avail. I’ve even seen folks recommending drinking apple cider vinegar for relief, too, which makes no sense to me, given that cider should be by its very nature ACIDIC!
HELP!
Mark H.
I posted not long ago that HCL with pepsin helped me and that I felt better. Well I spoke a little to soon. My cough would not go away so I recultantly tried Prilosec that the doctor wrote for me. It seems to work great at 1 20 mg pill a day yet I countinued with pretty much the same diet. Even had a bit of beer and wine now and again. After 2 weeks it got worse, the relux so the doctor said 2 pills a day and it got really worse. I stopped that for a time and did feel better but was having more reflux and cough. I saw the doctor again and we agreed to have an endoscope which showed some stomach gastritis and a polyp in the stomach and some irregular color in the esophagus just above the Z line or junction to the stomach. All were biopsied and the only one a bit of a problem was the esophagus spot was Barretts which reflects some cells changing from esophagus cells to intestinal cells. It was non dysplasic and small as I understand. So again PPI”S but nexium and stronger, 40 ml per day. In addition I discovered that Pepsin the digestive enzyme from the stomach is what migrates into the esophagus and when acidified by anything over a ph of 5 or possibly even 6 ph can cause injury to the tissue. And the pepsin stay on in the esophagus. Apparently PPi’s only slightly reduce the pepsin while diminishing the stomach acid considerably. So while HCL can help with digestion I now wonder why we would add pepsin which seems to only add fuel the the fire as they say. So with the slight damage to my esophagus year scopes will be require to watch and see what happens to the Barretts tissue and if it progresses or stays the same or even a remote possibility that it could revert. The other possibility is that it could be LPR rather than GERD. That is in the upper airway. So according to Dr. Jamie Kaufman of the Voice Institute of New York who is the expert in the field of LPR, in her book STOPPING ACID, THE REFLUX DIET COOKBOOK AND CURE. Being very careful about diet can greatly improve ones condition. In fact her recommendation for Barretts is lifelong medication and a very alkaline diet-eating only foods that have a maximum PH of 6. As well as yearly or more frequently. There seem to be some new approaches to addressing Barrets like Radio Frequency Ablation to gently burn away the bad cells to allow for regrowth of the appropriate ones. So very long posting but that is where I am now – trying to follow those recommendations as well a juicing green to try to help rebuild cells etc. I am having a trans-nasal scope this coming week by an ENT specialist to see if that upper airway stuff has been involved in any damage. Sorry for the long post but that is what I have learned in the past month or so. Best to all who are suffering. By the way the UK version of Gaviscon is pretty helpful in stepping down from the PPIs and works for better sleep at night to. Have to search the inter net to get it from the UK as it is different from the US brand and his not supposed to be allowed to be shipped here. You can get it. Oh by the way calcium channel blockers – blood pressure medication, can cause acid reflux – I took one for 5 years and no doctor ever told me that could be a possible side effect. It causes weakening of the LES. It is also thought to affect the Lower Urinary track – relaxing some valve and causing leaking. Any questions I will try to answer. I have no stock or involvement with any of the products I have mentioned.Best to all. Edward
Your symptoms’ are so similar to mine ive had for 12 months, throat clearing , lump in throat/chest feeling and a cough and then a slight saw throat hoarsness worse in the afternoon. Im on Lanzaprozile and Gaviscon but they don’t work. LPR is usually indicated by high Pepsin levels which I have , I haven’t tried HCL with pepsin as im afraid this is adding even more pepsin so im very confused like you you is LPR (silent reflux) caused by to much acid or low acid or could be one or the other ??? and should I try HCL ???.
Chris,
Great article. I’m looking forward to reading the follow-up ones.
My other half has been on Omaprazole since before I knew him – so more than five and a half years! Even before I met him, I was aware that this sort of medication was only supposed to be taken for a period of a few weeks to allow a stomach ulcer to heal, I asked him if he had – or had had – a stomach ulcer and he said that no, he didn’t think so…but he had the bacteria that caused it…or something. So I asked him had he been treated with antibiotics and he said he hadn’t! So he was prescribed a drug which would make his body less able to fight off the bacteria instead?! And is still taking it 6, 7 years or more later?!
All he knows is that if he doesn’t take one, he suffers. I’ve tried to get him to understand what they’re doing to him, that it can’t possibly be a good thing to have low levels of stomach acid but he can’t see past the fact that it hurts if he misses a dose…
Salt into the wound: I went to see my doctor a couple of days back. I’d had several bouts of gallstone pain (it’s been a problem, off and on, for 10 years but I’d had several bad bouts in close succession) and the last one had been followed by a night and a day of reflux – which was, as I was at pains to make clear to him, the first time I’d experienced any indigestion-like symptom in several years. I was asking for advice on lifestyle and diet to try and keep these symptoms under control and I was also a bit concerned about pancreas function/possible damage. So guess what?? He said (paraphrasing here), “Don’t eat fatty meals; let’s try you on these,” and handed me a prescription for Omeprazole! For goodness’ sake! I told him I would be reluctant to take it and explained why…he just flannelled and told me to keep the prescription and maybe give them a go if I changed my mind. No faith in the mainstream medical establishment at all: I believe they are trained, indirectly, by people who have an interest in making money (eg drug companies). Nice to see that your mission is to identify root causes of illness and seek to cure, rather than treating the symptoms with drugs and/or surgery – this is exactly in line with what has been a big bug-bear of mine for many years.
Cheers again, Catherine
PS My beloved sister-in-law is a GP and she knew nothing about gallstone attacks and biliary colic…
I am confused by the use of Betaine HCL? I have read a lot of information on how to use it. Is it only to be used when you eat a protein meal? or at every meal? After meals I feel like I swallowed a rock (no matter what I eat) or even if I drink too much water at once. I have Celiac, Type 1 diabetes (40 years) Hashimotos and have been treated for GERD for many years off and on. PPI meds do not work. The pressure in my stomach is so bad that some days I can only take small breathes as my diaphragm is being jammed up into my lungs, I feel like I need to be stuck with a pin! I am also sure I have leaky gut as I have sore joints and muscles, anemia that has not gotten better on the Celiac diet and other symptoms. So, is there is a step by step instruction on how to get started on Betaine HCL? I was taking 2 capsules at each meal as directed on the bottle. On the second day I thought I had died and gone to heaven! The pressure had gone down considerably and I felt like my meals were going through my system better (I could hear it!) as well the pressure up through my shoulders had eased up too! On the third day I woke up in extreme pain and burning up to my nasal passages? I am not sure how to proceed at this point? I want to start the SCD soon but I am in the middle of moving and it would be hell to not have my own kitchen to start it properly but I would like to keep on the Betaine HCL if I can? any suggestions?