Issue 120: The Secret Sauce to Good Digestion

Writing about bowel habits last newsletter got me thinking about how many people misunderstand stomach acid. No, really! Look at drug store shelves and you’ll see great numbers of products designed to help you control it. But is that what you really need to feel good?

To answer that question for yourself, you’ll definitely want to understand stomach acid before you take your next heartburn medication.

---

The Irony of It All

There is a real irony to heartburn, reflux, and GERD (gastroesophageal reflux disease). The symptoms of low stomach acid are surprisingly similar to those of high stomach acid. They create a burning sensation in the chest and meals that repeat all the way up in the throat. Doctors and regular folks alike too often conclude that there must be too much acid in the stomach.

Hydrochloric Acid: The Friend You Never Knew You Needed

Technically, stomach acid is actually hydrochloric acid, or HCl. HCl is a popular corrosive acid used for laboratory, industrial, and manufacturing purposes, and can even be found highly diluted in some household cleaning products as muriatic acid.

HCl (aka stomach acid) is also naturally released by the parietal cells of the stomach lining as part of our digestion when we eat food. We first break down food mechanically (chewing, massaging by the stomach muscles) and then chemically via HCl in the stomach.

The big surprise is that the vast majority of people (I’ll grant you - not all) who suffer from reflux actually have too little stomach acid. We need enough of it for proper digestion. Think of what HCl does: it’s an acid that dissolves food into a semi-liquid so it can be moved easily into the small intestine where nutrients are absorbed. HCl keeps food moving.

Along with dissolving food, the increase in stomach acid triggers the release of pepsin, an enzyme that breaks down protein, and intrinsic factor, which separates vitamin B12 from animal proteins.

💡 Lightbulb Moment: low stomach acid is one key reason why elderly people tend to eat too little protein (poor digestion makes it uncomfortable to eat more than a little) and to become anemic due to low vitamin B12 and iron.

You can figure out what happens when someone has low stomach acid! First it prevents food from being broken down well or quickly. Food then sits in the stomach, keeping you feeling full and uncomfortable. Undigested food can begin to ferment, and that’s when post-meal discomfort really starts to kick in. You might start to burp, feel bloated, and/or develop heartburn.

This is what’s happening: the incompletely digested food puts pressure on your esophagus (specifically, the lower esophageal sphincter, or LES), causing that chunky mush to push its way back up, carrying some HCl with it. That combo irritates the esophagus and creates the burning sensation associated with reflux or heartburn. Did you know that the irritation and inflammation of the esophagus can travel all the way up, getting as far as your sinuses? It can be a source of increased mucus formation, leading to coughing and even sinus infections!

All because there’s not enough stomach acid.

Who is at risk of low HCl?

Almost anyone can have low stomach acid. Most commonly it affects:

• People who suffer with chronic stress, regardless of age.
  • Note that very anxious people might be more prone to it. I’ve known anxious tweens and teens with low stomach acid.
• People who suffer from eating disorders (low HCl and ED often walk hand in hand).
• People who have been sick (digestion overall can be off).
  • Stomach acid should return to normal as they heal.
• Post-menopausal humans.
• People who are 45 or older (everyone develops low HCl as they age, so this may be an issue for you if you have trouble digesting food).
• Everyone 60 years old and over is already experiencing lower stomach acid.

Problems with Stomach Acid Suppressing Meds

It’s the norm for people who experience reflux or heartburn to reach for over the counter acid suppressing medicines, like proton pump inhibitors (omeprazole) or H2 blockers (e.g. Pepcid). Doctors also prescribe these medications when their patients report the symptoms. Obviously we want pain relief!

However, many of my clients have taken these drugs for long stretches or indefinitely. As a result, they suffer from multiple nutrient insufficiencies, which contribute to a cascade of health conditions. Short term use - say, 1-2 weeks - does not increase these risks.
Always talk to your doctor before discontinuing any prescribed medication. That said, a clinical nutritionist can coordinate with your doctor, assess your digestion and health conditions, and devise a personalized healing plan.

So, what to do?

Luckily, under normal circumstances there are a number of approaches to help alleviate reflux and heartburn. Since it’s pretty likely that those symptoms are due to low stomach acid, these interventions are designed to increase HCl rather than suppress it.

• Drink 4-6 ounces of water with lemon juice or raw apple cider vinegar before each meal..
  • Start small with the lemon or raw ACV - ½ tsp - and work up to a larger amount that you can tolerate.
  • Make sure you mix it with something, e.g. water, unsweet tea, or even extra virgin olive oil as a dressing for a salad or cooked greens. Straight lemon or vinegar can be hard on tooth enamel.
  • These stimulate the stomach’s own natural production of HCl.
• Add bitter greens and herbs into your meals.
  • Our entire digestive tract is lined with taste receptors for bitter, not just our tongues.
  • When bitter hits these receptors, they don’t communicate flavor to the brain. Instead they communicate the need for stomach acid to digest the food.
  • This is a big reason why herbs are known for settling the stomach.
• For occasional reflux, bloating, or discomfort after a meal, put a few drops of cocktail bitters (like Angostura or Peychaud's) into a couple of ounces of water and drink it down.
• Finish your last bite of food at least 2-3 hours before you lie down to sleep.
• Elevate your head on a wedge pillow or put the head of your bed on blocks.
• If you find that you don’t get enough benefit from the ideas above, a professional bitters supplement and/or digestive enzymes might be necessary. Please be assessed by a clinical nutritionist to choose the best course of action.

As I mentioned in my last newsletter, chewing is the first step of digestion. Make sure to chew very thoroughly to make it easier for your stomach to process the food you send down to it! Chew until mush before swallowing, and you will feel better after eating.

You might also be surprised at how your bowel habits improve when your stomach acid is on point.

Et Voilá!

There you have it! Stomach acid is the unsung hero of digestion. Now you know.

I’d really love to hear your thoughts on this (and any other!) topic! Feel free to respond to this email. While you’re at it, send me your questions on other topics of integrative nutrition. I genuinely want to hear from you!

---

CIN Now Offers Health & Wellness Coaching!
Click Here to Schedule Your First Session!