Authors: Elizabeth Lipski
H. pylori infection:
Sometimes H. pylori infection can cause belching, with or without other digestive symptoms. Ask your doctor to test for H. pylori.
The Heidelberg capsule:
This test measures your ability to produce hydrochloric acid when challenged with alkaline substances. See
Chapter 11
for complete details.
Make lifestyle changes.
Eat slowly and chew your food well. Avoid carbonated beverages. If you smoke, stop. Be glad you have such a benign reason to stop. Reach and maintain ideal body weight. Stop chewing gum or sucking on candy. As an alternative, you can suck on or eat umeboshi plum, or you can make it into a tea. These salty, fermented plums are highly alkalizing and aid in digestion.
Do a self-test or do a Heidelberg capsule test to see if you have enough hydro-chloric acid.
I often find that taking betaine HCl capsules eliminates belching in my clients. (See
Chapters 3
and
11
for more information.)
Try charcoal tablets.
These can absorb toxins, make breath smell better, and calm an overexcited digestive system.
Check your supplements.
Some supplements, such as fish oils, can cause belching. Try any of the remedies for heartburn, gastric reflux, and hiatal hernia.
Hiatal hernia occurs when a portion of the stomach gets pushed through the diaphragm and into the thoracic cavity where it doesn’t belong. Hiatal hernias may or may not cause symptoms, but the most common symptom is heartburn; they can also be a cause of GERD. Hiatal hernias are found in about 20 percent of all middle-aged Americans. Dr. Dennis Burkitt, called the father of fiber, hypothesized that hiatal hernia was a contemporary problem and the result of a modernized diet. Straining with bowel movements is one cause. Chiropractic adjustment can gently put the stomach back in place, and in many cases only a single adjustment is necessary.
Gastroesophageal reflux disease (GERD), also known as heartburn, is caused by stomach acid backing up into your esophagus. It’s not that you necessarily have too much acid but rather acid that is in the wrong place. The esophageal sphincter is supposed to keep the stomach contents in place, but if the sphincter relaxes, acid can
push up into the esophagus. The most common symptoms are heartburn, regurgitation, and trouble swallowing. Less common symptoms include coughing, chest pain, wheezing, excessive salivation, belching, and a sour taste in the mouth.
GERD is alarmingly common: 44 percent of us have heartburn monthly, 10 to 20 percent weekly, and 10 percent daily. Another 3 to 7 percent suffer from Barrett’s esophagus, an esophageal illness caused by acid reflux that results in scarring, constriction of the esophagus, swallowing disorders, and an increased risk for esophageal cancer.
For most people, heartburn is a mild, self-limiting problem, yet for 20 percent of those affected it becomes a serious health problem. Stress plays a huge role. Figuring out how you can simplify your life and relax more can go a long way to solving the problem. Sensitivities to gluten and other foods can also trigger symptoms. I have several clients whose GERD has vanished after they stopped eating gluten-containing grains, eggs, or other foods.
Lifestyle plays a role in GERD. Other triggers include wearing tight-fitting clothes, lying down, bending over, and eating large meals or specific foods. If you experience heartburn in the middle of the night, be sure to eat your last meal at least four hours before going to bed. Heartburn is common among pregnant women whose organs are squashed in a most peculiar way. Some drugs can also cause heart-burn or reduce the tone of the lower esophageal sphincter. The most common are NSAIDs, aspirin, steroids, birth control pills, diazepam, nicotine, nitroglycerine, progesterone, provera, and theophylline.
There are several categories of medications that are used to decrease hydrochloric acid production. Heartburn sufferers commonly take antacids, such as Tums, Rolaids, Maalox, and Mylanta, for temporary relief. H2 acid blockers such as Tagamet, Pepcid, Axid, and Zantac have been used for a long time and partially block acid production. Proton-pump inhibitors (PPIs), such as Prilosec, Prevacid, and Nexium, are also used to block production of stomach acids completely. PPIs are huge money makers and as a group generate the third-highest sales of all drugs sold worldwide.
Once you begin taking acid blockers your doctor will probably want you to stay on them indefinitely. These medications were originally approved for 12 weeks. Joel E. Richter, FACP, chair of the department of gastroenterology and hepatology at the Cleveland Clinic, recommends using them for four to six months. This allows the inflammation to heal. About half of people taking them would like to stop. The good news is that 60 percent of people who stopped stayed symptom free a year later. Research indicates that there is a rebound in many people who stop taking PPIs. They stop and they have rebound symptoms of GERD, which encourages them to
stay on the medication. Weaning off of the medications slowly can help prevent this. Rather than weaning off of the PPIs and moving to H2 blockers or antacids, try the suggestions included in this chapter.
There are other repercussions of taking antacids. A recent study looked at 155 healthy people who had been using antacids for heartburn over long periods of time. The study found that 47 percent had erosion of the esophagus and 6 percent had Barrett’s esophagus, a more serious condition. People with Barrett’s esophagus who take PPIs to prevent further development of cancer have high levels of leaky stomach (gastric hyperpermeability). People on PPIs have been shown to have decreased levels of calcium, magnesium, and zinc; iron deficiency; vitamin B
12
deficiency; and increased risk of developing osteoporosis, depression, irritable bowel syndrome, pneumonia, and Clostridium difficile infectious diarrhea. Blocking stomach acid increases your risk of developing small intestinal bacterial overgrowth. The parietal cells respond to these medications by making more acid. Eventually the parietal cells get exhausted, so over the long term, antacids cause the parietal cells to make less HCl and intrinsic factor, which is necessary for absorption of vitamin B
12
. People who stay on PPIs long term have an increased risk of developing gastric polyps and atrophic gastritis, which both increase risk of developing stomach cancer.
People on these medications often have poor digestion. There is also evidence that pancreatic enzymes aren’t activated without proper stomach acid. HCl is needed for proper digestion of protein. Symptoms can present as bloating, pain, and diarrhea.
People on PPIs also have higher levels of IgE antibodies after three months of usage. Women over the age of 50 who take PPIs for more than a month increase the risk of hip fracture due to poor mineral absorption. The longer women take PPIs, the higher the risk of hip fracture. Use of the older H2 blockers does not increase risk.
H. pylori test
Heidelberg capsule test