Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (85 page)

Digestive enzymes.
Use these to enhance complete digestion of foods so that they don’t become allergens. Take one capsule each time you eat.

DGL licorice.
This will soothe inflammation and stimulate repair. Take one to three tablets, chewables, or capsules before meals. You could also consider using the demulcent herbs marshmallow, meadowsweet, and slippery elm.

Folic acid.
This will protect mucous membranes from inflammation elsewhere in the gastrointestinal tract. Take 800 mcg daily.

Hypochlorhydria (low stomach acid) has been associated with many common health problems. (See
Chapters 3
and
11
.) Stomach acid is used to begin the process of protein digestion. Stomach acid also provides our first defense against food poisoning, H. pylori, parasites, small intestinal bacterial overgrowth, and other infections. In addition, without adequate acid we leave ourselves open to indigestion, decreased immune resistance, mineral deficiencies, and vitamin deficiencies. A normal stomach acid level is a pH of 1.5 to 2.5. As we age, the parietal cells in the stomach lining produce less hydrochloric acid. Use of acid-blocking medications increases stomach pH to 3.5 or higher.

Common symptoms of low stomach acidity include belching or burning sensations immediately after meals, bloating, a feeling that the food just sits in the stomach without digesting, and an inability to eat more than small amounts at any one sitting. Poor HCl levels have been associated with childhood asthma, chronic hepatitis, chronic hives, diabetes, eczema, gallbladder disease, lupus erythematosus, osteoporosis, rheumatoid arthritis, rosacea, under- and overactive thyroid conditions, vitiligo, and weak adrenals.

Stomach acid is also necessary for absorption of many minerals, so mineral depletion may occur with use of these medicines. Minerals that can become depleted include iron, calcium, magnesium, zinc, and copper. Adequate HCl is necessary for the absorption of vitamin B
₁₂
from food. B
₁₂
deficiency causes weakness, fatigue, and nervous system problems. Most B-complex vitamins require normal levels of stomach acid for proper absorption. Vitamin C levels are also low in people
with poor stomach acid. Acid is critical for the breakdown of protein bonds in the stomach.

Hypochlorhydria may be caused by the following: pernicious anemia, chronic H. pylori infection, long-term treatment with proton-pump inhibitors (PPIs, such as Prilosec), autoimmune gastritis, and mucolipidosis type 1V; it is also common in autoimmune diseases.

Heidelberg capsule test

Self-test for HCl adequacy

For healing options, see
Chapter 3
.

Dyspepsia
is a general term that means “bad digestion” in Latin. About 40 percent of us complain of bad digestion. It’s typically self-limiting and goes away on its own. If you have two or more of the following factors, it’s time to see your doctor: being over age 50, loss of appetite, feeling full even though you haven’t eaten much, trouble swallowing, blood in your stools or in phlegm, or abdominal masses.

Gastritis
is a general name that describes any inflammation in the stomach that doesn’t involve an ulcer. This could be a chronic issue or something that’s acutely painful. The most common symptoms are gnawing or burning ache or pain in your stomach that gets better or worse with food, loss of appetite, bloating, belching, hiccups, indigestion, nausea, vomiting, vomiting of blood, dark stools, feeling full even if you haven’t eaten much, and weight loss. It’s typically found when a gastroenterologist does an endoscopy. It can be caused by alcohol, infection such as with H. pylori, taking NSAIDs (such as aspirin), smoking, chronic stress, bile reflux, drinking poisons or caustic substances, and autoimmune disorders.

Other causes include corticosteroids, cancer drugs, and antibiotics; excessive coffee consumption; organ failure; and severe stress or trauma. It is common in the elderly, affecting 20 percent of people between the ages of 60 and 69 and 40 percent of people over age 80. The lack of hydrochloric acid secretion in the elderly allows for bacterial growth, such as H. pylori; however, when treated with antibiotics, symptoms improve.

Long-term effects of gastritis include poor vitamin B
₁₂
status in all people. Signs of B
₁₂
deficiency often mimic those of senility. Many people have B
₁₂
deficiencies
with normal serum levels. Tests for B
₁₂
status include methylmalonic acid and trials with B
₁₂
injections or sublingual B
₁₂
.

Gastritis is usually treated with H2 blockers or proton-pump inhibitors (PPIs). However, there are natural solutions that don’t have the long-term effects that H2 blockers and PPIs have. Looking at triggers such as stress, medications, and poor HCl production is also an important step toward prevention.

Gastric ulcers occur in the stomach and the duodenum (the first section of the small intestine) where gastric juice has burned a hole in the lining. It hurts! Gastric juice is so acidic it would burn your hand if you spilled some on it. A mucous layer protects the stomach tissue from being eaten away by pepsin (a protein-splitting enzyme) and the gastric juices. Secretions of bicarbonate (baking soda) from the stomach lining are mixed into the mucus, buffering the acid. This makes an effective barrier to keep the stomach lining from harm. Pepsin, the real villain in this story, slowly digests this mucus layer, and if the mucus isn’t replaced, gastric juices come into contact with the stomach lining and ulcers occur.

About half a million Americans have ulcers. About 10 percent of us will develop ulcer disease at some point in our lives. Each year 6,000 American people die from ulcers, half from peptic ulcers and half from duodenal ulcers. Since the discovery and screening of H. pylori infections in 1982 the incidence of ulcers has been decreasing. Eighty percent of ulcers are caused by H. pylori infections, 10 percent are caused by the use of NSAID medications, and another 10 percent are of unknown origin.

Symptoms include abdominal pain that is frequently described as burning. This pain can radiate to your back and typically occurs one to five hours after you’ve eaten. You may feel better if you eat, take antacids, or vomit. All of this typically is in a daily pattern that is specific to you. As if this isn’t enough to alert you to see a doctor, if you have bleeding, are anemic, have unexplained weight loss, feel full even though you only ate a little bit, have increasing trouble swallowing or painful swallowing, suffer recurrent vomiting, or have a family history of GI cancer, see a doctor now. If you have sharp and sudden severe stomach pain that persists, bloody or black stools, bloody vomit, or vomit that looks like it has coffee grounds, seek immediate medical help.

On the other hand, if you are slowly burning a hole in your stomach from overuse of NSAIDs like aspirin, Motrin, Aleve, and prescription pain relievers, you may
not notice a thing until you begin to see bleeding or have anemia. Continued use of these therapies has been widely shown to cause ulcers and hospitalizations. It’s estimated that up to 30 percent of regular NSAID users have ulcers. NSAIDs block pain but also block healing and repair to the stomach lining by decreasing beneficial prostaglandins and cyclooxygenase. It has been estimated that 107,000 people are hospitalized each year because of NSAID complications, and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone.

Ten percent of people with ulcers and gastritis do not have H. pylori infection, nor have they used NSAID medications. For these people, the cause of ulcers and gastritis is still a mystery. Looking at stress, diet, and lifestyle may yield important clues. Stress plays a significant role in ulcers and gastritis. While low-grade stress probably won’t cause an ulcer, severe stress has been shown to cause ulcers in both animal and human studies. Psychological stress increases stomach acid and causes the mucus to become more fragile, making it easier for ulcers to form.

There are simple blood, stool, and breath tests that detect H. pylori. In a breath test, you swallow a capsule, drink a liquid, or eat a pudding that contains urea that’s been tagged with carbon. You then breathe into a container, and if the carbon atom is present, it signals high amounts of urease and you are diagnosed with H. pylori infection. Blood tests are done to discover if you have elevated H. pylori antibodies. Stool testing looks at antigens to H. pylori. If you’ve been having severe symptoms or bleeding, your doctor may order an endoscopy.

H. pylori infection is common even in those of us without ulcers. There is debate about whether treating people who are without symptoms will be of benefit or not. Is this a bacteria that can become detrimental in the wrong environment but is harmless in others? H. pylori has also been associated with increased risk of duodenal and gastric cancers, chronic gastritis, cirrhosis, and chronic indigestion. On the other hand, it appears to protect much of the world’s population by preventing inflamatory bowel disease. Obviously, much still needs to be learned here.