GERD - Hiatal Hernia- Gastric Reflux

Did you know the third leading medication prescribed in the United States is a proton pump inhibitor (PPI) to decrease stomach acid? In fact, there are over 110 million prescriptions written every year. Proton pumps inhibitors only relieve symptoms. They don’t fix the problem. With reflux irritation they only hide the symptoms and in fact can cause a lot of problems. There is an increase in risk of pneumonia and C-diff bacterial infections in patients on PPI’s.   Why are so many people on proton pump inhibitors? What is causing an epidemic in gastric reflux?

Stomach acid is needed for absorption of iron, Vitamin B12 and calcium. Patients on these medication also have a diminished ability to absorb these minerals and vitamins. They are more likely to develop conditions related to deficiencies of these substances.  Are we really helping patients by doing this?

Gastrointestinal esophageal reflex disease or GERD is ultimately caused by poor dietary choices especially ingestion of high carbohydrate diet and gluten. When you eat large amounts of these foods it signals the hormone gastrin which is released by the stomach and helps in the release of cholecystokinin which tells the gall bladder to release bile salts and bile for the digestion of fats. Gastrin also stimulates the pancreas to secrete digestive enzymes and stimulates the stomach to secrete stomach acid. The stomach acid needs to get down to a ph of 3 to be effective at digesting proteins. When the stomach ph is below 3 it will turn gastrin off.

Normal ph is 7. When the ph drops to 6, that is 10X’s more acidic than a ph of 7. When it drops to 5, that is 100X’s more acidic than a ph of 7. When it drops to 3 that is 10,000X’s more acidic than a ph of 7. The stomach can operate between a ph of 1 and 3. So maybe we aren’t producing enough stomach acid.

The esophageal sphincter is a band of muscle tissue between the esophagus and stomach that is suppose to close to prevent acid from regurgitating up the esophagus. It will start to close at a ph of 4.5.

So lets say you are not making enough stomach acid and your ph is 5. In this case your stomach is 100X’s more acidic then ph of 7. The esophageal sphincter will still be open and acid can reflux up into the esophagus. This can cause symptoms of heartburn.  This patient is then put on a proton pump inhibitor to stop stomach acid production. The medication is very effective. A proton pump inhibitor medication will stop 97% of stomach acid production. This can cause other problems. Food will sit longer in the stomach since it’s not being digested. Stomach acid is suppose to keep bacteria from migrating up from the large intestine into the small intestine. With decreased stomach acid a condition called small intestinal bacteria overgrowth or SIBO can occur. Another problem with decreased stomach acid is the increase in a bacteria called Heliobacter pylorii which is linked to ulcers. In fact, proton pump inhibitors were originally developed to treat ulcers. It takes about two weeks to heal an ulcers with a PPI. They were not designed to be used for years and years.

Other problems that develop from low stomach acid are food is not fully digested and this leads to chronic constipation. Gall bladder problems, gastritis and irritable bowel syndrome can also be related to low stomach acid. 

At Midwest Functional Medicine we run extensive lab work to develop an individual approach that is specific to your needs. You are assigned your own personal health coach to walk you through the process and hold your hand the whole way. Two locations in Bloomington, Illinois and Swansea, Illinois to serve you better. But you don’t have to travel. Online consultations are available.