GERD/Acid Reflux/Heartburn – Low Stomach Acid or Too Much Stomach Acid?
Acid reflux is one of the most underrated health symptoms today. Although I have covered this topic somehow in some of my posts before, now I would like to specify the problem closer so you could understand what is really going on.
In my previous posts I have stated that GERD or acid reflux is caused mostly by low stomach acid. It is actually true that low stomach acid is involved in heartburn of most people, but for better understanding of why the GERD appears in the first place we have to learn what are the possible causes that lead to stomach acid leaking to the esophagus.
What is GERD?
Gastroesophageal reflux disease is actually the health symptom that is caused by stomach acid in the esophagus. The stomach acid may leak into the esophagus:
- because of weakly closed esophageal sphincter
- because of gas producing bacteria in the intestines/stomach. That gas makes a pressure on the esophageal sphincter so it opens up and gas with stomach acids leaks into the esophagus.
So what is the possible scenario how actually GERD develops?
- short term stress may cause too much stomach acid or esophageal sphincter dysfunction.
- long term stress shuts off the digestion – stomach acid production, pancreatic enzymes, bile acids what leads to deficiencies of magnesium, (fat soluble) vitamins and amino acids. Add to it the iodine deficiency due to low intake of sea food and you get the ideal conditions for long-term health issues due to inability to produce enough stomach acid even if you are no more in stress.
- due to low stomach acid and/or nutritional deficiencies (magnesium, choline) or stress the esophageal sphincter is not properly closed; due to SIBO a lot of gasses causes the esophageal sphincter to open so stomach acid can leak. Even if you have just a little stomach acid you still get heartburn because esophagus is not designed to host even small amounts of gastric juices.
If you use some acid blocking medications in that stage you can resolve the symptoms but the real problem will be still there and without any stomach acid you can not digest proteins so you will probably develop serious nutritional deficiencies (magnesium, calcium, amino acids). I think that in the beginning it is the low stomach acid for most people that starts the cascade of the other health problems.
Here is a list of conditions that add to or directly enable the heartburn to appear:
- too low stomach acid didn’t activate esophageal sphincter to close (or the problem is due to nutritional deficiencies – magnesium, choline, calcium)
- esophageal sphincter is not closing tightly (possible mechanical problem)
- stomach is not emptying right (perhaps not properly working pyloric sphincter)
- obesity (the fat causes the pressure on the stomach)
- Helicobacter pylori (causes low stomach acid production)
- overeating – stomach holds a lot of food – esophageal sphincter is not properly closed
- eating junk food (wine, alcohol, large portions…)
- low pancreatic enzymes
- bad bacteria in the intestines
- bad intestinal peristalsis
All causes from the list above may be actually present simultaneously in one person, however usually it is the SIBO, H. pylori infection, constipation, overeating (junk food), nutritional deficiencies and stress what causes the heartburn in many people.
In psoriatics there is about 5% of people who actually have too much stomach acid. Others may have normal levels, but most of the psoriatics have definitely low or almost no stomach acid.
But having the symptoms is still good although many people (including the psoriatics) don’t have acid reflux nor any other apparent intestinal issues. In those people the stomach acid production may be so low that even though they have SIBO and fermenting food in their intestines from low stomach acid they don’t feel