This column first appeared in print in the July 2019 issue of Revelstoke Mountaineer Magazine.
There are many logical fallacies in the health and wellness world, many the result of seeing the body as a machine made of independent parts, rather than complex, interdependent, and communicative. We see cooking fat clog a kitchen sink and assume that our arteries must become clogged by saturated fat. When we get heartburn, we assume we must have too much stomach acid – after all, it’s burning, and acid is corrosive, right? Acid-suppressing drugs are a multi-billion-dollar-a-year industry vested in convincing you the cause of your digestive woes comes from your hyper-acidic stomach and can be addressed with that pepto pink solution. Clever marketing combined with trending alkaline diets may lead you to the assumption that acid is the opposite of healthy and we can live well without it. Au contraire, your stomach acid is the prized conductor of a most important bodily symphony: digestion.
Antacids may quell the symptom short term – but this doesn’t mean excess stomach acid is the issue. Most of the time, heartburn is caused by too little acid struggling to churn, which can shoot back up through the esophagus causing irritation and inflammation. Low stomach acid also sets off a chain of events which leads to lower esophageal sphincter malfunction (which allows churning acid to shoot up). Low stomach acid leads to bacterial overgrowth in the stomach and intestines, which sets the stage for maldigested carbohydrates. The resulting gas increases intrabdominal pressure, causing the lower esophageal sphincter to malfunction.
Breakin’ it down to build you up
Stomach acid (HCL) plays a key role in the digestion of protein, carbohydrates, fat, vitamins, and minerals. When food is eaten, the production of stomach acid triggers pepsin, an enzyme that breaks down protein. Without this, proteins don’t get broken down into individual amino acids and peptides. Since amino acids are the precursors to neurotransmitters, this can lead to anxiety, depression, and insomnia. Intact proteins are more likely to become inflammatory once they reach the small intestine, where they can leak through the gut and trigger allergic and autoimmune reactions. Vitamin B12 requires stomach acid and subsequent intrinsic factor to be absorbed. Low stomach acid can interfere with folate absorption by lowering pH in the small intestine. Stomach acid is also necessary to absorb minerals, in particular iron, calcium, and zinc.
Downstream, HCL triggers the secretion of hormones that stimulate the pancreas and gallbladder to release their own secretions, including enzymes, bicarbonate, and bile. Without our acid conductor, these hormones are underproduced and these stages of digestion underperform, negatively affecting absorption of carbohydrates, fats, and bowel motility.
Stomach acid is our first line of defense against harmful bacteria and parasites in food, liquid, and air we consume. On the other end of the stomach, HCL prevents normal bacteria present in the intestines from travelling into the stomach and esophagus, where they can cause problems. Lowering stomach acid increases vulnerability to h.pylori, a bacteria which resides in the stomach lining and decreases acidity levels in order to survive. When this bacteria proliferates, its presence can lead to chronic heartburn, GERD, and ulcers.
Light my fire
As we’ve seen, you aren’t just what you eat, you’re what you absorb and digest. Digestion begins in the mouth, where chewing breaks down food. Life is busy and this stage often gets rushed. Chewing food well is important. It’s why our teeth are in our mouth and not our stomach. Well-chewed food reduces stress downstream, begins breakdown of starches, and can even help us relax and be mindful while eating. Taking some slow, deep breaths and sharing gratitude for your meal can help you feel safe enough to secrete digestive juices (rest and digest mode). Drink room temperature water in between rather than with meals to avoid diluting stomach acid when eating. Aim to avoid overeating as this increases intra-abdominal pressure. Easy on the alcohol, sugar, spicy foods, caffeine, and suspected allergens; these foods can weaken the lower esophageal sphincter and irritate the stomach lining. Leafy greens, grated raw beets, bitter herbs, lemon, and apple cider vinegar all stimulate digestive secretions. Most importantly, getting our nervous systems into rest and digest (aka eat and secrete) mode requires stress management/vagal tone. Tone your vagus nerve by taking 5-7 deep belly breaths per minute, singing, laughing, and doing yoga.
Diagnosing and treating heartburn is layered. It involves assessing acidity levels, hormones, h.pylori, condition of stomach lining, digestive efficacy, and microbiome. Appropriate action can include supplementation, stress management, and dietary changes. If you are experiencing symptoms of chronic indigestion, instead of suppressing symptoms, work with a qualified healthcare professional who can help you safely restore healthy digestive function.