Chronic Acid Reflux and the Decline and Fall of the Modern Stomach: Part 1
Copyright 2011-2017 by Joseph Ben Hil-Meyer Research, Inc.
By Bruce Berkowsky, N.M.D., M.H., NCTMB
Stomach Dysfunction: A Modern Epidemic
We depend upon the digestive system to supply the trillions of cells of the body with the nutrients they require to function properly. Lacking these nutrients, every tissue of the body performs less efficiently. It should be understood that tissues are actually organized groups of cells working in unison. Organs such as the heart and kidneys are composed of tissues.
These days, seemingly most people are suffering from one disorder or another, and even if they do not complain of digestive problems, a breakdown in the digestive process is always a factor in the development of chronic disorders.
In Digestion and Dyspepsia, R.T. Trall, M.D. writes: "We are a nation of dyspeptics and we are growing worse continually. Everyone is more or less dyspeptic now-a-days and because everyone is ailing in this particular manner, it seems to be nobody's business except those who make opportunity of misfortune [i.e., the drug companies]. However, [overcoming chronic dyspepsia] should be everyone's first order of business."
Although it sounds as if Trall, an early American naturopath, is describing the United States of the 21st century, he actually made this observation in 1874. At that time, most people's dietary staples came from family farms where everything was grown or raised without the use of chemical fertilizers, pesticides, herbicides, growth hormones, antibiotics and genetic engineering. Given this, it is difficult to calculate how much worse this digestive crisis is now when a diet largely populated with adulterated and processed foods has become the norm.
Dyspepsia is a somewhat archaic medical term that refers to painful, difficult, or disturbed digestion, commonly accompanied by heartburn, flatulence and other types of stomach discomfort.
One of the most common forms of dyspepsia has, in recent years, been given the name GERD or gastroesophageal reflux disease. As is the wont of modern medicine, certain symptoms of common disorders are often regarded as stand-alone, unique ailments. In fact, GERD is a symptom of a complex network of systemic dysfunctions featuring a very prominent gastrointestinal tract component.
The Digestive System
The body is not comprised of a vast collection of independently operative parts. Rather, all of its functions are completely interactive and finely coordinated. Therefore, it is misleading to view GERD as being exclusively a stomach disorder. In fact, most of the symptoms associated with any disease are local expressions of generalized states.
It is virtually impossible for a digestive system disorder to be localized to one particular organ as the digestive system consists of the mouth, esophagus, stomach, small intestine, large intestine, pancreas, liver and gall bladder, the actions of which are all orchestrated to function in concert.
Dr. Trall, one of the founding fathers of traditional naturopathy, writes: "As digestion is the most complex of all the organic processes, its derangements, which constitute indigestion, or dyspepsia, are the most complicated of all morbid conditions...It is a great mistake to regard dyspepsia as peculiarly, or especially, a disease of the stomach...We can see how essentially cooperative are a multitude of organs and structures in the digestive process. In some cases one structure or organ will be more obstructed, impaired, or deranged than others, and in other cases two or more will be the seat of the more troublesome symptoms."
Trall goes on to describe the vast variety of symptoms found among those who are dyspeptic, depending upon which of the digestive organs are most deeply affected. Accordingly, stomach symptoms such as chronic acid reflux are an expression of only a fraction of the actual underlying dysfunction. Diverse symptoms such as constipation, headache, fatigue, heart palpitations and chest oppression commonly accompany pronounced symptoms of stomach distress such as GERD.
Clearly, symptoms of dyspepsia such as acid reflux are merely one aspect of a systemic pattern of dysfunction that extends far beyond the digestive system. The general loss of vitality and operational efficiency of the organism as a whole causes the digestive system to falter. Trall observes: "The debility of the stomach, or other digestive organs in any case of dyspepsia, is no greater and no worse that that of all other parts of the body. Dyspepsia is, therefore, but a name for universal physical deterioration, although the symptoms of the general condition may embrace all the aches, pains and distresses our language can express."
In turn, digestive weakness invariably initiates deterioration in every organ of the body. Digestion is the process by which foods are broken down into small molecules so that they can be efficiently assimilated into the blood and then used to nourish every cell in the body. Trall writes: "Nutrition, being the first process of organic life, all other parts of the system are disproportionately debilitated when the digestive function is impaired."
The Cause Of Chronic Acid Reflux
When seeking to understand the cause of GERD, it is important to reiterate that it is a local expression of a general state. Only after this local symptom has been contextualized, via the delineation of the general state, can the localized condition involving the esophagus, stomach, diaphragm, intestines, etc. be clearly understood and effectively addressed.
In Digestion and Dyspepsia, Trall cites the following quote excerpted from Wood's Practice Of Medicine by George B. Wood, M.D. (which at the time was a popular manual among medical doctors regarding the theory and practice of medicine): "The most specific source of dyspepsia is the combined influence of sedentary habits and errors of diet."
Here again, a description of a common disorder that plagued Americans in the 1870s can serve well to explain a variety of the same disorder that has reached epidemic proportions among 21st century Americans.
Unquestionably, the typical American diet of this age has devolved dramatically since Trall's day. Given the dreadful dietary habits of today, it is surprising that most people are able to function at all. As far as sedentary habits go, since the invention of the television's remote control couch potatoes no longer have to stand up and move except to raid the refrigerator for another stomach-punishing snack.
Sedentary behavior greatly impacts digestive vitality because it leads to weakness of the muscle fibers, including those of the abdomen and diaphragm, which assist in peristaltic movement along the digestive tract. The action of the diaphragm also exerts what can be described as a tonic massage upon the stomach and liver, both of which are situated just below it. Additionally, the lymphatic system, which drains toxins away from every cell of the body including those of the digestive system, is propelled in large part though the lymphatic vessels by the contraction and expansion of the skeletal muscles.
As noted below, one of the fundamental elements of good health is proper posture, something that can be maintained only with regular exercise. When posture sags so do some of the vital organs that are suspended by connective tissues, which in turn are attached to the spinal vertebrae and ribs. This helps explain how sedentary behavior encourages hiatal hernia or prolapse of the stomach and/or intestines.
The Fundamental Elements of Life and Health
There are other major contributors to the general state that sets the stage for GERD, including mental and emotional stress and insufficient hydration. However, the most basic factor in this reference, as is the case with most chronic disorders, is a deficiency of the fundamental elements of life and health.
Human life is dependent upon the presence of certain fundamental conditions: proper diet; pure water; fresh air; sunlight; adequate exercise, warmth, rest and sleep; emotional harmony; proper posture.
As a human being, you have an inherent relationship with these fundamental elements -- disease is an outgrowth of a deficiency or excess of one or more of them. Restoration of health in the ill person is accomplished through the same means of sustaining life and preserving health in the well person.
If these fundamental elements are not restored, surgery and drugs (even natural medicines such as herbs and homeopathy) can only act upon the superficial symptoms of the underlying disharmony which, if left unresolved, may eventually manifest in some other, and perhaps more threatening, form.
Autotoxemia and Enervation
Deficiency or imbalance of Nature's elements gives rise to the two primary roots of disease: autotoxemia: a level of bodily toxicity sufficient to impair vital functions and propel the body toward disease; enervation: when vital energy is expended in excess of the body’s normal production and falls below requirements for efficient operation.
Autotoxemia stems from poor diet, impure air and water, synthetic cosmetics, prescription drugs, cigarettes and other sources that can result in symptoms such as constipation, weak kidneys, unhealthy skin and shallow breathing. Enervation is primarily due to lack of rest and sleep, continual emotional stress and the habitual use of stimulants such as caffeine and alcohol.
These two root factors work in conjunction, creating a vicious cycle. Autotoxemia causes congestion and overload, making the body work harder, and so, increases enervation by using up the powers of life to excess. Enervation, on the other hand, increases autotoxemia by slowing down all vital functions, thus leading to a back-up in normal fluid circulation, and, in turn, waste-removal.
Clearly, good health and the cure of disease depend upon effective body cleansing and rebuilding of vital reserves that invariably requires a complete relationship with the fundamental elements of life.
The Folly Of Viewing GERD as a Stand-Alone Stomach Disorder
In addition to being a local expression of a general state, GERD, as previously discussed, involves the entire gastrointestinal tract, not just the stomach. GERD sufferers commonly experience constipation, generalized flatulence, irritable bowel syndrome and/or have a history of some other bowel disturbance such as inflammatory bowel disease.
Furthermore, those who present with GERD to one degree or another have liver sluggishness and pancreatic insufficiency. After the stomach completes its role in the digestive process, the semi-digested food mass (known as chyme) empties from the stomach into the small intestine. Once there, the digestive secretions of the other digestive organs (including the small intestine, pancreas, liver and gall bladder) mix with the chyme and complete the breakdown of food into absorbable form.
While the digestive process begins in the mouth and continues in the stomach and then in the small intestine, it is actually not a linear process. Complex feedback mechanisms exist between all the digestive organs that help facilitate their orchestrated function. Therefore, if there is congestion of the liver and gall bladder, weakness of the pancreas or sluggishness of the bowels, they will all impact the performance and vitality of the stomach.
Thus, as the stomach does not operate within a vacuum, it is utterly implausible to expect long-term resolution of GERD exclusively with drug suppression of stomach symptoms. Unfortunately, allopathic medicine's penchant for reductionism and symptom suppression rather than a holistic perspective and the removal of cause has launched it on this ill-considered fool's errand.
GERD: Associated with Low Stomach Acid, Not High Stomach Acid
Contrary to the popular misconception that GERD is the result of an excessive production of stomach acid, in most cases it is actually related to low stomach acid production. Many cases of GERD respond very well to supplementation with betaine hydrochloride (hydrochloric acid) with pepsin (the protein-digesting enzyme produced in the stomach) and/or raw, unfiltered apple cider vinegar. I will discuss acid supplementation in detail in Part 2 of this discussion to be presented in the next issue of Nature's Therapies Journal.
Hypochlorhydria is the term for low stomach production of hydrochloric acid. Gastric (i.e., stomach) acidity is required not only for the digestion of proteins but also for the absorption of B12, calcium, magnesium, iron and other essential minerals.
The typical American junk food/processed food diet is abnormally high in protein and low in high-water content, alkalizing fruits and vegetables. High protein-content flesh foods are powerful stressors to the acid-producing cells of the stomach, because pepsin (the protein-splitting enzyme secreted by the stomach) is most active in a strongly acidic environment. Each time a high-protein flesh food meal is consumed, said cells are challenged to elevate their efforts beyond the range of normal function.
Digestion is one of the most energy-consuming processes of the body and needs a continual supply of a wide range of nutrient complexes to manufacture the requisite hormones, enzymes and digestive juices. The nervous- and hormonal systems respond to a high-protein, high-fat meal by escalating metabolism and local gland and muscle function.
In the long term, this type of overactivity leads to depletion of the body's glucose (used for energy), protein (raw material for enzymes and many hormones) and other vital nutrient reserves. In turn, this results in what the Chinese refer to as Deficient Yin (blood, lymph, mucus, hormones, enzymes, prostaglandins and nutritive substances are all manifestations of bodily Yin ). Here we can see that enervation is not only one of the root factors in the development of GERD, but egregious dietary habits is one of the primary factors in the establishment of systemic enervation.
Since the body's Yang (movement and action processes, including circulation, secretion, peristalsis, respiration, metabolism and immunological function) is sustained by the Yin, it must become exhausted as well and is known as Deficient Yang or Deficient Chi.
The concept of hyperfunction leading to hypofunction is one of the most crucial insights for understanding the true nature of health and disease.
It should also be noted that flesh-foods leave an acid-ash residue that tends to acidify normally alkaline tissue fluids. Ironically, when the extracellular fluids (the fluids between the body cells), which bathe the HCL-producing parietal cells of the stomach, are acidified in this way, they lose their ability to manufacture stomach acid.
Forty percent of those people over 40 years old and 50% of those over 60 (according to studies performed by the Mayo Clinic and Johns Hopkins University) produce too little stomach acid. Complete loss of ability to make stomach acid: achlorhydria occurs in 30% of people over 65 years-of-age primarily as a result of atrophic gastritis: chronic stomach inflammation with atrophy of its mucous lining and secreting glands.
This is the legacy of many years of generalized overeating, improper food combining and heavy indulgence in flesh foods, which helps to explain the common incidence of B12 deficiency among elderly non-vegetarians. Studies have shown that the majority of people 80 years or older have abnormalities related to low B12-levels. A significant portion of the memory loss and neuro-psychiatric disorders common among the elderly may be so related.
Low gastric acidity encourages longer residency of protein foods in the stomach–hence, a protracted acid secretion. Though the concentration of stomach acid may be reduced, the extended period of time that the stomach is exposed to an acid challenge (even a relatively dilute one) not only encourages acid reflux, it also predisposes the stomach lining to organic changes consistent with ulcer formation.
In addition, improper food combining (most prominently the taking of starch foods, e.g., bread, grains, potatoes, and protein foods, e.g., flesh foods at the same meal) causes the starch foods to be held up in the stomach: an organ that does not participate to any great extent in starch digestion. Consequently, the warm, moist gastric environment encourages bacterial and fungal fermentation of starches, especially if hypochlorhydria is extant.
Acids are produced as a by-product of fermentation. Antacid medications provide relief in some instances, but not by curtailing stomach acid hyper-secretion, but rather, by neutralizing the acids of fermentation and the corrosive effects of protracted hydrochloric acid exposure. In other instances, the antacids make the stomach so alkaline that it evokes a powerful HCL secretion as a reflexive counterbalancing response, which then facilitates protein digestion and stops heartburn. However, this short-term symptomatic relief in the long-term worsens hypochlorhydria by either suppression or exhaustion of the stomach's already compromised acid-producing cell population.
Also, stomach acid is a crucial microbe-controlling, anti-infectious substance. Low gastric acidity encourages the proliferation of alkaline-loving, food-bound microorganisms, including yeasts (such as Candida albicans) and pathogenic bacteria, which aggressively compete with "friendly bacteria” for colonizing sites along the intestinal walls. Dysbiosis refers to a state where the population of pathogenic microbial species in the gut has increased to the degree that they precipitate undesirable changes in the normal activities of the gastrointestinal tract.
Dysbiosis negatively affects the entire gastrointestinal tract from mouth to anus. This is why the use of high quality probiotics and probiotic-rich foods such as raw sauerkraut can improve the health not only of the stomach but of the gums as well.
From the perspective of the Five Element Theory of Chinese medicine: Wood, Fire, Earth, Metal, Water, these fundamental interdependent elements of the material world underlie all the relationships between the human body and the natural environment as well as between normal physiological activity and pathological developments.
According to the Chinese Five Element Theory, the spleen-pancreas is the yin organ, and the stomach is the yang organ, of the Earth element. The ancient Chinese considered the pancreas to be a component of the spleen and attributed the pancreas' digestive activities to the spleen. Modern practitioners have compensated for this by substituting the term "spleen-pancreas" for "spleen" in their discussions of the yin organ of the Earth element.
The Earth element organs (epicenter of feelings of being nurtured and satiated) are particularly disturbed by emotional stress. That is one reason why emotional stress is often a primary factor in indigestion, eating disorders and gastric ulcers.
Emotional symptoms such as anger or nervous tension are well known for causing digestive problems. Less well known is the impact upon digestion regarding feelings of being unnurtured, uncared for or emotionally neglected. These particular feelings deplete the vitality of the stomach and pancreas.
In this depersonalized era where many children spend their days in daycare centers or as latchkey kids and adult relationships are frayed by the demands of economic challenges, busy schedules and workplace stress, feelings of being unnurtured, uncared for or emotionally neglected are becoming increasingly commonplace. This is one reason why the 21st century variety of the general state of autotoxemia and enervation is so often prominently expressed locally as a stomach disorder such as GERD.
As the stomach and pancreas are the paired organs of the Earth element, their functions are completely interdependent. Therefore, impairment of the stomach will necessarily downgrade the vitality and efficiency of the pancreas and vice versa. Most individuals who present with the symptoms of GERD not only have low stomach acid production but pancreatic insufficiency as well.
In Chinese medicine, the pancreas (which they associate with the spleen) is considered the primary organ of digestion, and thus, the key organ involved in the transformation of food into vital force (chi) and blood. In The Web That Has No Weaver, Ted Kaptchuk, O.M.D. writes: "If the transformative and transporting functions of the spleen [pancreas] are harmonious, the chi [vital force] and blood can be abundant and the digestive powers strong. If the spleen is in disharmony, then the whole body, or some part of it, may develop deficient chi or deficient blood."
Like hypochlorhydria, pancreatic insufficiency is often a legacy of long-term dietary abuse. The pancreas is the major source of digestive enzymes for intestinal digestion (the digestive phase which ultimately facilitates the uptake of nutrients from the gastrointestinal tract into the blood). Habitual refined sugar intake in conjunction with a high-protein, high-fat flesh food diet requires a vigorous hormone/enzyme response by the pancreas (i.e., hyperfunction), which eventually diminishes that organ's ability to produce hormones, enzymes and other vital secretions, resulting in the hypofunctional state referred to as pancreatic insufficiency.
The Danger of Treating GERD with Drugs
In reference to the drug treatment of chronic dyspepsia, Dr. Trall writes: "Much has been written by physicians to commend some plan of medication. The public mind has been so long accustomed to relying on medicine to remove the penalties of transgression, when disobedience to the laws of health has resulted in disease, that recovery and drug store have come to be regarded as one and inseparable."
These days antacid and acid-blocking drugs, which suppress chronic acid reflux, are some of the most commonly used medications. However, they engender serious side-effects. Antacids are alkaline chemicals that neutralize the acid in the stomach but do not necessarily inhibit the renewed secretion of stomach acid. Acid-blocking drugs such as proton pump inhibitors (PPIs) actually suppress the stomach's natural secretion of hydrochloric acid by interfering with the stomach's gastric juice-producing parietal cells. The importance of stomach acid in the digestive and nutrient-assimilation processes has already been discussed.
While suppression of stomach acid may temporarily reduce stomach discomfort and esophageal inflammation, it not only inhibits the assimilation of vital nutrients but also does not in any way diminish the underlying root causes of chronic acid reflux.
Most antacid and acid-blocking drugs include warnings on their packaging indicating that they are intended for temporary use only. If they are continued beyond the limited period indicated, general health can begin to precipitously decline as a result of vital nutrient deficiencies.
Low stomach acid impairs the body's ability to absorb calcium and magnesium, both of which are essential for the maintenance of bone density. In this reference, a 2009 study published in the medical journal Gastroenterology found that acid-blockers were linked to an increase in osteoporosis-related hip fractures. By counteracting gastric acid secretion, vitamin B12 absorption is antagonized as well. As noted above, vitamin B12 malabsorption impairs nerve and brain function. Other nutrients that require stomach acid for their absorption include: protein (inhibited protein digestion translates to lower levels of essential amino acids in the blood), cobalt, copper, chromium, manganese, molybdenum, iron, selenium, vanadium, zinc, vitamins A and E and vitamins B1, B2 and B6.
Drugs are synthetic chemical toxins that suppress symptoms via the interruption of natural biochemical processes within the body. It should be understood that while symptoms are unpleasant and sometimes dangerous, they are not the disease itself but are often distress signals alerting the individual to the need to eliminate specific causative factors in order to avert tissues' destruction. At other times, as is the case with eliminative actions such as sneezing, coughing, diarrhea, etc., symptoms are evidence of the body's effort to resolve the disease. Thus, symptom-suppressing drugs override the body's "inner physician" and halt the body's efforts toward self-cure.
The human body is designed to be self-curing and all the functions of the body are constituted to strive toward health, not disease. Self-cure is the first imperative of the body's systemic operations. As discussed above, disease is the outgrowth of either an excess or deficiency of the fundamental elements of life and health (pure food, water, fresh air, sunlight, rest and sleep, etc.). Therefore, the first step in eliminating a chronic disease is the elimination of those factors that obstruct one's inherent relationship with those fundamental conditions. If a substance such as the synthetic chemicals that constitute drugs is of no use to the body when it is healthy, then that substance is not fundamental to the recovery of health.
Over time, the body attempts to compensate for the artificially induced deficiency of stomach acid by secreting more gastrin, a hormone (produced in the stomach, upper part of the small intestine and pancreas) that stimulates the stomach to increase its gastric acid production. This elevated gastric secretion will continue so long as the stomach is hindered from doing so by acid-blocking drugs. The risk of this is that excessive gastrin levels can stimulate the growth of esophageal, stomach and pancreatic cancer cells.
The toxic chemicals used in acid-blockers not only impact the entire digestive system but may also alter various chemical processes in the body that regulate neurological or immune function.
As discussed above, stomach acid is a crucial microbe-controlling, anti-infectious substance. Low gastric acidity encourages the proliferation of alkaline-loving, food-bound microorganisms. A recent study published in the medical journal Clinical Infectious Diseases concluded that gastric acid secretion suppressants increase susceptibility to the complications of gastrointestinal infections and elevate the risk of premature death. The study's author Edith R. Lederman, M.D., an infectious disease specialist at the Naval Medical Center in San Diego, says “...this is the first study to have found an association between use of antacids and increase of mortality.”
All of this lends credence to Dr. Trall's 19th century observation: "The error of regarding dyspepsia as a local disease instead of a constitutional infirmity leads to the mischievous practice of employing local [symptom suppressing] medications...This is an excellent method of curing dyspepsia by killing the patient or mitigating symptoms by destroying vitality."
Clearly, the road of antacid and acid-blocking medications is a perilous one. As with any disorder, the first order of business for the restoration of normal stomach function is the removal of cause: improper diet, sedentary behavior, unrelenting emotional stress, etc.
Additionally, certain healing foods, herbs and non-invasive techniques, which will be described in the next issue of Nature's Therapies Journal, can relieve discomfort and speed the healing process.
Please read Chronic Acid Reflux and the Decline and Fall of the Modern Stomach: Part 2, which is a detailed discussion of the trying and potentially dangerous stomach symptom chronic acid reflux.
Written by Dr. Bruce Berkowsky, N.M.D., M.H., NCTMB
Dr. Berkowsky, a registered naturopath, master herbalist and classical homeopath--is President of Joseph Ben Hil-Meyer Research, Inc. He is the founder/teacher of both Spiritual PhytoEssencing and the Natural Health Science System which he designed following many years of research and clinical practice, and includes herbology, nutrition, homeopathy, aromatherapy, exercise, traditional nature-cure as well as East/West healing arts/bodywork. Dr. Berkowsky teaches in-depth seminars/teleseminars/workshops to health-care professionals and spiritually aware individuals.
Disclaimer: This publication is intended as an educational tool, and not as a prescription. Seek the advice of your health-care provider before discontinuing any medication and/or trying any new remedy or technique.