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Thread: Too much or not enough acid

  1. #1
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    Too much or not enough acid

    Tricia-I would like reiterate the main two points I made earlier today in a hew thread. In response to your question on what mechanism would cause reflux symptoms in low acid individuals, as you stated damage could occur in reflux with a PH of 4 so I fail to understand the mystery. Second you did not respond to the question of how you ascertained that doctors who prescribe PPI's do not believe that overly acidic stomachs is the problem. Nor did you respond to the point of what degree do they actually have meaningful tests which screen for too little or too much acid. I do not ask these questions again in any sense of badgering, but only to make sure that you understand I feel the questions were not answered and that I see them as important. A final question is what are your thoughts on those who take Betaine and other acidic supplements which improve their symptoms. Do you believe such individuals are actually suffering from hypochlorhydria or something else?

  2. #2
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    I copied the following from a website selling HCL. I am not familiar with the Dr Cheney mentioned but his comments are interesting and may contribute to the conversation.

    "Stomach acid is a paradoxical substance: too little can actually make you think you have too much. Many people think they have acid reflux or GERD, and they take Prilosec or other antacids to reduce the amount of stomach acid. In actuality, they may not have enough acid in their stomach to trigger the opening of a valve at its base. When food begins to fill the stomach, acid is released to assist with digestion. When enough acid is detected, the valve opens, releasing the food into the small intestine. If there isnít enough acid, the valve doesnít open. The food, mixed with what little acid is present, is forced back up the esophagus, creating a burning sensation. Paradoxically, the answer to the burning sensation is more acid, not less. Antacids can create a vicious cycle in these cases."

  3. #3
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    i Nelson- Just want you to know that your input here and how this discussion may have effected the approach you are taking with your problems is appreciated. You seem to have it as bad as anyone, and while being careful not to give you false hope, it seems like some of your symptoms could in fact be from too little acid.

    I was going to post my ongoing experiment with my own treatment on the stopping nexium thread, but perhaps it is better placed here. I took two Betaine with a meal last night with no noticeable acidic reaction. I have been advised by a health proffessional to take as many as I can to find a maximum tolerance level, and then to continue to take the maximum alowable before acidic symptoms occur. This persons position was that often the body will start to produce more acid with this treatment and you can start lowering the amount of betaine you take

  4. #4
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    Matt Hawk et al

    Hi Hawk and Everyone So according to the site that is selling HCL it's the pyloric sphincter ( the opening between the stomach and small intestine ) that won't open because there is not enough acid in the stomach . The food etc shoots back up into the esophagus ( because it can't get into the small intestine ) , and causes GERD like symptoms. Not clinical GERD, but GERD like symptoms.

    So it's primarily the food, not acid -- shooting back up in the esophagus that causes GERD like symptoms. ( burning ) It reminds me of Alachasia ( which has nothing to do with acid ) where people are misdiagnosed with GERD. It sort of has the same concept too as gastroparesis contributing to GERD ( gastric pressure ) . Now we know the theory , but is that the theory that everyone shares on how low acid causes GERD symptoms i wonder ?

    Hi Matt Sorry i missed your questions , you didn't have them highlighted so i didn't see .



    Quote Originally Posted by Mattnapa View Post
    What are your thoughts on those who take Betaine and other acidic supplements which improve their symptoms. Do you believe such individuals are actually suffering from hypochlorhydria or something else?
    It is really hard to say . First off digestive diseases have a really high placebo effect . Remember too , there is that brain - gut connection. Just the act of getting healthy , trying different things and getting a more positive optimistic outlook can have a huge positive effect on how you feel physically. . I know personally my GERD / LPR symptoms got much better after i changed my attitude . Digestive diseases also have a tendancy to wax and wain / come and go regardless of what you do , so it can be hard to judge what really helped.

    I'ts been 9 years for me since getting GERD / LPR. I have seen every cure known to man . come in to these forums in 9 years . HCL is nothing new to me , many many have used HCL over the years . HCL , Apple cider vinegar, manuka honey , low carb diets , ginger root juice . There was even a guy here who said his GERD was cured from a banana only diet . Some have proclaimed total cure, some improvement in symptoms , and many get their symptoms back again . . Even though some things may not make logical sense , you have to keep an open mind . That is why discussing theories help . There are multple causes for both GERD and GERD symptoms ( there is a difference between GERD and GERD symptoms) and things can be very individual . A lot isn't understood yet . I'm not in a position to rule anything out ... not even bananas

    Quote Originally Posted by Mattnapa View Post
    You did not respond to the question of how you ascertained that doctors who prescribe PPI's do not believe that overly acidic stomachs is the problem.
    THis is what you dont seem to grasp Doctors know- we all know , that GERD has nothing to do with too much or too little acid in the stomach . GERD is ALL about abnormal acid exposure to the esophagus .That is the only thing it is about . It has nothing to do with amounts of acid . GERD is diagnosed strictly by measuring the amount of acid that hits the esophagus .

    The amount of acid produced in the stomach is not the problem with GERD , it is mechanics ( the LES etc ) that allows the esophagus to be over exposed. They don't know how to fix the mechanics so they shut off the acid , even though acid isn't the real problem . They shut off the acid even if there is not too much , because they don't know how to stop it from reaching the esophagus and staying there too long. . They haven't invented drugs for that yet . So it's not the amounts of acid -- it is where the acid is going.

    Quote Originally Posted by Mattnapa View Post
    In response to your question on what mechanism would cause reflux symptoms in low acid individuals, as you stated damage could occur in reflux with a PH of 4 so I fail to understand the mystery.
    Here is some GERD 101 . When you go to the doctor with reflux symptoms , he will often order an endoscopy . If you have esophageal erosions on endoscopy ( esophagitis ) that's it , he positively diagnoses you with GERD .

    If you have no erosions ( which happens in over half of the people with GERD symptoms ) the next step is to have a 24 hour ph test or Bravo ph test which are supposed to be the definitive tests for GERD

    These tests measure acid exposure to the esophagus . That is what GERD is . It has nothing to do with how much acid you make ,GERD only has to do with how much acid hits the esophagus .

    First of all .........one acid reflux episode is defined as a drop in ph of below 4 , for 4 seconds or longer .

    Everyone in the world refluxes acid into their esophagus . It is 100 percent normal and those without GERD have no symptoms from it . It is normal for someone without GERD to reflux up to 50 acid reflux episodes a day and have no problems-- ( of course everyone has occasional heartburn ) That is normal reflux .Anything under 50 .

    GERD is pathological reflux . You need more than 50 reflux epiisodes to hit the esophagus and 5-6 percent of acid exposure to the esophagis in a 24 hour period . That is what you need on a test to be diagnosed with GERD .

    Anything below that , the doctor will tell a person GERD isn't their problem because they shouldn't be getting symptoms with normal amounts of acid reflux hitting the esophagus. Many dictors tell people . they must have a sensitive esophagius etc . Doctors have a habit of blaming symptoms on stress , but truth is these digestive diseases are not completely understood yet . .

  5. #5
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    Matt,

    i am going to try the HCL this week for sure.

    strangely, I don't reflux after i eat food, which could mean that i am low on acid..

    Another weird problem compared to others, is I don't have any lung symptoms (no cough, no wheezing AT ALL, clear chest xray, perfect breathe test, 98% oxygen levels), I am baffled, why does it get into the mouth area..Also i scored very good on manometry.. To fool the doctors for a second, i deliberately did a swallowing motion and they immediately asked me DID you swallow, so I knew it was not a hoax procedure..
    The TLESR may be related to the pylorus sphincter, so thats something i have to pursue, after I max out my flex spending account for next yr..

    btw, none of the celebrities have LPR, so they may be getting this fixed, with all that money they have.. I have got to figure out which GI's treat them.. The ones taking insurance, are useless..

  6. #6
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    Quote Originally Posted by tricia View Post
    Hi Hawk and Everyone So according to the site that is selling HCL it's the pyloric sphincter ( the opening between the stomach and small intestine ) that won't open because there is not enough acid in the stomach . The food etc shoots back up into the esophagus ( because it can't get into the small intestine ) , and causes GERD like symptoms. Not clinical GERD, but GERD like symptoms.



    So it's primarily the food, not acid -- shooting back up in the esophagus that causes GERD like symptoms. ( burning ) It reminds me of Alachasia ( which has nothing to do with acid ) where people are misdiagnosed with GERD. It sort of has the same concept too as gastroparesis contributing to GERD ( gastric pressure ) . Now we know the theory , but is that the theory that everyone shares on how low acid causes GERD symptoms i wonder ?

    Matt replied
    Earlier you said that the LES opens in response to stomach distension. I assume distension is roughly synonymus with gastroparesis? I am not sure I understand the cause part of this equation. If distension is accepted as causing TSLRS what are we saying is causing distension? Seemingly it has to do with the contents of the stomach. Your last sentence says a theory is understood. Is that theory simply distension causes TSLRS, or is the theory to include what causes distension? I do not mean to answer a question with a question, but it seems you are asking for a juxtaposition and I am not clear on what I am to juxtapose with.





    It is really hard to say . First off digestive diseases have a really high placebo effect . Remember too , there is that brain - gut connection. Just the act of getting healthy , trying different things and getting a more positive optimistic outlook can have a huge positive effect on how you feel physically. . I know personally my GERD / LPR symptoms got much better after i changed my attitude . Digestive diseases also have a tendancy to wax and wain / come and go regardless of what you do , so it can be hard to judge what really helped.

    I'ts been 9 years for me since getting GERD / LPR. I have seen every cure known to man . come in to these forums in 9 years . HCL is nothing new to me , many many have used HCL over the years . HCL , Apple cider vinegar, manuka honey , low carb diets , ginger root juice . There was even a guy here who said his GERD was cured from a banana only diet . Some have proclaimed total cure, some improvement in symptoms , and many get their symptoms back again . . Even though some things may not make logical sense , you have to keep an open mind . That is why discussing theories help . There are multple causes for both GERD and GERD symptoms ( there is a difference between GERD and GERD symptoms) and things can be very individual . A lot isn't understood yet . I'm not in a position to rule anything out ... not even bananas


    Matt replied
    I understand these paragraphs to indicate a certain murkiness and fluidity to both GERD causation, symptomology and treatment. I have no particular disagreement



    THis is what you dont seem to grasp Doctors know- we all know , that GERD has nothing to do with too much or too little acid in the stomach . GERD is ALL about abnormal acid exposure to the esophagus .That is the only thing it is about . It has nothing to do with amounts of acid . GERD is diagnosed strictly by measuring the amount of acid that hits the esophagus .

    Matt replied
    This is much more definitive, and I am not sure what it is based on. If you are saying that we do not know the relationship between stomach acid and reflux in the esophogus I might agree. But to say we are sure there is no relationship seems dubious. I assume the former is correct?

    The amount of acid produced in the stomach is not the problem with GERD , it is mechanics ( the LES etc ) that allows the esophagus to be over exposed. They don't know how to fix the mechanics so they shut off the acid , even though acid isn't the real problem . They shut off the acid even if there is not too much , because they don't know how to stop it from reaching the esophagus and staying there too long.


    Again I am sorry, but I think a clear explanation of "why" doctors are prescribing PPI's in this circumstance is necessary. Either they believe there is a causal role with reducing stomach acid, or they are claiming that treatment relieves symptoms. If you are saying something different I am not clear on what it is. Also I do not understand how we know the amount of acid is not the problem. Since the treatment stops the production of stomach acid it is difficult to understand how it is not a problem with the disease.










    These tests measure acid exposure to the esophagus . That is what GERD is . It has nothing to do with how much acid you make ,GERD only has to do with how much acid hits the esophagus .

    Matt said
    Maybe we are arguing about semantics, but a disease is more than a snapshot of a certain moment. If you wish to say causation is not known fine, but a diagnosis losses something without it. Second it does not only have to do with how much acid hits the esophogus, it also has to with the makeuip of that acid and the ability of throat tissue to resist acid damage

    First of all .........one acid reflux episode is defined as a drop in ph of below 4 , for 4 seconds or longer .

    Everyone in the world refluxes acid into their esophagus . It is 100 percent normal and those without GERD have no symptoms from it . It is normal for someone without GERD to reflux up to 50 acid reflux episodes a day and have no problems-- ( of course everyone has occasional heartburn ) That is normal reflux .Anything under 50 .

    GERD is pathological reflux . You need more than 50 reflux epiisodes to hit the esophagus and 5-6 percent of acid exposure to the esophagis in a 24 hour period . That is what you need on a test to be diagnosed with GERD


    Matt said-
    What is the significance of diagnosis?

    Anything below that , the doctor will tell a person GERD isn't their problem because they shouldn't be getting symptoms with normal amounts of acid reflux hitting the esophagus. Many dictors tell people . they must have a sensitive esophagius etc . Doctors have a habit of blaming symptoms on stress , but truth is these digestive diseases are not completely understood yet . .
    Matt said-
    I guess we are different minds. You wish to identify what the standards are for diagnosis. I wish to identify the logic behind the standards.

  7. #7
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    i Nelson - The point on celeb's is interesting. I had considered that a diagnosed celeb might help, but it does seem unusual that we have not even seen one come forward with at least GERD. It would seem like a stasticlal longshot that not one has it.

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    Celebrities with GERD

    Simple Google Search......................

    [url]http://www.reflux.org/reflux/webdoc01.nsf/(vwWebPage)/FamousPeople.htm?OpenDocument[/url]

    [url]http://www.drdonnica.com/display.asp?article=8680[/url]

    [url]http://www.drdonnica.com/celebrities/00006904.htm[/url]

  9. #9
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    As per my post under medication [url]http://forums.heartburn-help.com/showthread.php?t=8261[/url]

    perhaps low acid may cause gerd-like symptoms, the way the research article suggests that ppi's may cause EE (food allergy/increased esophageal permeability), which is an esophageal disease, which mimics gerd in some ways.

  10. #10
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    btw on the celebrities topic.. I don't think the ones mentioned here really have LPR..
    GERD is definitely not a big deal.. Millions have it.. LPR is a big deal because it can affect your work, as you need to speak, attend meetings, and dental problems are another story..

    If it was GERD, I would not think about it for a second.. The 2nd endoscopy i did, the GI told me, you will never EVER get cancer, the esophagus is nice and pink. I kept telling him, I don't care about my esophagus, do something my above throat area.. I just need to live until 50yrs of age.. I am 39 now..

    So apart from Ashley Simpson which I again think which could be a lame excuse for that concert appearance, None have LPR.

    I remember when I had tinnitus years back, I was so distraught and was attending these meetings where they spoke about William Shatner..

    Coming to think of it now, LPR is a trillion times worse than tinnitus.

    Strangely, I have had only 2 problems my life, and both not curable.. damn.

  11. #11
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    To go back to the discussion with Tricia, I believe the main point is whether the stomach environment has any causitive role in initiating TSLRS. It seems Tricia's position is that it does not. I remain unclear if she is positing any causitive role in TSLRS. To me it seems counterintuitive to suggest that the stomach environment does not play a role, and would suggest that studies should be able to answer the question. Are there studies which "show" there is no role?

    Also I would assume stomachs with higher acid levels decrease the amount of time meals remain in the stomach. Therfore it seems like there is a tradeoff between using acid blockers simply to lower the PH levels of reflux triggered by random TSLRS events, and increasing the amount of time stomach contents are available for random TSLRS events. I believe it has been shown that TSLRS occur more often when the stomach is occupied, or is that incorrect?

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    Matt and I_ nelson

    Hi Matt Aside from swallowing, TSLRS are also beleived to be triggered by abdominal distention . The people selling HCL do not claim that low acid causes GERD. They claim it causes GERD like symptoms. Have you had a ph test ?

    Hi I Nelson Mick Jagger takes 2 prevacid a day for voice problems.... at least he was taking prevacid in the documentary i saw on him. It showed him visiting his ENT ( he is ENT to a lot of stars and i can't think of his name ) Beside the prevacid , he also gave Jagger a throat spray to keep the mucous off of his vocal chords.

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    Tricia- I do believe that the manufacturers of HCL are saying that it returns the stomach back towards normative function in the cases where acid is lacking. If they are not saying it directly then experts and doctors are. It seems that your implication is that a return to normative digestive function play no role in the frequency of TSLESR's. As stated, I find that counterintuitive, and see no basis for the claim that it has been proven not to be the case

    As for causing GERD or GERD like symptoms, I am still unclear on what that claim means. It is my understanding, in at least some cases, the claim is that the exact same mechanism of refluxing above the LES is occuring.

    Also I would like to re-emphasixe the point about the speed in which stomach contents are digested and moved through the system (motility I assume). If HCL and other digestive aids increase the speed in which this occurs, it would seem logical that it would reduce the overall amount of TSLERS.

    I think there is enough anecdotal information in place to suggest a a double blind study be done with a control group, an HCL digestive aid group, and a PPI group for those testing with low stomach acid is needed

  14. #14
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    Matt,
    So how have you been doing since you started the HCL? I like the way you think and I'm interested to know how your condition is doing.

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    Uhhh, I-Nelson,

    GERD is definitely not a big deal.. Millions have it.. LPR is a big deal because it can affect your work, as you need to speak, attend meetings, and dental problems are another story..
    OK, I get the fact that you're suffering with LPR - but don't belittle what other people are going through. GERD IS A BIG DEAL. Your image of it may be simply 'a little heartburn". But that's not what it is. It's a horrible debilitating condition for some of us. So is LPR.

    And, by the way, Tinnitus leads a lot of people to commit suicide. Obviously, and thank goodness, you don't have it that badly. But a lot of people do. And they might choose to be missing their vocal chords if they could get rid of the tinnitus.

    Until you've lived in someone else's shoes, don't judge them. And until you've lived with someone else's disease and how it affects their life, it's really not nice to judge the "quality" of the disease compared to yours.

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