Heartburn Tablet

Could someone explain how low hydrochloric acid stomach acid causes heartburn?

I’ve been reading how low hydrochloric acid (good acid for digesting foods) causes an increase in bad acid, or something.. which causes heartburn. How does this work exactly?

Some confusion here on all sides of the issue.

YES heartburn is cause when the lower esophageal valve (LES) fails to close, permitting “splashing” of stomach acid into the esophagus. It has nothing to do with how long food sits in your stomach (though that can be a related issue, and it can aggravate the GERD as well.)

Human digestive enzymes are produced mostly in our stomach and pancreas and are secreted in response to meal consumption through a variety of mechanisms that include smelling food, chewing food, stretch receptors that announce the arrival of a food bolus, etc. We don’t normally get them from the food we’re digesting… but we can use plant-based enzymes to supplement human digestive enzymes from time to time, if necessary.

YES risk factors like obesity, diaphragmatic dysfunction and sliding hiatal hernia, pregnancy, etc. are associated. These are because they increase abdominal pressure and/or create pressure (from the diaphragm) against the LES so it is mechanically inhibited from closing normally. Not all GERD is the same! There’s more than one cause, and frequently multiple causes must be addressed to correct the problem.

However, we DO now know a lot more about what triggers normal LES closure… it’s pH at the antrum (bottom) of the stomach. If the stomach pH is not below 2.5-3 (highly acidic) the LES is not triggered to close. Valve doesn’t close, so splashing is permitted. In these cases (estimated to be more than 80% of the time) restoring the proper pH will trigger valve closure… and voila. GERD problem solved.

According to current medical guidelines, “normal” stomach pH can vary between 2.0 and 4.0. That may not sound like a lot, but pH is a logarithmic scale… so it’s a huge difference, which places “normal” pH potentially WAY outside the optimal physiologic trigger range.

Stomach acid production decreases with chronic inflammation, chronically increased cortisol levels, regular coffee use, stress, improper chewing, “distracted eating”, etc. (FYI – It’s not the caffeine, it’s another ingredient in the coffee.) And because decreased stomach acid often leads to poor digestion and low-grade chronic gut inflammation… which in turn increases cortisol… there’s a vicious cycle here.

Why arent HCl tablets given? First, because the new understanding of LES physiology has not yet trickled into most mainstream doctors’ body of knowledge. But also because an HCl protocol can be daunting – it requires taking a lot of pills, and diligently taking them EVERY time you eat. Sometimes it’s only part of the problem… other issues need to be addressed first, or you’ll make things worse. And sometimes (fairly rarely) the problem really IS too much stomach acid.

Human bodies are complex systems!

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