It's been a while since my last contribution to the NECA blog. But I'm back and ready to continue talking about digestion. (You've all been waiting eagerly, I assume...) If you haven't seen the first two parts of this series, I suggest you scroll back and start there. Digestion is a step-by-step process. There is a definite launching point for the rest of the digestive cascade. It's like starting a great Netflix drama on season 3; without the proper set-up, the story line doesn't make any sense.
So, now you're all caught up on how the brain and nervous system set the table (heyyo!) for proper digestion. You know that chewing and salivating takes a lot of the burden off of the rest of the digestive tract. You know how simply changing a few tiny habits in those two northernmost points can help alleviate a wide range of digestive symptoms. So let's continue south to the stomach!
Think of the stomach like a muscly pouch filled with acid. We've mentally prepared ourselves for food, we've salivated, and both of those responses trigger stomach acid to be secreted so when the food enters the stomach, there's a nice acidic bath waiting for it. VERY acidic, in fact. Ideally, a pH (a scale of acid/alkaline measurement - 0 being most acidic, 14 being most alkaline) between 1.5-3.0. That sounds scary but don't worry. The lining of the stomach is built to handle it.
The acid goes to work breaking down the food even further while our muscle pouch churns and stirs it all together. This sounds sort of gross but it is absolutely necessary in order for the further breakdown and absorption processes that happen in the small intestine.
Our stomach acid has a few more important jobs. Stomach acid can technically be thought of as one of the first lines of immune defense. What I mean is that bacteria, viruses, parasites, and any other sort of pathogen living on our food can't survive in an acidic environment. The acid actually kills and digests the pathogen! In other words, the acid is a natural defense against food-borne illness. Stomach acid also keeps healthy, beneficial bacterial colonies in check. Without it, we see an overgrowth of H. pylori and other gut microbes.
A properly acidified stomach is necessary for the absorption of all sorts of vitamins and minerals. B vitamins and calcium are two examples of nutrients that require sufficient acid for absorption.
Another job of stomach acid is to signal the production and secretion of pancreatic enzymes. Some of these enzymes end up in the stomach but most of them go to the small intestine where they continue the chemical breakdown of the food.
Finally, stomach acid is needed to trigger the opening of the valve at the bottom of the stomach (the pyloric sphincter). This allows that churned up mush out of the stomach and into the small intestine. Without enough acid, that valve doesn't want to open.
This is a great time to take a detour and talk about how insufficient acid levels can lead to acid reflux (or GERD). But wait. Isn't acid reflux caused by too much acid in your stomach? It can be. But truthfully, TOO MUCH stomach acid (Hyperchlorhydria) is the root of the problem 1% of the time. The actual cause is too little, or Hypochlorhydria.
Remember that valve we were talking about a few paragraphs ago? Like I said, that valve doesn't open if it doesn't sense a highly acidic pH, leaving that glob of food to sit in your stomach longer than it should. What happens to food in dark, warm, damp environments? It starts to rot! Gross. But true. The fats rancidify, the proteins putrify, and the carbohydrates ferment. And if you've ever opened a bottle of fermented beverage, you know about the gasses that can build up (bloating).
Those gasses build up until they push open the valve at the top of the stomach (Lower Esophageal Sphincter). Once that valve opens, the gasses escape in the form of burping and belching. This also allows the liquids (not as acidic as we need, but still slightly acidic) that are sloshing around to travel up into the esophagus, a tissue that isn't built to handle acids like the stomach. That causes the painful burning sensation often called "heart burn". And that is why acid-suppressing medications work. They don't fix the root cause of heartburn, but they DO stop the stomach from producing any acid at all, easing the destructive and painful effects of those sloshing liquids on the esophageal lining. Unfortunately, for the same reasons they help ease the pain, those acid suppressing drugs only weaken digestive function.
So now we know what can happen if we aren't producing enough stomach acid; nutrient deficiency, food-borne illness, acid reflux, etc.. But what causes our production of stomach acid to slow? Prolonged use of antibiotics and other medications, infection, poor diet, chronic stress, and aging all contribute to low production of stomach acid. We definitely have control over most of those factors, but even if we're doing everything right, we still might need some help.
There are a few therapeutic foods that can help create a nice acidic environment in the stomach. For example, a tablespoon of apple cider vinegar in 4-8 ounces of water. Taking this each morning or even 5-10 minutes before each meal can help stimulate digestive juices. If apple cider vinegar is too intense, you can do the same thing with half a lemon squeezed into some water. Other foods and herbs that aide the digestive processes of the stomach include pineapple, papaya, ginger, and dandelion root.
Sometimes we need a little extra support in the form of supplementation. There are tons of acid supplements** out there. The two main ingredients to look for are betaine hydrochloride and pepsin, an enzyme that helps with protein digestion. I've found in my lyme journey that I need a bit more help. I use a product with betaine HCl and pepsin along with a ton of other enzymes and gut-healing nutrients.
(**I would NOT recommend an HCl supplement to young children or anyone with ulcers or other gastric inflammation. In that case we would need to look at a gut-healing protocol with some gentler digestive support.)
When the risks of LOW stomach acid are so clearly detrimental - poor digestion, malabsorption, nutrient deficiencies, food-borne illness, GERD - it's hard for me to comprehend how stomach acid has been so vilified. We've been misled to think that this substance that our bodies naturally produce is causing all of our digestive problems. That simply couldn't be further from the truth. If you still need some convincing, please check out Why Stomach Acid Is Good For You by Jonathan V. Wright, M.D. and Lane Lenard, Ph.D. They go much deeper into the ideas I've outlined here. Heck, I'll gladly lend you my copy!