Acid Reflux does not have to be a chronic disease.

One of the largest moneymakers for the pharma industry is GERD, or Gastro Esophegal Reflux Disease, commonly called acid reflux.  Millions of people suffer from it, and tens of billions of dollars have been spent managing this disease with drugs known as Proton Pump Inhibitors.

The so-called treatment for acid reflex is to take a daily pill of PPI for the rest of your life.  As this article from the New York Times blog shows, taking PPIs long-term leads to a whole host of bad health issues.

http://well.blogs.nytimes.com/2012/06/25/combating-acid-reflux-may-bring-host-of-ills/

Is it any surprise that continually messing with your body’s natural acid production process creates a cascade of ill effects that result in poor health?  Why would you want to to this to your body, when it is much more useful to get to the root cause of acid reflux?

Conventional wisdom holds that acid reflux happens because the body is producing too much acid, hence the use of PPIs to block acid production.  But what if this is completely false?

The most amazing idea in acid reflux is one that I have been championing for some time. It is the hypothesis that the cause of acid reflux is not that the stomach is producing too much acid, but that it is producing too little!

Consider this; as we get older, we produce less and less acid normally. So how is it that we get reflux as we get older? Why on earth would the body produce too much acid in the first place?

Here is my alternate explanation.

When you produce too little acid, you can become constipated, and this can lead to too much gas. This gas must come out of the body, one way or another! The first way it comes out is well known, in the form of flatulence. But the second way it comes out is by mingling with stomach acid and pushing acid bubbles up through the esophagal sphincter – this is one of the main reasons for acid reflux.

The irony is that if this (highly testable) hypothesis is correct, PPIs should count among the largest frauds ever perpetuated by the pharma industry. Think about this; we take people who are producing too little stomach acid in the first place, and the health industry is pushing them to use drugs to lower the acid still further! Is it any surprise that you end up with malabsorption, anemia and other long term problems?
If you have reflux, ask your doctor if you can go on a short dose of HCL (stomach acid) tablets.  You can get these at any health food store over the counter, because people who are weight training use them to help digest the extra protein they are consuming.

Root Cause

Even the dose of HCL tablets is not a long term cure.  To get to a cure, we have to get to the root cause of the illness, which is to treat the underlying constipation.  In the majority of cases, constipation is likely a simple matter of an undiagnosed lactose intolerance, or a gluten intolerance.  Stop drinking milk and the problem often goes away.  This is doubly ironic because people with acid reflux tend to drink more milk under the mistaken belief it will coat the stomach and provide relief from reflux.  If you are lactose intolerant, the opposite will happen; the milk will rot in your gut, turn into gas which pushes the acid up your esophagus and causes more reflux!

Acid Reflux is not a acid production issue; it is a reflux issue.  The proper way to treat it is figure out why acid is coming up the espohegal sphincter, and stop that from happening.

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  • Koli Lodha

    Very pertinent, Ravi. Do you think the same applies for babies, then? My little one had reflux, was treated with ppis and antacids for three months and yes, did have mild constipation too! But here’s the thing, she is not lactose intolerant since she seems to have slowly outgrown reflux and loves her milk. Makes me think that the doctors just misdiagnosed a plain old sicky baby symptom as acid reflux and gave her unnecessary medication!

    • Ravi

      Koli, thank you for the note! I think reflux in babies can be due to many reasons. However, the first thing I would suspect is a bacterial imbalance in the gut. This is because babies are born with sterile guts, and they inherit their gut flora typically from the mother from breast-feeding in their first few weeks after birth. If they are bottle-fed, they are more likely to have digestive issues at an early age because bottle nipples are sterilized, while breast nipples are not. Chances are she had colic, not reflux.
      I am not a fan of treating babies with PPIs and antacids…the first thing I would do, believe it or not, is ask the mother to take a spoonful of her own spit, and feed it to the baby! This will transfer some of the required bacteria from mom to child. Of course there are no studies on this, so we have to use our own judgement. Do this twice a day for a few days, and the symptoms should disappear.