Tums, Rolaids, Nexium, the majestic pill: if the stream of ads for medication to cut down tum acid are to live believed, we’re inwards the midst of a serious epidemic of excessive tum acid. We are absolutely drowning inwards the materials too should all run to our doctors for prescription-strength drugs to lower it. How else could nosotros work organisation human relationship for the fact that over the counter too prescription medications to process heartburn, GERD, too other forms of indigestion are amid the exceed selling drugs of our time? Contrary to what we’ve been led to believe close these conditions, most effects of indigestion are due to too little tum acid, non likewise much. Yes, you lot read that correctly. We are not awash inwards excess tum acid. If anything, we’re starving for it.
If this sounds illogical, it’s exclusively because many of us are unfamiliar amongst the anatomy too physiology of our ain digestive tracts. It makes sense at initiative off glance that likewise much tum acid would crusade the discomfort nosotros associate amongst indigestion, but our primer on this purpose of the digestive procedure volition discover that rather than making our stomachs less acidic, nosotros desire to make sure our tum acid is strong too abundant. When tum acid is insufficient, indigestion is exclusively i amid myriad weather condition that result. The listing of wellness complications that tin give the sack live tied straight or indirectly to depression tum acid stretches from acne to vitiligo, too if at that topographic point were to a greater extent than mutual weather condition amongst the letters due west through Z, they’d live on the list, too.
So hither nosotros go…
The esophagus is pretty simple. It’s the pipage that runs betwixt our oral cavity too stomach. When nosotros swallow food, it travels downwardly the esophagus until it drops happily into the stomach. Between the esophagus too the tum is a circular musculus called the lower esophageal sphincter. (Because it’s a sphincter at the lower terminate of the esophagus. Nice, huh? Sometimes the people who call these things lob an like shooting fish in a barrel i our way; usually not, though.) Most of the time, this sphincter stays closed. When nutrient presses upward against it from the bottom of the esophagus, it opens upward to permit that nutrient go into the upper share of the stomach. But things don’t simply become i way here. The tum tin give the sack also ship nutrient back up into the esophagus too out the mouth. (If you’ve always had the unfortunate experience of vomiting, you’ve experienced this firsthand. If not, you lot tin give the sack behave a fiddling experiment for yourself. It involves cheeseburgers, chili cheese fries, too a lot of alcohol.) So yeah, normally, the sphincter exclusively lets things become down. If things are coming dorsum up, there’s a work downwardly below.
What’s downwardly below? The stomach. The amazing, incredible sack of muscle that is capable of expanding too contracting similar a balloon. And, much similar the heart, the tum has muscular contractions all on its own, without us having to tell it to contract. (Called “involuntary contractions” inwards the medical scientific discipline world. And give thank you lot goodness for them. Imagine how much of our fourth dimension we’d waste matter if nosotros had to consciously tell our stomachs to churn or our hearts to beat. When would nosotros always accept fourth dimension to
watch Chopped reruns on Food Network read the latest research inwards peer-reviewed nutrition journals?)
Here’s the bargain amongst the stomach: it is indeed a sort of hollow pouch or sack, surrounded past times a duad of layers of muscle. These muscles are responsible initiative off for to a greater extent than of the mechanical breakdown of nutrient inwards the stomach—literally the motion of the nutrient this way too that, breaking it downwardly into smaller pieces, variety of similar a chewing procedure within the stomach. As nosotros mentioned inwards previous parts of this series, cells inwards the tum also make hydrochloric acid, or HCl, commonly known every bit tum acid. HCl’s master copy chore is to denature proteins. (Think close what lemon or lime juice does to seafood inwards a ceviche—the poly peptide is “cooked” past times the acid—transformed into a completely dissimilar state. That’s what HCl does.) Other cells lining the tum secrete gastric lipase, which industrial plant on breaking downwardly fats, but the vast bulk of fatty digestion doesn’t come about until nosotros hitting the small-scale intestine. (FYI, most enzyme names terminate inwards –ase. Fats are also called “lipids,” thus the enzyme that breaks them downwardly beingness called lipase. Just similar the enzyme that breaks downwardly the milk sugar, lactose, is called lactase.) There is really fiddling breakdown of carbohydrates inwards the stomach; most of that also happens inwards the small-scale intestine.
The 2nd affair the contraction of tum muscles does is assist amongst the chemical breakdown of food. While these muscles are movin’ too shakin’, so to speak, they combine the smaller bits of nutrient amongst HCl too digestive enzymes. Think of it similar a washing machine: the chewed upward nutrient mixes amongst tum juices the same way your washing machine twists too turns, swishing muddy clothe around inwards soapy water. Remember what I said last time, when I talked close the mouth, too how of import it is to chew. I said that sufficient chewing breaks the nutrient downwardly genuinely good too gives the tum a “head start.” The to a greater extent than you lot chew, the less operate your tum has to do inwards that department, too the to a greater extent than surface expanse at that topographic point is for the HCl too enzymes to do their jobs.
Before nosotros become whatever further, nosotros should comprehend a nifty fiddling factoid close tum anatomy. We usually think of the tum every bit i continuous sack. Technically speaking, it is. But within that sack are 3 master copy compartments: parts 1 and 2 of this series, it’s of import to eat slowly. If you lot wolf your nutrient down, hardly pausing to breathe betwixt bites, your initiative off few bites of nutrient volition all the same live sitting inwards the fundus piece the whole balance of the repast comes tumbling inwards after. Now your tum acid has to play grab up. It simply barely heard the knock on its door too suddenly at that topographic point are a K to a greater extent than people knocking. If you’ve always had the sensation that nutrient is sitting inwards your tum similar a brick for an sixty minutes or so afterwards you’ve eaten, this is a probable culprit. SLOW. DOWN. (If you lot are so inclined, experience costless to insert the words “the heck” inwards betwixt those two.)
Okay. Moving along. Another heart too individual secreted past times cells lining the within of the tum (or “lumen,” to usage anatomy geek-speak again) is mucus. You tin give the sack think of it kinda similar the materials that comes out of your olfactory organ when you’re sick, but let’s stick to a to a greater extent than positive interpretation of its role: the mucus that lines the within of the tum is what protects the tum muscles themselves from beingness digested past times tum acid. (Because those tum muscles are made of protein, right? So think close what would come about if they were inwards direct contact amongst HCl. Not good.) This is also why chronic dehydration tin give the sack crusade tum ulcers: the biggest constituent of this protective mucus is water. Not plenty H2O means not plenty mucus. Not plenty mucus means stomach acid eating away at the tum itself too burning a hole right through it!
The argue it feels similar it’s burning is
because it is. Burning the lining of your
esophagus, that is!
The affair is, the esophagus does not accept this protective mucosal coating, so when the lower esophageal sphincter (LES) opens upward for some reason, too the acidic contents of the tum become dorsum upward into the esophagus, it feels similar burning. This is where the term “heartburn” comes from, fifty-fifty though, every bit you lot tin give the sack reckon now, it has aught to do amongst the heart. Anatomically speaking, the tum too LES are higher than most people think they are, so it exclusively seems similar the hurting is happening close the heart. The give-and-take “reflux” is a to a greater extent than plumbing equipment description, because the contents of the tum are refluxing dorsum upward.
Okay. Got it. So the query nosotros should live thinking of adjacent is, why does the LES opened upward too permit acidified tum contents dorsum into the esophagus, causing us to accomplish for the nearest jumbo-size tub of chalky, berry-flavored antacids? Lots of reasons. One is, oddly enough, pharmaceutical drugs! Here’s simply a partial listing of things the authors of this book telephone telephone “LES weakeners”: Bronchodilators (like albuterol too ephedrine), NSAIDs (painkillers similar aspirin & ibuprofen), calcium channel blockers too beta-blockers (used for high blood pressure), Valium, too Demerol. Also: cigarettes! Influenza A virus subtype H5N1 duad of foods are also said to weaken the LES: chocolate, coffee, peppermint & spearmint, onions, too alcohol. (Not that I think this is a argue to surrender these things. After all, peppermint tea is also recognized for helping digestion, too onions accept health benefits out the wazoo. If you lot don’t oft experience reflux, I reckon fiddling argue to rest away from the foods on that list.)
|Don't endeavour this at home.|
What are some other reasons why that sphincter loosens up, allowing reflux to happen? Does it loathe us? Did nosotros do something to it inwards a onetime life? No. (Well, perchance you did, but I didn’t.) It’s all close tum acid. Contrary to what all those ads would accept us believe close tum acid, the tum is supposed to be acidic. Really acidic. In fact, a tum at balance (i.e. non actively digesting food) should accept a pH of betwixt 1 too 3. (Note, for those of you lot who don’t retrieve high schoolhouse chemistry: a pH of vii is neutral. The lower the number, the to a greater extent than acidic. And it’s a logarithmic scale, so a pH of half dozen is ten times to a greater extent than acidic than 7, too v is 100 times more acidic than 7. So a pH of 1-3 is pretty darn acidic, too that’s at rest!) Actual HCl inwards active digestion has a pH of around 0.8. That is some seriously potent acid, folks. When, for reasons we’ll instruct to soon, non plenty tum acid is beingness produced, or the tum acid that is being produced is less acidic (or to a greater extent than alkaline) than it should be, it causes a MAJOR derailment of our happy fiddling digestive train. When HCl is potent too abundant, the tum breaks downwardly nutrient speedily too sends it along into the small-scale intestine. But when there’s a lack of tum acid, or acid that’s likewise alkaline, nutrient stays inwards the tum longer than it’s supposed to. This is the develop that gets stuck at the station too causes problems both ahead and behind. The work it causes behind is reflux. When foods—carbohydrates, inwards particular—stay inwards the tum longer than they should, they start to ferment. This results inwards bubbles too gas (think of grains fermenting to brand beer, although the fermentation procedure is a fiddling different), and it is this bubbling gas that refluxes dorsum into the esophagus. It has nothing to do amongst likewise much tum acid. Raise your manus if you lot didn’t know that! And remember: fifty-fifty though this nutrient & acid mixture is less acidic than it should live (because of decreased acid), it’s all the same far to a greater extent than acidic than anything the esophagus is designed to handle, peculiarly considering it has no protective mucus. So that’s why nosotros instruct that burning sensation.
There are many to a greater extent than things that tin give the sack become incorrect from depression tum acid to final result non simply inwards reflux/GERD, but inwards a laundry listing (dirty laundry, at that!) of wellness complications that attain from the mildly irritating to the downright deadly. We’ll instruct to the details adjacent time.
But earlier we’re finished for the day, nosotros should in all probability utter close what causes depression tum acid inwards the initiative off place, right? Because if nosotros know nosotros desire lots of it, too nosotros desire it to live strong, nosotros involve to know what makes it decrease too weaken.
Easy-peasy. Go dorsum to part 2 of this series, where nosotros talked close the brain, too how beingness stressed out, inwards a hurry, angry, or otherwise experiencing negative emotions keeps our fight-or-flight machinery dominant, too gives our nice, calm, rest-and-digest parasympathetic nervous organisation a kicking inwards the jimmies. Our modern, stressful, go-go-go lives are a recipe for depression tum acid. Also: eating inwards a rush. Remember, digestion is similar a well-orchestrated symphony: our bodies accept to instruct the right signals at the right fourth dimension too all the players accept to do their part. If nosotros swallow inwards a hurry too and so rush off to the adjacent coming together or to alternative upward the kids, the bulk of that nutrient volition live within the tum earlier the tum has fifty-fifty registered that at that topographic point is nutrient there. The tum acid catch-up game begins, too approximate what? Yep, that nutrient volition at nowadays sit down inwards the tum longer than it otherwise would. And nosotros know what happens next.
And a tertiary affair that tin give the sack crusade depression tum acid iiiiiiiiiiiiizzz…
ANTACIDS! Ding ding ding! Prescription too OTC antacids neutralize whatever fiddling tum acid our bodies do care to make during our hurried too over-stressed mealtimes. Just when nosotros should live supporting more tum acid, nosotros do the opposite. The calcium too other alkaline metal ash minerals inwards antacids serve every bit buffers against the acidity nosotros experience “burning” our esophagus. And yes, the burning subsides, but this is a short-term band-aid, non a solution to the underlying crusade of the situation.
Prescription acid blockers are similar antacids on crack. See, chewable antacids buffer the acid that’s already been produced. It doesn’t alteration anything at a cellular score or mess amongst human physiology. (If you’re into criminal offence dramas, think of them every bit “accessories afterwards the fact.”) But prescription acid blockers genuinely forestall the secretion of acid inwards the initiative off place. (Ever heard acid blockers referred to every bit “PPIs” or “proton pump inhibitors?” They instruct that call because they inhibit the teeny, tiny pumps embedded inwards tum cells that are supposed to force protons [actually, hydrogen ions, H+, or acid] into the lumen of the stomach.) If nosotros know anything close digestion—and we’re surely commencement to slice together the puzzle—this is the last affair we’d desire to do to ensure expert digestion. Oh, those kooky modern medical standards. They instruct me every time!
|This is the best modern medicine has to offering you. Pathetic. |
And a darn shame!
(We'll comprehend natural heartburn remedies inwards an upcoming post.)
So at nowadays that nosotros know reflux is non the final result of excess tum acid, too that nosotros genuinely desire to increase tum acidity, how do nosotros fill upward that tall order? Stay tuned for adjacent time. We’ll also become over another consequences of depression tum acid, most of which volition brand reflux hold off similar a walk inwards the park.
For a slap-up recap of all this, banking concern check out these 2 posts from Balanced Bites:
And this amazing serial past times Chris Kresser. (It’s half dozen parts, but the existent bang for your buck is inwards the initiative off 3-4. And he’s much to a greater extent than succinct than I am. Well worth your fourth dimension to read if you lot always experience reflux, bloating, or gas!)
Remember: Amy Berger, M.S., NTP, is non a physician too , LLC, is non a medical practice. The data contained on this site is non intended to diagnose, treat, cure, or forestall whatever medical condition.
Digestion for (not-so) Dummies: The Stomach, Pt.1
4/ 5Oleh Margaret Garland