Digestion, acid reflux and the antacid debacle

February 28, 2012

Cancer, Health

Crazy as it initially sounds, in three out of four cases of reflux, the cause is decreased production of hydrochloric acid.

by Dr. Thomas Alexander — 

The human digestive system is nothing short of miraculous. Its intricacy and efficiency go beyond anything ever designed by human scientists. This amazing system takes every kind of diverse food, chews and kneads it to a pulp, and subjects it to extremely acidic and alkaline conditions. And like a powerful machine, it pulses, contracts, expands and then delivers a wash of enzymes, hormones and other digestive juices.

After that, a highly selective, constantly changing proactive membrane called the intestinal lining lets in only the digested foods and prevents other particles from invading the body. In addition, the gastrointestinal system (GI system) has the highest amount of nerve cells in the body, second only to the brain.

Sometimes things go wrong with this system, and we try to fix it by blocking acid production with drugs or by cutting out the gall bladder or parts of the intestine. Such drastic measures are often the sad result of an incomplete understanding of the human body. But a lack of understanding is not really a plausible excuse, because what is discussed here has been known for decades, yet has not been implemented.

Acid reflux happens when the gastroesophageal valve, which prevents stomach acid from going back up the delicate esophagus, is not completely functioning. Acid then irritates the comparatively vulnerable cells of the esophagus, causing discomfort.

The typical allopathic response to this ailment is to prescribe acid blockers. I also did exactly this for many years, though with my knowledge and love of physiology, I intuitively felt it was wrong. It was not until I worked with Dr. Jonathan Wright in Seattle that I realized how severe the consequences of such an approach can be. After all, the acid phase of digestion is critical for absorption of vitamin B-12, the breakdown of proteins and the assimilation of most minerals and trace elements.

Some people live with a genetic condition in which they are unable to make hydrochloric acid. These individuals are at a higher risk for various diseases, including stomach cancer, stomach polyps, gastrointestinal tract infections, osteoporosis and autoimmune diseases.

Imagine what we are doing by creating a drug-induced absence of hydrochloric acid. You guessed it — creating the same problems as the person who cannot genetically make it.

Even the Wall Street Journal caught on to the dangers of using today’s strong acid blockers. In an October 10, 2005, article entitled, “The Hidden Dangers of Heartburn,” Tara Pope discusses the dangers of using the modern proton pump inhibitor. She points out a five-fold increase in cancer of the esophagus since the widespread introduction of acid blockers into the medical system. Acid blockers may help the symptoms of reflux, but they do not cure the cause of reflux.

So what should you do if you have reflux or digestive problems? It turns out, quite surprisingly, that more than three-quarters of patients with reflux have low stomach acid. (This is based on my clinical experience.) The weak acid production, in turn, decreases the stimulus for the valve to shut and, hence, causes reflux.

So the problem, which has often been termed “hyperacidity,” could actually be decreased acid production. Crazy as it initially sounds, in three out of four cases of reflux, the cause is decreased production of hydrochloric acid. Other important causes of heartburn are unhealthy and excessive diets, food allergies and high intake of caffeine.

My advice to anyone with reflux or other digestive problems is to see a health care professional with a holistic outlook. The practitioner can then rule out possible causes of low stomach acid, such as an infectious bug called Helicobacter pylori. This seems to be where probiotics can help with treating heartburn.

There are ways to assess acid production and the integrity of the stomach mucous lining to withstand acid production. Once those things are under control, the practitioner will help determine how to replace the acid you should be making. Chances are that not only will your reflux subside, but the biggest benefit of all is that your digestive system will function normally. This is imperative for a happy ending.

As tragic as the use of acid blockers is, the often unwarranted surgeries done on the gall bladder are even worse. While there are situations where surgery is indicated and helpful, the vast majority of these surgeries are preventable and can do more harm than good. This is especially true when there are no actual stones in the gall bladder, but based on a test called an HIDA scan, patients are told that their gallbladders are not ejecting as much bile as they should. This problem can usually be addressed by cleaning up the diet, adding essential fatty acids like olive oil and eliminating food allergens.

I was on a flight to Seattle once and sat next to a young Mexican man who had just moved to the United States. He had dutifully taken up the American fast food lifestyle and was experiencing fatigue and pains in his gut. He had been told that he needed his gall bladder removed. Having nothing else exciting to do in the air, I explained to him, in detail, what he could do to turn the situation around. He took my card and, about two months later, I received a happy, relieved and grateful e-mail from him about how his problems had resolved, and he felt better than he had in a long time.

I have to add the usual disclaimer that the FDA does not necessarily endorse my views and that this is not intended to be medical advice, but information you can use to find your own way to optimal health.

Help resources

To connect with other people with acid reflux, you can join the discussion on this topic at

If you want to read more about low stomach acid, I suggest an excellent book by Jonathan Wright, M.D., called Why Stomach Acid Is Good for You.


Thomas Alexander, M.D., is a board-certified internal medicine doctor who now practices holistic and integrated medicine in Scottsdale, Ariz. While he has done further studies in endocrinology, his passion is looking at the whole picture. or 480-998-3551.

Reprinted from AzNetNews, Volume 28, Number  4, Aug/Sept 2009.

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