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Re: GERD tangent » Quintal

Posted by Larry Hoover on December 11, 2008, at 18:56:16

In reply to Re: GERD tangent » Larry Hoover, posted by Quintal on December 11, 2008, at 11:42:21

> Thanks Lar, my doctor hasn't said exactly what it is. I started having this problem last year when I was using ibuprofen every day, so she thought it might be a patch of inflammation. I've have always had a tendency towards reflux/regurgitation, maybe due to a weakness in my lower esophageal sphincter? I have some of the other symptoms of GERD like excessive salivation and pain on swallowing. Right now I'm having to take 60mg lansoprazole and the pain hasn't entirely gone away yet. It's hard to eat. My doctor was giving me 15mg p.r.n last month but that didn't give much relief. Antacids seemed to make it worse.

Have you been tested for Helicobacter pylori? It's the bacterium that is a leading cause of ulcers. Stressors can trigger many of your symptoms. Alternatively, you seem to be describing classic GERD symptoms. Gas pressure can make a competent esophageal sphincter leak, so an upper GI barium x-ray series is often required to see what's really going on.

> I too am concerned about nutrient deficiencies and other imbalances that might happen as a result of excessive acid suppression. I was wondering if abnormal stomach pH has any effect on the digestion of proteins? We were taling about optimum pH of enzymes in class this week and pepsin happended to come up as an example.

Absolutely the case. Pepsin is inactive if you suppress stomach acid. That's one reason I started using bromelain. It's not only a good digestive aid, easily breaking down protein, but it's also a potent anti-inflammatory.

> I didn't know anything about the process of acid release/production, thanks for the advice. I'm not sure I've grasped it properly. Does this mean B12 deficiency leads to a delay in acid release so even less B12 is absorbed?

Yes.

> Which would then be a viscious circle until you correct the problem by supplementing B12 (I suppose via the sublingiual route)?

Sublingual is best, but high-dose oral supps (I mentioned the 1 mg size) still leads to intestinal uptake, presumed to be via osmosis. In North America, doctors give B12 shots for pernicious anemia, whereas in Europe, they simply use high-dose oral B12. Both work, but I bet the patients prefer avoiding the needle stick.

> And PPIs might aggravate the underlying problem (even though they treat the symptoms) since they further impair B12 absorbtion?
>
> Q

Indeed. You understood my intent. I struggle to keep from writing a book each time I post.....there are factors and considerations and feedback controls and blah blah. It's really pretty complicated. Your stomach has to sense the presence of food, the type of food, and how much, before it can appropriately secrete acid, enzyme precursors and other substances. Consider the hormone, gastrin http://en.wikipedia.org/wiki/Gastrin
And look at section 1.5 'Factors influencing...'

PPIs do indeed treat the symptoms, but they lead to further complications, including dependency on the treatment itself. Moreover, you face iatrogenic (doctor caused) achlorhydria, which is a problem in itself.

Lar

 

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poster:Larry Hoover thread:866984
URL: http://www.dr-bob.org/babble/20081204/msgs/868174.html