What if we got it all wrong?

Just wondering how many of us ever thought that we could have had it all wrong with why we have GERD/LPR:

We know that lots of time it's caused by the LES/UES not working properly or staying open, yet lots of time when given PPIs the symptoms often return or don't improve much at all.

What if the REAL causes are to due with LOW stomach acid and vagus nerve damage/malfunction?

To my understanding the LES/UES are controlled by nerves just like lots of other organs/structures in our body, so is stomach acid production. LES/UES also would only close properly if the acidity in the stomach is at 2.5-3 Ph to properly close. These valves could also fail to function properly if the nerves are not working.

So what if the real culprit of our problems are all to due with the vagus nerve which controls the opening/closing of valves and stomach acid production not working properly? This might be what the medical world really need to work on is to learn how to restore the proper functioning of nerve systems and the important of stomach acid - Without enough not only do we not digest or absorb well (we need enough acid to properly digest protein and sterilize food to prevent stomach gas, and to trigger bile/pancreas enzyme release) This might also explain why lots of GERD/LPR patients also have nerve-related problems like low esophagus mobility, IBS, and so on.

Just a thought when we are usually just shoved with PPIs or surgeries when the real cure might be dysfunctional nerves and/or low stomach acids!

I hear ya Lostahguy, I actually have/had out of the blue digestion/absorption and IBS-like problems and had 2 bad colds/flu before all this LPR-like problem started, which is why I am thinking the vagus nerve have been damaged from either virus or being under some sort of stressful events. Have you tried a neurologist that specializes in vagal stimulations etc.? I might find a so called chiropractor neurologist as they seem to be able to help patients with vagal irritations/damage
(http://ehealthforum.com/health/symptoms-of-vagus-nerve-dysfunction-t321969.html0)

Lack of stomach acid would also explain why I started having quite a bit of gas and burps and not gaining weight back (food not getting properly digested and absorbed). I try the HCL Betaine capsules to see if they really help.

Here's a pretty interesting video that seem to explain a lot (although some people might discredit it because "he's not an MD")
http://www.youtube.com/watch?v=lvSWgwKJavw

Right on, liang!

It is estimated by some that 90% of GERD and heartburn and reflux is caused by too little stomach acid, especially among people over 50 who's acid production has dropped as a part of aging. If you have no other stomach ailment that requires acid reduction to get healed (ulcers, gastritis, etc.) you owe it to yourself to explore this possibility.

I'm not sure if I can post links to other sites here, so just Google Chris Kresser, and read his articles on Gerd and Heartburn. He will explain how low acid makes perfect sense and can cause almost all the other symptoms people complain about that go along with heartburn. He will also explain a simple test you can do using Betaine HCL that you can buy at almost any drug store or health food shop to determine if you have low acid. You'll need to be off any other acid reduction drugs to do this test. Do that with caution, as it must be done gradually.

BTW has anyone tried this? (Gaviscon Advanced Raft)

http://fauquierent.blogspot.tw/2010/10/gaviscon-advance-for-non-acid.html

BTW just curious... How many of you have a really cold sinus cavity? This might sound weird but lots of time when I clean the nasal passage the inside feel ice cold, surely that' not normal?

ive got the gaviscon not alu advance stuff, its basically double dose from my understanding.

i dont think its a case of getting it wrong, i think its a case of ignorance on behalf of some doctors and some patients.

liang7079 said...
BTW has anyone tried this? (Gaviscon Advanced Raft)

http://fauquierent.blogspot.tw/2010/10/gaviscon-advance-for-non-acid.html

I use the Canadian version of Gaviscon. It contains 313mg of sodium alginate, along with magnesium carbonate. The US version has aluminum, which I choose to avoid. The US version does have sodium alginate, but it is listed as an inactive ingredient, for some strange reason, so there is no way to know how much of it is in there.

Life Extension also makes a similar product called Esophageal Guardian. It has 500 mg sodium alginate per tablet, along with calcium, magnesium, and potassium carbonates or bicarbonates.

The blog linked above says its for non acid reflux, but it can be used for any type of reflux. It creates a gel like layer that sits atop your stomach contents and prevents anything from entering the esophagus.

This kinda confirm the theory that lots of our "mysterious" and chronic conditions are really nerve-related from viral damages or shock/stressful events etc or physical damage ie. surgery.

http://www.youtube.com/watch?v=L-y3GeQeOwM

Oh, I also had absorption problems and digesting difficulties and bloated ness , they settled down 6 months after the initial problem started .

yep i agree re posture. also i found binge drinking fizzies like beer initiated it.

sometimes now though, i think its pressure.

its a combination of so many things for me, but bad posture and this pressure that just pushes it up are the worst. i possibly have SIBO hence the back pressure. i eat a GAPs diet now, it helps so far.

well id say 99% of my gerd occurs when i need to relieve pressure. i didnt notice it until i started really analysing my gerd. often id need to burp, but often it is just a slight pressure needing to escape. not sure if this is the result of sibo or not.

also id say some people just eat too much. not everyones stomach is 1-1.5l im sure. some maybe bigger, some smaller. and most people dont realise how long it really takes to digest food from the stomach. its possible to continuously be adding food to a stomach. if i had night time gerd, i wouldnt eat at least 5 hours before bed. but thats just me.

liang7079 said...
Thanks for your answers people! I seriously was about to order the Gaviscon Advanced when I read it contains Potassium Bicarbonate which neutralizes stomach acid - I am already having some digestion/absorption issues (and the Betaine/Pepsin capsule did not cause any discomfort, which probably confirm that I am not producing enough acid) so don't need to neutralize what little acid I have left. I might try just the Sodium Alginate (it is available on its own)later on.

liang - there are so many different versions of Gaviscon out there, even in one country, that it's difficult to keep it all straight. Then add the even further differing versions in other countries, with the weirdest of all being here in the US, where is lists sodium alginate as an INACTIVE ingredient - it can make your head spin.

But they all have various combinations of sodium alginate (or aglinic acid) and some type of carbonate or bicarbonate. And the carbonate comes in various forms as well, usually calcium, magnesium, potassium, or sodium. They way I understand it, you need both ingredients to make it work. The carbonate acts as an activator for the alginate. When they mix together with whatever liquid you drink with it, the carbonate causes the alginate to bubble up into a foamy gel, one that floats on top of all your other stomach contents, creating that barrier to the esophagus. Kind of like oil on top of water. They don't mix.

As far as I can tell, the amount of carbonate needs to be at least 15-20% of the amount of alginate to make it work right. That's the widest ratio I have seen. So if you have 500 mg of sodium alginate, there should be, at the least, about 75 mg of one of the carbonates.

So when you get up to the Gaviscon Advanced formula, with 1000 mg of sodium alginate, there will likely be 200 mg of potassium carbonate per dose. Like you, I am taking betaine HCL. At first it was just with the main meal, but now that I realize I am not making enough acid on my own, I take some with each meal, but a little more with the largest meal. My reflux issue has been only at night while lying down (usually in the middle of the night), so I take Gaviscon every night around 8pm. The Canadian version I use has 63 mg of magnesium carbonate and 313 mg of sodium alginate.

With that small amount of magnesium, I am not worried about it neutralizing much acid. And I could always take a little more HCl to counteract it if I was. As soon as it mixes with the alginate, which happens right away, it's going to stay up there on top of everything, so I don't think that tiny bit is going to work against me. To put that 63 mg in proper perspective, a single tablet of TUMS contains 750 mg of calcium, and the suggested dose is 2-4 tablets.

Gaviscon can be a life saver - perhaps literally, if you have Barrett's as I do. I wouldn't dismiss if for fear of neutralizing your acid. Or try the Canadian formula or the Life Extension version, if the Advanced seems like overkill. Canada drugs dot com can get you Gaviscon and Amazon the Life Extension brand.

Post Edited (rjdriver) : 2/15/2014 5:13:09 AM (GMT-7)

Interesting theory.  I read up on the vagus nerve right before my Nissen Fundo because they said there was a very slim chance it could be damaged during the surgery.  I was shocked at how much that very important nerve does; Major impact to so many functions.

However, I never thought about it in reverse, that maybe it had something to do with the reflux itself.

Too late regardless for me, I already had the surgery 12/2012.  I am glad I had it, but the side effects are a bit bothersome.  Major gas pressure and bloat no matter what I do.  I think I have burped all of 12 times since my surgery.

I acquired my reflux about 20 years ago while going through infertility treatments.  I was on major hormone shots, and 6, yes 6 estrogen tablets a day.  I thought I had an ulcer because I had one as a teenager.  Nope, just like everyone says......"here's a purple pill, you'll have to take it for the rest of your life." 

Also, my breathing issues and burning lungs were always blammed on allergies, but I know for a fact we can all aspirate on reflux acid and damage lungs.  My friend had this happen, and so did I.

Haven't been on the site for a while.  This is truly a wonderful site!  Take care, Anita