Pepsin supplementation possibly makes reflux worse?

Pepsin is an enzyme that the body uses to break down proteins. That's the reason why it is in the HCL supplements as both are important. The key is to keep pepsin out of the esophagus as this causes problems. It has been proven that alkaline water can denature pepsin that is in the esophagus which gets rid of some of the LPR symptoms. I'm not sure if I have any pepsin present in my esophagus but do know that when I eat acidic things it tends to give me more LPR symptoms. The only thing I can come up with is that here is pepsin present and the acid is activating it.

With the supplements the pepsin is also not released until inside the stomach so it should be safe to say that taking a supplement with pepsin will not necessarily cause it to migrate to the esophagus. Reflux must happen for this to occur. And since the body produces pepsin naturally, whether you take the supplement or not, the pepsin will make its way there regardless.

I have read that it is not that acid that causes pain, it is actually pepsin, which binds to the stomach and esophagus and then is activated in an acidic environment.

Are you sure your problem is too little acid rather than too much? I've heard people say it can cause stomach problems but not really reflux problems. The standard test is to take some alkaline ant acids in the morning. If you burp, or feel like you want to burp after a few minutes then the problem is too much acid.

The excess gas that you have may be a byproduct of the food being broken down by bad bacteria. When you don't have enough acid to break down the food and have too much bad bacteria, then the bad bacteria will feed off the food and break it down. The byproduct of that is gas which then causes pressure on the LES which also causes reflux. This would tell me that you still do not have enough acid to break down the food. I have read that when taking the HCI supplement to increase the dosage by 1 pill each time you eat until you feel a burning sensation and then from there on take that dosage minus 1 pill and that would be the dosage you need to correctly break down the food. If you would like to take additional enzymes to help with the process I would suggest taking a multi-enzyme as there are other enzymes besides pepsin that break down protein as well. Bromelain is an enzyme that breaks down protein and I don't think it has the same effects on the esophagus as pepsin does.

If these problems you are having are due to an overgrowth of bad bacteria, you should also take care of that issue as well as it will end up causing other issues down the road. Bad bacteria is usually kept at bay by normal acid production. For this I would suggest taking a probiotic with different types of good bacteria. There are also tests that can be done to determine if an overgrowth of bad bacteria is present. I believe this is considered as SIBO. If you are familiar with the Fast Tract diet, it explains a lot about SIBO and some simple tests you can do at home to determine if this is something that you have. I don't remember the specifics but I think it involves eating certain types of foods and seeing how your body reacts in a relatively short amount of time.

While one day doesn't make a trend, I felt less burpy yesterday while off the pepsin and so far today as well. There were days recently where it felt like I was burping every minute for most of the day, so this feels like progress.

I did still wake up 3 times during the night with some minor reflux, but it did not fill me with dread and anxiety the way it often does. Also checked my saliva and urine pH, there were only slightly acid whereas the day before they were very acidic (around 5 or 6 using the test strips).

Thanks Andy, I have been drinking Aloe and sometimes ginger, but didnt realize they were also anti fungal, nice bonus! It has been hard for me to say whether I have too much acid or too little. During dome days I get burpy soon after eating even while on Zantac (Ranitidine) 150 mg 2x per day.

Or, I may have a day with little burpyness followed by it starting at night. Then, always I get a fair amount of throat gurling during the night that may have some amount of reflux with it and this is what always wakes me up as I am a light sleeper.

So maybe I just produce a lot more acid at night. Considering taking a dose and a half of Zantac at night to see if that can stop the night time waking...

Progress so far is that sleeping more upright and getting off the pepsin has me going two nights in a row without feeling any dread or anxiety upon waking from the reflux, which means it is usually easier to get back to sleep and I think deeper sleep at that, will gladly take that for now...