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The Truth About Acid Reflux and H2 Blockers

Inflammation Circuit

By: Michael Lam, MD, MPH; Carrie Lam, MD; Jeremy Lam, MD

An image of a diagnosis of Gastritis along with some capsules and tablets of H2 BlockersH2 blockers are commonly-used medications for gastrointestinal (GI) tract disorders that cause excess stomach acid. You can get some of them over the counter, while others are given with a prescription only. Along with Proton Pump Inhibitors (PPIs), their main action is to inhibit the production of stomach acid. At face value, they are very effective. H2 blockers are able to reduce stomach acid production by up to 70% over a 24-hour period.

But these gastric acid suppressants may not be the best way to deal with GI tract disorders that produce excess stomach acid because they don’t actually solve the root cause, and ultimately have negative effects on health.

A Guide to Gastric Disorders

GI tract disorders that create a state of gastric hyperacidity include acid reflux, Gastroesophageal Reflux Disease (GERD), peptic ulcers, gastritis, and Zollinger-Ellison syndrome (ZES). These and other common digestive disorders can have a big effect on your health.

GERD

Gastroesophageal Reflux Disease (GERD), or chronic acid reflux, is a very common condition affecting between 10-20% of the population in North America. Pregnant women are especially vulnerable to GERD, as are those with a hiatal hernia, where the upper part of the stomach bulges upwards through the diaphragm.

GERD affects the lower esophageal sphincter and its symptoms include:

  • Heartburn after eating, which sometimes worsens at night
  • Regurgitating food or fluid that usually tastes sour
  • Pain in the chest
  • A lump in the throat
  • Difficulty swallowing
  • Persistent cough
  • Aggravation of asthma
  • Laryngitis

Peptic Ulcers

Peptic ulcers are sores, or openings, in the stomach’s inner lining, which are called gastric ulcers, and also in the lining of the top part of the small intestine (duodenum), which are called duodenal ulcers. Up until a few decades ago, peptic ulcers were thought to be caused by stress and eating spicy food (which do worsen the condition but do not cause it). Now it is well documented that they are caused by H. pylori bacteria and by prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Symptoms of peptic ulcers include:

  • Burning sensation in the stomach
  • Heartburn
  • Pain
  • Bloating
  • Burping
  • Nausea
  • Feeling full
  • Vomiting
  • Vomiting blood
  • Blood in stools
  • Blackish stools
  • Weight loss
  • Breathing difficulty
  • Changes in appetite
  • Feeling faint

Gastritis

Gastritis is inflammation in the stomach’s lining, which can be caused by the same bacteria that causes peptic ulcers, from the overconsumption of alcohol, and from the overuse of pain medication. It can be chronic or acute, and if left untreated can lead to peptic ulcers and even stomach cancer. Its symptoms include:

  • Indigestion
  • Feeling full after eating
  • Nausea
  • Vomiting

ZES

ZES is a condition where tumors, called gastrinomas, develop in the duodenum and pancreas. These gastrinomas secrete a lot of gastrin, which then triggers acid production in the stomach. It’s a very rare condition, and its symptoms include:

  • Burning sensation in the upper abdomen
  • Heartburn
  • Acid reflux
  • Diarrhea
  • Nausea
  • Vomiting
  • Weight loss
  • Changes in appetite
  • Bleeding in the GI tract

Inflammation: The Common Denominator

An image of a woman laying on the couch holding her stomach next to a plate of unfinished cake. She is in need of a H2 Blockers to help with her upset stomachIn all of the different GI tract disorders that can cause excess stomach acid, the one thing they have in common is some type of inflammation. In fact, inflammation is either the cause or the result of the condition, or both.

But inflammation is the correct response to the different stressors that your GI tract, and your body in general, faces. These stressors can include:

  • Bacterial and viral infections
  • The overuse of certain medications
  • Unhealthy diet
  • Exposure to toxins
  • Chronic diseases
  • Mental/emotional distress
  • Alcohol and drug use
  • Exposure to allergens

The inflammation circuit is one of six circuits of the NeuroEndoMetabolic (NEM) Stress Response, which is your body’s global response to stress. The other five are the hormone, the bioenergetic, the cardionomic, the neuroaffect, and the detoxification circuits. They all work together to fight the harmful effects of stress.

The inflammation circuit is composed of the immune system, the gut, and the microbiome. When the gut flora is off balance and leaks develop in the gut lining, substances enter into the bloodstream that shouldn’t be there. This prompts an immediate immune response, which then creates inflammation in the area. But if these leaks persist and the microbiome remains unbalanced, the immune response will keep going and the inflammation becomes chronic.

This inflammation can travel to other parts of the GI tract, causing different issues there, and to the rest of the body as well. Inflammation in the lining of the stomach is called gastritis, and it can lead to peptic ulcers and even stomach cancer. If it does end up causing issues such as peptic ulcers or GERD, a natural result will be excess stomach acid.

But understanding all of this leads us to one conclusion: before reaching for H2 blockers or PPIs, we need to manage the stressors that are causing this inflammation in the first place. We also need to understand the role of adrenal fatigue in order to ensure a full recovery.

The adrenal glands are part of the NEM’s hormone circuit, and they produce your body’s main anti-stress hormone, cortisol, which is responsible for inhibiting the immune system and neutralizing inflammation once their job is done. But with chronic inflammation, and any kind of chronic stress, they work until exhaustion, at first producing a lot of cortisol until they can’t produce it anymore. This condition is called Adrenal Fatigue Syndrome (AFS).

Symptoms of AFS include fatigue, weight gain, insomnia, hair loss, loss of libido, food and drug sensitivities, heart palpitations, hypoglycemia, PMS, infertility, lowered immunity, constipation, and GI tract issues.

The Alternative to H2 Blockers

Diet and lifestyle changes that address the root causes of GI tract disorders, including those that create excess stomach acid, are healthier and more sustainable than taking H2 blockers or PPIs. To be fair, if you only needed H2 blockers occasionally, it wouldn’t be a cause for alarm. But unfortunately, it’s a regular practice in the medical community to prescribe them indefinitely.

Different studies have shown that using H2 blockers and PPIs can trigger or aggravate health problems. For example, a meta-analysis conducted in 2017 on 7,703 people found that 50% of those with a recurring C. difficile infection were also using some kind of gastric acid suppressant. Some H2 blockers have also been found to worsen kidney problems.

Although side-effects are not very common, they are still worth noting, and they depend on the type of gastric acid suppressant you take. Side-effects can include headaches, diarrhea, dizziness, and rashes.

If you have AFS, especially in the more advanced stages where your adrenals are exhausted, many of your body’s functions will have slowed down in order to conserve energy. This includes your detoxification circuit, which is responsible for getting rid of toxins and metabolic byproducts, including those that are left over after the breakdown of a medication. Using medications such as H2 blockers and PPIs adds a bigger load to your liver and the rest of your already-overworked detoxification circuit. This can lead to energy crashes, gastric slowdown, and ultimately a catabolic state in some people.

This creates the risk of increased toxicity levels in the system, which brings its own set of challenging health issues. And if these medications are only treating symptoms on a surface level, without addressing the root cause, then they should only be used if very necessary, and the bulk of recovery needs to be focused on diet and lifestyle.

The most important step you can take is to reduce any causal stressors. Try to find the root causes of your particular condition, and do your research to ensure the steps you take to address the cause. Of course, if your peptic ulcers are caused by H. pylori infection, you may need to take antibiotics. But be aware that you will need to rebuild your microbiome after, since antibiotics are one of the biggest culprits in microbiome imbalance.

An image of a Variety of fermented vegetables in glass jars, an alternative to taking H2 BlockersThe adrenal fatigue diet is very anti-inflammatory and gentle on digestion. Add to it a few probiotic-rich foods that support the microbiome, such as miso, kimchi, sauerkraut, and kefir, and that’s already half the battle. Bone broth is also especially good at sealing up the leaks in the gut . Make sure to stay away from spicy food or fatty foods at first, since they can make your acid reflux worse, until your digestion is back to normal.

This kind of diet will also strengthen the adrenals so they can begin to secrete cortisol again and neutralize inflammation. Also, cortisol will help with stress, but you need to make sure you are doing your part in reducing it. Get enough rest and sleep, and only take supplements you know are suitable for your current needs and condition. If ever in doubt, it is always best to be supervised by an experienced medical professional who has a holistic approach to health.

 
© Copyright 2019 Michael Lam, M.D. All Rights Reserved.


Dr. Lam's Key Question

Acid reflux, GERD, gastritis, and peptic ulcers are all common gastrointestinal conditions that can make your life miserable. But taking H2 blockers and proton pump inhibitors are only a temporary solution. What you need is to address the root causes. Here’s how.

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