What really causes acid reflux? The conventional answer to this question is that acid backflows into the esophagus via a weak LES but that is not so much a cause as yet another symptom. Even the word ‘reflux’ gives the game away because it refers to a fluid going in the wrong direction.
So why is stomach acid going in the wrong direction? It must be because there’s too much acid, right? After all, the medications for heartburn, acid reflux, and GERD prescribed by doctors all focus on either neutralizing acid or suppressing it, so it must be the acid.
Ads for antacids and other reflux medications echo this: “Rennie works directly on the cause of the problem – the acid in your stomach – to relieve acid reflux symptoms.”
This simply does not make any sense given that the stomach is designed to be acidic in the first place and functions better at a lower pH (i.e. more acidic) than it does at a higher one. A low pH is vital for preventing the overgrowth of harmful microbes like bacteria and yeasts. It is also essential for the absorption of minerals, vitamins and other nutrients from food.
Additionally, it’s well known that as you age, you tend to produce less stomach acid and that acid reflux is more common in the elderly than it is in the young. This gives the lie to acid being the cause of acid reflux and in fact suggests the opposite.
There are two valves in the stomach. At the top is the lower esophageal sphincter (LES) and at the bottom is the pyloric sphincter. Both of them are acid sensitive. When there is a sufficiently acidic environment in the stomach, the top valve shuts and the bottom valve opens.
When there is insufficient acid, however, the top valve remains partially open and the bottom valve stays shut longer, which means food hangs around in the stomach longer than it should.
On top of that, lack of acid means the necessary digestive enzymes are not activated fully so food starts to ferment because it is not broken down properly.
Fermentation produces gas and gas also produces pressure. With the bottom valve shut, the only way the pressure can be released is up, forcing its way through the LES, along with some of the gastric contents.
According to gastroenterologist, Dr. Noar: “The pyloric sphincter has a very narrow diameter. It never opens more than about 2 or 3 mm. So to pass, your food has to be ground down to millimeter-sized pieces.
Your stomach contracts to press food through the pylorus. But the lower esophageal sphincter has to hold against this pressure. If the LES is too weak, it opens. The result is unchallenged reflux.”
To further complicate matters, alkaline reflux has pretty much the same symptoms as acid reflux, including heartburn, nausea and hoarseness and can be caused by PPI medication for acid reflux, which increases stomach bile regurgitation.
“It is common to confuse reflux symptoms for hyperchlorhydria, when the symptom may actually be associated with hypochlorhydria.” Hyperchlorhydia is low stomach acid.
Anything basic, like bile, which has a pH greater than 7, can burn just as much as something acidic.
All roads lead to Rome
Just about every ‘cause’ of acid reflux can be traced back to a bad diet and lack of stomach acid, including SIBO (small intestine bacterial overgrowth), malabsorption of carbohydrates. helicobacter pylori, candida overgrowth, obesity, magnesium deficiency, and hiatal hernia.
The modern diet of excess carbs, sugar, and processed foods is acid forming, as are most pharmaceutical drugs and chronic stress, but they make the body acidic, not the stomach: “The pH of the body has an inverse relationship to the pH of the stomach.”
In other words, your lifestyle and dietary choices are far more likely to be the root cause of acid reflux than the overproduction of acid. An acidic diet, coupled with stress and medication, makes your stomach more alkaline, leading to nutrient deficiencies, an inability to absorb nutrients and a vulnerability to pathogens.
The symptoms of low stomach acid are, among others, heartburn, GERD, indigestion, constipation /diarrhea, and allergies!