Before I studied nutrition, the only thing I knew about stomach acid was from looking down the stomach aisle at the pharmacy. From what I saw, I assumed it must be something bad. I now know this is totally not the case! In fact, stomach acid is one of the key components of our digestive system. It’s rare that someone is producing too much stomach acid, even though some of the symptoms such as acid indigestion, heartburn or GERD might make you feel otherwise. So, what’s the deal, then?

The major purpose of stomach acid is to breakdown food once it enters the stomach. If we are producing adequate amounts, the acid is able to properly break down the fats, carbohydrates and proteins so it may move along to the next phase of digestion. Stomach acid also ensures we are able to absorb the nutrients from the foods we’re eating. When someone suffers from low stomach acid, a condition known as hypochlorhydria they are unable to actually reap the nutritional benefits of the food they eat. When our food is not broken down properly it can sit there-in our stomachs-until the process can be completed. What exactly does this look like? It’s not pretty. Undigested food in the stomach translates to rancidified fats, putrefied meats and fermented carbohydrates-which leads to, you guessed it-heartburn, gas and bloating, among other symptoms. Are upper GI conditions such as heartburn always caused by low stomach acid? Not necessarily, but quite often this is the case. Taking acid-reducing medications providing temporary relief only will worsen the issue long-term.

Chronic or long-term hypochlorhydria, especially from long-term use of acid-reducing medications can lead to lack of mineral absorption, increased osteoporosis, autoimmune complications and increase the risk for SIBO. Another more surprising issue that can arise is for people who have food sensitivities or allergies. There is evidence showing that food allergies can cause gallstones, which can block bile from being released and ultimately lead to infection or inflammation in the body. This process can be linked to low stomach acid secretion, so in essence, an individual who suffers from food allergies or sensitivities could greatly help their digestive process by not only identifying and removing those foods from their diet, but working on building up and regulating their stomach acid production.

So, the big question-what can we do to increase stomach acid production? Stay tuned for Part Three of this series to find out!


Resources:
Kines, K., & Krupczak, T. (2016). Nutritional Interventions for Gastroesophageal Reflux, Irritable Bowel Syndrome, and Hypochlorhydria: A Case Report. Integrative medicine (Encinitas, Calif.), 15(4), 49–53. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991651/

Wright, J.V., Lenard, L. (2001) Why Stomach Acid is Good For You. Lanham, MD: M. Evans, An imprint of The Rowman & Littlefield Publishing Group, Inc. 

In the Spring of 2017, I began experiencing pains under my left rib cage. It was startling enough to make an appointment with my doctor, who quickly theorized the term I’d grow to hate-stomach ulcer. I was tested for H. Pylori, an infection thought to be the major cause of peptic ulcers but the test came back negative. So, she sent me to the pharmacy for some over the counter antacid medication and told me to call if it got worse. I took the medication for about two months with little relief. This was the Summer I officially gave up underwire bras out of sheer pain from the wire resting on my ulcer (If there’s a bright side to this phase of my life, it’s that I ditched underwire bras for good and have never been comfier!)

About a year and a half later, I had grown lazy and the pain came and went, but always came back. This was when I realized I finally had to get real with myself. At this time, I also was smack dab in the middle of my Nutritional Therapy Practitioner program and had just read the book “Why Stomach Acid is Good For You” by Jonathan V. Wright MD and Lane Lenard, PhD which only further reminded me of the dangers of not letting this ulcer finally heal. An untreated ulcer could lead to perforation and ultimately the acid can burn a hole through your stomach lining, which can be life threatening. In addition, ulcers cause inflammation in the body and any type of chronic inflammation can lead to a whole host of issues, including cancer.

So, how did I finally find relief and heal my ulcer?

Eliminating coffee: A tragedy, part one
The first step is admitting you have a problem, right? I convinced myself that I had “tried everything”-except I hadn’t. I was so resistant to giving up coffee, but let me tell you-this was a big game changer. It wasn’t easy-I was easily drinking at least two or three cups a day. But, after a hellish week of hating everyone and having the world’s longest headache, I finally adjusted and no longer was in pain with each sip. Sometimes, you have to be real with yourself. In this case, I realized was really hurting myself and my caffeine addiction was a major factor.

Eliminating alcohol: A tragedy, part two
Did you know alcohol is a gut irritant? Makes sense, right? For someone with a sore on the lining of the stomach, alcohol is a big no-no. It was tough, but giving up wine until my ulcer healed combined with no caffeine was when I finally started to notice a big difference in how I felt. Not to mention I was sleeping better and felt more refreshed overall.

Natural Supplements: Why is my poop green?
Let me preface this by saying I am not recommending any sort of supplement to anyone except explaining what I took and why I chose to take it. But, as an NTP I am well versed in a variety of natural supplements that can help heal the body. The protocol I laid out for myself was done so with a lot of trial, error and research:
Gastrazyme: This is a supplement made primarily of chlorophyll and raw cabbage juice. Raw cabbage juice itself has been known to have healing effects for the GI and intestinal tract. Gastrazyme also has Vitamin A, which aids in the development of epithelial cells. One note: Don’t be surprised if the chlorophyll turns your poop green!
L-Glutamine: One is the most abundant amino acid in the body, glutamine has a number of health benefits benefits, one of which is to support the integrity of the mucosal lining. In the mucosal lining of the small bowel, glutamine is actually a fuel for metabolism, regulating cell proliferation, repair and maintaining gut barrier functions.
Bone Broth: In addition to a number of nutrients, bone broth contains collagen and glutamine, which can aid in the healing of the gut lining. I recommend making your own-it’s not as scary as you think! If you have an Instant Pot, I love using this recipe from Primal Palate:
https://www.primalpalate.com/paleo-blog/instant-pot-beef-stock-bone-broth/

I found that when my ulcer was at its worst, drinking bone broth each afternoon was really comforting and seemed to provide some relief and I do believe sped up healing. Whether that’s true or not, it did make me feel better and tasted delicious!

When all else fails: Listen to your doctor
I know-this sounds obvious. While it’s important to do the research and be in the drivers seat of your own health decisions, it’s important to work side by side with your doctor or medical professional. While in school, I learned about the importance of stomach acid and when my ulcer returned, I decided, against my doctor’s advice to try the more natural approach and not take the medication they had recommended. After months of trying to heal with little relief, I decided to begin taking the medication again (a proton pump inhibitor). In my case, this was the best decision for me. By reducing my stomach acid during this period of time, the ulceration was able to heal. Combined with the gut-healing nutrients I was taking, I finally felt better and was glad I listened to my doctor. Remember, it's important to advocate for yourself but working alongside your doctor or medical professional will help you come to a mutual understanding, which is the often the best chance for positive health outcomes.

Inhale. Exhale.
For many, stress and anxiety increases the production of stomach acid, which is why for years people theorized that stress caused stomach ulcers. While there is not enough research to prove the direct cause, it can have an impact on healing. If you suffer from stress or anxiety I urge you to do what you can to try to reduce your stress levels. Seek the help of a professional if needed-stress can lead to a whole host of health issues, not to mention prolonging your healing.

Patience is a virtue
An ulcer is an open sore on the inside of your body-it’ going to take time to heal. Once you start to feel relief, it’s important to take enough time to truly heal before you start increasing your stomach acid or introducing any of the gut irritants you had to give up in order to get to that point of feeling better. As tempting as it might’ve been, I maintained the protocol for many weeks after the pain went away to be sure I was finally healed. It's not worth it to have to backtrack your progress. 

In conclusion, stomach ulcers can be, quite literally, a giant pain-but it doesn’t have to be that way forever. By working with your doctor, nutritionist or holistic medical professional, you too can be on your path to health and healing. And, bonus-now that I have the experience and tools in my kit to know how to find relief, if I'm ever faced with another ulcer I'll know exactly how it needs to be addressed. 

Resources:
Biotics Research (2016) Retrieved from https://www.bioticsresearch.com/sites/default/files/LIT-042%20Gastrazyme%202016-BRC.pdf

Rao, R., & Samak, G. (2012). Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. Journal of epithelial biology & pharmacology, 5(Suppl 1-M7), 47–54. doi:10.2174/1875044301205010047 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/

Wright, J.V., Lenard, L. (2001) Why Stomach Acid is Good For You. Lanham, MD: M. Evans, An imprint of The Rowman & Littlefield Publishing Group, Inc. 

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Coffee and I have been best friends for quite some time. In high school, I distinctly remember my Mom trying to shove coffee down my throat out of desperation after yet another morning of trying to wake me up for school. Once I entered college and the working world, it became an addiction. Sure, I joked about it-but the idea of sitting down in my tiny cubicle and starting my day without my morning coffee would be downright unsettling. So unsettling, in fact that I was often late for work, just so I could start my day without the added stress of not having my delicious morning beverage.

How did I know it had become a problem? In the Winter of 2018 during a terrible storm, we woke up to a basement with several inches of water and the entire county was without power. My biggest concern? Not that my cat’s litter box was floating across the room. How would I get my coffee?

I knew it was bad, but after developing a stomach ulcer that just wouldn’t go away, I finally knew I had to do it-I had to end my coffee addiction. The fact that I felt my stomach ripping apart after each sip and I somehow didn’t care eventually reminded me that this had to end. So-I did it. I went cold turkey. No coffee, no caffeine for the unforeseeable future. Those first few days, to put it mildly were…AWFUL. I was nauseous, dizzy, weak and ready to bite everyone’s head off. I hated the world and I especially hated those heathens in the Starbucks drive-thru line. And the headache? I actually had to take a day off work because I could barely see straight. By the fourth day, the symptoms started to subside and as each day passed, I slowly stopped caring less and less about those people in line getting their coffee. By the end of the first week, I stopped wanting to bite everyone’s head off. By the end of the first month, I finally started to feel like my ulcer was on the path to healing.

Now? Okay, so I’d be lying if I said I didn’t still indulge in the occasional decaf here or there now that my ulcer finally healed. So, why not go back to my regular caffeine habits? I’ve come up with four reasons I’m continuing to live a limited caffeine lifestyle and why you may consider doing the same:

Caffeine impacts your stress hormones
When we immediately start our day with a stimulant such as coffee, we’re sending a signal to our stress hormones that we’re ready for attack. Our body will release the hormone cortisol to help regulate our hormones and calm us down. So, what’s wrong with that? Cortisol is a really important hormone to help us in those fight or flight moments (think of our ancestors when they had to ward off an animal attack). Unfortunate for us, we now live in a world that is constantly stressed OUT. All the time. Simply sitting in traffic each and every morning can trigger that same cortisol response that our ancestors only dealt with when faced with the occasional threat. By consuming that morning cup of coffee, we’re setting up our day to be a roller coaster of hormonal spikes and crashes before we’ve even faced any of those outside stressors. Elevated levels of cortisol can lead to insulin resistance and adrenal fatigue, which each come with a whole host of unpleasant signs and side effects. With life’s stressors being bad enough, why make it worse?

I can speak from experience and say that my anxiety levels have definitely improved since lowering my caffeine intake. When the going got rough, my instinct in the past was always to run to my Keurig or down to the cafeteria at work. I thought coffee would calm me down. In fact, it only elevated my anxiety even more. I didn’t realize this until I broke the habit, so you’ll just have to trust me on this one.


Caffeine impacts our blood sugar levels, blood pressure and more.
Okay, so this isn’t so much a criticism of caffeine as it is for the things some of you might be adding to your coffee- flavored creams and sweeteners. Remember what I said about caffeine impacting our cortisol levels? Combine that with a first-thing-in-the-morning, blood sugar rush from added sugar and we’ve set our day up for a roller coaster of imbalance. Added sugars supply food energy but no other nutrients (what is known as “empty calories”) and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. If you aren’t ready to nix the coffee habit completely, consider lowering or eliminating the added sugars. This is where reading food labels comes in handy. Many creamers labeled as having “natural ingredients” include cane sugar. It took me a while, but once I lowered and finally got rid of the sugar in my coffee for good, I began to truly appreciate the taste of the coffee even more (which isn’t really helping my argument for eliminating coffee from your diet, but baby steps, right?). Things like pure vanilla extract and cinnamon are great additions (or decaffeinated tea) that won’t do the same damage as sugar.

Caffeine and our hydration levels
For years, I woke up and the first thing I consumed was my cup (or three) of coffee. But, did you know that diuretics such as coffee, tea or soda can have a huge impact on your body’s hydration? Hydration is a key foundation in overall health-arguably the most important. Dehydration can lead to migraines, digestive issues such as constipation or colitis, depression and joint pain, to name a few. The general rule of thumb is to consume in ounces your body weight divided in half (example: A 140 pound person should on average consume 70 ounces of water). However, diuretics can detract from this and make us further dehydrated. If you do consume caffeine, we should be adding roughly 1.5 ounces of water per ounce of diuretic on top of our regular water consumption in order to stay properly hydrated.

Caffeine and our circadian rhythm
Our circadian rhythm is the process in the body that regulates our sleep and wake cycle. There are many disruptors in modern day life that can impact our circadian rhythm including light cycle, eating habits and yes-caffeine. An article published by Science Magazine shows a study where participants consumed caffeine up to a few hours before bed. The results showed upwards of a half an hour delay in their natural sleep cycle-meaning, it made it harder for the participants to fall asleep. For those of you who regularly consume caffeine later in the day, this could be impacting not only your ability to fall asleep but to stay asleep and wake up feeling fully rested.  

Conclusion
While I decided to address my caffeine addiction because of a serious medical issue, I’ve seen so many added benefits besides healing my body. One of the biggest? Being able to drive down the street and no longer feel the gravitational pull each time I pass a coffee shop. It’s given me a sense of freedom to no longer need coffee, but rather have it only when I really am going to enjoy the experience (and forget what anyone tells you, decaf can be just as delicious as the real deal). Plus, I know that the next time we get another storm and there is no coffee shop open for miles, I won’t bat an eye. Ah…freedom.

References:
Burke, T. M., Markwald, R. R., McHill, A. W., Chinoy, E. D., Snider, J. A., Bessman, S. C.,  Wright, K. P., Jr (2015). Effects of caffeine on the human circadian clock in vivo and in vitro. Science translational medicine, 7(305), 305ra146. doi:10.1126/scitranslmed.aac5125 Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657156/
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Delli Bovi, A. P., Di Michele, L., Laino, G., & Vajro, P. (2017). Obesity and Obesity Related Diseases, Sugar Consumption and Bad Oral Health: A Fatal Epidemic Mixtures: The Pediatric and Odontologist Point of View. Translational medicine @ UniSa, 16, 11–16. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536157/