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Low acid vs high acid theory

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Posted 5/10/2013 2:58 PM (GMT -5)
I know this topic has come up before but here is my take. I am little out place with my thoughts because I just go back and I wanted to ask this.

For those who have taken the acid test with their doctors. I forget the name of the test, it is the one where you stay with this portable machine to measure your acid levels during 24 hrs. If the test shows your high in acid than that mean you have an acid problem right? You would need PPIs or acid reducers.

If the test was to show normal or no acid would't that mean that more acid would be necessary?

We hear about ppl "curing" their heartburn/GERD/LPR with HCL or ACV. However, wouldn't this be an issue for older people? Or could it inlcude young people. I mean, can someone have low acid if they are not eating well or have candida or SIBO?

Has anyone received test results with low acid? I just dont get how some ppl improve on it and others do not. The theory is that food stays in the stomach while it ferments and it creates acid reflux. But if you had the Nissen, some ppl still have symptoms don't they?

Sorry I am all over the place. Ultimately what I am asking if everyone here believes or has been tested with the 24hr test and shown they have high acid levels? The obvious answer would then be to reduce the acid, but it is a double edge sword because you can suffer from taking ppis in the long rum. And woulnd't the food start fermenting in your stomach after reducing stomach acid for a while, thus inducing the rebound effect many ppl get?

 

Posted 5/10/2013 3:48 PM (GMT -5)
Here's my understanding: we all have too much acid for the fragile tissues of the esophagus. When the acidic stomach fluids go up through the LES, that causes heartburn for most people. The meds reduce the acid in your stomach so you don't feel the burning. Acid reducing meds to not treat the cause of the heartburn.

Some people do find that the cause of their heartburn was too little acid, so they add acid like HCL, food digests better, and the pressure on the LES is relieved. Once stretched, the LES doesn't go back to the way it used to be, but you can improve a lot.

I finally got off meds by following the Fast Tract for Heartburn diet. Getting off the meds and avoiding hard to digest foods (especially resistant starches) enabled me to finally heal.

Here's an article on resistant starches: http://digestivehealthinstitute.org/2013/05/10/resistant-starch-friend-or-foe/

 

Posted 5/10/2013 5:13 PM (GMT -5)
The 24 hour pH tests measure reflux events above the level of the stomach. So neither "high acid" or "low acid" would be correct terminology. A person has a high # of reflux events, of either acid or weakly acid material, or they have "normal" exposure. The latter category may still experience symptoms from even "normal" exposure, and it does NOT indicate that the acid content of their stomach is low and needs to be increased (by way of HCL or ACV).

I personally don't buy the "low stomach acid" theory at all. Many people do great on PPIs. Though PPIs do increase food transit times, it's hardly true that people are having symptoms from food sitting there fermenting in their stomachs for too long.

Posted 5/10/2013 6:56 PM (GMT -5)
drtinsac, I think what Nickles means by "high acid" is the total amount of acid present at one time. I can say from my experiences and my pH probe results that I break this rule. I have an average amount of acid in my stomach at any one time and an average pH, and I still have a lot of problems with reflux. I can also say that my reflux is extreme enough that I get heartburn whether I've had a giant meal or have been fasting for 48 hours. There is a slight difference in magnitude, but not always in the most logical way.
Posted 5/10/2013 7:34 PM (GMT -5)
I don't think it's normal to have a measure of acid inside the stomach from a 24 hr PH/impedance test. The PH sensors are located ~5cm above the LES (distal sensor), and another ~15cm up (proximal sensor). There are impedance sensors between them. The DeMeester score is based on conditions at the distal sensor, and considers (at least) # of acid reflux episodes and duration of acid reflux episodes. There is no sensor in the stomach. Someone could say that they had an average pH of (x) or (y) amount of time that the sensor was at pH 4 or below. But that is referring to the lower esophagus, not the stomach.

Given that, my point is that a 24 hr PH test is not going to indicate whether it's a good idea for a person to add more acid to their stomach since the test is not about the stomach, it's about reflux in the esophagus.

Unless I'm missing something, or we are talking about a different test. I've heard about a Heidelberg test to measure PH in the stomach, but I don't think anyone is having that test done.

Also, you'd think if low stomach acid was a significant cause of GERD symptoms, that it would come up SOMEWHERE in the medical literature related to GERD symptoms. It does not. That is not to say there is not a medical condition of low stomach acid that causes SOME symptoms, only that it's not discussed by medical professionals dealing with GERD symptoms.
Posted 5/10/2013 8:33 PM (GMT -5)
I claim to be no expert and I'm not looking for a right or wrong answer.

Yah, thats it the Heidelberg test. What do you mean nobody can have that test?

I agree that low acid would be in journal. However, we cannot discount the fact that for a long time doctors thought an ulcer was caused by stress or other things and not h pylori. A dr had to give himself the bacteria to prove to drs what he had discovered. This wouldnt be the first or last time the medical community would be wrong. We also cannot discount the fact that "some" ppl have improved with HCL. Like I said I am no expert. Everyone is different what works for me may not work others. And we are all lookin for answers, whether its here or with doctors. We all have theories and this what am thinking. My question was sort of answered, but the Heldiberg test was what I was referring to. If that measures acid, then wouldn't this help doctors. I read somewhere it's expensive.

Also, if ppl are improving with different diets, then they are on to something. I personally believe in the low acid theory, BUT I haven't tried it. Yes, I'm scared, I want to know for sure what I have, And what Other test do I need. Obviously we need acid, and if we turn it off then digestion may take longer. Idk, just some thoughts.
Posted 5/10/2013 8:48 PM (GMT -5)
I never said no one can have a Heidelberg test. I said I don't think people ARE having it done. I just did a quick journal search for it, and there are papers there from the late 1960s, the latest one I can find at first glance is 1987. Have you read of people having that test done lately?

I've not read anyone here who said they've had it. It is no where mentioned in current literature on GERD.

For people with GERD symptoms, not stomach symptoms, there is a problem caused by excessive reflux, or by parts of the body that for some reason are hypersensitized to normal amounts of reflux. So the acid level within the stomach itself is not of primary importance, the focus is on what's going on with acid in the esophagus.
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