ABOUT THE TEST
The Heidelberg pH Diagnostic System is a state-of-the-art diagnostic tool for measuring the pH Levels (pH is the scale we use to measure acidity or alkalinity), in the digestive tract. It can accurately assess a patient who may have Hyperchlorhydria (Excess Stomach Acid), Hypochlorhydria (Low Stomach Acid), Achlorhydria (Absence of stomach Acid) Pyloric Insufficiency, and excess mucus. The Heidelberg pH Capsule is a micro-miniaturized radio transmitter, designed for swallowing. Well over a million capsules have been used to date. The pH capsule is activated, calibrated and then swallowed. The patient wears a Transceiver around his/her neck, which picks up the telemetric pH data from the patient’s abdomen. This information is transmitted to a Computer Interface Module for signal processing. The data then appears as a pH graph on a dedicated computer. The capsule contains absolutely no radioactivity!
Heidelberg pH Capsules are used extensively in pharmaceutical research, pharmaceutical design, Preventive and Functional Medical practices, and by many of the major pharmaceutical manufacturers, world-wide. There have been over 141 published clinical studies using the Heidelberg system.
A clinical study of 1000 patients at the University of Heidelberg’s Department of Gastroenterology used the system to measure the efficacy of an orally administered 5 c.c. dose of an alkaline challenge test on fasting patients using sodium bicarbonate (Baking Soda). The purpose was to quantify the ability of each patient’s stomach to produce stomach acid. There are also a number of other clinical observations, related to common G.I. problems, such as gastric ulcers, acute or sub-acute gastritis, stomach emptying syndrome, dumping syndrome, pyloric insufficiency, heavy stomach mucus, and delayed stomach emptying.
Unlike other pH tests, which require the use of an invasive nasal-gastric tube, or a standard endoscopic procedure, which in many cases may traumatize the patient; the Heidelberg pH diagnostic test is accurate and minimally invasive (requiring only the swallowing of a vitamin-size capsule) and is very user and patient friendly.
PHYSIOLOGY OF DIGESTION
The gastro-intestinal (GI) system extends from the brain to the rectum; it is one that is critical to health, but poorly appreciated. It communicates with the external environment, and actually has its own brain! The surface of the intestines, which is greater than that of a tennis court, is where most of the action occurs. This is where the body decides what to digest and absorb and what to excrete. It is where the outside world meets the inside of the body, so it is an area of battle between our body and other life forms that want to feed on it. The GI system contains the majority of immune cells in the body for good reason. As a result of its interaction with food, living organisms and toxins, the GI system is the major system where things go wrong. The main functions of the GI system are; digestion of fat, carbohydrate and protein; absorption of their constituent parts, excretion of waste and toxins and to act as a barrier to keep out toxins, poisons, bacteria, viruses and parasites.
Digestion has components that include neurological, chemical, mechanical and hormonal influences. The GI tract may be broken down into distinct areas, which are: mouth (sensing toxins or the sense of taste, chewing, salivary digestive enzymes, swallowing); esophagus (transport from mouth to stomach); stomach (production of stomach acid and pepsin, a digestive enzyme, for digestion; HCL to sterilize microbes ingested with food and water; food storage and mechanical breakdown), small intestine (digestion by mechanical means, pancreatic enzymes and bile), hepato-biliary (bile formation and secretion, neutralization of toxins) and the large intestine which absorbs water and eliminates waste. Let’s talk about each section in more detail.
The most important functions of the mouth are mastication and saliva. Chewing food increases the surface area on which mechanical and enzymatic actions increase digestibility of the food. Saliva consists of a mix of digestive enzymes, lubricants to facilitate swallowing and immune protective molecules. The main enzyme, amylase, digests complex sugars. It only works in the mouth between a pH of 7.0-7.4. Outside those ranges it becomes inactive. Once it reaches the stomach, normal acid production inhibits its action. You can check your mouth pH with litmus paper. Check just prior to consuming food or fluids. If it is consistently outside this range, you may already have suboptimal digestion. The mouth produces agents that protect against invaders, including: lactoferrin (an iron containing protein with bactericidal and fungicidal activity), lysozyme (an enzyme that destroys bacterial walls), hypothiocyanate (oxidizes bacterial walls), and Secretory IgA, the most prevalent immunoglobulin in the body.
The esophagus is protected by mucosal secretions. Its major job is transporting food. The major problem with the esophagus is erosion from Gastro-esophageal reflux. (More on this later).
The stomach is the main area of protein digestion, which must occur in an acidic environment. Stomach acid also sterilizes microbes in food and water.
Digestion continues in the small intestine. Food from the stomach stimulates the release of two hormones, secretin and cholecystokinin. At the same time, food, acid peptides and mucosal irritation of the upper duodenum due to acid, cause the stomach to stop producing the hormone gastrin, which shuts off acid production and delays stomach emptying. Secretin causes the pancreas to produce bicarbonate, (baking soda) which neutralizes the acid and activates pancreatic digestive enzymes. At the same time Secretin causes release of pancreatic digestive enzymes, trypsin, chymotrypsin and amylase, which must all work in an alkaline environment or they are not active. Cholecystokinin release is stimulated by the presence of fat. It causes the release of the fat digesting enzymes lipase, cholesterol esterase and phospholipase. Additionally it causes the gall bladder to secrete bile. In a typical day the liver produces a whopping 600-1200 ml of bile, which is stored in the gall bladder for future use. Bile acids functions include: a “detergent” action that decreases the surface tension of fat particles thereby emulsifying large fat particles (Just like soap does); breaking them down into smaller size so digestive enzymes can work. Bile also aids in transportation and absorption of fatty acid “micelles” across the intestinal wall into the body. Inadequate production of bile leads to significant loss of fat in the stool. If you have greasy stools that float, you have serious problems with your liver and gall bladder. Bile also facilitates excretion of Bilirubin (end product of red blood cell destruction), excess cholesterol and fat soluble toxins, while assisting in the absorption of fat soluble vitamins.
The intestines normally move food through the system in one direction in a process called peristalsis. This is under control of the enteric (GI) nervous system, which runs mostly independently from the brain. There are more nerve cells (about 100,000,000) in the enteric nervous system than in the rest of the peripheral nervous system combined. It is connected to the brain only by about 2,000 nerve cells of the vagus nerve. Most of the communication is one-way going from the enteric nervous system to the brain. Cutting the vagus nerve has little effect on the function of the enteric nervous system. Interestingly, the primary neurotransmitter, serotonin is also a neurotransmitter found in the brain. Most of the serotonin in the body is located in the enteric nervous system. Anti-depressants, which work on affecting serotonin levels, can have a significant effect on GI function.
Peristalsis is controlled by the enteric nervous system. Dietary fiber plays an important part in stabilizing GI motility. Fiber consists of carbohydrate that is indigestible by humans, but not by bacteria. Fiber provides bulk to the stool. Its presence shortens transit time through the intestines. It binds bile acids and toxins to aid in their excretion. Most conditions that affect the GI system also affect motility, either increasing (diarrhea) or decreasing (constipation).
DISORDERS OF THE STOMACH
Stomach complaints number among the most frequent in our society and can be debilitating. Unfortunately for the unaware public, the diagnosis given and the treatments of choice are often exactly the wrong ones. The GI system is a “Top-Down” one, in that a problem at the beginning will lead to problems further down.
The most common stomach ailments include familiar sounding names such as: acid reflux (Gastro-esophageal reflux or GERD), “over-acid” stomach, ulcer and gastritis. Here is a quick true or false quiz to check your knowledge of common stomach ailments:
Most stomach and esophageal complaints are a result of too much stomach acid – T/F
Treatments for these complaints are medications that decrease stomach acid – T/F
Most ulcers are caused by stress – T/F
Almost everything you have learned about these complaints from your friendly pharmaceutical ads on TV is incorrect. If you answered true to any of the questions you are dead wrong.
Let’s begin with an “over-acid” stomach that is supposed to be the cause of ulcers and GERD. The stomach is the main location of protein digestion, which must occur in an acidic environment. One of the truly amazing feats of the body, one that is little appreciated, is that, to go from the average body pH of about 7.2 to the harsh acidic environment of the stomach, pH 1-2.5, requires that the body concentrate hydrogen ions (acid) over 3,000,000 times that of the blood! To create a liter of stomach acid requires 1,500 calories!
Chronic stomach ailments become more frequent the older we get. Now ask yourself- given that it takes a huge effort by the body, one that requires many calories and the presence of many essential nutrients to create stomach acid (HCL) and given that as we age virtually all metabolic processes slow down, does it really make sense that most stomach complaints are due to too much acid? No, it makes sense that they are due to too little acid (hypochlorhydria). The following may all be caused by or made worse by low stomach acid:
Do your fingernails chip or break easily?
Do you have distaste for meat (not a vegetarian for moral reasons)?
Are you sleepy after eating?
Do you have bad breath?
Do you experience epigastric burning or gastric reflux?
Do you have a decreased ability to taste or smell?
Have you had an anemia that was unresponsive to iron?
Does taking vitamins upset your stomach?
Do you have a sense of excessive fullness after meals? (Does food just sit there)
Do you not feel like eating breakfast in the morning?
Do you burp, belch, have gas or pain within 30 minutes of eating?
Do you have small white spots on your finger nails?
Do you consume coffee, alcohol, soft drinks, junk food or refined carbohydrates on
more than an occasional basis?
Have you had excess stress and feel anxious? (Butterflies in stomach)
Do you take any of the following medications: Birth Control pills, aspirin, ibuprofen,
acetaminophen, antacids, anti-histamines, anti-depressants or prednisone?
Do you have a low protein diet by choice?
Do you have low estrogen levels (peri-menopausal or menopausal) or have low thyroid?
Have you ever had an ulcer?
Has a family member ever had an ulcer?
Is your hair thinning?
All of the questions above are signs and symptoms of hypochlorhydria. If you have several or more symptoms, or if you are taking any stomach medications, you probably have low stomach acid. If you feel fuller sooner, stay fuller longer than you used to or if you burp within 30-60 minutes of eating, you probably have low stomach acid.
What does stomach acid do? It sterilizes food, killing pathogenic bacteria; it digests protein itself and also activates the protein digestive enzyme pepsin. Without HCL, the inactive pepsinogen produced by the stomach is not converted to active pepsin. HCL signals the lower esophageal sphincter to close! When LOW stomach acid decreases the ability of the sphincter to close the acid that is produced can reflux back into the esophagus, causing GERD!! Finally, stomach acid is one factor stimulating the release of Secretin from the pancreas, which then causes release of pancreatic digestive enzymes and bicarbonate to continue the digestion process. This in turn also inhibits more food from being dumped into the small intestine before it is adequately digested in the stomach.
Some of the important factors that can affect the ability to produce HCL are: low levels of certain amino acids, lack of zinc and potassium; a diet high in refined carbohydrates and fat; sodas; poor nutrition leading to mitochondrial dysfunction (mitochondria produce the energy needed to concentrate acid); use of antacids and proton pump inhibitors and infection with the bacteria H. pylori.
So what actually causes GERD? It probably starts with low stomach acid, which then causes the esophageal sphincter to not close tightly, leading to what acid there is refluxing into the esophagus, causing inflammation and ulceration of the sensitive esophageal mucosa. At the same time, low acid may cause intestinal dysbiosis, or overgrowth of undesirable bacteria. These bacteria then ferment sugars from a bad diet. High levels of hydrogen or methane gasses produced by bacterial fermentation have also been shown to decrease esophageal sphincter closing- a double whammy!
Standard treatment options are exactly the wrong ones. There are multiple medications to neutralize or block production of HCL. Unfortunately low acid is what started the problem in the first place. Yes, the treatments do offer that ever-so-valuable “temporary relief from heartburn”, but in the long-run exacerbate and perpetuate the problem. If you have been prescribed Prevacid or similar medication for a protracted period of time, you are at risk for increased rates of osteoporosis and stomach cancer. Has your MD actually checked your levels of production of HCL, checked for an H.pylori infection or done an endoscope? Have you continued with the same complaints, trying different medications with no resolution? Have your digestion and GI complaints become progressively worse? You might want to re-think your treatment options.
Lack of, or too much stomach HCL can lead to a host of secondary conditions, including but not limited to:
Food Allergies – Many allergies are the result of incomplete conversion of proteins into peptides and subsequently into amino acids, which are the basic building blocks of all proteins. Many proteins are potential allergens and will cause allergies if not converted in the stomach and small intestines into amino acids.
Osteoporosis – As a part of the body’s normal metabolism, the body produces acid. This is most obvious in the first stage of digestion inside the stomach. When the parietal cells in the stomach are over producing HCL, and the normal physiologic buffering in the digestive tract does not neutralize all of it, the excess acid that is not expelled can be stored. This occurs mostly in the interstitial spaces, also called the extracellular matrix, which is the space around the cells. As a basic illustration, for every molecule of acid that is stored in tissue, an equal molecule of bicarbonate, or base substance, needs to be put into the blood, because the physiology of the body knows that it will be needed to remove the excess acid out of the body later. In effect, the body tries to maintain the proper balance to stay healthy. As more acid accumulates in the body, it is stored and pushed further into the matrix, and ultimately the acid is pushed into the cellular structure. When this occurs, the first thing the acid does is displace potassium, then magnesium, and then sodium. As a person age increases, or ill health occurs, the blood and skin pH will often move from its alkaline state, toward the acidic side. As potassium leaves, it requires phosphate in the process of leaving; the body removes this phosphate from bones. The result of this is, calcium is also released from the bones, and ends up as free calcium in the system. As a preservation mechanism, the sodium the body will be retained through the operation of the kidney. The human body has specific homeostatic regulators that keep everything working and in balance. Digestive pH is critical in these processes.
On the flip side, if too little stomach acid (Hypochlorhydria or Achlorhydria) is produced, then minerals will not be separated from the food and the body will not be able to absorb them. The effect of a calcium, magnesium or phosphorus deficiency can be osteoporosis, a deficiency of iron will lead to anemia, of chromium and vanadium to insulin dysregulation and so on.
Diabetes – People with hypochlorhydria or achlorhydria have a greater tendency for disturbed carbohydrate metabolism. Abnormal glucose tolerance curves were found in 48% of patients with inadequate acid production in the stomach. Diabetics with and without neuropathy have decreased acid secretion in the stomach. The average incidence of achlorhydria in patients with diabetes mellitus is about 33%. Published clinical studies indicate that 18% of diabetics under the age of 40 were hypochlorhydric, or achlorhydric, and 64% of diabetics over the age of 50 were hypochlorhydric, or achlorhydric. Clinical studies also indicate that increasing the stomach’s ability to produce HCL, coupled with proper dietary intake, and exercise made a marked improvement in all of the test these patients.
Asthma – Gastric secretion of HCL following a standardized meal was studied in 200 asthmatic children. 80% had levels of HCL below normal, while only 3% of the control group of children had similar low levels.
Anemia – Pernicious Anemia is due to Vitamin B12 deficiency. Most commonly, the cause for impaired binding of Vitamin B12 by Intrinsic Factor is autoimmune atrophic gastritis, in which autoantibodies are directed against the stomach’s parietal cells as well as against Intrinsic Factor itself (rendering it unable to bind Vitamin B12 in the small bowel). Gastric parietal cell antibodies are present in 95% of patients with pernicious anemia and up to 30% in iron deficiency anemia. These antibodies are also found in association with thyroid disease. The occurrence increases with aging. This condition results in the complete loss of the first stage of digestion due to complete loss of HCL production (Achlorhydria).
AIDS – Acquired Immune Deficiency is an infectious disease caused by the human immunodeficiency virus (HIV). Malabsorption of the nutrients consumed, yeast infections, Candida, diarrhea, bacterial and fungal infections, nausea, abdominal cramps, vomiting, weight loss, and extreme fatigue all occur. In the acute phase the breakdown of the immune surveillance system of the mucosal barrier caused by the depletion of mucosal CD 4+ cells. This results in the systemic exposure of the immune system to microbial components of the gut’s normal flora, which in a healthy digestive tract, is kept in check by the mucosal system. When a person contracts the HIV virus they will develop some form of hypochlorhydria, either hidden hypochlorhydria or obvious hypochlorhydria. As the virus progresses to the final stages of the disease, they will become achlorhydric. At this stage there is no sterilization, or conversions of the nutrients consumed. Because of this lack of sterilization and conversion, orally ingested pathogens and bacteria are allowed to flourish, in the digestive tract, causing many serious problems.
Gastritis – Hypochlorhydria or hyperchlorhydria will set the stage for increased risk of infection from organisms such as Candida and H. Pylori. These organisms are directly associated with chronic gastritis, peptic ulcers and stomach cancer. Hypochlorhydria will result in diminished protein breakdown, sterilization, conversion, and subsequently reduced absorption. Unfortunately, people with reduced acid levels in the stomach frequently suffer from what they assume is elevated stomach acid (Heartburn, bloating, reflux, nausea, frequent burping, irregular stools), and as a result often take acid-lowering drugs and medications. These symptoms are identical in patients that have Hypochlorhydria or Hyperchlorhydria. Many physicians assume that their patients are overproducing HCL, and prescribe acid reducing medications, or Proton Pump Inhibitors (PPIs), when in fact the patient is deficient in HCL production. Reducing the body’s HCL production encourages H. Pylori activity. It will also increase the risk of developing peptic, or duodenal, ulcers, pancreatic/gastric cancer, and Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma. People with hyperchlorhydria will retain food in their stomachs for long intervals. The retention of food in the stomach is called Delayed Emptying or Marked Delayed Emptying. People with Marked Delayed emptying of the stomach can retain foods from one meal in their stomachs for as much as 24 hours. This condition, if not treated, can result in excoriation of the stomach and intestinal mucosa. The over production of HCL will prevent the pyloric sphincter from relaxing, inhibiting the migration of chyme (emulsified foods) into the digestive tract. Medications and supplements are subjected to the caustic effect of prolonged exposure to HCL, which reduces their effectiveness.
GERD – Esophageal reflux occurs when gastric fluids are pushed back through the lower esophageal sphincter into the esophagus and throat. GERD is one of the most misdiagnosed conditions in the medical profession. This is mainly because; the symptoms associated with reflux are virtually identical in patients that are over producing Hydrochloric acid, or under producing Hydrochloric acid. Both conditions can result in belching, reflux, gas, bloating, abdominal discomfort, irregular stools, etc. The gastric juices, with or without the presence of Hydrochloric Acid are very bitter to the taste, which leads many people to believe that they are over producing Hydrochloric acid (HCL). Unfortunately many doctors are prescribing acid reducing medications or Proton Pump Inhibitors (PPIs), without having a true indication of the patient’s digestive condition. Acid reducing medications or PPIs inhibit the parietal cells from producing HCL. Prescribing an acid reducing medication to a patient that is not producing sufficient HCL will cause the patient to become achlorhydric, which is the complete lack of HCL production in the gut. Acid reducing medications should only be prescribed when ulceration of the gut mucosa is present. These products should only be use on a short-term basis to allow healing of the damaged tissue. Long-term use of these products will cause many serious problems, and affect the overall body chemistry. Only a small percentage of the total population suffers from the over production of Hydrochloric acid, or Hyperchlorhydria. People with Hyperchlorhydria and reflux should be prescribed a medication that mimics the normal physiologic buffering that occurs in the digestive process.
Skin Diseases – The over production of hydrochloric acid in the stomach, and the inability for the body’s normal physiologic buffering to neutralize the HCL, can cause the intestinal tract to become acidic. This may also result in a decrease in the overall blood and body pH. Some of the skin conditions related to decreased body pH are; inflammation of the eyelids and corneas, inflammation of the gums, cracks in the corners of the lips, dry skin, hives, itches, pimples and eczema. Furthermore, the skin tends to be red and irritated in regions where there are heavy concentrations of sweat, like the knee, eyebrows, underarms, mouth, anus, and vulva.
WHAT TO EXPECT DURING A pH DIAGNOSTIC TEST
There are medications that will alter the test results, and make it invalid. Proton Pump Inhibitors (PPIs), acid reducing medication, antihistamines, antibiotics, are a few of the medications that will alter the test results and make it invalid. Various medications will affect the test results because they have a repository effect in the body, meaning, they will remain in the body tissue long after you stop taking the medication. This is especially true for proton pump inhibitors (PPIs) and acid reducing medications. The length of time and quantity of medication you have taken will determine how long it will be necessary for you to stop taking the medication.
You will be instructed to fast the evening before coming in for the test. If you are scheduled for a pH test in the morning, you will be instructed to fast after your evening meal, the day before the test. If you are scheduled to be tested in the afternoon, on the test day, you may eat a very light early morning meal that does not contain any type of fatty foods or fatty acids. You may not drink sodas, coffee, fruit juices, milk, or tea
WHAT DOES FASTING MEAN?
Fasting means not eating. You may not eat meat, fish, poultry, and vegetables. Do not drink coffee, milk, sodas, fruit juices, beer, wine, or any product with alcohol. Alcohol will inhibit the parietal cells in the stomach from producing hydrochloric acid. The morning before the test, do not brush your teeth with any type of toothpaste that contains sodium bicarbonate. If you are not sure, if your toothpaste contains sodium bicarbonate, don’t use it; brush your teeth with water. It is ok to drink water, as long as you are very conservative in the amount taken.
WHAT TO EXPECT ON THE DAY OF TESTING
On the day of the test, you will be given a pretest consultation, to make sure you have fasted properly, and have stopped taking any type of medication that may affect the test results. You will be required to complete a release, consent form for the clinic. If you have reservations about having a pH test, do not do it. Mental anguish and stress will alter the test results.
The doctor will activate and calibrate the pH capsule to make sure it its accurately recording the pH values. A transceiver will then be placed over your stomach. The transceiver receives the information from the pH capsule and sends it, via telemetry, to the computer where the information is displayed on a graph. You will swallow the capsule with a sip of water. You will be instructed to lie down or recline. There is no discomfort to you during a Heidelberg pH test. You will be relaxed and comfortable while the test is being done.
When the pH capsule enters the gastric juices in the stomach, the graph line will move down scale to indicate a base line acid. The base line acid level is normally the amount of free Hydrochloric acid that is always present in an empty stomach. Normal health adults will have a base line acid level in the 0.5 to 1.3 pH range.
When the base line acid level in your stomach shows on the graph, you will be given a measured amount of a saturated solution, of sodium bicarbonate, which will cause the stomach to become alkaline. The time it takes the stomach’s parietal cells to produce sufficient hydrochloric acid, to bring the stomach back down to its original base line acid level, will determine what condition you have. A normal healthy adult’s stomach after an alkaline challenge will reacidify on average, in 20 to 22 minutes average.
CONDITIONS DIAGNOSED BY A HEIDELBERG TEST
A person that is over producing Hydrochloric acid may have delayed and marked delayed emptying of the stomach. Foods, supplements, and medications are subjected to the prolonged exposure to high acid levels for long intervals, reducing their effectiveness. A person that is over producing acid will reacidify in 10 minutes or less. To verify the over production of HCL, you will be given two additional alkaline challenges. Each of the two challenges will reacidify at the same time or at faster times. This is proof positive that you are over producing HCL. Left untreated this condition will cause damage to stomach and intestinal mucosa, and set the stage for many types of gastric cancers. Unless excoriation is present a Proton Pump Inhibitor (PPI) or acid reducing medication should not be used as the treatment protocol. These products should only be used on a short term basis to allow healing of the damaged tissue. Long term use will cause the patient to become seriously hypochlorhydric, or achlorhydric. Hyperchlorhydria should be treated with a medication that mimics the normal physiologic buffering that occurs in the digestive process. Mental stress is a major cause in people that are over producing Hydrochloric acid.
People with Hidden Hypo will have what appears to be a normal base line acid level in their stomach, or 0.5 to 1.3 pH. Patients with Hidden Hypo, are producing Hydrochloric acid, but not in sufficient quantities to sterilize and convert a complete meal. Patients with Hidden Hypo may require a second sodium bicarbonate challenge to the parietal cells. The first challenge may fall into the 26 to 28 minute reacidification range, which will put them in the borderline Hypo range. The second challenge will move them up into the Hypo range. Patients with Hidden Hypochlorhydria will take 28 to 30 minutes or more to reacidify after a sodium bicarbonate challenge to the parietal cells. Depending on the doctors diagnosis and suggested treatment protocol, patients with Hidden Hypo, may only need to supplement with a recommended medication during a meal.
Patients with Obvious Hypo do not have a base line acid in down in the 1.0 to 1.3 range. They may have a fasting pH level in their stomach from 2.5 to 5.5 pH. When the stomach’s parietal cells are challenged the stomach may not return to its original base line acid level for 40 minutes or longer. In some cases it may take many hours for the stomach to reacidify back to the original base line acid level, which will not be in the optimum range for sterilization and conversion. Patients with Obvious Hypo do not have sufficient acid in their stomachs to start sterilizing and converting a meal. People with Obvious Hypo will need to supplement with a medication before a meal to condition the stomach for the incoming food, and during a meal.
Achlorhydria is the complete absence of Hydrochloric acid in the stomach. Achlorhydria does not require an alkaline challenge, because the stomach is already in an alkaline state, of 7.1 to 8.5 pH. In many cases acid reducing medication or Proton Pump Inhibitors will cause achlorhydria. There is virtually no sterilization, or conversion of the nutrients consumed, resulting in reduced absorption and support for the body’s immune system. Patients with Achlorhydria will be deficient in Vitamin B-12. Absorption of B-12 is accomplished by Intrinsic Factor, also produced by the stomachs parietal cells. During testing the doctor may give you measured amounts of an acid supplement, to bring the stomach pH down to the proper level to promote good conversion and absorption. The doctor may also do a routine blood test to determine if you are deficient in vitamin B-12, and if you are anemic. Many people with achlorhydria will have primary or pernicious anemia. Curing the anemia in some case will restore the parietal cells ability to produce Hydrochloric acid.
GERD or esophageal reflux is one of the most misdiagnosed disorders in this country. Many doctors assume that when reflux occurs, it is the result of the over production of Hydrochloric Acid, which is usually not the case. This is mainly because the symptoms associated with reflux are virtually identical is patients that are over producing Hydrochloric acid, or under producing Hydrochloric acid. Both conditions result in reflux, belching, bloating, abdominal discomfort, irregular stools, etc. Many doctors use the “best guess” method, rather than an accurate pH diagnostic test, in many cases their best guess is will not reflect what is really happening in the patient’s digestive process. Unfortunately many doctors are prescribing Proton Pump Inhibitors (PPIs) or acid reducing medications to patients that are not producing enough acid. This misdiagnosis and treatment, usually result in the patient becoming achlorhydric, and sets the stage for many serious ailments. Before prescribing any type of medication for reflux, your doctor should have an accurate pH Diagnostic test, to confirm his diagnosis.
The pylorus is the lower orifice of the stomach opening into the duodenum. In a normal health adult the pyloric sphincter prevents the contents of the stomach from dumping into the small bowel until the nutrients are sterilized, converted, and emulsified. When the sphincter does not close properly (Pyloric insufficiency), it will allow fluids from the duodenum to flush back into the stomach, when a peristaltic squeeze occurs. A congenital defect, ulceration, scar tissue, and stomach pH will cause the sphincter to remain open; allowing the contents of the stomach to dump into the small bowel, before sterilization and conversion is complete. Unsterilized and unconverted nutrients dumped into the small bowel will cause allergies, parasitic, and bacterial infections. A Heidelberg pH test will verify the presence of pyloric insufficiency, without the use of an endoscopic procedure.
When the test is complete, the doctor will review the test results, and setup a treatment protocol for you. In some cases, the doctor may request that you return for a second consultation, and pH test in 6 to 8 weeks, to evaluate your condition and make adjustments to your treatment protocol. In some instances, after the stress is removed from the stomach’s parietal cell, the cells will start producing more hydrochloric acid, which will allow the reduction of medication needed.
The first stage of digestion is vitally important in maintaining optimum health and longevity. The digestive system and proper diet is critically important in maintaining a healthy body and immune system. People in the 45 and up age groups, but not limited to these groups, are 100 times more likely to have hypochlorhydria or achlorhydria. Hyperchlorhydria is not limited to any particular age groups, and is only found in 18% or less of the total population.