Indigestion and antacids #heartburn #protonpumpinhibiters

Many people routinely reach for antacids as a solution to indigestion.  Drs prescribe what are called proton pump inhibitors (PPI) but there is a problem with routinely taking bicarb and with PPI’s.  Digestion within the stomach requires acid, so by reducing stomach acid you are making digestion worse.  It could be that acid isn’t the problem, the stomach after all is used to being acid; should be acid.  Maybe the problem is lack of acid and leakage of bile into the stomach.  Bile is made by the liver and enters the top portion of the small intestine.  Bile is very alkaline.  The small intestine needs to be alkaline for the digestive enzymes that are secreted here to work.  Strong alkaline in the intestine does not result in symptoms but in the stomach it does.

As well as neutralising stomach acid bicarbonate of soda contains sodium and can result in an imbalance of the levels of potassium and sodium.  Too much sodium in the body will cause water to be retained resulting in pressure on the heart as it struggles to pump this extra volume.  To prevent this the kidneys have to work harder.  In the short term this is probably not a problem but when taken in excess over extended periods it can.

PPI’s work by reducing the production of acid by the stomach and as previously stated this acid is required to enable the stomach enzymes to work.  Acid in the stomach has another important function, it acts as a disinfectant; it literally kills ingested bugs preventing them from reaching the intestines and even into the blood.

For adequate digestion in the stomach the body needs magnesium, zinc and activated B6.  Activation of vitamin B6 needs magnesium and zinc.  So indigestion maybe a deficiency of the vitamin  but is far more likely to be a deficiency of one or both of the minerals.

Heartburn is more than  indigestion its probably caused by reflux.  Reflux is when some of the stomach contents are regurgitated into the esophagus (gullet).  The esophagus is used to a mild alkaline state so whether its acid or a strong alkaline the esophagus won’t like it.  Reflux should be prevented by contraction of a ring of muscle called a sphincter at the top of the stomach, where it joins the esophagus.  The sphincter may not keep tightly shut because the pressure behind is too strong, the stomach is too full, or gravity is working against it.  So keep meals small especially before bed, keep the head higher than the stomach when sleeping.  Wear loose clothes, so that the stomach isn’t under pressure and if its a cause lose some weight as abdominal fat will increase the pressure from outside the stomach.  Sleeping on your left side helps too because the esophagus enters the stomach toward the right side with greater capacity of volume of content to the left; sleeping on the left keeps the contents in this greater area minimising the risk of reflux.  And, although magnesium is a muscle relaxant its needed for energy, and holding that sphincter shut requires energy so a magnesium deficiency could also be a cause.

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