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 Integrative Medicine: Introduction to the Digestive System 

The process of digestion continues in the stomach after the food bolus passes into it from the mouth through the esophagus. The stomach secretes hydrochloric acid, mucus to protect the stomach walls from the acid, and proteolytic enzymes to begin the process of protein breakdown into smaller peptide molecules. These enzymes require an acid environment with the pH level being in the range of one or two, which is quite acid. The acid environment of the stomach also helps to kill bacteria, viruses, fungi and other microorganisms that enter the stomach with food. When stomach acid secretion is impaired, the stage is set for an increased risk of infection from organisms such as Candida or yeast and Helicobacter pylori, a bacterium that is associated with chronic gastritis, peptic ulcers and stomach cancer. Furthermore, low acid or hypochlorhydria will result in poor protein breakdown, and subsequent poor absorption of amino acids, the building blocks for many important chemical compounds and structures within the body.

Diagnosis and Treatment of Hypochlorhydria or Low Stomach Acid
How can one tell if he has low stomach acid? Surprisingly, one may have symptoms that are often associated with elevated stomach acid. One may experience burning pain and regurgitation discomfort in the upper abdomen and lower chest area. Additionally, one may feel gas in this area and burp excessively. After meals, one may feel that the food seems to remain in the stomach and has difficulty progressing through the intestines.

To diagnose a suspected low acid condition in the stomach, a complementary physician may order a gastric acidity test called a Heidelberg capsule. This capsule is the size of a large vitamin B or antibiotic capsule. It contains both a pH meter, which measures acidity in its environment, and a radio transmitter. The patient has a belt containing a radio receiver strapped around his abdomen. Signals from this radio receiver can be recorded on a strip of paper. The information recorded is the pH of the environment surrounding the Heidelberg capsule. The patient is asked to swallow the capsule and the recording of the pH begins immediately.

The method of administering this test that we do in our office is to attach a string to a loop on the capsule. Once the capsule is swallowed and enters the stomach, the pH should normally be in the acid range. If the pH remains neutral at around seven, then one may conclude that the patient suffers from achlorhydria or no stomach acid. At this point, the capsule may be gently removed from the stomach by pulling on the string so that the capsule passes through the mouth. If, on the other hand, the pH does drop to an acid pH of one, the patient may be challenged by having him drink a small quantity of bicarbonate of soda solution. This is an alkaline solution, which will bring the pH back up to eight or so. Stomach acid should then be secreted to acidify this solution within 10 to 15 minutes. The bicarbonate solution may be given four times, each time after the solution has been reacidified. A normal result occurs when reacidification takes place each time. If this doesn’t occur, then the diagnosis of hypochlorhydria may be made. Treatment of hypochlorhydria involves the administration of betaine hydrochloride or glutamic acid as supplements along with meals.

Diagnosis of Intestinal Permeability
The small intestine has two major functions. The first is to allow necessary substances into the bloodstream in order for the body to use these raw materials to grow and function properly. Among these substances are sugars, amino acids, fats, vitamins, minerals and other food factors. Pancreatic juices passing into the small intestine and secretions from the small intestine promote the completion of digestion, so that these smaller molecules may be absorbed into the bloodstream. When there is a problem absorbing these substances into the bloodstream, the patient is said to have a malabsorption syndrome.

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 About The Author
Michael Schachter MD, FACAM Director of the Schachter Center for Complementary Medicine, Michael B. Schachter, M.D., is a 1965 graduate of Columbia College of Physicians & Surgeons. He is board certified in Psychiatry, a Certified Nutrition......more
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