Ever since the book, Why Stomach Acid is Good For You, I've wondered if it is true that GERD can be caused by too little, not too much, stomach acid. Is it possible that too little stomach acid can cause GERD? If so, by what mechanism would this occur?
EDIT - After reading the answer below, I’d like to add a little more information.
I don’t disagree with the fact that GERD is caused by a malfunctioning lower esophageal sphincter (LES), and I don’t disagree with known causes that would contribute to a malfunctioning LES, but what seems very likely to me is that low stomach acid is an additional cause of a malfunctioning LES. This reasoning behind this is that undigested food is putrefying and rotting, expelling gas within the stomach, then increasing pressure on the LES. It could even be possible that low stomach acid is the cause in a large majority of the cases of GERD.
There is an entire integrative medicine field, aka holistic health, that has identified in many cases GERD is actually caused by too little stomach acid (1, 2, 3). And while I am usually not one to ever listen to this field of medicine, they make some really astute observations.
- Esophageal cancer is on the sharp rise, coincidentally in an era with the most robust acid reducing medication available.
- Stomach acid production declines with age.
- Food nowadays lacks enzymes, which causes digestive organs to overwork, causing the acid producing mechanism of the stomach to fatigue.
- GMO Wheat 3.0 has gluten proteins which are undigestible to many people.
I realize this isn’t what the mainstream doctors believe, but the mainstream is being influenced by a 15 billion dollar industry. The PPI section in the store is huge. I’ve been to multiple gastro docs, and it’s like assembly line Prilosec prescribing. Two people who know our family, that have both been diagnosed with esophageal cancer, just happen to be taking Prilosec / Nexium for many years prior. Another friend had to have is colon cut out because of a bacterial infection, which could have been caused by the elimination of the body’s first line of bacterial defense (stomach acid).
All evidence pointing to low stomach acid seems legitimate, so why not give it proper attention. So here I’d like to diagram what I believe to be the problem: the step-ladder catch-22 inflammation and putrefication snowball effect. Remember, all of this is on the basis that when it comes to low stomach acid, GERD is being caused by the rotting / putrefication of food in the stomach (due to the pyloric sphincter remaining shut) and the resulting gasses which bubble up past the 2-way LES causing GERD. Then, the rotting food causes inflammation in the stomach which results in the stomach producing less acid, and the problem starts to compound. It basically goes like this:
Eat Meal -> Low Acid -> Undigested Food -> Pyloric Sphincter Stays Shut -> Putrefying & Rotting (GERD) -> Gastric Inflammation -> Next Meal -> Lower Acid -> Undigested Food -> Pyloric Sphincter Stays Shut -> Putrefying & Rotting (GERD) -> More Gastric Inflammation -> Next Meal -> Lower Acid -> Undigested Food -> Pyloric Sphincter Stays Shut -> Putrefying & Rotting (GERD) -> More Gastric Inflammation -> And So On…
When you go down this step-ladder road for a few months, the avenue out of it is daunting, if not impossible. In my opinion, we could have millions of sufferers in our country, and for that reason I want to find out the truth.