Misconceptions about Stomach Acid Production Article 4 of 12 T his column is devoted to the recognition of visceral dysfunctions and the involuntary muscle contractions they produce that cause, perpetuate, and prevent correction of structural misalignments. The related loss of joint range of motion and associated discomfort and/or pain are often treated as structural problems. If the real cause is not identified accurately, patients do not receive the benefit of chiropractic care that they deserve. Any form of prolonged stress can create this diagnostic dilemma. I have delineated the specific cascade of physiological events involved with chronic stress and detailed why it doesn't matter if the stress is structural, emotional, or caused by visceral dysfunction. Muscle contractions and loss of range of motion are always involved, regardless of the source. The key is to find the cause because when it is known, the required therapy becomes obvious. Last month. I suggested that whatever your present therapeutic procedure, before the patient leaves the treatment room, you should ask him or her to be seated and then perform tlie 60-second chiropractic screening test. The test includes three simple palpatory findings and one passive rangc-of-motion test, and it identifies those patients who cannot meet the demands for energy presently placed upon it. After palpating the universal stress point for contraction, we ask the patient to sit up as straight as possible and bend down his or her head. Next, you will slide your fingers down the spinous processes from Tl toward T12. You should feel the "C-shaped" posterior curve of a normal thoracic kyphosis. Observe if there is a loss of the normal kyphosis and feel for a depression formed in the middle dorsal spine. This condition is not a permanent or static condition. It is transitory and caused by muscle contractions emanating from the abdominal organs, especially those associated with digestive dysfunction: stomach, biliary, pancreas, duodenum, and jejunum. Last month, we covered the compromised gastric and duodenal mucosal lining that can be irritated by stomach acid and the deleterious effects of antacids and proton-pump inhibitors. This month, we'll discuss common misconceptions concerning normal stomach acid production. Misconception #1 - Acid is present at all times in the stomach. Depending on which study you read, it takes young, healthy adults on average about 45 minutes for their bodies to produce stomach acid. The number increases as we age. especially by age 40 to 45. and is reduced drastically in most people by age 60 to 65. Misconception #2 - Stomach acid digests enzymes. Stomach acid does not digest food. As you know, hydrochloric acid creates the active protein-digesting enzyme pepsin from its inactive state, pepsinogen. Stomach acid then must maintain the pH in the stomach between 3.0 and 5.0 for pepsin to continue digesting protein. Misconception #3 - Betaine HCI digests protein. Concentrated hydrochloric acid has a pH of 1.8 as it enters the stomach. Thus, it cannot be put into a capsule or tablet form. Of course, the contents of the stomach quickh dilute the stomach acid to the 3.0 to 5.0 level. The truth is that betaine hydrochloride is a protein molecule that is harvested from beetroot. It contains the amino acids methioninc and cystcinc. which contain sulfur. The liver needs sulfur for the metabolism of protein, among other reasons. Stimulating Stomach Acid Production Hydrochloric acid production is under both nervous and < hormonal control. Stimulation to the vagus nerve first affects the enteric nervous system of the stomach wall and then the oxyntic cells to secrete pep-sinogen and a smaller amount of stomach acid. Vagus stimulation also excites production of the hormone gastrin. which is secreted by the cells in the upper one-third of the stomach and. to a lesser degree, by Brunner"s cells in the duodenum. The hormone is car ried by the blood to the oxyntic cells, which greatly increase their secretion of HC1 acid and to a lesser extent pepsin. Further stimulation to produce stomach acid comes from the stretching of the stomach wall as food slowly enters, as well as by the presence of small amounts of cither alcohol or caffeine. A second function of gastric acid is to kill most of the bacteria tliat enters the body with food. This process is not 100% effective. Some bacteria survive to take up residence and multiply in the intestinal tract, particularh the large intestine. How Stomach Acid Is Produced Stomach acid is not made bv the cells of the stomach. like pepsinogcn. The ingredients, namely hydrogen (H ) and chloride (CP). must be donated from the blood. They pass through the parietal cells and are only combined inside the stomach. This is an important point because, as we discussed last month, stomach acid could easily destroy the wall of the stomach if it were not protected by a thick layer of mucus. Like the salivary glands in the mouth, mucus is secreted by the cells in the stomach to protect it. When a person needs antacids for indigestion, it is not because there is too much acid: it is because the stomach cannot produce a good quality mucus to protect itself. Step 1: The body pulls carbon dioxide (CO,) from the blood and puts it into the parietal cells of the stomach where it combines with water to form carbonic acid (H,CO,). Step 2: Carbonic acid is divided by an enzyme called carbonic anhvdrase into its two parts: hydrogen (H ). which is acid in solution, and bicarbonate (HCO,). which is alkaline. The hydrogen is put into the stomach, and bicarbonate is returned to the blood. Step 3: Chloride (CP) is transported from the blood directly into the stomach where it combines with hydrogen to form HC1 acid. Step 4: The body also exchanges potassium (K ) for sodium (Na ) as part of its placing chloride into the stomach. Involuntary Muscle Contractions Contractions related to an inability to produce adequate stomach acid can be palpated under the right anterior costal arch, involve the muscles related to movement of the trunk, and work in collaboration with several other muscles that control the abdominal wall. It is important to remember the contractions are transitory and are found only when the related viscera is distressed. When these muscles are contracted, the patient may also complain of headaches, shoulder pain, abdominal bloating or distension, and constipation. Muscle contraction may be traced from the midthoracic spine. Pottcngcr"s saucer, and around the intercostal spaces to the chest. In main cases, muscle contraction can be found moving upward along the spine to the shoulder and then upward along the side of the neck spreading to the tissues of the cervical region (phrenic nerve). Pottenger"s saucer may be found w hen either the right or left costal arch reflexes arc active. Next month, we will discuss the relationship of inadequate stomach acid and biliarv distress. Dr. HowaniLoomis lias an extensive background in enzymes and enzyme supplements. He is the founder and pn'sident oj Enzyme I'omiulationsS:, Inc. His knowledge of physiology, biochemistty, and enzymol- og\> lias made him a sought-after speaker and a prolific writer. Dr. LoomispublishedENZYMES: Hie Key to Health in 1999. Contact info: 6421 Enterprise Lane, Madison, WI 53719, customerservice@ loomisinstitute.com
