In the Clinic
Many people today feel that as they are getting older, they develop dyspepsia and have too much acid. While this may be true in 10% of the people, it is usually not the case. However, in the 1980s, 3 of the top 5 most popular drugs (Zantac, Pepcid, and Tagamet) suppressed stomach acid production. Â The science and physiology of the body shows that this approach is just the opposite of what is happening in the body. The facts are simple. As we age a cell in the stomach called the parietal cell starts to functions less optimally (just as the ovaries slow down on hormone production in the 40s leading to menopause). The parietal cell produces only two things: 1) Hydrochloric acid and 2) intrinsic factor, the latter being a B-12 absorption protein. Many of the elderly require B-12 shots for pernicious anemia because the injection bypasses the stomach and puts the B-12 right into the blood stream. Â If there is insufficient acid present (one of the functions of Hydrochloric acid is to keep the stomach sterile) the yeast and bacteria will grow in the stomach and when food hits the acid deficient stomach, it becomes like a fermentation cauldron (moonshiners would call it a still) and these bacteria produce irritating organic acids and gas. The approach is not to shut off the acid but determine over or underproduction.
The Heidelberg test is a unique device where we swallow a capsule that contains a pH meter (acid sensor), a battery and a radio transmitter. The patient wears a special belt over the stomach (antenna) and the pH of the stomach is transmitted to the printer so we continuously monitor the pH. See the adjacent picture of a patient being administered this test. We then challenge the patient with a slightly alkaline substance (good old Arm and Hammer baking soda) and see if the stomach can produce acid. Based on the results we will suggest some sort of digestive assistance which is in many cases a tablet form of Hydrochloric acid (aka Betaine Hydrochloride).