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I am more interested in why current heart burn medication which reduces stomach acid takes away the pain associated with heart burn.

So what exactly does it do, does it block the pain, or just send the body different signals?

Assuming the heart burn is caused by infact not enough rather than too much.

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6 Answers

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Please read the book "Why Stomach Acid is Good For You" Supplementing with Hydrochloric Acid and following the other recommendations by Dr. Wright in this book helped me overcome devastating heartburn about 5 years ago.

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Thanks I will add this book to my "to read list" – Ryan H May 5 2011 at 22:08
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Acid reflux is a problem of too little acid in the stomach...contrary to what the TV commercials say for Nexium, etc. Take the Betaine HCL and or Apple Cider Vinegar 3 tablespoons in 8 oz of water to increase the stomach acid. – Dexter May 5 2011 at 22:32
The acid soppers do reduce acid but does nothing to solve the problem. Undigested food only partially digested ferments and causes gas which rises up past the flap and causes the heartburn in the esophagus. More acid less undigested food equals no more heartburn. – Dexter May 5 2011 at 22:36
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right on. in a pinch, i've used lemon juice to get rid of heartburn. – bionicanna May 6 2011 at 0:27
liquid whey from yogurt or raw sauerkraut also works in a pinch... the good bacteria helps. – Kim The Nourishing Cook May 6 2011 at 3:27
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Getting off acid reflux medicine (specifically Protonix) is what led me to going paleo about four months ago. The only shred of appreciation I have for that drug is that I grew so sick of it (literally and figuratively) that I started feverishly researching and found my way to a Marks Daily Apple forum about GERD/heartburn/acid reflux and the devil incarnate (PPIs!) and truly turned my LIFE around in addition to my stomach discomfort.

I have always had some minor stomach issues - low levels of discomfort that I just accepted as normal. I did enjoy spicy food, drank socially and even had the occasional cigarette, consumed dairy every day, mixed my protein shakes with fat free conventional milk, drank fruit juice, ate whole grains with every meal, drank way too much coffee. I was thin but very skinny-fat, was a chronic cardio-er for a long stretch of years before gaining about 40lbs through weight training and a ridiculous overconsumption of things like Muscle Milk. However, in the grand scheme of things, I really thought I was making a daily commitment to being healthy - even though I lived with an almost daily GI discomfort that I was constantly "titrating" with water, Tums ("at least I'm getting my calcium!", milk, food, snacks, etc.

I came home from a week in Central America with my friends, during which time I think I was unintentionally eating as close to paleo as I ever had before. Lots of fresh vegetables and fruits, a ton of meat and fish, lots of natural Vitamin D, a lot of water and actually not too much alcohol for a spring break during college, and a ton of swimming/hiking/climbing/surfing etc. Felt great and had a blast. I came back home (to my routine and usual 'healthy' habits) and quite possibly the worst stomach pain I had ever experienced - I was slumped over at my desk all day long and had people seriously worried. I went to the GI who asked next to nothing about my diet/lifestyle, told me to enjoy a certain list of foods in moderation, to opt for the "healthy" choices I had already been opting for for years, and to come back the next day for an endoscopy. Went in, went under general anesthesia, woke up all out of wack to a report of minor gastritis and a prescription for Protonix. Did what the doctor told, filled it, and took it every day.

I felt better at first, but definitely had some odd side effects in the bathroom. I spent a couple of months with smooth sailing, but it was almost like I rewound to a few years prior when the discomfort was not as bad, but definitely still there. Within six months (and after multiple 10 minute, $30 co-pay doctor visits for the same $20/month prescription dosage), I was taking the pill but once again "titrating" with a little snack, a little milk, a little water, a little less coffee, etc. It was when the doctor refused to refill my prescription over the phone when I was unable to go into the office that I became irate and researched alternatives on my last few days of the medication.

I found Mark's Daily Apple and found it to be so intuitive and intriguing. I am a recent graduate and did some coursework in evolutionary science, statistics, biology, chemistry, etc. - and found no reason to not try it out. I went paleo on the first day of no medication and even on that very first day, I had ZERO GI discomfort. I chalked up every shred of feel-good to a honeymoon phase, a placebo effect, etc. - but I just continually felt good! My skin was clearing up, my feet/armpits weren't smelling, my hair was thickening, my mood was AWESOME, my concentration was out of control, my energy levels were so constant, my sleep/wake cycle was military-like, my confidence was rising, a desire to exercise replaced my previous "I guess I should exercise" mentality, my body fat was dropping while my muscles were growing (never before happened simultaneously for me), my endurance was increasing, I craved NOTHING non-paleo, and I could go on and on and on.

I was in shock and had to resist the temptation to become that obnoxious-to-everyone-eating-SAD paleo guy that runs around distributing copies of the Primal Blueprint and cans of coconut milk. I was adding ACV to my water bottle to help replenish the acid that was being turned off for almost a whole year. Almost everyone I see regularly has been noticing my mental and physical changes, and I have even had a few friends go paleo to resolve certain chronic conditions. I see a paleo physician (www.paleophysiciansnetwork.com) who has watched all of my metrics improve (cholesterol ratio, testosterone, Vitamin D, tris, etc). I have never felt or looked better.

While I can't get down to the nitty gritty molecular level of PPIs, I can safely say that this lifestyle shift has given me the life I never thought I could have. Everything I chalked up to bad luck, bad genes, impossibly difficult decisions, unsustainable lifestyles, etc - has been handed to me. A little ACV goes a long way, but a cutting out antinutrients and Neolithic foods goes even further. I'm no longer in the (multimillion dollar) business of treating discomfort - it is no longer something to treat. The transition from "healthy" SAD listen-to-your-fat-depressed-doctor "everything in moderation" lifestyle to something so simple, intuitive, scientifically-backed for millions of years, and rewarding is an amazing thing. I would recommend it to anybody before they turn to modern medicine to enable unhealthy lifestyle choices and embark on a lifelong journey of treating groups of side effects ("diseases" is what they call a lot of them nowadays....poor you!) with more drugs, then treating more side effects, then spending the last years of your life as a clueless, helpless shell of the person you once were, giving your estate to the pharmaceutical giants instead of your living loved ones (may or may not be happening to a few of my family members).

Thanks to PH for a great community and best of luck to anyone who finds their way to this post while finding out how to get the !@#$ off PPIs.

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Awesome story! Thanks for sharing TS! Paleo helped me get off meds (high bp) and get out of the revolving refill=copay door! – sherpamelissa May 10 2011 at 20:50
Thanks Melissa. Really does make you think, right? I like to use Angelo Coppola's line that "humans are not broken by default" ...and I can't believe I ever let someone convince me I was. Being human is not all that hard once you're doing human things! – TS May 11 2011 at 14:29
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If your heartburn medication is a proton pump inhibitor, what it will do is reduce the amount of acid produced by the parietal cells in the lining of your stomach.

If you are having issues with your lower esophageal sphincter and stomach acid is escaping from your stomach into your esophagus this can cause damage to the delicate tissues in your esophagus that are used to a much higher pH.

This is probably what is causing you the pain, unless you have duodenal ulcers in which case the damage is in your intestines, or possibly if you take a lot of NSAIDs you might have gastric ulcers actually in your stomach.

So, less acid in the stomach lowers the pH of anything that might escape into your esophagus or intestine and gives any ulcers or irritated tissues a chance to heal.

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I should have clarified this is not a problem that I am suffering from. However I have a client that is, and the guy wants the most information on everything... took me forever to get him to go paleo and I don't know how much stuff I've read on that... (i've lost count) – Ryan H May 5 2011 at 22:08
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GERD is an issue of stomach acid ending up in the wrong place - your esophagus, your throat, eustacian tubes and even in your mouth (causing gumline cavities).

It's not at all likely an issue of too much stomach acid, but rather misplaced. It also may or may not be an issue of too little stomach acid. Some do have results increasing acidity, others don't.

I have GERD. The severity is much reduced on a paleo diet but it is still a problem. For 12 months, I've been following recommendations by Chris Kresser with varying results. I still think that eventually, I'll either need to go on meds (not preferred) or have a fundoplication (preferred but thus far no medical professionals deem it a reasonable option until it's been demonstrated that meds don't work for me....quite a catch 22)

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Katherin, please see the recommendation I made above about reading the book by Dr. Wright. Believe me. I was in incredible pain, until I followed his advice. It cured me. – Thomas Seay May 6 2011 at 0:28
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I'd suggest looking at meds sooner rather than later. Stomach acid going where it should not causes a lot of damage to cells (increased cancer risk....). – Turnkey May 6 2011 at 5:04
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Katherine, Sorry, but based on personal experience I am seconding Turnkey. As much as we all want to think that eating primal/paleo can solve all of our problems, the reality is that for some people it just won't. And yes, I HAVE read Dr. Wright and others like Chris Kresser. Even Dr. Wright says on his website that for people with damage from long-term, on-going, severe heartburn, i.e., Barrett's esophagus (a pre-cancerous condition), that the only safe option may be to stay on the PPI meds. What optimizing my diet HAS done is partially reverse the damage and I DON'T want to jeopardize that. – JCB May 6 2011 at 17:23
As always, it's easier to prevent something than it is to cure it. ITA. I will go on meds if I need to (though I'd rather do surgery - ie fundoplication) but for a variety of reasons, the meds are, for me, additionally risky. FTMP, I've been incredibly unimpressed with Wright though I will read the book (just requested it from the library). Fasting is super helpful:) Yay that. And digestive enzymes (Now Super Enzymes and Platinum Digest) help tremendously though far from completely. Adding Betaine hasn't helped at all. – Katherine May 7 2011 at 20:26
And thanks so much for your input Thomas, Turnkey and JCB. It really is tremendously helpful to have the differing perspectives. – Katherine May 7 2011 at 20:27
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Years ago I had peptic ulcers, I had an endoscopy (camera down the throat) and saw the pictures, 4 holes as plain as day.

I was tested for H. Pylori bacteria, a common bacteria that causes ulcers, the treatment of which is a specific antibiotic. The test was negative.

Rather than pursuing diet or lifestyle issues, the doctor just prescribed Nexium. This did eliminate the ulcer symptoms (localized pain, occasional heartburn and GERD). However, he said I'd have to take it for the rest of my life (at the time I was about 30) and it was going to cost me about $50/month out of pocket (health care only covered a portion).

I said to heck with that and started to "hack" my diet. I eliminated things one at a time for a week or two: tomatoes, dairy, coffee, alcohol, spicy foods, etc. When I quit coffee for 3 days, I felt better. After about 2 weeks of no coffee, all symptoms were gone though some localized discomfort remained. After about 2 months, that went away too and I felt totally fine. I added back teas and had no problems. So it was just coffee (not caffeine), which I found just has some adverse effect on me.

Of course the doctor never even mentioned or asked about this. Much better for him to push drugs and get me out of his office within 15 minutes I guess.

When I had the symptoms, I used to take Tums or Rolaids, which knocked out (hid?) the symptoms, but really messed with my digestion for 2-3 days afterwards.

I also think that heartburn can be caused by the same kind of inflammatory response that causes many other "diseases of civilization" (high blood pressure, cardiac problems, diabetes, etc), and so can be treated with the dietary changes recommended by the Paleo diet, or by finding the irritant (coffee in my case). I would guess that virtually any case of heartburn can be cured with dietary changes (don't tell the pharma companies that) unless you have a specific problem or disorder, so I'd pursue that before starting to take drugs.

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Just to give everyone an update,

I've picked up the book "Why Stomach Acid is good for you" finished reading it about a week ago, and talked with my client that has been having the heart burn since he was in his 20's.

I recommended the book to him, gave him some guide lines, and yesterday he walked into the gym. I went to shake his hand and he gave me a large hug.

He informed me that he has thus far gone 5, (today would make 6 days) without any heart burn medication (he was on nexium) and this is the first time since he can remember that he has gone more then 2 days without heart burn while not being on any medication.

He said the book really gave him a much better idea of what the drugs were doing to his system, and he no believes that an improper digestion could be leading into a lot of other issues that he is having. (I tend to agree)

Yesterday, he was in a good mood and the best I've seen him in a long time.

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