Kicking My 2-per-Day Nexium Habit

This post has been a long time coming, hasn’t it?!  It’s been quite a while since my first ode to the glories of Hydrochloric Acid, but I think I’ve fully wrapped my words around just exactly what it took to finally break my Nexium habit, heal my GERD, and dramatically improve my ability to digest the foods I was putting into my body.  As I commented to my acupuncturist when he first suggested that I try the tactics that I’ll talk about in this post, “There’s no point in taking all that raw liver if I’m not actually digesting any of it!!”

Three principle factors contributed to my being able to break my need for Nexium and permanently get rid of my very serious heartburn/GERD problem:

1)       Stopping taking the Nexium cold turkey.  I had tried this step alone, without the following two, several times, and it was brutal.  I could not stand the discomfort.  But weaning off these meds is not going to help, it’s got to be a full, wholesale commitment.  When you stop taking proton pump inhibitors, it allows your proton pumps to start working again, albeit at inhibited capacity.  So you get acid in your stomach again.  Which is actually a really good thing.  The bad thing is that the esophageal sphincter doesn’t close tightly (which it hasn’t been all along), so the acid bounces or flows up past the tissue which can handle its intensity (which it also would have been doing, if there had been any acid in the stomach – which there wasn’t, because of the proton-pump inhibitor), and severely irritates the tissue above the sphincter, which can’t handle the acid.

But the thing is, stomach acid is there for a purpose – it digests protein, and it tells the gall bladder, pancreas, and liver to get busy with bile and enzyme production and secretion – in other words, it is a critical step in the digestive process.  Proton pump inhibitors basically remove, metaphorically, a full flight of stairs in the 5-ish-story staircase of digestive processes.  You are going to have a very hard time getting from the 2^nd to 4^th floor when the 3^rd floor stairs simply don’t exist.   Moreover, without stomach acid, you’re going to be sending food which should have already been partially digested down the line undigested – which can give pathogenic microorganisms in unwelcome locations extra food to nosh upon.  (Something I’m going to discuss in an upcoming post in more detail!)

Therefore, it might seem somewhat counterintuitive, but the next most critical step was to do the exact opposite of what the proton pump inhibitors accomplish:  add stomach acid, instead of preventing its production.  Thus Step 2:

2)      Supplementing with Betaine HCl (Hydrochloric Acid).  One of the theories about stomach acid and the esophageal sphincter is that too little stomach acid doesn’t give sufficient motivation to get the sphincter to close up tightly, and it gets lazy.  With sufficient (supplemented) acid in the stomach, it will respond by closing up tightly, therefore preventing reflux.

This can be tricky.  You want to find a happy medium, whereby you have enough stomach acid to motivate the sphincter to close, but not so much that you actually have too much stomach acid – which feels very, very different from heartburn, surprisingly.  My experience is that it feels like a lot of unpleasant pressure – not burning.  It may take some experimenting, but you will eventually find the dosage that you need by taking the pills WITH meals (this is critical!!  Don’t take them on an empty stomach, or even 10 or 15 minutes after eating – it must be with your food!  You will regret it otherwise!), adding more capsules until you no longer have heartburn but also don’t have pressure or other excess stomach acid symptoms.

If you do take too many HCl pills, it is easy to remedy this problem:  take a TUMS (which you probably already have on hand, if you’re anything like I was!), or a spoonful of baking soda dissolved in water.  It will neutralize the excess acid.  It may take a while to find your happy medium, and with time and proper nutrition facilitated by your new found digestive capabilities, your happy medium should gradually decrease as your body begins to be able to make its own sufficient supplies of HCl.

Personally, I started out taking 2 HCl pills per meal, 3 if it was super extra heavy on protein (like steak).  It took about 7 months of supplementation to get my body to the point where it didn’t need any supplemental HCl at all;  I tapered off it gradually, as I sometimes forgot to take it, or experimented with only taking one pill instead of two, and in the end, I realized I needed to stop taking it completely because it was causing diarrhea, not excess pressure in my belly.

It is worthwhile to note that sometimes, especially with children, the standard capsules of HCl are too much acid, even, than the body needs.  There are smaller capsules for sale, or you can open up the larger capsules and divide their contents up into smaller pills, if needed.

3)      Implementing the GAPS protocol.  Poor stomach acid production can be a factor of a number of things, including gut dysbiosis and adrenal exhaustion.   The GAPS protocol can help with these issues, particularly in terms of reestablishing healthy gut flora populations.  I’ve talked so much about GAPS elsewhere, I’m not going to go into it again here – but suffice it to say, I am confident that without a doubt, starting GAPS made a significant impact on my body’s ability to relaunch its stomach acid production capabilities.

There were a few other small tweaks that made the above steps manageable.   These included:

1)      DGL or Licorice, combined with saliva.  Even tho my esophageal sphincter tightened up appropriately with adequate HCl supplementation, the tissue, both in the stomach and below it, which was exposed to those heightened levels of HCl was very damaged and inflamed.  The extra HCl inflamed it further.  However, chewing DGL or Licorice about 10-15 minutes before every meal puts a protective mucus-like lining over these tissues, before they are exposed to the unexpectedly high levels of HCl.  This allows those tissues to heal, while also allowing your body to begin to rebuild them with the more adequate nutrition being processed by means of the HCl.  If you cannot take DGL or licorice, supposedly slippery elm bark can serve the same function, tho I had better luck with the licorice/DGL.

2)      Swallowing coconut oil, either small pieces or the liquid.  I found that this helped a lot, by laying on the top of the liquid in my stomach and prevent unpleasant contact with the esophagus.

3)      Digestive Enzymes.   These can be very beneficial in helping digestive processes below the stomach.  If stomach acid has been low for a long time – years, like it had been in my stomach – the pancreas hasn’t been producing and delivering sufficient enzymes to handle full digestion, because it hasn’t been getting cues from the stomach – and its acid – to do so.  Therefore, even with sufficient HCl supplementation, heartburn may creep up ½ to 1 ½ hours after eating – not a stomach acid problem, but a problem below the stomach, particularly with respect to high-fat foods (which GAPS emphasizes).

Digestive enzymes, I found for my body, are best taken up to ½ hour before a meal – to get down below the stomach before the food and HCl comes in.  Some things I’ve read, however, recommend taking them right after finishing eating;  if you find this works better for you, be cautious, because it could be having a different effect than you expect – digestive enzymes can have a basic ph, meaning that their relief of heartburn when taken after eating could be a result of neutralizing acid, which, as we’ve seen, is exactly the opposite of what we want to be doing.

(Enzymes can also be helpful in removing pockets of pathogenic microorganisms in the gut, which can be extremely difficult to eliminate because they create a sort of calcification layer to protect their colonies.  Enzymes are necessary to break through such calcifications.)

4)      Beet Kvass.  I’m not entirely sure if this helped or not, but I did try to be pretty diligent about making and taking beet kvass on a daily basis for quite a while during this stomach healing journey.  I read in one of my books about supplementing a particular nutrient which I had never heard of before (of course now I can’t for the life of me find the place that I read this — or the name of the nutrient!!) — and I’m always skeptical about supplementing nutrients instead of getting them from whole foods sources.  So I looked up the nutrient and found that one of the most concentrated sources of this nutrient was beets!  After that, I made a concerted effort to regularly drink beet kvass on a daily basis, since beet kvass is supposed to be extremely beneficial in so many ways, and is a probiotic on top of it all.

There were a few things I tried which didn’t work for me, but may work for you – also one thing I’ve heard of but haven’t tried:

1)      Bitters.  These are an ancient remedy which theoretically should prompt the stomach to secrete more acid.  I’m pretty sure my stomach was way, way to far gone in terms of its ability to care for itself in this respect – it needed a crutch AND a wheelchair, not a gentle nudge.  But for some people, this may be a good option to try, before resorting to HCl supplementation, and seems like an excellent idea for those with occasional heartburn, rather than persistent chronic GERD, as a general maintenance of digestive health tactic.

2)      Mastic Gum.  This is a tree resin from the Mediterranean, another ancient stomach remedy.  It is naturally anti-bacterial (though I would assume, like many other natural anti-bacterial agents, it tends to favor the bad bugs and leave the good ones alone) and has been used to treat stomach ulcers.  Traditionally it is chewed, not swallowed.  I tried taking this in capsule form, and in about 1/10 of a capsule, chewed/mixed with saliva.  In both instances it caused almost immediate diarrhea.  Needless to say, I didn’t try it again.  But it might work for you!  Just make sure you’re near a bathroom just in case it doesn’t!

3)      Ox Bile.  People with impaired gall bladder and liver function may find that ox bile supplements help them digest fats more effectively, the ineffective digestion of which may cause heartburn symptoms.

4)     ACV (Apple Cider Vinegar — the live active cultured stuff, i.e. Braggs).  Thanks to Lea in the comments for reminding me about this one!  As I understand it, ACV can help stimulate your stomach to produce more HCl–however, it will not likely increase the acidity in the stomach to sufficient levels the way HCl supplementation can.  Nevertheless, if this works for you, and does stimulate your stomach to produce its own HCl, I would say that’s a far better option than even HCl supplementation — best to get things going on their own as quickly as possible!

I have actually adding a lot more ACV recently to foods and drinks — to my water glass, in particular — I’ve been finding that it tastes really good to me.  Especially in the water, which I add magnesium drops to as well, the tartness of the ACV nicely counteracts the sweet-ish magnesium flavor.

I read a lot of books related to heartburn and stomach acid issues.  Why Stomach Acid is Good for You was by far the most helpful one.  This book definitely has issues, and a lot of repetitiveness, but there is still some good info in it, and it got me started on the right track in terms of supplementation.  I would recommend it for additional reading, with the caveat that it should be taken with a grain of (sea) salt and a critical mind.

I’d be interested in hearing from readers what has worked for them in terms of permanent heartburn/GERD recovery and healing — what remedies have you found beneficial?

Photo Credit:  Rennett Stowe

This post is part of Monday Mania, Traditional Tuesdays, and Fat Tuesday.