Medical myth: Stress, stomach acid and your digestive health
[Spoiler alert / bottom line: Please don’t use antacids - they’re exactly the opposite of a healthy solution to indigestion. Reduce your stress and change your diet instead.]
We all know stress isn’t good for digestion.
Most people (including many doctors) will say that stress causes an increase in stomach acid leading to an erosion of the mucosal tissue causing ulcers in the stomach and upper part of the small intestine.
Seems logical, right?
Wrong.
That’s actually the opposite of what really happens:
Stomach acid actually decreases with stress.
In fact, secretion of ALL digestive enzymes decreases with stress.
Here’s why:
Digestion is a complex, ‘energetically expensive’ process.
From an evolutionary standpoint, our bodies perceive stress as a threat to our survival; since digestion is not an essential function when it comes down to acute survival, the body prioritizes any threat / stress by restricting blood flow to the digestive system (part of the “fight-or-flight” / sympathetic response).
Instead, it sends blood and energy resources away to the organs and tissues which help the body survive - namely the muscles and brain - so the body can run away or fight for survival.
ANTACIDS FOR HEARTBURN MAKE NO SENSE AND ARE DAMAGING
What most people don’t realize is that heartburn is a symptom of LOW stomach acid production and not too much stomach acid production.
At rest, our stomach acid environment is at a 3-3.5 pH level. (Neutral pH, as in water, is 7.0.)
In order to effectively digest a protein rich meal, we need to get our stomach acid environment down to a 1.5-2.2 pH level. This is very energy demanding and due to a variety of factors, many people struggle to produce enough acid.
When we don’t produce enough acid, food sits in our stomach longer and begins to ferment and create gas and pressure that can open up the lower esophageal sphincter, valve. The acid that is in the stomach then regurgitates up into the esophagus where the tissue is not protected from the acid and it creates a burning sensation and overtime creates significant damage to the esophagus.
DIGESTION IS A TOP-DOWN PROCESS.
With so much focus on probiotics, prebiotics, and other supports - it can be easy to forget about the need for stomach acid to jumpstart the ENTIRE digestive process.
Here’s ludicrously oversimplified roadmap of digestion to give you an idea of why:
Hydrochloric acid, or HCl, helps increase the acidity of the stomach (lowers the pH) so that proteins can be broken down into smaller chains that can be absorbed.
HCl initiates and greases the wheels by activating the protein-digesting enzyme pepsin. Pepsin then starts chopping proteins into smaller peptides and amino acids.
Then, in the intestines, peptidases break these smaller peptide chains down further into amino acids and friendly microbes of the microbiome work together with other gastrointestinal secretions to digest fat, carbohydrates, fibers, and polyphenols. All of these processes require a certain pH as well.
The microbiome also creates and extracts metabolites from otherwise non-digestible material (like fibre) to provide our bodies with a huge array of very important molecules that are key to our health (hence the importance of keeping these guys happy by eating your veggies, etc).
Our gut, body, and brain require the breakdown products of both our own digestion and microbial ‘digestion’ - referred to as the “metabolome” - for optimal function. Up to 25% or more of the total metabolome is dependent on healthy gut flora.
The greater the quantity and diversity of the metabolome that you produce (or can produce in response to a stress), the better your body can respond to stress and physiological needs on the spot. This underpins resilience, immunity and healthy aging.
So:
Healthy digestion is necessary for a healthy microbiome, which is necessary for a healthy metabolome, which is what helps our body respond to its environment.
GET IT RIGHT FROM THE START
When stomach acid is too low, the initial steps in the stomach are botched and ALL later stages of digestion are compromised:
Low stomach acid and low pepsin activation disrupts the function of other digestive enzymes, bile acids, the ability for healthy bacteria to grow; and reduces our ability to yield the most benefit from the healthy activity of our gut microbiota.
Low gastric acidity promotes the growth of unwanted microbes and the creation of their toxic byproducts that gunk up liver function, create inflammation, and contribute to body aches, brain fog, and fatigue. Low acidity increases the chances of infection by outside pathogens from the bacteria in our air, food, and mouth.
THE MANY ROLES OF STOMACH ACID
We’ve established by now that if there isn’t sufficient HCI production and your stomach acid levels are not optimal, your body cannot break food down properly.
But HCl does some other critical things:
HCL is also a natural disinfectant so that if there are any pathogens like parasites or harmful bacteria on your food, they are killed before making it further into the digestive process.
Stomach acid also signals closure of the valve between the bottom of the throat and the stomach (AKA the Lower Esophageal Sphincter/LES).
When stomach acid is too low, that valve doesn’t close properly, food doesn’t break down properly and the acidic contents of the stomach come back up the throat, causing heartburn, indigestion and acid reflux.
Bad news bears.
So, proper digestion, immune response, and a healthy microbiome all depend on good acid production in the stomach.
Let’s review:
Stress leads to decreased blood flow to digestive system including the stomach…
which leads too lower HCl…
which impedes the signal to close the LES…
so the stomach stays open…
and acidic stomach contents come up and irritate the esophagus, causing heart burn, reflux and indigestion.
That’s the real story about stress and stomach acid.
But wait - there’s more.
With stress, there is also less protective mucus production, so stomach acid – even at low levels - can injure the fragile lining of the gut, furthering digestive distress and inflammation, causing ulcers, poor nutrient absorption, and ultimately weight gain.
So, when doctors provide acid blockers to relieve heart burn…
Disaster!!
Here’s what happens:
Proton pump inhibitors lower stomach acid…
which decreases the ability of our digestive system to properly digest our food…
leading to poor digestion…
impairing nutrient absorption…
and irritating and inflaming the gut.
This causes increased reactivity to foods (often perceived as allergies or intolerances), puts more stress on the body and can cause weight gain and hormone imbalances.
When I work with my clients, I am often working to heal and repair digestive function.
More drugs is not the answer.
HELP YOUR BODY, HEAL YOUR GUT
Decreasing stress and inflammation is one the best ways to allow the gut to heal.
Easier said than done, you say? Sound impossible?
Well, stress comes in many forms (post coming soon), many of which we don’t even realise affect us, so it may be easier than you think to cut it down: background noise, unnecessary trips to the supermarket, sleeping in a room with too much ambient light, heat or noise, wearing clothing that’s too tight, squinting through glasses that need a prescription upgrade, consistently being late…these are just a few of the little things that can really add up on your body cumulatively.
Other more obvious routes to decreasing stress are saying NO to too many commitments, deep diaphragmatic breathing, supplementing properly, meditation,
yoga and eliminating reactive foods (which are just a different type of stress to the body).
When I work with people, one of the first things we do is inventory where unnecessary stresses may be coming from and refine their lifestyle…
Take a moment to consider this: where are you creating needless stress on yourself?
TAKE ACID
The pH lowering kind, of course…
If you’re not making enough stomach acid, supplementing may be essential: taking betaine HCL and/or a tablespoon of apple cider vinegar diluted in 2oz of water directly before meals can be a very valuable method for assisting digestion, allowing the body to better absorb macronutrients and critical micronutrients like vitamins, minerals, peptides and other critical building blocks.
In certain instances, I would also support the digestion with certain mucilaginous (“slimy”) herbs such as slippery elm, marshmallow and deglycinerized licorice to sooth and protect the mucus membranes in the stomach. (This depends whether someone is also working with Candida/SIBO/bacterial overgrowths - the long-chain carbohydrates in these teas can worsen those conditions.)
I might also recommend bitter herbs to help the body produce it’s own digestive juices – including stomach acid – to support proper food digestion. Of course, treatment depends on the what else the person is working with.
Other useful tips you can easily incorporate into your lifestyle can be seen below:
Image courtesy of DrJockers.com
When you heal your gut, the rest of your body will heal and you will feel better, have more energy and probably be happier. (Most of your serotonin - your ‘feel good’ neurotransmitter - is stored in your gut!) The gut is the epicentre of our wellbeing, and controls so much of how we experience life. It’s profound.
If you’d like to go deeper on the causes of low stomach acid and what you can do about it, here’s an excellent article.
