Stomach

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Anatomy and Physiology

The stomach is a major protein-digesting organ made up of the fundus, antrum, and pylorus. It has a capacity to hold 2-3 quarts of liquid or solid material at a time, secretes up to 2 ½ quarts of digestive juices daily, and has a normal pH between 1.5-3. There are about 35 million glands in the stomach. Stomach secretions include pepsin, hydrochloric acid, mucus, a small amount of lipase (a fat digesting enzyme), and intrinsic factor.

The stomach has two types of glands. The gastric glands have mucus neck cells (secrete mucus), parietal cells, and chief cells. The parietal cells secrete hydrochloric acid (HCl). The pH of the HCl is 0.8 and it is one of the two major protein digestive enzymes in the stomach. Many people as they get older slowly lose their ability to produce enough HCl. There is much evidence that this is not a normal condition but a result of years of abusing their stomach (and it just begins to quit). The other major protein digesting enzyme is pepsin and it’s produced by the chief cells. Pepsin works best in a pH of around 2 and if the stomach pH gets as high as five (fairly common in people on antacids), it will be inactivated. HCl by lowering stomach pH thus helps pepsin. Pepsin is necessary to digest the collagen in meat and without pepsin meat digestion would be very much retarded.

Three main factors cause the stomach to secrete HCl and pepsin:

1) Food entering the stomach causes the antrum to produce gastrin. Via the circulation the gastrin will reach the gastric glands and cause them to increase pepsin production three fold and HCl eight fold.

2) Stimulation from the vagus nerve increases gastric secretion - pepsin more than HCl.

3) Smelling food and possibly even strong thoughts of food will stimulate gastric secretion.

The second type of gland in the stomach is the pyloric gland. It secretes a thin mucus to protect the stomach wall from being digested by HCl and pepsin. Other mucus cells produce an alkaline gel-like mucus for added protection and to help lubricate the food. Any irritation in the stomach will increase mucus production even more. Without mucus, it would take about three hours for the HCl and pepsin to eat a hole in the stomach wall.

Intrinsic factor secreted in the stomach combines with vitamin B-12 and aids it in being absorbed in the ileum of the small intestine. Most cases of vitamin B-12 deficiency are due to lack of intrinsic factor and the resulting failure of B-12 to be assimilated rather than from dietary deficiencies.

The fundus has very little tone and mainly holds food. If there is already older food in the stomach, when new food enters, the old food will be positioned nearer the stomach walls. The gastric glands will start secreting, and about 3 times a minute a peristaltic mixing wave will help mix the food and gastric gland secretions, and move the outermost layer of food toward the antrum. In the antrum gastric secretion is increased and the peristaltic waves are as much as six times stronger. This greatly increases the mixing and digestion of the food (the food-gastric gland mixture is called chime and will be referred to as that from this point on). From the antrum the chime is moved into the pyloric sphincter, which is kept constricted to stop chime from entering the duodenum of the small intestine prematurely. Only a strong peristaltic wave will push chime through.

Certain factors will increase the tone of the pyloric sphincter and slow stomach emptying. These include:

1) When the pH of the chime is below 3.5-4.0 in the duodenum (this slowing is accomplished through a reflex known as enterogastric reflex via the vagus nerve).

2) Fatty food or distention due to too much chime in the duodenum will also produce an enterogastric reflex.

3) Products that irritate the duodenal lining will produce an enterogastric reflex.

Increased acidity, fats, and irritants, will also cause the small intestine to secrete secretin and cholecystokinin. These hormones decrease stomach secretions thus slowing stomach emptying.

If the stomach has been empty at least eight hours, it can produce a strong contraction that we call "hunger pangs". These will last between 2-10 minutes and will increase our desire to eat.

Studies have shown that an average meal wills if entering an empty stomach take about four hours to totally pass through into the duodenum. If eating in between meals is practiced, some of that original meal can still be in the stomach 14 hours later. Eating in between meals thus encourages fermentation, putrefaction and gas.

Symptoms of Stomach Dysfunction

Throughout the rest of this chapter we will mainly be concentrating on three major conditions that affect the stomach: too little HCl secretion, too much HCl secretion, and hiatal hernia syndrome.

1) Symptoms of decreased HCl (hypochlorhydria): Hypochlorhydria is a diagnosis that is often overlooked by the medical profession, but this author among others has found this to be a fairly widespread condition with many consequences. Symptoms include odiferous gas, stomach distention shortly after eating, a burning feeling in the stomach 1-3 hours after eating sometimes accompanied by a headache, gallstones, problems digesting protein, rectal itching, decreased assimilation of iron, copper, zinc, manganese, magnesium, (deficiencies of these minerals can lead to prostate problems, slow ligament and muscle healing, heart problems, etc., etc.), gastric cancer.

The hydrochloric acid in the stomach kills many germs that enter our body through our food; in hypochlorhydria this is decreased and we are more likely to become ill (especially if our immune system is depleted). Decreased HCl will also make calcium assimilation very difficult (see parathyroid chapter for low calcium symptoms) and if the lack of acidity is systemic (throughout the body), calcium will tend to be taken out of solution and deposited in joints and connective tissue (causing arthritis, bursitis, etc.). Partially digested protein due to hypochlorhydria can enter the circulation and cause inflammation and antigen activity. The antigen activity and decreased calcium assimilation make allergies a common symptom of hypochlorhydria.

Interestingly enough, hypochlorhydria will respond to taking antacids. The antacids will make the stomach even more alkaline and this will stimulate the body to produce HCl which will digest the protein and stop the heartburn. The habitual taking of antacids will exhaust the stomach’s ability to produce HCl.

2) Symptoms of too much HCl and possibly ulcers: burning pain on an empty stomach, pain relieved by eating, vomiting blood.

3) Hiatal hernia is a partial protrusion of the stomach above the diaphragm. This is another condition that is sometimes missed by medical diagnosis. Symptoms include heartburn that can radiate to the chest and mimic pains of an oncoming heart attack, burping, vomiting, feeling like your food isn’t going down, indigestion after a heavy meal.

Causes of Stomach Dysfunction

1) General causes of stomach dysfunction include eating too many refined foods or greasy foods, not chewing well, overeating, too many different food combinations at a meal, alcohol, spicy foods, caffeine, vinegar.

2) Eating a heavy protein and starch or sugar at the same meal (e.g. hamburger on a bun). As the stomach works on the protein, the carbohydrate is waiting. If stomach emptying is delayed (from overeating, eating in between meals, etc.) the carbohydrate can start to ferment and cause heartburn and organic acid formation. At this point an antacid is often taken. This will neutralize the organic acid and relieve the heartburn, but will also neutralize the HCl and retard the protein digestion.

3) Too much salt intake and cigarette smoking both lead to increased incidence of stomach cancer.

4) Nerve pressure in the mid thoracics can cause stomach dysfunction (see Appendix A).

5) Causes of hypochlorhydria:
    a) Eating foods that are too cold or drinking cold or ice water before or with your meal.
    b) Taking antacids fairly regularly, through acid rebound, will exhaust the parietal cells and cause hypochlorhydria.
    c) B vitamin deficiencies (due to poor diet, increased intake of sweets, etc.).
    d) Stress will cause increased sympathetic nervous system stimulation and hypochlorhydria.
    e) Eating in between meals or eating a diet too high in protein will eventually exhaust the parietal cells.
    f) The author has found that eating foods you have an allergy or food sensitivity to will decrease HCl production.

6) Causes of increased HCl and ulcers include stress, (via excessive vagal stimulation), smoking, spicy foods (pepper, mustard, etc.), certain medications (aspirin, prednisone, cortisone, reserpine), hypoadrenia.

7) Causes of hiatal hernia include overeating or too many combinations at one meal (this leads to stomach distention and gas and can push the stomach through the diaphragm). Laying down and resting or bending over after a large meal can have similar results. Tight belts, corsets, lack of exercise, trauma to the stomach can all cause hiatal hernia. People with weak diaphragms (especially due to poor breathing habits) are more prone to hiatal hernia. In my practice I have found this condition common in pregnant women in their second or third trimesters. They will often come in weak and pale and complain of no appetite and inability to hold food down. The correction described later in this chapter will almost always bring immediate relief, return of normal skin color, etc.

8) According to Guyton’s Basic Human Physiology: "Gastric ulcers occur in patients who have normal or LOW secretion of HCl... ulceration in the stomach almost certainly results from reduced resistance of the stomach mucosa to digestion rather than to excess secretion of gastric juice." He goes on to state that aspirin and alcohol reduce mucosal resistance.

Other Indications of Stomach Dysfunction

1) A weak pectoralis major (clavicular division) or rhomboid will possibly indicate stomach dysfunction (see Appendix C and figures 12.2, 10.1).

2) A patient lying on their back should take a full inspiration then let half out and hold their breath. In this phase of respiration if both pectoralis majors (clavicular division) test weak simultaneously it is a good indication of the presence of hypochlorhydria.

3) If taking 2 HCl Tablets after a meal prevents your heart burn it is another indication of hypochlorhydria (it is best though not to use HCl tablets as a TREATMENT; it is better to restore the stomach to normal functioning so it can produce its own HCl).

4) If you can’t hold your breath for 40 seconds it is a good indication of a weak diaphragm and the possible presence of a hiatal hernia, especially if the other symptoms are present. It is estimated that 35% of Americans over 50 have a hiatal hernia.

5) With the patient lying down, putting your hand into the patient’s abdomen below the breast bone and pushing it headward and slightly to the left will make a strong muscle test weak in the presence of a hiatal hernia.

Prevention and Treatment of Stomach Dysfunction

1) Chew well, don’t eat in between meals, don’t eat more than three different courses per meal, avoid tobacco, excessive salt, spicy foods, caffeine, eat when relaxed.

2) Rubbing vigorously a reflex area between the 5th and 6th, and 6th and 7th ribs, on the left side from directly under the nipple to the sternum, for one minute, 3 times a week, will help many stomach problems (see Appendix B).

3) Holding 1" above each eyebrow with your hand for 5 minutes once daily is also a reflex area healing to the stomach.

4) Ingesting milk if allergic to it will cause the pyloric sphincter to spasm. Ingesting any food you’re allergic to may temporarily halt HCl secretion.

5) See a good chiropractor to check for nerve pressure (see Appendix A).

6) Animal studies have shown that charcoal broiled foods, smoked foods, and cayenne pepper, can cause stomach cancer.

7) Exercise can reduce stress and thus balance stomach secretions.

8) Hot and cold applications (3 minutes hot followed by 30 seconds cold repeated 3 times, twice daily, over the stomach and mid thoracics) can help regulate the stomach.

9) The following herbs are reported helpful for stomach dysfunction in general: slippery elm, red clover, chickweed, yarrow, strawberry leaves.

10) For a bleeding stomach - put an ice pack over the stomach, swallow small amounts of ice, don’t eat, call your doctor immediately.

11) For hypochlorhydria:
    a) See a chiropractor skilled in Applied Kinesiology cranial correction.
    b) Drink a glass of warm water 15 minutes before each meal, OR put an ice pack over the stomach for 10 minutes, 15 minutes before the meal.
    c) Eat lots of whole grain, a little brewers yeast to supply ample B vitamins.
    d) Don’t overeat high protein foods (keep it to 10% of your daily intake), avoid antacids.
    e) Don’t eat in between meals.
    f) Making a tea from the rind of sour oranges and drinking it before meals is helpful to restore normal HCl secretion.
    g) Sunlight tends to normalize HCl secretions.

12) For hypochlorhydria and ulcers:
    a) Drink a glass of ice water 15 minutes before your meals.
    b) Eat lots of olives, millet, avocado, almonds.
    c) Avoid antacids, milk, spicy foods, high protein foods.
    d) Don’t eat in between meals.
    e) Propolis extract is helpful, as is drinking ½ glass of raw potato juice before each meal.
    f) Drink lots of water, decrease stress, exercise, get lots of sun.
    g) Eating aloe vera gel is often helpful as is comfrey root and burdock root tea.
    h) Eating refined sugar can increase stomach acidity by 20% and aggravate ulcers.

13) For hiatal hernia:

a) To prevent it: don’t overeat, don’t bend over too soon after eating, no eating in between meals or late at night, practice deep breathing, eat lots of high fiber foods.

b) For treatment: Step 1 - Rub the whole sternum vigorously for 3 minutes (this is a reflex to stimulate the diaphragm). Step 2 - Have the patient lie on their back, put your fingers under their rib cage and slightly to the left of midline (make sure abdominal muscles are relaxed), have the patient breathe deeply and on expiration push inward (deeper) and toward the feet to "pull" the stomach down (see figure 12.2). Step 3 - For three expirations give a quick deep pull toward the feet. Often during one of the "pulls" you will feel gas moving. Step 4 - Rub the sternum for 1 minute. Step 5 - Check breath holding time; if over 40 seconds and #5 in indications of stomach dysfunction is negative, the treatment was successful. If still positive, try again tomorrow. Step 6 - After successful correction, to prevent recurrence, instruct the person that for the next week every morning upon arising they should drink one pint of warm water while standing up, wait 5 seconds and jump up once. If the hiatal hernia has recurred during the night the weight of the water while jumping should usually correct it by pulling the stomach down.

14) Many antacids contain aluminum hydroxide. Aluminum is a suspected cause in Alzheimer’s disease and also can cause weakness, constipation, and phosphorus deficiencies.

Antacids containing magnesium hydroxide can cause diarrhea, iron and potassium deficiencies.