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Stomach disease

Category: Illness or disabilities

Type

Involuntary

Introduction and description

The purpose of the Stomach is to break down food and liquids we have ingested into a form that the body can use. 

Most of the food and drink we ingest consists of molecules that are too large to pass into cells, so one function of the stomach is to make it into a manageable size. The second function is to break the food down chemically in a process we call digestion into molecules of a type capable of being passed across the walls of the intestine.

   

Diseases of the stomach

I have provided more detailed sections for certain problems with the stomach, notably

But this catch-all section enables me to capture any observations that are not covered by these sections. 

 

Many of the supposed other illnesses of the stomach are related to gastric acid.  Gastric acid is produced by cells in the lining of the stomach, which are coupled in feedback systems to increase acid production when needed. Other cells in the stomach produce bicarbonate, a base, to buffer the fluid, ensuring that it does not become too acidic. These cells also produce mucus, which forms a viscous physical barrier to prevent gastric acid from damaging the stomach. Cells in the beginning of the small intestine, or duodenum, further produce large amounts of bicarbonate to completely neutralize any gastric acid that passes further down into the digestive tract.  If this system is not interfered with, one cannot suffer from any of the other supposed illnesses :

  • Hypochlorhydria - having too little or no gastric acid  
  • Hyperchlorhydria - having high levels of gastric acid.
  • Gastroparesis - the stomach motility disappears and food remains stagnant in the stomach

Symptoms

 

The typical immediate symptoms of stomach problems include nausea, vomiting, bloating, cramps, diarrhea and pain, but there are delayed symptoms from stomach problems, some of which will be discussed in the context of the causes.

It is known that low levels of gatsric acid result in various forms of calcium imbalance and thus lead to osteoporosis and loss of bone.  This is one reason why the elderly suffer fractures and literally shrink in size, as old age afects the stomach and its ability to secrete acid.  Gastic acid goes down as you get older.

Efficient calcium absorption is essential for skeletal health. Patients with impaired gastric acidification display low bone mass and increased fracture risk, because calcium absorption is dependent on gastric pH.   PMID:  26945509

Causes

Stomach problems appear to be an area in which the lack of understanding of how the stomach works is causing untold misery and illness. We need to first look at the emotional state of the person, because this is how illness can start.

Stress and extreme emotion

The sympathetic nervous system acts to suppress stomach motility as part of the 'fight or flight' response, as such any stress or high emotion will serve to impair the stomach's functions.  In times of high stress, gastric acid is not released, and stomach motility is suppressed.  Thus indigestion and heartburn, for example, Gastroparesis and Hypochlorhydria are not caused by an 'excess' of acid but by stress, fear, anxiety, depression, sadness, loneliness and all the negative emotions that provoke the sympathetic nervous system into action.  

and health in general, many old people suffer from a lack of acid,
not too much

Stress causes low stomach acid and low stomach acid can result in the spread of pathogens - The stomach is a key part of our immunological response.  The stomach acid is the second line of defence [after the mouth and its friendly bacteria, with the tonsils] against the entry of pathogens.  The acid is a key weapon. 

Gastric acid, gastric juice or stomach acid, acts as both a digestive fluid and a form of ‘disinfectant agent’.  Formed in the stomach, it is composed of hydrochloric acid (HCl) .05–0.1 M (roughly 5,000–10,000 parts per million or 0.5-1%) potassium chloride (KCl) and sodium chloride (NaCl).

Many microorganisms have their growth inhibited by such an acidic environment, which is helpful to prevent infection.  The acid can do nothing with toxins or heavy metals, but it can do something with fungal organisms, bacteria and viruses.  It can also attack parasites.  Thus by either using pharmaceuticals to reduce stomach acid, or by being stressed, we have effectively opened the door to invasion by fungus, bacteria, viruses and parasites. 

So although there is a link between stomach problems and parasites, fungus etc, the link is secondary in terms of causes.  The principle cause is negative emotion coupled with the very very unwise use of over the counter antacids, or medically prescribed pharmaceuticals.

 

Stress causes low stomach acid and low stomach acid can result in the entry of irritants - The acid plays a key role in digestion of proteins, by activating digestive enzymes, and making ingested proteins unravel so that digestive enzymes break down the long chains of amino acids.   Thus any lack of this acid sends undigested food into the intestine where it acts as an irritant.  There is thus a cause effect chain operating here, where the undigested food may then be the cause of intestinal disease.

It can also cause gall stones and kidney stones, as again the unprocessed food finds its way into these organs.  We have found no proof as yet, but it might seem logical to assume that it also has a hand in appendicitis.  Thus the use of antacids or pharmaceuticals such as PPIs may have a profound knock on effect.  Here is an example from eHealthme.  Nexium is a PPI.

eHealthme - On Jun, 25, 2016

72,094 people reported to have side effects when taking Nexium.
Among them, 901 people (1.25%) have Gallstones

 and if we take an over the counter pharmaceutical such as Gaviscon, we find the following

eHealthme - Most common Gaviscon side effects

  • Diarrhea - (111 reports)
  • Headache - (85 reports)
  • Dizziness - (84 reports)
  • Renal failure acute - (82 reports)
  • Dehydration - (80 reports)
  • Anaemia - (72 reports)
  • Constipation - (62 reports)
  • Itching - (51 reports)
  • Blood glucose increased - (46 reports)
  • Memory loss - (43 reports)

so kidney failure is one side effect.

Nutritional deprivation

Nutritional deprivation can cause stomach disease - this includes an imbalance in foodstuffs such that the stomach is unable to handle the imbalance - for example too much food or too little food, or too much fat, too many carbohydrates and so on.  Artificial food colourings cause' gastrointestinal upsets'.

 

Lack of amino acids and calcium imbalance - Gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility.  Gastrin is released in response to certain stimuli. These include:

  • ‘Stomach antrum distension’ [being full!]
  • vagal stimulation (mediated by the neurocrine bombesin, or GRP in humans)
  • the presence of partially digested proteins, especially amino acids, in the stomach
  • hypercalcaemia (via Calcium-sensing receptors)

So we have the link with extreme emotion again, and the link with nutritional deprivation [lack of amino acids] and an added specific nutritional problem in that calcium imbalance can be a cause of insufficient gastrin.

This is an example of the food being served in our hospitals. 

Poor Smell and taste - Thirty percent of the total gastric acid secretions to be produced is stimulated by anticipation of eating and the smell or taste of food.  Thus food which is nutritionally worthless with little taste or smell will result in poor digestion.  About fifty percent of the total acid for a meal is secreted in the ‘gastric phase’. Acid secretion is stimulated by distension of the stomach and by amino acids present in the food.  The final 10% of acid is secreted when chyme enters the small intestine, and is stimulated by small intestine distension and also by amino acids. The duodenal cells release entero-oxyntin which acts on parietal cells without affecting gastrin.  Thus again, if the food is nutritionally suspect with low levels of amino acids, indigestion may result.

But there is another aspect of nutritional deprivation which is key.

Not enough salt - As one can see from the make up of Gastric acid, both Chloride [from salt] and potassium are key to digestion.  Thus any reduction of intake of salt will affect digestion and the effectiveness of the stomach.  One assumes this is why we naturally like salt with food.  As the chloride levels are depleted by the digestive process, they can be topped up by adding salt to the food.  Animals and birds will travel hundreds of miles to find salt licks, so this same process operates for them as well and they have the common sense to follow what their body tells them to do.

A typical adult human stomach will secrete about 1.5 liters of gastric acid daily. Thus there is a relatively high demand for both Chloride, sodium and hydrogen ions, which are secreted separately from the cytoplasm of parietal cells and mixed in the canaliculi. Gastric acid is then secreted into the lumen of the gastric gland and gradually reaches the main stomach lumen.

 Pharmaceuticals

One of the most common causes of chronic stomach problems is use of medications.  We have already seen one of the main culprits - PPIs - proton pump inhibitors, and the over the counter antacids, but there are others that do other sorts of damage:

The list of pharmaceuticals that cause damage is too long to include here, but here are some links for you to follow under the heading that eHealthme use

In 2016, eHealthme completely reordered their site.  This meant that every link we had provided to their data no longer worked.  The links to eHealthme take you to their site but not the relevant section.  Thus you can use the link, but you will need to search under ‘symptoms’ and then use the section ‘drugs causing symptoms’ to get the information. 

Carbonic anhydrase inhibitors - The enzyme carbonic anhydrase catalyses the reaction between carbon dioxide and water to form carbonic acid. This acid immediately dissociates into hydrogen and bicarbonate ions.  Remember that the stomach produces bicarbonate, a base, to buffer the gastric fluid, ensuring that it does not become too acidic, as well as mucus, which forms a viscous physical barrier to prevent gastric acid from damaging the stomach.  Thus any toxic substance which attacks this enzyme reduces the protective layer in the stomach – According to Dr Duke’s Phytochemical database there are no natural inhibitors, but the medical profession and pharmaceutical companies have invented one.

Carbonic anhydrase inhibitors are a class of pharmaceuticals that suppress the activity of carbonic anhydrase. They are used as antiglaucoma agents, diuretics, antiepileptics, in the management of mountain sickness, gastric and duodenal ulcers [!], neurological disorders, or osteoporosis.  They are also used in the treatment of gout.  The following is a study, not absolute numbers of sufferers:

eHealthme
Gallbladder disorder is found among people who take Acetazolamide, especially for people who are female, 50-59 old …, and have Gastrooesophageal reflux disease . Top conditions involved for these people :

  • Sleep Disorder (7 people)
  • Meniere's Disease (7 people)
  • Irritable Bowel Syndrome (7 people)
  • Herpes Virus Infection (7 people)
  • Gastrooesophageal Reflux Disease (7 people)

The knock on effect of taking these medications is thus rather catastrophic.  By affecting the delicate balance of the stomach, one not only lets pathogens through [Herpes, IBS, Meniere], but also affect the stomach acid balance [GERD] and the person is so ill they cannot sleep.

 

Anti-histamines - Nerve endings in the stomach secrete two stimulatory neurotransmitters: acetylcholine and gastrin-releasing peptide. Their action is both direct on parietal cells and mediated through the secretion of gastrin from G cells and histamine from enterochromaffine-like cells. Gastrin acts on parietal cells directly and indirectly too, by stimulating the release of histamine.

The release of histamine is the most important positive regulation mechanism of the secretion of gastric acid in the stomach. Its release is stimulated by gastrin and acetylcholine and inhibited by somatostatin.  Thus anti-histamines can completely disrupt the delicate mechanism of the stomach causing not just indigestion, but the entry of pathogens into the rest of the body.

H2 antagonists - also called H2 blockers, are a class of medications that block the action of histamine at the histamine H2 receptors of the parietal cells in the stomach. This decreases the production of stomach acid. Despite being anti-histamines, they are not called this.  They are used to treat peptic ulcer disease and gastroesophageal reflux disease.  Examples include – cimetidine, ranitidine, famotidine, nizatidine and Zantac

eHealthme - Most common Zantac side effects

  • Chest pain - (2,040 reports)
  • Diarrhea - (1,695 reports)
  • Dizziness - (1,593 reports)
  • High blood pressure - (1,442 reports)
  • Thrombocytopenia - (1,163 reports)
  • Back pain - (1,115 reports)
  • Depression - (1,096 reports)
  • Pneumonia - (1,032 reports)
  • Abdominal pain - (948 reports)
  • Cough - (864 reports)

Octreotide  - As we saw Gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility.  Gastrin release is inhibited by Somatostatin.  Somatostatin - also known as growth hormone–inhibiting hormone acts directly on the acid-producing parietal cells via a G-protein coupled receptor  to reduce acid secretion.  Octreotide (brand name Sandostatin,) is an octapeptide that mimics natural somatostatin pharmacologically, though it is a more potent inhibitor of growth hormone, glucagon, and insulin than the natural hormone.  It is used for a host of symptoms – again it is symptom and not cause based medicine – fistulas, esophageal varices in liver cirrhosis, imaging such as PET scans.............

Wikipedia
The most frequent adverse effects …. are headache, hypothyroidism, cardiac conduction changes, gastrointestinal reactions, including cramps, nausea/vomiting and diarrhoea or constipation, gallstones, reduction of insulin release, hyperglycemia or hypoglycemia, and (usually transient) injection site reactions, slow heart rate, skin reactions such as pruritus, hyperbilirubinemia, hypothyroidism, dizziness and dyspnoea.  Rare side effects include acute anaphylactic reactions, pancreatitis and hepatitis. One study reported a possible association with rheumatoid arthritis  Some studies reported alopecia in patients who were treated by octreotide.

Proton Pump Inhibitors - The pH of gastric acid is 1.5 to 3.5 in the human stomach lumen, the acidity being maintained by the proton pump H+/K+ ATPase. Proton Pump Inhibitors inhibit this process.  Their record is not good.  Interestingly, this is one instance where the use of PPIs is entirely due to the placebo effect.  The person believes they work, so they calm down and then because the stress levels have subsided, the indigestion goes.  The parietal cell releases bicarbonate into the bloodstream in the process, which causes a temporary rise of pH in the blood, known as an alkaline tide.  Thus the use of PPIs which inhibit the proton pump can cause imbalances of the delicate acid/alkaline balance in the blood as well.

Sodium bicarbonate and some mineral water

Sodium bicarbonate neutralises gastric acid.  Thus given that most of our woes are actually caused by a lack of gastric acid, sodium bicarbonate would seem to be a problem.  And indeed any very alkaline foods and drinks may also pose a similar problem. In the duodenum, gastric acid is naturally neutralized by sodium bicarbonate. This also blocks gastric enzymes that have their optima in the acid range of pH.  The neutralization is described by the equation:

HCl + NaHCO3 → NaCl + H2CO3

The carbonic acid rapidly equilibrates with carbon dioxide and water through catalysis by carbonic anhydrase enzymes bound to the gut epithelial lining, leading to a net release of carbon dioxide gas within the lumen associated with neutralisation.  Thus the end result is indigestion, burping or farting and too much salt.  Overall we can see that an excessively alkaline food intake – any alkali that reacts with hydrochloric acid in other words – is not at all helpful.  Adverse reactions to the administration of sodium bicarbonate can include

bloating, metabolic alkalosis, and oedema due to sodium overload.  It can also lead to congestive heart failure, and hypertension due to the increase in sodium. It has also resulted in metastatic calcification, kidney stones, and kidney failure [Wikipedia].

Sodium bicarbonate mixed with water is actually being used as an antacid to “treat acid indigestion and heartburn” by some alternative health practitioners – not a good idea.  It is used for treatment of hyperkalemia, and it is sometimes used to treat aspirin overdoses. Aspirin requires an acidic environment for proper absorption.  It has also been used in the treatment of tricyclic antidepressant overdose. 

We also know it as baking powder, but when used in cooking the neutralisation of the acids and the production of carbon dioxide occurs in the food, not in us.  So in fact, unless you get the measurements wrong, used in cooking it does you no harm.

BUT, it is found dissolved in many mineral springs. It is among the food additives encoded by the European Union, identified as E 500.  Since it is in mineral springs you may find it in mineral water.  In some cases, the amount of sodium bicarbonate in mineral water is very high and given the constant advice by those who know no better to drink more water than we actually need, this could be a problem.   

 

Anosmia

Anosmia means we have lost our sense of smell.  With that loss of smell also goes much of our ability to taste anything as well.  Thirty percent of the total gastric acid secretions to be produced is stimulated by anticipation of eating and the smell or taste of food. This signalling occurs from higher centres in the brain through the vagus nerve. It activates parietal cells to release acid and ECL cells to release histamine. The vagus nerve also releases gastrin releasing peptide onto G cells. Finally, it also inhibits somatostatin release from D cells.  Thus by not being able to taste or smell food, or it has to be said, by being in a position where one is simply presented by a meal which is tasteless and odourless, the body does not have time to produce enough gastric acid to digest it. 

Pancreatic and duodenum disease or damage

Gastric acid production is regulated by both the autonomic nervous system and several hormones. The parasympathetic nervous system, via the vagus nerve, and the hormone gastrin stimulate the parietal cell to produce gastric acid.  Gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility. It is released by G cells in the pyloric antrum of the stomach, duodenum, and the pancreas.

Thus any damage to the pancreas or duodenum could decrease the amount of gastrin being produced and cause indigestion and stomach problems.

Toxins

Assuming that one's gastric acid levels are adequate, the stomach is still unable to deal with a toxin.  Toxins are simply hostile agents to the body and include insecticides, pesticides, Heavy metals such as lead or mercury, cadmium or nickel.  If we have leaky mercury amalgam fillings, we are constantly swallowing mercury.    Alcohol in excess can be treated as a toxin in this respect.  Nanoparticles appear to present a quite alarming new threat to the stomach.  They are found in sunscreen lotion and in lipsticks, and are being actively researched as a form of medicine!  But they destroy cells and thus are as likely to destroy the stomach cells as any other cells.

The relationship between chemical elements in rainwater and the frequency of hospitalizations for gastric and duodenal peptic ulcers was studied on the population of the province (Voivodship) of Opole, Poland, during the years 2000-2002. There is a high positive correlation between hospitalized cases of gastric peptic ulcers with chromium in rainwater (r = 0.71), cadmium (r = 0.63), and lead (r = 0.70). …... These correlations were higher on men, suggesting that there are gender correlations involved. In duodenal peptic ulcers, we observed a high positive correlation between chromium in rainwater and hospitalized cases (r = 0.61) and mild positive correlations with lead (r = 0.57), copper (r = 0.52), and cadmium (r = 0.51). Significant gender differences were not found. These positive correlations may be due to the biological activity of the elements, such as their cytotoxic activity, enhanced local adrenergic stimulation on mucosal vasculature, ion channel (mainly calcium channels) remodeling, and, for example promoting infection by Helicobacter pylori.  PMID:  20437109

Food allergy

And food intolerance, in this case the body is treating the food as a toxin or poison.  You need to read the section to obtain full details as the area is quite complex.

Physical damage 

Both physical damage from being physically hurt and damage from surgical intervention can result in stomach disease. Gastroparesis, for example, can occur from a blockage at the distal end of stomach.

A 32-year-old man without any underlying diseases except for non-alcoholic fatty liver underwent laparoscopic adjustable gastric band surgery in 2010. He had no significant complications postoperatively. He underwent routine health check-ups with near-normal gastroduodenoscopic findings through 2014. However, in 2015, routine gastroduodenoscopy showed that the gastric band had eroded into the stomach. His gastric band was removed laparoscopically, and the remaining gastric ulcer perforation was repaired using an omental patch. PMID:  26867553

Parasites

Parasites, such as hookworms, tapeworms, and so on can cause cysts and general damage to the stomach if they are allowed to get a hold.  Entamoeba histolytica, for example, is the cause of  Amoebiasis, or Amebiasis, which is a gastrointestinal disorder.  But they will only get a hold if the gastric acid is low as a consequence of inadvisable use of pharmaceuticals, stress and nutritional deprivation.

Viruses

There is increasing evidence accumulating for the role of viruses in stomach diseases and notably stomach cancer.  For example

"Nuclear factor-kappa B (NF-kappaB) inhibition by NF-kappaB p65-specific siRNA induced a near-cessation of cell proliferation in EBV-positive stomach cancer cell, and notably diminished cell proliferation in EBV- positive Raji lymphoma cell. …., NF-kappaB inhibition may be beneficial in the therapy of EBV-positive stomach cancer, but influence variously EBV-negative stomach cancer.  PMID: 19968495"

But at the same time, the ability of that virus to cause disease is again linked with the inadvisable use of pharmaceuticals, poor nutrition and extreme negative emotion.

Nervous system disease

The production of gastric acid in the stomach is tightly regulated by positive regulators and negative feedback mechanisms. Four types of cells are involved in this process: parietal cells, G cells, D cells and enterochromaffine-like cells. Besides this, the endings of the vagus nerve (CN X) and the intramural nervous plexus in the digestive tract influence the secretion significantly.  Thus if there is any damage to the nervous system, it will have a knock-on effect on the stomach.

Treatment

 The principle cause of stomach disease is negative emotion - stress, fear, anger, hate, loneliness, depression, anxiety, .......  Thus the treatment is not a pharmaceutical or interventionist surgery, but relaxation and the other methods we have on the site for invoking the parasypathetic nervous system - various forms of controlled breathing like Belly breathing .  Quite a number of 'suppression activities' on this site should help a great deal, including an attempt to turn all that negativity - hate and fear into something positive - love.  There are advocates of music therapy and indeed that too works and we have covered this on the site under listening to beating sounds and listening to music.  

Another major cause is nutritional deprivation - so the obvious thing to do is eat better more nutritious food, more slowly.  Enjoy the food, chew it properly, eat it with friends and family so it is a social act.

How it works

The means by which an experience is obtained depends entirely on the effects the resulting disease produces, for example, it may be caused by extreme pain, or the dehydration that results from constant vomiting or diarrhoea.

A number of the experiences are simply caused by poisoning.

 

References and further reading

  • Nuclear factor-kappa B inhibition reduces markedly cell proliferation in Epstein-Barr virus-infected stomach cancer, but affects variably in Epstein-Barr virus-negative stomach cancer. Jeong JY, Woo JH, Kim YS, Choi S, Lee SO, Kil SR, Kim CW, Lee BL, Kim WH, Nam BH, Chang MS. Center for Antimicrobial Resistance and Microbial Genetics, Department of Infectious Diseases, University of Ulsan College of Medicine, Seoul 138-736, Korea
  • Biol Trace Elem Res. 2011 Jun;140(3):253-61. doi: 10.1007/s12011-010-8694-1. Epub 2010 May 1.  The content of elements in rainwater and its relation to the frequency of hospitalization for gastric and duodenal peptic ulcers in Opole Voivodship, Poland, during 2000-2002.  Tubek S1, Bunio A, Szyguła R, Krasowski G.
  • J Orthop Res. 2016 Mar 4. doi: 10.1002/jor.23221. [Epub ahead of print]  Hypochlorhydria-induced calcium malabsorption does not affect fracture healing but increases post-traumatic bone loss in the intact skeleton. Haffner-Luntzer M1, Heilmann A1, Heidler V1, Liedert A1, Schinke T2, Amling M2, Yorgan TA2, Vom Scheidt A2, Ignatius A1.- 1Institute of Orthopedic Research and Biomechanics, University Medical Center Ulm, Helmholtzstraße 14, 89081, Ulm, Germany; 2Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

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