Slightly Heart Burn is good for Stomach & Spleen Digestion Function

[williamtell]

Thanks for the clarification - that was indeed what I was trying to clarify.
Please tell me where the Su Wen says that Wood controls the acid of stomach. All I can think of is that the Su Wen says that Liver corresponds to the acid (sour) flavor, but that is not the same thing.

Stomach acid is an expression of Stomach Fire (Stomach Yang). It can be easily upset by Liver disharmony across the Ke cycle.

There are a number of different patterns that lead to acid reflux or GERD. Today I will take a french flavored approach.*

In the book "The Treatment of Disease in TCM, Vol. 5: Diseases of the Chest, Abdomen & Rib-side" by By Philippe Sionneau, Lu Gang, Publisher: Blue Poppy Press page321.

Philippe Sionneau and Lu Gang list 3 disease cause, disease mechanisms.
begin quote
1.Liver fire invading the stomach
Emotional upset is usually the disease cause of binding and depression of the liver qi. Over time, liver depression may transform into fire or heat. If this fire or heat counterflows horizontally and invades the stomach, they can burn stomach fluids, making the fluids hot and acid. Once invaded by such depressive heat, the stomach typically becomes disharmonious. The stomach qi counterflows upward bringing with it the acid juices in the stomach. Thus there is acid regurgitation.

2. Cold dampness obstructing internally
Cold dampness usually arises from excessive consumption of uncooked, chilled foods or from external contraction of cold, damp evils. If cold dampness obstructs the middle burner they may affect the spleen's movement and transformation and lead to collection of water in the stomach. Over time, this cold dampness may transform into heat. If this heat then burns the collected water into acid and causes the stomach to become disharmonious, there can be upward counterflow of stomach qi and thus acid regurgitation.

3.Food accumulating and stagnating in stomach
When food is taken in, it should be ground,decomposed,and sent downward by the stomach within a certain period of time. If the spleen and stomach are damaged by dietary irregularities or invaded by external evils, they may fail to do so. Then the food may accumulate and stagnate in the stomach, fermenting and becoming acid and leading to stomach disharmony if the stomach becomes disharmonious, the stomach qi will counterflow upward, resulting in acid regurgitation.
end quote

This excerpt is clearly from a TCM perspective. It is interesting that they don't include stomach heat.(many other sources do) The next few pages of the book give the clinical information for discriminating these 3 patterns, as well as the acupuncture point prescriptions and formulas.

My interest today is a brief view of acid reflux being caused by too little stomach acid. More and more this is what I see clinically. I often find that if clients not on medication for acid reflux add supplementation of digestible HCl, known as betaine hydrochloride before meals it quickly alleviates the symptoms while we treat the underlining cause.

Here is a quote from a article in Acupuncture Today titled "The Purple Pill Myth"

begin quote
The function of your stomach acid is to digest protein. When someone has their stomach acid "turned off," they can't digest well (more on what turns off stomach acid in a moment). When someone eats a piece of chicken, it lands in the stomach, and needs hydrochloric acid to break it down. When there isn't enough hydrochloric acid, the protein sits in the stomach and starts to putrefy, creating acid and gases. The person might have some symptoms — a sour stomach, belching, or even acid reflux. But, this all happened because they initially didn't have enough acid to digest properly.
If you have good amounts of stomach acid, it closes the upper sphincter of the stomach when you eat to prevent that good acid from going up into the esophagus. And, it also opens the lower sphincter to empty your stomach after the food has been digested. But if you don't have enough acid, not only can you not digest the protein, but the upper sphincter doesn't close tightly enough, causing acid reflux and potential damage to the esophagus. Low stomach acid also causes the lower stomach sphincter to stay closed, which leads to the Spleen qi symptom of "fullness after eating." It's not the normal feeling of being full after eating, it's being overly full, because the stomach doesn't empty properly.
end quote
link to complete article
http://acupuncturetoday.com/mpacms/a...e.php?id=32409

I suspect that at the core of most chronic cases of acid reflux is spleen deficiency. Since we are quoting big books.

Here is a quote from huangdi neijing LINGSHU

Volume III Books VI - IX N.V.N. Edition
by Nguyen Van Nghi, Christine Recours Nguyen, Tran Viet Dzung
Translated from the French by Edward S. Garbacz, MD
With Additional Commentary by Sean Christiaan Marshall, D. Ac.
© Jung Tao School of Classical Chinese Medicine - 2002
Rough Draft For JTS Students Only
Page 367
Quote
• Among disturbances of the 5 organs:
_ the heart governs eructations
_ the lung, cough
_ the liver, logorrhea (2)
_ the spleen, pyrosis (3)
_ the kidney, yawning.

• Among disturbances of the 6 bowels:
_ the gallbladder governs anger
_ the stomach, the ascent of the energy (food) and hiccups
_ the large and small intestines, diarrhea
_ the bladder, urinary incontinence
_ the Sanjaio, edema (anasarca).

• Among the 5 Sapors:
_ the sour sapor first reaches the liver
_ bitter, the heart
_ spicy, the lung
_ sweet, the spleen
_ salty, the kidney
_ tasteless/bland, the stomach.

2. Abnormal or pathologic garrulousness.
3. Heartburn, acid reflux.
End Quote

This quote says the spleen (governs) pyrosis. Interesting.

on the high horse
I struggle to provide the direct quote because I think it is lazy and unprofessional to say this book says ... without providing at least page numbers and edition. Also different versions of the classics have different wording that can lead to a different interpretation. I also am not the source of the information and do not want to misrepresent myself as an expert. It seems others do. In the end though, in my view, what is paramount is clinical outcomes. Acupuncture for me is not a philosophical endeavor.
off the high horse

This is an incomplete discussion on acid reflux and GERD. In another post maybe we can go into the long term effects of proton pump inhibitors and its ramifications on an aging population, or how to diagnose and treat acid reflux, or the use of digestive enzymes as a poor/inferior substitute for supplementing spleen deficiency.

*French flavor- Philippe Sionneau is french and this copy of LIng shu was translated from the French by Edward S. Garbacz, MD

[AAPrescott]

Just for clarification - in case anything was miss-understood. I am understanding there to be a distinction between Liver Fire invading Stomach (pathological condition) and the idea that Stomach Fire is 'controlled' by Liver. The latter idea seemed to be suggesting that the natural 'heat/fire' of Stomach came from the Liver.

I agree that lack of acid may be a major problem that is commonly miss-treated. A distinction I would make which I think is implied by what the last post is saying, is between the normal heat/fire of Stomach and the pathological which can sometimes get confused.

[williamtell]

Just for clarification - in case anything was miss-understood. I am understanding there to be a distinction between Liver Fire invading Stomach (pathological condition) and the idea that Stomach Fire is 'controlled' by Liver. The latter idea seemed to be suggesting that the natural 'heat/fire' of Stomach came from the Liver.

I agree that lack of acid may be a major problem that is commonly miss-treated. A distinction I would make which I think is implied by what the last post is saying, is between the normal heat/fire of Stomach and the pathological which can sometimes get confused.

Here is an excerpt from notes on a talk Bob Flaws did on GERD, with all the TCM speak!

Disease Mechanisms
The primary disease mechanism of this disease(GERD) is liver wood invading spleen and/or stomach earth
It will cover 65 to70% of PX

The main mechanisms for the liver becoming replete are unfulfilled desires and/or anger, both of which may damage the liver

If the liver invades the stomach, the stomach qi loses its harmony (implies its downbearing) and counterflows upward

If the liver invades the spleen, the spleen becomes vacuous and weak

If the spleen becomes weak, it will fail to upbear the clear

If the spleen fails to upbear the clear, the stomach qi is less likely to downbear the turbid

In addition, if the spleen loses control over the movement and transformation of liquids these may collect and accumulate, transforming into dampness

If dampness obstructs the middle, it results in feelings of glomus fullness and distention

If spleen vacuity is servere enough we could get vacuity cold, due to a spleen yang vacuity. In addition, vacuity cold due to spleen vacuity or cold due to over-eating chilled foods may lead to contraction and constricture resulting in pain.

If the liver becomes depressed and the qi becomes stagnate* then this liver depression qi stagnation may tranform into heat.

If liver depression endures for some time or is extreme, it may transform into heat. Such transformative heat is all the more likely if the patient eats or drinks foods or beverages which also engender heat internally, like spicy hot acrid peppery foods, fried fatty greasy oily foods,alcohol all engender heat internally in the stomach

Depressive heat may then mutually engender stomach heat

If heat is severe, it may damage the network vessels in the esophagus and force the blood to move frenetically outside its channels, thus resulting in retching of blood

If heat is complicated by Spleen qi vacuity not containing the blood, this may also contribute to bleeding

If heat endures for a long time (months, years), eventually it will consume and damage yin fluids. so we can get a stomach fluid dryness or a stomach yin vacuity

If heat combines with dampness, it may transform into damp heat

If qi stagnation endures for some time, it may eventually result in blood stasis

Since food in the stomach is moved and transformed by the qi, if qi becomes stagnant, or if the qi becomes vacuous (not strong enough to move the food)then we could get food stagnation

Because the liver’s functioning depends on that viscus’s receiving proper nourishment by the blood, because the spleen is the root of blood engenderment, and because the spleen typically becomes vacuous and weak as part of the aging process, liver depression tends to get worse in late middle age

[williamtell]

In another post maybe we can go into the long term effects of proton pump inhibitors and its ramifications on an aging population, or how to diagnose and treat acid reflux....

In a recent Seminar "Internal Medicine: Herbal Alternatives to Drugs, Part I" by John Chen Pharm.D., O.M.D., L.Ac.
John Shen mentioned that the proton pump inhibitors (used to treat “Gastric Acid” Disorders) made available as over the counter medications were some of the Doctor"s strongest medications and predicted that in the future it would lead to increased cases of atrophic gastritis. If untreated, atrophic gastric may lead to gastric carcinoma.

Our client population on products like Nexium, might not realize that all proton pump inhibitors do is suppress acid and do not treat the underlying causes. This is another example of what oriental medicine has to offer.


Proton pump inhibitors include Prilosec (omeprazole), Nexium (esomeprazole), Pravacid (lansoprazole), and Protonix (pantoprazole).

[AAPrescott]

Very good point.

[AAPrescott]

This is very strange I thought I had responded to some of these topics but I have waited an extra day and my responses have not appeared. I agree very much with your comments. I am not trained in herbs and so this is just an amateur guess. But it seems we might perhaps consider a proton pump inhibitor to be a 'cold' medicine and inhibiting the true heat or fire of the stomach. It is understandable that this may appear to produce some benefit for those with stomach fire pathology in the short term. Perhaps I am stretching it but akin to the Chinese concern about chilled drinks which may actually exacerbate a pathology of stomach fire (by counter-reaction) - law of similar transformation perhaps.

[williamtell]

I agree that lack of acid may be a major problem that is commonly miss-treated. A distinction I would make which I think is implied by what the last post is saying, is between the normal heat/fire of Stomach and the pathological which can sometimes get confused.

This is not Chinese medicine!
Having brought up the area of low stomach acid, I wanted to mention a couple ways to test for it

One do-it-yourself test simply involves taking a tablespoon of apple cider vinegar when symptoms arise. Vinegar has a low pH, which means that like stomach acid, it is highly acidic. If you take a tablespoon of vinegar, and your symptoms vanish, it’s likely that you have low stomach acid.

Another is Taking HCL tablet before meal... See below

2 others I did not know about are the beetroot test and baking soda test, I have not tried either of these

The Beetroot Test for Low Stomach Acid
From:http://www.terawarner.com/blog/2012/...eak-digestion/
This discolouration of the urine, to red or pink, after eating beets is called beeturia. It’s caused by the betalain pigments in the beets, breaking down and being excreted. The stomach acid and the flora of the gut play an important role in breaking down the pigments in food, so if they are low or compromised you may experience beeturia. Often people eat or drink beetroots on purpose in order to test their digestive health.
When you are low in stomach acid, your body is not able to metabolize and assimilate beetroot pigments properly. Chances are the same thing is happening for a lot of other foods you are eating. Being able to digest and absorb the vitamins and minerals in your food is very important for your health. If we can’t absorb our B12, we get tired. A lack of zinc will affect our immune system and thousands of the body’s processes. The partial digestion of proteins can cause havoc in the system, as they get absorbed in large portions into the bloodstream. Other factors involved may include an imbalance of the gut flora, the liver, and iron or B12 deficiencies.
How to Test for Low HCL Acid in the Stomach
http://www.livestrong.com/article/49...n-the-stomach/
Step 3
Conduct an at-home test to see if your HCL is low. Mix 1/4 tsp. of baking soda in an 8 oz. glass of cold water. Drink the baking soda and water mixture first thing in the morning before eating or drinking anything. Time how long it takes to belch after drinking the mixture. You should belch within 2 to 3 minutes if your HCL is adequate.
Step 4
Purchase supplemental HCL tablets from a health food or nutrition store. Take one 10 grain HCL capsule at the beginning of a substantial meal with protein. Take two capsules at the beginning of the next meal. Continue adding a capsule at every each meal until you feel a burning sensation in your chest. Note how many capsules you took before you felt the irritation and inform your physician. Generally, the higher the number of capsules you take, the lower your HCL is. Note there are many versions of this test on line
Another more involved way of taking HCL tablets to determine Low HCL
http://drnatashaturner.com/wp-conten...-challenge.pdf