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Caffeine and the Fermentation Model of GERD
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Cargoshorts Offline
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Caffeine and the Fermentation Model of GERD
Hi James,

For over 3 years now I've been in agreement with you, Dr Bob, and others who say that GERD is the result of LOW stomach acid, not HIGH stomach acid. My own experiences and history with GERD seem to support this theory. The one puzzle piece that I can't seem to make fit is caffeine. Caffeine is one of a handful of universal triggers for people with GERD, yet I can't see what it has to do with either fermentation or the opening of the LES. The only thing I can think of--and it's a stretch--is that GERD people have worn out adrenals, and when they ingest some caffeine their adrenals take a "hit," and they are even LESS able to deal with fermentation in the stomach than they were before, assuming that the adrenals have anything to do with stomach fermentation in the first place. Like I said, it's a stretch.

Or maybe caffeine really does turn on the pumps in the stomach, causing them to crank out gastric juices. But that wouldn't open the LES. Do people with GERD have an LES that is ALWAYS open because it is so worn out? Maybe that would explain it.

Any thoughts or theories on how caffeine fits into the picture? Been scratching my head over this for quite a while now. Thanks.
07-15-2012 03:03 PM
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James Offline
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RE: Caffeine and the Fermentation Model of GERD
(07-15-2012 03:03 PM)Cargoshorts Wrote:  Hi James,

For over 3 years now I've been in agreement with you, Dr Bob, and others who say that GERD is the result of LOW stomach acid, not HIGH stomach acid. My own experiences and history with GERD seem to support this theory. The one puzzle piece that I can't seem to make fit is caffeine. Caffeine is one of a handful of universal triggers for people with GERD, yet I can't see what it has to do with either fermentation or the opening of the LES. The only thing I can think of--and it's a stretch--is that GERD people have worn out adrenals, and when they ingest some caffeine their adrenals take a "hit," and they are even LESS able to deal with fermentation in the stomach than they were before, assuming that the adrenals have anything to do with stomach fermentation in the first place. Like I said, it's a stretch.

Or maybe caffeine really does turn on the pumps in the stomach, causing them to crank out gastric juices. But that wouldn't open the LES. Do people with GERD have an LES that is ALWAYS open because it is so worn out? Maybe that would explain it.

Any thoughts or theories on how caffeine fits into the picture? Been scratching my head over this for quite a while now. Thanks.

Actually it is well known that caffeine does relax the lower esophageal sphincter (LES), which is why it contributes to reflux:

Gastroenterology. 1980 Dec;79(6):1262-6.
Inhibitory effect of coffee on lower esophageal sphincter pressure.
Thomas FB, Steinbaugh JT, Fromkes JJ, Mekhjian HS, Caldwell JH.
Abstract

We examined the effect of 150 ml of caffeinated instant coffee at two pHs, 4.5 and 7.0, on lower esophageal sphincter pressure in 20 normal volunteers and 16 patients with reflux esophagitis. When ingested alone coffee at pH 4.5 and 7.0 caused a decrease in basal sphincter pressure in normal volunteers from 19.4 +/- 1.5 to 13.7 +/- 1.0 mmHg (P ¿ 0.01) and from 18.7 +/- 1.5 to 16.0 +/- 0.8 mmHg (P < 0.05) respectively. When coffee at pH 4.5 was drunk with a mixed nutrient test meal, the resting sphincter pressure in normal subjects fell after 30-60 min with the nadir, 11.2 +/- 1.0 mmHg, being recorded at 60 min (P < 0.01). Coffee at pH 7.0 with the test meal resulted in a fall in pressure to 14.3 +/- 1.5 mmHg (P < 0.02) at 60 min. In patients with reflux esophagitis, coffee at pH 4.5 lowered lower esophageal sphincter pressure from 9.1 +/- 1.0 to 5.5 +/- 0.6 mmHg (P < 0.005); coffee at pH 7.0 decreased lower esophageal sphincter pressure from 8.5 +/- 1.1 to 6.9 +/- 0.7 mmHg (P < 0.05). In these patients, mean basal pressure, 9.2 +/- 0.8 mmHg, decreased to 5.2 +/- 0.7 mmHg (P < 0.001) 45 min after drinking coffee at pH 4.5 with the test meal. Coffee at the neutral pH caused a fall in pressure from 8.8 +/- 1.1 to 6.5 +/- 0.7 mmHg at 60 min after the test meal. Thus, coffee at either pH 4.5 or 7.0 caused a decrease in fasting and postcibal lower esophageal sphincter pressure in normal volunteers and patients with reflux esophagitis. The magnitude and the duration of the effect were greater after coffee at the lower pH. These data support the clinical belief that coffee may cause or aggravate heartburn by decreasing lower esophageal sphincter pressure.

To be more specific the caffeine increases nitric oxide, which in turn is what actually relaxes the LES.

http://www.MountainMistBotanicals.com
07-16-2012 09:46 PM
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Cargoshorts Offline
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RE: Caffeine and the Fermentation Model of GERD
Jeez, I had no idea I was lobbing you a softball, James! What a simple answer. All the hours and years I've been reading about heartburn, acid reflux, GERD, and scratching my head about caffeine--and never came across this info til now. Wow.

When you're done with your cancer book, any chance you could write an acid reflux book? Look at the millions--or is it billions--of $$ people in the US spend on antacids and acid blockers. Do you realize what a public service that would be? Of course, the Pharmedicos who are raking in that money - the Tums, Tagamet, Omeprazole money - would probably buy every copy of your book just to burn it. Or sic some government agency on you, or plant a bomb under your car.Sad It is truly sad what's going on with obesity, GERD, Barrett's esophagus, and all the rest.

Speaking of your cancer book, when it's ready will you be "making the rounds," doing interviews to promote it? Any chance we'll be seeing you interviewed by Dr. Sanjay Gupta?? Dr. Oz?? John Stossel?? Al Roker? Smile Keep us posted so we can tune in to watch.
07-16-2012 11:43 PM
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James Offline
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RE: Caffeine and the Fermentation Model of GERD
Once I get the cancer book finished I have to finish the other book I was working on first. That book is on osteoporosis, osteomalacia and osteoarthritis. I also touch a little on osteopenia as well. There is a lot of confusion between these conditions as well and thus a lot of myths surrounding them as well such as acidosis causing osteoporosis.

I had not thought about shows like Dr. Oz, but that would be a great idea. I will look in to TV programs when it is done. Thanks.

http://www.MountainMistBotanicals.com
07-18-2012 01:24 PM
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