In this episode, we detail connections between H. pylori and hypochlorhydria, while highlighting possible downstream effects on nutrient absorption. We examine how reduced gastric acidity can impair the liberation and assimilation of certain micronutrients, including iron, calcium, vitamin B12, and more; and we further discuss the impact of low stomach acid upon downstream digestive enzyme activation and gut microbial balance. The discussion also highlights the role of compromised gastric acidity in conditions such as small intestinal bacterial overgrowth (SIBO).

Topics:

1. Hypochlorhydria

- Low stomach acid.

- Aging, autoimmune gastritis, chronic PPI use, H. pylori infection.

2. H. pylori

- Common gram-negative bacterium that colonizes the stomach lining.

- Symptoms.

- Produces urease.

- Ammonia neutralizes acid, creating a protective microenvironment.

- Additional virulence factors and ability to form biofilms contribute to persistence.

3. Gastric Anatomy & Layers

- The stomach: hollow, muscular organ for mechanical and chemical digestion.

- Regions: Cardia, fundus, body, and pylorus.

- Layers: Mucosa, Submucosa, Muscularis externa, Serosa

4. Mucosal Layer

- Surface mucous cells secrete a thick bicarbonate-rich, protective mucus.

- Gastric pits lead to gastric glands, which contain specialized secretory cells.

5. Specialized Gastric Cells

- Parietal Cells: Secrete hydrochloric acid (HCl) and intrinsic factor (IF).

- Chief Cells: Secrete pepsinogen (converted to pepsin by HCl) and gastric lipase.

- Role of HCl: Activates pepsin, denatures proteins, and contributes to nutrient absorption.

- Intrinsic factor and vitamin B12 absorption.

6. Vitamin B12 Absorption

- Essential for DNA synthesis, RBC formation, neurological function.

- Released from food proteins by gastric acid and pepsin.

- Impaired absorption.

7. Role of Gastric Acid in Broader Micronutrient Absorption

- Absorption of minerals.

- Soluble, ionized state.

- Iron: HCl aids in preventing insoluble precipitates and supports iron absorption.

8. Protective Role of Gastric Acid

- Acts as a line of defense against ingested pathogens.

- Maintains low microbial diversity in the stomach.

- Low HCl and SIBO (Small Intestinal Bacterial Overgrowth).

9. Symptoms of Low Stomach Acid

- Bloating, early satiety, excessive belching.

- Undigested food in stool, chronic constipation.

- May reflect impaired enzymatic activation and digestive insufficiency.

10. Conclusion

- Multifactorial causes and downstream effects.

- Optimal range of stomach acid: neither high nor low.

Thank you to our episode sponsor:

1. ⁠OmneDiem®'s⁠ ⁠Histamine Digest®⁠ and ⁠Histamine Digest® PureMAX⁠

2. ⁠Histamine Digest® Histamine Complete⁠ with DAO, Vitamin C, Quercetin, Bromelain, and Stinging Nettle Root Extract.

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