Heartburn, Acid Build-Up and Low Blood Sugar

Whether you have heartburn (GERD), bloating with meals or symptoms commonly attributed to hypoglycemia, you may not know it but one of the most common causes for all of these conditions is a gastrointestinal disorder known as gastroparesis.

Gastroparesis is a Latin term for ‘paralyzed stomach’ and is used to describe various symptoms attributable to slow emptying of the stomach.  Gastroparesis can lead to symptoms such as heart burn and GERD (gastroesophageal reflux disease) because the when the normal and persistent production of stomach continue throughout the day without being emptied, stomach acid builds up and refluxes or splashes back up into the esophagus causing the symptoms we commonly describe as heartburn or reflux.

Watch Dr. N’s CoffeeTalk on Heartburn

Sometimes the excessive collection of acid in the stomach will cause people to misinterpret the symptoms as low blood sugar or ‘hypoglycemia’.  This is because the excessive stomach acid will make the person feel shaky, weak, hungry and even nauseated, and when the person eats some food the symptoms resolve.  The association of these symptoms and their resolution with food understandably but mistakenly attributed to low blood sugar.

The excessive stomach acid is actually causing the patient to experience some low grade nausea.  The resolution of the symptoms is because food stimulates the stomach to increase it’s emptying action and also acts as a excellent acid neutralizer. We have experienced this before when we have been nauseated or vomiting from the flu or during pregnancy – we will eat some toast, soup or crackers to help us deal with the nausea we experience.

The other important fact is that our physiology is designed to help us maintain normal blood sugar levels even if we go without food for extended periods of time.  We were in essence designed as Stone Age humans who for millions of years were constantly exposed to unstable food supplies and would often go for extended periods of time without eating.  If we were to find ourselves in the unfortunate circumstances where we went without food for a weeks at a time, we might feel very hungry but our blood sugar levels would remain constant for many weeks without food.

Other Symptoms Associated with Slow Stomach Motility

When the stomach’s grinding and emptying motility action is impaired, other portions of the intestinal tract may also be impaired.  Under normal conditions, the stomach is constantly emptying its contents into the small intestine  From the upper esophagus all the way through to the colon, the intestinal tract is operating like one long bucket brigade with one portion of the GI tract passing its contents along to the next portion.

Sometimes patients will experience food (especially when it involves liquids) seeming to stick in the esophagus shortly after ingestion.  They will feel a fullness or pressure in the chest often below the breastbone (sternum).

They an also experience some slowing of intestinal contents in the colon which results in constipation.

The slowed  motility may also result in occasional frequent of loose stools because of overgrowth of some of the normal bacteria that colonize the small intestine and the colon.  There is a mixture of upwards 400 different species of bacteria that normally live within our intestinal tract and when the motility of the intestine slows down, a portion of the bacteria grow out of proportion of the others and results in diarrhea or an urgency to have a bowel movement shortly after eating.

Autonomic Dysfunction is the Underlying Cause Gastroparesis

I am convinced the vast majority of the patients with heartburn or misinterpreted sense of hunger or low blood sugar have gastroparesis because of underlying autonomic nervous system (ANS) abnormalities.  The ANS is responsible for operating and coordinating the function of all of the bodies organs such as the lungs, intestinal tract, cardiovascular system (heart, arteries and veins) and bladder.

Dysfunction of the ANS can cause the slowing of the intestinal tract motility and cause the bloating, heartburn or constipation discussed above.  The most common causes for the autonomic dysfunction can be due to Insulin Resistance from obesity or excessive carbohydrate intake, a physically stressful event such as surgery pregnancy or a major illness.  Some patients give a history of bloating, constipation or heartburn from early childhood.

Fortunately, the autonomic dysfunction can be accurately diagnosed and reversed with a short course of medications, changes in their diet or both.

Patrick Nemechek, D.O.

Patrick Nemechek, D.O.

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