ASSESSING AND TREATING DIGESTIVE DYSFUNCTION Just the Basics

David Vaughan, CN
Copyright 2011, D. Vaughan

Hydrochloric Acid
HCL has three primary functions: 1) Sterilize what is eaten, and kill acid sensitive bacteria, viruses,
yeast, mold and fungi, and parasites; 2) digest proteins (in conjunction with pepsin) so it can be
assimilated more easily by the intestines; 3) trigger the pyloric sphincter to open and the esophageal
sphincter to stay closed, allowing the predigested contents of the stomach to enter the small intestine
for further processing and preventing reflux into the esophagus.
Inadequate hydrochloric acid (HCL) can cause an entire cascade of problems, and as a result, can
undermine virtually every process of metabolism, from tissue regeneration to immune function, to
neurotransmitter balance, and much more. Inadequate HCL contributes to the root cause of many (if
not most) human health problems.
The Faulty Hydrochloric Acid Challenge Test
The hydrochloric acid challenge" commonly used by many practitioners is completely misguided and
simply cannot assess HCL production status. In this test the patient takes increasing amounts of HCL
with successive meals. It then contends if stomach burning occurs at a low dose, you are producing
enough HCL already, and dont need to supplement with HCL. Heres why this challenge is completely
faulty and should never be used for determining stomach acid production status.
Dr. Jonathan Wright, MD has done a good deal of clinical work with HCL and has stated that a normal
healthy stomach will produce the equivalent hydrochloric acid of approximately 32 HCL capsules
during a meal. This means a patient with normal HCL production should be able to take 32 HCL
capsules on an empty stomach without experiencing a burning sensation. This of course is an
experiment that nobody would normally be willing to do.
So what causes the burning sensation that usually occurs during the HCL challenge test? It is clearly not
the quantity of HCL until one gets to about 32 capsules. The burning sensation happens because the
stomach lining becomes irritated by the acid. This means only one thing the mucosal barrier that
normally protects the stomach lining is insufficient and is allowing the HCL to begin digesting the
protein of which the stomach lining consists. So, the HCL challenge test is actually only testing the
mucosal barrier integrity, which is of course very valuable information.
If the HCL challenge test causes burning, the mucosal barrier needs repair. Now before beginning
repair it is very important to determine why the barrier has been weakened. The most typical cause of
this weakness is a chronically elevated cortisol level, or an infection of the GI tract and stomach (often
by helicobacter pylori). The stomach will typically only produce enough of a barrier to prevent the HCL
it is generating from causing damage. This means that a poor mucosal barrier is typically the result of
poor HCL production. Far more often than not, a burning reaction to the HCL challenge test reveals
very low acid production just the opposite of what its proponents claim that it does.
To reverse this self perpetuating problem one must first improve mucosal barrier integrity before
implementing HCL supplementation, or damage to the stomach can easily occur. The recommended
protocol for doing this is below.
Proper Testing for HCL Status

The only truly reliable HCL assessment test is by Heidelberg Capsule Radiometry
(http://phcapsule.com). The only problems with this test are that it is hard to find, expensive, and time
consuming. But it provides absolutely accurate and inarguable results.
The HCL test that requires swallowing a pH indicator on the string then retracting it is in our opinion
not a useful test and should be avoided. Unless you are testing the stomachs parietal cells ability to
produce adequate acid throughout a series of buffer challenges you will learn almost nothing about
the stomachs digestive capability. Only the Heidelberg test does multiple buffer challenges and
measures them accurately.
A note on Tissue Mineral Analysis (TMA)
Hair analysis used to be considered a reliable way to assess digestive capability. However, a
comparison of hundreds of HTMA results with Heidelberg pH Capsule test results shows no correlation
at all. It appears that mineral assimilation and HCL production have almost no relationship, and that
enzyme production is the biggest factor in mineral assimilation.
Signs of poor enzyme production in a TMA (Tissue Mineral Analysis also known as Hair Analysis"):

All 4 electrolytes (Na, K, Ca, Mg) lower than average

All major minerals low
Electrolytes low + lower than average toxic metal levels

If you see any of these in an HTMA then aggressive digestive enzyme supplementation is warranted.
The Quick Functional HCL Test
Provide your patient with 6 HCL capsules and an ounce of baking soda (bicarbonate of sodium). Tell
them to have the baking soda and 4 ounces of water in a glass ready before attempting this test. In the
middle of the meal have the patient take all 6 capsules of HCL. If they experience a burning sensation
at any time after taking the HCL then their stomachs mucosal barrier is insufficient. They should
immediately drink the water with the sodium bicarbonate added to it to neutralize the HCL. If they are
able to take all 6 HCL capsules with no burning sensation then their mucosal barrier is intact and HCL
production is probably normal. Repeat the test a few more times over a week to insure accuracy.
H. Pylori
Test for H. pylori using GI Effects panel or H. pylori stool antibody test, and treat accordingly. Note:
Mucosal barrier repair must be done concurrently with H. pylori if H. pylori is detected. Recommended
treatments: Mastic Gum (2 capsules twice daily on empty stomach); Matula Herbal Formula Tea (as
per packaging instructions, for 30 days or more); Amazon Digestion Support (2-3 per meal for 60 days)
Mucosal Barrier Repair
When mucosal barrier integrity is found to be inadequate these are the recommended steps toward
correction.
1. Diagnose and treat any GI tract infections
2. Eliminate all reactive foods
3. Identify and reduce or eliminate all internal and external stressors to reduce the demand for
cortisol. possible sources of high cortisol production

4. Begin treatment with nutrients to heal the stomach and gut. This therapy can take anywhere
from 6 weeks to several months to complete. Use the HCL Therapy Guidelines (below) to test
for healing of the mucosal barrier after 2 months or longer if possible.
The products we recommend are called Mucosa Max and L-Glutamine Powder. They can be
ordered from Ultra Life on their Advanced MT page.
HCL Therapy Guidelines
Many manufacturers make an HCL product. Use only one that also contains pepsin. Our current
favorites are HCL #1, #2, or #3 from Ultra Life if you know the patients Metabolic Type, or Betaine
HCL Pepsin from Pure Encapsulations because it is inexpensive and has the correct ratio of HCL to
pepsin, and the correct dosage (520 mg HCL). HCL therapy is usually required for life. We have rarely
seen native HCL production improve in spite of years of digestive and other therapies.
1. Begin by taking one HCL capsule in the middle of each meal - never before or after a meal.
2. Increase the dosage by one capsule per meal every other day.
3. Stop and reduce dosage by at least one capsule per meal if any burning occurs, and implement
the Mucosal Barrier Repair regime (above).
4. Stop at 6 HCL capsules per meal. Taking more than 18 capsules per day can upset the
acid/alkaline balance of the body, and exhaust the bodies buffering systems.
5. Vary dosage per meal depending on the size and constitution of the meal. A large meal with lots
of protein may require 8 capsules. A bowl of fruit requires only 1 capsule.
6. Do NOT use only 3 capsules at a meal. For some unknown reason taking 3 capsules tends to
reduce ones native ability to produce HCL.
Enzymes
In our opinion, every patient should use digestive enzymes regardless of their digestive capabilities.
There are many good brands and plenty of bad ones too. If you use a professional line of supplements
you will likely avoid the bad ones. We personally recommend the use of enzymes from Ultra Life found
on their Advanced MT page. They have three main products (Enzigest #1, #2, and #3) which are
specific to the dietary macronutrient ratios you are recommending to each patient, and have a wide
active pH range and survivability.
Enzymes should ideally be taken approximately 20 minutes after completion of a meal, and never
during a meal. This theoretically promotes the body to continue to produce its own natural enzymes
without sensing that enzyme production is already adequate.