ALTERNATIVES TO ACID-BLOCKING DRUGS

Heartburn drugs are among the most widely prescribed medicines in the United States. The twenty billion dollars spent annually on acid blocking drugs may be the least of the costs of using them. Acid blocking drugs increase risk to antibiotic resistant infections, gastritis, pneumonia, bone fractures, dementia and likely cancer. Therefore, we will offer plenty of different options.

Antacids which are less-dangerous when used occasionally, are discussed at the end of this article. Acid blocker drugs are divided into two general groups. One is the histamine-receptor antagonists and includes the drugs ranitidine (Zantac), cimetidine (Tagamet) and famotidine (Pepcid AC). The other and more potent group is called proton pump inhibitors and includes omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid) and rabeprazole (Aciphex) as well as Nexium, the purple pill.

While these acid-blocking drugs were tested to treat symptoms in the short-term (4-8 weeks, is the recommended maximum), long-term use can cause the body to up regulate gastrin. Gastrin is the hormone that tells the parietal cells of the stomach to make more acid. The pharmaceutical companies know this (and even offer free samples to help get you hooked).

Gum recession and characteristic patterns of eroded tooth enamel may alert the dentist to life-threatening bulimia, with its binging and purging or more commonly, erosive GERD, ‘gastro esophageal reflux disease.’ GERD can cause erosive ulcers in the esophagus, with symptoms ranging from discomfort to death.

Commonly prescribed for GERD, acid-blockers lessen stomach acid secretions, unfortunately reducing this very important immune bacterial barrier, compromising digestion of critical nutrients, keeping food more antigenic, enhancing allergic response.

Most indigestion symptoms (heartburn) occur when acidic stomach chyme refluxes (squirts) back up into the esophagus through the lower esophageal sphincter. So, if you have this problem, avoid esophageal sphincter relaxers such as caffeine, chocolate, mint, peppermint or spearmint.

Better to heal the compromised gut dietarily by enjoying bone soups and gelatin, soaked chia or flax seeds, as well as food sources of glutathione like raw asparagus, broccoli or egg yolks, and not forgetting bitters and digestive enzymes, beneficial bacteria and yeasts, masticating DGL licorice and using demulcent herbs like marshmallow, mastic gum or slippery elm.

To reduce reflux, one can try a few lifestyle modifications. First of all, try to eat small, frequent meals instead of three big meals a day. Nibbling small amounts of food at each meal exert less workload on the stomach and therefore requires less acid secretion for digestion. If thick around the middle, relief may come from losing those extra pounds. Increased upward pressure from extra bulk can be part of the reason that the esophageal sphincter is failing. Going from flabby to firm also makes tighter and stronger sphincters.

Avoid ingesting high-fat meals, especially those from fast food chains. High fat foods remain in the stomach longer, thus stimulating the production of more stomach acid. Surprisingly, many beverages also significantly stimulate acid secretion (beer, wine and soda pop). Drinking beer doubles stomach acid within an hour.

Smoking will make acid reflux worse, so if you are addicted to smoking tobacco, symptoms are a sign that now is the time to quit. In addition, alcohol and drugs like Advil (NSAIDs including aspirin) best also be avoided. A person with reflux should also avoid known foods that seem to make symptoms worse. It is also a good idea to stop eating three hours before bedtime. A sleeping position with the head and upper body elevated often helps. Elevate the head of the bed (don't prop someone up on pillows, since this often makes things worse).

Antihistamines or proton-pump blockers, like Axid, Pepcid, Tagamet and Zantac can cause mental confusion. Taking these medications for a long time (more than 2 years), more than doubles odds of having dementia or ‘mild cognitive impairment’. One needs good digestion for optimal mental function.

Low stomach acid compromises mineral and protein digestion, sometimes reducing bone density 30-50% in one year (whereas typical bone loss with inactivity after midlife is 1-2% per year, peaking at 3-4% right at climacteric). The dentist watches helpless and hopeless as the ‘symptom-suppressed’ patient’s teeth melt away under the prolific soft sticky plaque that results from compromised cellular immunity.

Nitrosamines are cancer-causing compounds produced in the stomach from chemicals called nitrites, especially if one is taking an acid-blocker. Cured meats, such as bacon, sausage, luncheon meats and cured hams, are high in nitrites, which are added to meat products as a preservative, an anti-microbial agent and a color fixative.

Nitrosamines are reactive at the cellular level, altering gene expression and causing DNA damage. The cellular alterations that occur as a result of nitrosamine exposure create a process much like accelerated aging in the body and that could spur on the development of Alzheimer's, Parkinson's and Type 2 diabetes mellitus.

Bloating, belching, constipation, indigestion and even thinning hair or fragile fingernails in women can all be symptoms of too little acid. Low stomach acid reduces tone of both gastric sphincters, allowing acid leakage both ways. Counter intuitively, lowering stomach pH by using supplemental acid during or up to a half hour after meals helps. Use more vinegar or betaine hydrochloride tablets (which is the same as trimethylglycine) until stomach feels sour, and then cut back. Digestive bitters before meals tightens tone of both sphincters.

Apple Cider Vinegar

Home cures for many common complaints call for a tonic of apple cider vinegar made by mixing 2 teaspoonfuls to 2 tablespoonfuls (for acute conditions) of vinegar in an 8 ounce glass of water (often combined with ½ to 1 teaspoonful honey) and drinking this before, during or after each meal. For some, less vinegar, more water throughout the day is a better way of taking apple cider vinegar unless treating an acute condition like acid reflux, cough, bronchitis, or sore throat (in which case the stronger mix of 2 tablespoons of apple cider vinegar to 8 oz of water 3x a day recipe is suggested).

Bitters

Bitters are indicated to aid: poor fat digestion, poor protein digestion, weakness due to chronic illness cellular and humoral immunity to fight infection, loss of energy and vitality, painful digestion, intestinal cramps, excessive gas, irritable bowel syndrome, poor appetite, anemia or excessive craving for sweets, fats and carbohydrates. Many people who are addicted to sweets avoid the bitter taste, a potent stimulator of immunity along with being highly beneficial for digestive, liver and gallbladder function.

To be effective, bitters must interact directly with the astringent taste buds of the tongue where they stimulate the bitter taste reflex and thus increase salivation. This intense experience triggers the gastric reflex to vagally secrete digestive juices. The increased flow of digestive juices from the pancreas, duodenum and liver results in better assimilation of nutrients and excretion of less undigested food.

Important bitter herbs include: Peppermint, Calendula, Dandelion, Artichoke leaf, Blessed Thistle, Andrographis, Angelica, Motherwort, Wormwood, Bitter Orange Peel, Lemon Peel, Gentian root, Centaury root, Mugwort, Goldenseal, Cascara Sagrada, Devil’s Claw, Tarragon, Hops, Boneset, Barberry, Chamomile, Yarrow, Horehound and Tansy. Swedish bitters are a famous blend of fourteen herbs.

Bitters range in effect from mild Chamomile to intensely strong Wormwood or Gentian. The bitters class of herbs has a variable therapeutic margin. The more mild the bitter the greater is the safe therapeutic range; the more intense the bitter, the more critical and narrow the dose range.

Bitters extract well into hot water and alcohol. Bitters may be combined with flavorful herbs such as Licorice, Orange peel, Lemon peel or Cardomen to give a better tasting remedy. Some bitters are destroyed by heat. Most bitters are taken in alcohol preparations or are the base of many liqueurs, and every bar has Angostura (gentian) bitters to mix with its libations.

The full effect of bitters is felt over time. Some response may be seen immediately, but their fullest benefit in the body is achieved when they are used over weeks and months. Bitters are usually taken 15-30 minutes before the meal (as an aperitif) or just after the meal. If too great a dose is imbibed, symptoms may worsen. If that occurs, lower the dose and gradually build up as the body gets stronger.

Border bicarbonate pumps produce puzzling patterns of cusp tip tooth decay

Leaking acid from dysfunctional sphincters causes increased reflex signaling to heighten pumping of neutralizing bicarbonate by local barrier cells to protect esophagus, duodenum and teeth.

Puzzling patterns of cusp tip tooth decay and erosion are often seen in patients with GERD. Plausibly, acid-triggered reflexly ‘over-responding’ bicarbonate pumps in the perimeter pulpal cells of teeth (dentinoblasts) exceed their protective role and then dissolve teeth (from the inside to the outside) via their dentinal tubules.

Tubule-transported highly alkaline bicarbonate efflux dismantles and saponifies structural collagen and dissolves heavily-mineralized seemingly impervious enameled cusps, first creating dimples and then craters right through their acid-resistant tips and/or quickly liquefies less dense and more permeable interproximal or cervical areas.

Diminished alkalinity in the small intestine from overwhelmed bicarbonate pumps keeps pH-activated small intestine pancreatic enzymes inoperative, further compromising digestion. Taking supplemental animal-derived pancreatic enzymes (stomach acid-protected ) are often quite helpful to aid complete digestion and relieve dyspepsia if the small bowel is alkaline enough. Supplementing with similar enzymes derived from plant sources work effectively in the small bowel no matter the ambient pH.

Our ability to absorb calcium and other minerals is strongly influenced by stomach availability of adequate dissociative HCl acid. Antibiotics kill off commensal intestinal bacteria that are normally protective against outside pathogens. Stomach acid also has an antibacterial effect. Taking antacids and antibiotics together removes both these protective barriers at once and leaves the body exposed.

Those using acid blocking drugs have triple usual risk to diarrheal life-threatening bowel infection (Clostridium difficle) or have 4.5 times increased risk to pneumonia over those who never utilized them. Commonly prescribed proton pump blockers (often employed to mitigate GI bleeding due to commonly recommended ‘preventive’ aspirin or plavix) double risk to second heart attack.

Low stomach acid creates inability to properly digest protein and folic acid, B6, B12, vitamins A and Es as well as many minerals, especially calcium and iron. Much more common than excessive acid, low stomach acid is quite prevalent, due to aging, genetics, use of common medications and fatigue or slow metabolism. Paradoxically, low stomach acid often creates similar symptoms to incompetent valves or excessive acid production.

Acid-blocking proton pump inhibitors almost triple the risk to hip fracture. Low stomach acid contributes to asthma, diabetes, food allergies, osteoporosis, iron deficiency anemia, pernicious anemia, candida, rheumatoid arthritis, intestinal infections, psoriasis, vitiligo, hives, eczema, herpetiform dermatitis and acne.

Helicobacter pylori

In the mucus-rich stomach, occasional urease-negative H. pylori planktonic growth is favored over sessile H. pylori pathogenic biofilm formation (that can now buffer acid with urease generated ammonia and thus thrive in community). The herbs mastic gum, marshmallow or the powdered inner bark of slippery elm have mucilaginous qualities, as do soaked flax or chia seeds.

Overgrowth of bacillus clostridia difficle by acid blockers is encouraged as well with occurrence of its responsive life-threatening diarrhea. At the same time, both these putative pathogens have their community reservoirs increased.

The gut is not sterile but full of commensal bacteria, with greatest numbers in the colon. The stomach is mostly sterile because of its acidity. However, some acid resistant bacteria can survive there, namely helicobacter pylori, which may be attracted to inflamed viral ulcers to establish a non-healing biofilm.

Inadequate reduced glutathione results in low energy which diminishes stomach acid production and dismantles cellular immunity. This ‘septic switch’ encourages viral expression of ulcers and establishment of biofilm proliferation seeded from benign opportunistic urease-negative commensal planktonic forms. But once helicobacter pylori to settle in, they change gene expression and become potentially pathogenic and urease-positive, chronically infecting these environmentally-inviting viral ulcers, preventing them from healing.

Antibiotic eradication of H. pylori is claimed to cure ulcer disease. But perhaps it simply allows virally-induced and subsequently biofilm-infected ulcers (which then develop into non-healing wounds) to finally heal (by both killing bacteria directly and by inherent anti-metabolic actions which also reduce the responsive inflammatory exudates that comprise the favored food of pathogenic biofilm).

These bacteria simply opportunistically exploit and compound the severity of the problem, really caused by zinc, selenium or magnesium deficiency or other factors uncoupling recycling of reduced glutathione (GSH). Lack of GSH encourages viral expression, replication and mutation, thus creating altered immune messaging, ulcers or fissures in the barrier tissues, as well as changed gene expression in commensal microorganisms, converting friendly biofilm to pathogenic.

Reduced glutathione (GSH) plays a major role in tissue integrity and protection against ulceration. Glutathione likely plays a role in the anti-ulcer effect of black and green teas. Many studies have shown the benefit of free radical scavengers (antioxidants) on promoting the healing of gastric and duodenal ulcers resistant to therapy.

Helicobacter pylori bacteria simply contributes to the damaging general free radical overload (no longer quenched as unavailable reduced glutathione also turns the ‘septic switch’ shutting down cellular immunity) by producing ammonia with their acid-buffering enzyme urease, which also eventually leads to the release of more free radicals and acid, causing further damage to the unprotected epithelium.

As a result, the gentle, fragile mucosal lining of the stomach and duodenum becomes one of the first tissues to suffer from the damaging chain reactions induced by oxidative free radicals. A dietary healing antioxidant complex, abundant in very potent and effective free radical scavengers, is present in virgin pine nut oil as well as many other natural substances that recycle glutathione.

In February 2005, Dr. Martin Blaser published a counter intuitive opinion about H. pylori, titled An Endangered Species in the Stomach, in Scientific American. He convincingly tied the decline of H. pylori in developed countries over the past 100 years to the modern upsurge in erosive esophageal diseases.

"The possibility that versions of this bacterium may actually protect people against diseases of the esophagus has significant implications. Current antibiotic treatments to eradicate H. pylori from the stomach need to be reconsidered to ensure that the benefits are not outweighed by any potential harm.

To fully understand H. pylori's effects on health, researchers need investigate the complex web of interactions between this remarkable microbe and its hosts. Ultimately, the study of H. pylori may help us understand other bacteria that interact with and colonize us, as well as the evolutionary processes that allow humans and bacteria to develop such intimate relations with one another."

Remedies

Beneficial yeasts saccharomyces boulardii or saccharomyces cerevisiae effectively combat clostridia (as well as candida). Gentian root potentiates essential oil of peppermint (sphincter relaxer avoided with GERD) to effectively quell potentially harmful helicobacter pylori, salmonella enteritidis, escherichia coli and staphylococcus aureus, while relieving dyspepsia. Perhaps peppermint schnapps with a dash of Angostura bitters will settle your stomach?

Taking acidophilus species replenishes our beneficial bacterial flora and can help reduce overgrowth of yeast. Many people take acidophilus to treat and prevent digestive disorders, vaginal infections and even viral illnesses. As it tones immunity, boosts benign bacteria and suppresses pathogenic destructive microorganisms, acidophilus helps the body to maintain a symbiotic commensal microbial biofilm.

Although the acid-blocking drug cimetidine (Tagamet®) may lead to quick symptom relief as advertised, chewable deglycyrrhizinated licorice (DGL) tablets with their anti-inflammatory, demulcent and bitter qualities are just as effective at healing and maintaining the healing of stomach ulcers. Chewable DGL is also helpful in treating ulcers of the duodenum, the first part of the small intestine. DGL will not raise blood pressure or create edema, sometimes associated with whole licorice.

Encapsulated DGL may not treat ulcers effectively, since the herb must mix with saliva to be activated. DGL used as a direct dressing or mouthwash is valuable in speeding the healing of mouth ulcers or canker sores. (Whole licorice, containing sweet-tasting glycyrrhizin, supports aldosterone and estrogen levels, treats respiratory infections and chronic fatigue syndrome or heals herpes ulcers topically.)

Mastica, the resinous gum of a species of Greek pistachio tree, Pistacia lentiscus, has been used successfully in Greece for hundreds of years as a remedy for a broad range of gastro-intestinal disorders. It has been found to be an effective alternative to pharmaceuticals in the treatment of gastritis, gastro-esophageal reflux disease (GERD) and many types of intestinal inflammation.

Mastic gum is a safe and effective alternative to antibiotics in the treatment of stomach and duodenal ulcers and the clearance of the biofilm bacteria so frequently called the root cause of these conditions, H. pylori. Unlike antibiotics, mastica does not eradicate the populations of friendly bacteria in the intestines, so crucial to health and well-being.

Alternatively, one can consume seven to eight bananas (banana powder is available) on a daily basis for a fast recovery from peptic ulcer. Repeated drinks of germinated almond milk will help heal peptic ulcer or it can also be cured by drinking white, green, witch hazel or chamomile teas at least three times in a day.

Gastritis results from an inflammation in the linings of the stomach, causing indigestion, nausea, vomiting sensation and vertigo. Coconut water is an effective home remedy for gastritis. Consume a glassful of fresh coconut water at least four times in a day to achieve relief from gastritis.

While 25-30% of people in the U.S. carry H. pylori in their stomachs, 80% show no obvious signs of the infection. Infection rates are much higher in Japan, at nearly 90%, due in part to crowding. Fifty people in Japan ate either 2.5 ounces of broccoli sprouts or 2.5 ounces of alfalfa sprouts each day for two months. Broccoli, a cruciferous vegetable, contains high levels of the protective phytochemical sulforaphane. Alfalfa is not a cruciferous vegetable and contains no sulforaphane.

Among those who ate broccoli sprouts, H. pylori levels decreased 40%. When they stopped eating broccoli sprouts, after another two months, H. pylori levels returned to pre-study levels. Consumption of alfalfa sprouts had no effect on H. pylori levels.

Helicobacter pylori infection along with consumption of red meat and dairy products increases the risk to gastric cancer. Epidemiologically, high intake of Allium vegetables (garlic and onions) as well as fruit, especially citrus fruit and consumption of fresh fish seems significantly protective. Curcurmin from turmeric has a significant effect against H.pylori biofilm and shows a significant inhibitory action on adherence of H. pylori to human cancer lines of HEp-2 cells.

The herb fumaria (fumitory) has helped improve lower esophageal function for many, aiding digestion. It contains alkaloids (including fumarine and protopine), bitter principles, tannic acid, fumaric acid, mucilage, resin and potassium. Fumitory also treats acne and eczema and supports the liver.

Find your friendly foods

Gut immune response mechanically rejects undesired acidified chyme containing molecularly threatening messaging back up into esophagus and oral cavity. An elimination-provocation diet is best useful at identifying antigenic allergenic foods. We use the blood type ‘avoid’ list as an inexpensive elimination guide, reintroducing those foods one per day (and looking for symptoms)after a hiatus of three weeks.

Blood type diet ‘avoid’ foods as described by Dr. Peter D’Adamo are typically the most common irritating culprits. Meals create our greatest controllable stress response, especially when they contain deformed AGEs (advanced glycation end-products) due to high-heat cooking. Regularly eating small raw or lightly cooked meals, larger early in the day, tapering in the evening is the key to balancing stress.

What commonly eaten foods might molecularly mimic one’s antigenic threats? The blood type diet is an effective immune-based approach to healing gut barrier and oral inflammatory problems. Four drops of blood on an Eldon card simply types one’s primary immune response via visible clumping of our own cells with food lectins.

Except for the blood type O negatives, visible ‘immune clumping’ to food lectins serves as a basic lesson in immune function. Blood type defines one’s primitive primary environmental immune response to these responsive membrane glycoprotein antennae of cellular messaging. Immunity is all about friend or foe? Slip means friendly membrane communication or sticky response (clumping) identifies, inactivates and allows removal of enemies.

The duodenum, jejunum and ileum that comprise the small intestine have lower amounts of bacteria than the colon. It is believed that the jejunum is where yeasts may flourish to cause fungal dysbiosis. The upper gut is also where parasites may lurk.

Conversely, the lower bowel, large intestine or colon, is full of bacteria which have many beneficial functions. Taking antibiotics upsets this natural balance and can cause serious "super-infection" with pathogenic bacteria (sometimes resulting in life-threatening pseudomembranous colitis). However, more often the imbalanced response to antibiotics is subtle and often goes unnoticed except for the development of a chronic “irritable bowel syndrome," a continuing bacterial dysbiosis problem.

Today, we see more and more gut dysbiosis (imbalances of "good" and "bad" bacteria in the intestinal tract). The fermentative disturbances that result are often linked to allergies to grains and/or excessive carbohydrate consumption. Way back in 1908, C.A. Herter spoke directly to that point:

"The use of gelatin as a foodstuff in bacterial infections of the intestinal tract has never received the attention it deserves. The physician is not infrequently confronted with a dietetic problem which consists in endeavoring to maintain nutrition under conditions where no combination of the ordinary proteins with fats and carbohydrates suffices to maintain a fair state of nutrition. The difficulty which most frequently arises is that every attempt to use carbohydrate food is followed by fermentative disturbances which delay recovery or even favor an existing infection to the point of threatening life.”

Therefore, we need a food which, while readily undergoing absorption, supplies caloric energy while being free from ordinary fermentative decomposition. Such a food is gelatin.

Gelatin

Gelatin helps keep the body in nitrogen balance. Gelatin, by being decomposed in the gut, prevents breakdown of systemic protein and thus spares protein. Unflavored gelatin is 85% protein and low in calories, it is an excellent choice for dieters and diabetics. Gelatin by itself, however, is not able to build up protein reserves in the body (which has given gelatin an undeserved bum rap in some circles).

Gelatin improves digestion because of its ability to normalize cases of both hydrochloric acid deficiencies and excesses, and belongs in the class of "peptogenic" substances that favor the flow of gastric juices, thus promoting digestion. As opposed to bone-wasting acid-blockers, gelatin (or even better, bone and marrow soup) relieves joint pain, builds strong bones while it eliminates GERD.

Gelatin’s traditional reputation as a health restorer has hinged primarily on its ability to soothe the GI tract. "Gelatin lines the mucous membrane of the intestinal tract and guards against further injurious action on the part of the ingesta," Erich Cohn noted back in 1905.

Cohn recommended gelatin to people with "intestinal catarrh"--an inflammation of the mucus membrane we call irritable bowel syndrome. Interestingly, the type of gelatin used in follow-up experiments on people with even more serious intestinal diseases was a "concentrated calf’s foot broth." This gelatin containing soup would have been rich in cartilage and bone and provided a better amino acid profile than straight collagen. Fish and fowl soups can also provide gelatin.

The body can create proline and glycine (mostly during alpha waves of sleep cycles, which are promoted by theanine, passion flower, red/brown seaweed and GABA). Neither proline nor glycine is considered "essential." The ability to manufacture collagen’s amino acids as abundantly as necessary, though, is probably true only when we enjoy radiant good health, often making them ‘conditionally’ essential.

If one is suffering from stiff joints, fibromyalgia, skin diseases and other collagen, connective tissue and cartilage disorders, temporary shortfalls of proline, glycine and other conditionally needed nutrients have likely occurred. Supplemented collagen cytokines are also become a major stimulant of stem cell production and a catalyst for growth and repair of nearly all body tissues.

A theory that has helped many people’s digestion is described in the book Eat Right 4 Your Type by Peter J. D’Adamo (Putnam, 1996). Yet the very grains that Dr. D’Adamo has found to be a problem for people with Type O blood types are easily digested if soaked in water, then cooked and even more so, if simmered in a gelatin-rich broth.

Blood type A people (who typically lack the abundant secretions of hydrochloric acid necessary for easy digestion of meats) find meats far easier to digest if they are served with a gelatin-based gravy, cooked in a gelatin broth or served after drinking a cup of rich bone soup and gelatin.

Gelatin can also alleviate the allergic reactions and sensitivities that D’Adamo correlated with blood types B and AB. Thus gelatin not only opens up dietary choices and possibilities for each blood type but is a big bonus for married couples of different blood types who prefer to eat similarly.

Fifty years ago Dr. Frances Pottenger pointed out a reason that raw food diets can be so effective in reversing disease and contributing to rejuvenation. "Man’s food in the raw state consists largely of hydrophilic (water loving) colloids. The heat of cooking on the other hand . . . precipitates the colloids of our diet. This change in colloidal state alters the hydration capacity of our foods so as to interfere with their ability to absorb digestive juices."

Happily for those who prefer to consume some of their food cooked, Dr. Pottenger went on to explain that this digestive problem could be easily remedied by adding one-half ounce to one ounce of gelatin to a cooked meal of meat, potatoes, vegetables and fruits. Gelatin, often used to make Jell-o and other desserts is typically made from the collagen of boiled bones, skins and tendons of animals. Many people still fear they can contract mysterious deadly ‘communicable’ mad cow disease from gelatin, while new evidence ties the neurological damage instead to organophosphate poisoning. We need to stop animal food factories and support integrated sustainable farming. Kosher gelatin is made with fish bones, and/or beef skins. Simmering parts of grass fed, free range or wild animals overnight makes best broth.

Vegan gelatin alternatives

Seemingly similar to gelatin is Agar-Agar, a complex polysaccharide produced from red seaweed. It is used mainly for its ability to gel and stabilize products. After heating to 100° C an Agar solution will solidify upon cooling (32-40°C) and remain solid if kept below the temperature of 85°C. Agar is sold in noodle-like strands, in powdered form, or in long blocks, and is usually off white in color.

Poorly absorbed from the GI tract, agar promotes friendly fecal bulk but tends to combine with nutrients and negatively influence absorption of dietary minerals, proteins and fat. These effects may result from partial breakdown of agar by intestinal flora and a resultant inhibition of proteolytic enzymes. Agar is not the best vegan alternative to gelatin, except that it is better at binding and helping excrete toxins.

However, in the East, kuzu, a member of the legume family, has been part of the cuisine of China and Japan for more than two thousand years. The starch that makes kuzu an outstanding jelling and thickening agent in cooking is partly responsible for its beneficial medicinal action.

Some of kuzu's complex starch molecules enter the intestines and relieve the discomfort caused by over acidity, bacterial infection, and in the case of diarrhea, excessive water. In many cases of abdominal aching and intestinal irritation, a bowl of kuzu gruel or pudding brings quick relief, particularly for children who often rebel at the taste of over-the-counter stomach medications.

Kuzu also contains a very high concentration of flavonoids, which account for its strong medicinal anti-inflammatory effect on the digestive and circulatory systems. Flavonoids, present naturally in kuzu and other plants, are fairly well known as antioxidants, which also have the ability to inhibit the contraction of smooth muscle tissue, thereby increasing blood flow and relieving cramping in the intestines.

Store kuzu in a sealed jar. When you buy kuzu (likely at a Japanese specialty store), the powder will be in small chunks. Crush the chunks with the back of a spoon before measuring. Use approximately 11 tablespoons of kuzu per cup of liquid for sauces and gravies and 2 tablespoons per cup for jelling liquids.

For most preparations, completely dissolve the measured amount of kuzu in a little cold water, and then add it to the other ingredients near the end of cooking time. Gently bring the mixture to a simmer, stirring constantly while the kuzu thickens and becomes translucent.

Chia seeds (Salba or desert sage)

Soaking chia, sesame or flax seeds creates copious amounts of gelatinous soluble fiber that can easily be added to a less than ideal diet to improve digestion, reduce GERD, slow transit time and help heal irritable or inflammatory bowel. The seed is so sustaining that chia and strength were the same word to hardy native meso-Americans.

The foods we eat, in the raw state, consist largely of hydrophilic colloids. However, cooking precipitates colloids. This change in colloidal state alters the hydration capacity of foods, interfering with the chyme’s ability to absorb digestive juices. If we ate a mostly raw diet, it would supply enough hydrophilic colloid to keep gastric mucosa in optimal condition.

Even raw foods must first be partially broken down by the digestive juices, beginning in the mouth and continuing through the upper GI tract, to allow the gelatinous reaction to take place. Those who suffer from slow digestion, excessive gas formation, relaxed cardiac sphincter and heartburn (in which the burning may be due to organic acids instead of expected excessive hydrochloric acid), which frequently accompanies chronic inflammatory disease of the heart, lungs, gall bladder and appendix, are usually restricted from eating raw foods.

A hydrophilic colloid may be used with whatever diet is favored by the patient. The patient with gastric atony or nervous indigestion who complains of heartburn and/or vomiting 4-5 hours after eating is often helped. There is a slowed emptying time of the stomach and an improved gastric tone. A strict dietary regimen is not as necessary when chia’s hydrophilic gel is present.

Chia’s hydrophilic colloidal properties aid the digestion of foods that might contribute to a sour stomach and the eater’s discomfort as a result. Many foods that had been formerly aggravating may be now tolerated with mild bother or none at all, if a hydrophilic colloid gel is part of the diet.

Those who have positive effects on their digestion from pureeing foods may also benefit from hydrophilic colloids found in soaked chia and other small seeds like flax, sesame and fenugreek. This gel may eliminate the need for pureeing (diagnosed by those undigested vegetables in the stool). Even raw vegetables, green salads and fruits, which are typically largely restricted unless pureed, may often be freely enjoyed by these folks with little or no discomfort after a short time.

One can use chia as a food extender and calorie displacer with the optimum ratio of water to seed, for most recipes, being 9 parts water to 1 part seed. One pound if seed will make 10 pounds of chia gel.

A most unique structural quality of chia seed is provided by saturating its hydrophilic (water absorbing) cells, which hold so much water, that when mixed with foods, they oust calories and fat without diluting flavor. Because chia gel displaces, it creates more surface area and actually enhances flavor rather than weakening it. Chia gel also functions nicely as an egg or fat substitute in many recipes.

To make chia gel (9 to 1 ratio): put water in a sealable container and slowly pour seed into water while briskly mixing with a fork or wire whisk. This process will avoid clumping of the seed. Wait a couple of minutes, whisk again and let stand for 5-10 minutes. Stir again before using or storing the gel in the refrigerator, where it will keep up to 2 weeks.

You can add this magical gelatinous mix to jams, jellies, hot or cold cereals, yogurts, mustard, catsup, salad dressings, tartar sauce or BBQ sauce. Add the gel, between 50-75% by volume, to any of the non-bake mentioned foods, mix well and taste. This creates a very smooth texture leaving the integrity of the flavor fully intact.

In addition to adding up to 50-75% more volume to the foods used, you have displaced calories and fat by incorporating an ingredient that is 90% water, along with needed soluble fiber, essential oils, protein and beneficial lignin messaging. Use as a fat replacer, for energy and endurance, or for added great taste, by substituting the oil in your breads with chia gel.

Top your favorite bread dough before baking with chia gel (for topping on baked goods, breads, cookies or piecrust, reduce the water ratio to 8 parts water to 1 part chia seed) and create added shelf life.

Chia makes a speedy super-easy wonderfully-textured tasty pudding by simply mixing 3-4 parts liquid to one part seed ratio. The liquid might be coconut water, hemp milk, almond milk with vanilla or maple syrup, chocolate rice milk or berry juice. Just blend and wait a few hours (if you can wait, overnight provides more health-promoting vigorous germination messaging).

Shirataki noodle

Konjac is a plant of the genus Amorphophallus, native to warm subtropical to tropical eastern Asia, from Japan and China south to Indonesia. Its large starchy corms are used to create a flour and jelly. The dried corm of the konjac plant contains about 40% glucomannan gum. This polysaccharide makes konjac jelly highly viscous. Konjac has almost no calories but is very high in soluble fiber. Thus, it is often used as a diet food and is a great way to reduce one’s refined wheat intake and enjoy pasta again.

Soluble fiber expands and forms a gel in the digestive tract that slows digestion, prolonging the sensation of fullness as well as a more complete and sustained absorption of glucose and other nutrients. This slow absorption of glucose evens out blood sugar response and reduces cycles of cravings, mood alteration and fatigue that come with blood sugar swings from eating lots of sweets or high glycemic foods.

Soluble fiber in western culture is typically not found in large amounts in low calorie foods. Common sources of dietary fiber are oat bran, oatmeal, onions, beans, peas, rice bran, barley, citrus fruits, strawberries and apple pulp. Eating large quantities may contribute to weight gain.

Asian culture has an alternative. The shirataki noodle used for 2000 years has virtually no calories and no digestible carbohydrates but provides a significant source of high soluble fiber that can be used as a noodle / pasta replacement with a multitude of sauce and garnish possibilities.

Japanese konnyaku jelly is made by mixing konnyaku flour with water and limewater. Hijiki seaweed is often added for the characteristic dark color and flavor. Without additives for color, konnyaku is pale white. It is then boiled and cooled to solidify. Konnyaku made in noodle form is called shirataki ("thread-konjac") and used in foods such as sukiyaki and gyudon. It is usually sold in plastic bags with accompanying water. It is available as the ‘Miracle Noodle’ from [miraclenoodle.com].

Shirataki noodles can be found both in dry and soft "wet" forms in Asian markets and some supermarkets. When wet, they are purchased in pre-packaged bags in liquid. They normally have a shelf life of up to one year. Some brands may require rinsing and blotting as the water they are packaged in has a bitter odor that may be unpleasant to those not accustomed to it.

When preparing noodles chow mein style, ingredients are stir-fried and then served over noodles that have been prepared separately. By contrast, lo mein involves tossing boiled noodles in the wok and mixing them with other ingredients during the steamy final stages of cooking. This allows noodles to pick up more sauce flavor.

Shirataki noodles are an excellent hypoallergenic source of soluble fiber which helps control irritable or inflammatory bowel symptoms. It can form the base of an awesome noodle pudding (totally guilt free) and can easily be added to soups. A half a package seems satisfying for most of the day, even later into the day and evening. These noodles can provide ‘comfort food’ experience without triggering ‘glutenous’ addictive behavior.

Konjac glucomannan flour can be used as a thickener as one would use corn starch, one teaspoon acts more like 10 teaspoons of corn starch. Add to gravy or soup or cooking sauces as a thickening agent without calories, without carbohydrates, just added beneficial soluble fiber.

When baking bread or cookies, increase fiber by adding one teaspoon of konjac glucomannan flour to 2 cups wheat flour. One can dissolve flour in water to use as a fiber supplement.

Some antacids seem more benign as therapy.

• Aluminum and magnesium hydroxide (Maalox®, Mylanta®)
• Aluminum carbonate gel (Basajel®)
• Aluminum hydroxide (Amphojel®, AlternaGEL®)
• Bismuth subsalicylate (Pepto-Bismol®, Kaopectate®)
• Calcium carbonate (Tums®, Titralac®, Calcium Rich Rolaids®, Children's Pepto®)
• Magnesium hydroxide (Phillips’ Milk of Magnesia®)
• Sodium bicarbonate

Antacids containing aluminum can poison us and clog digestion. All antacids, including sodium bicarbonate, inhibit folic acid absorption. People taking antacids benefit from extra folic acid.

Bismuth subsalicylate is both anti-inflammatory as well as antacid and provides soothing relief from indigestion, upset stomach, diarrhea, nausea and heartburn. It may react with sulfur on the tongue or in the stool, creating a harmless black color.

Children are recommended to not take bismuth subsalicylate when they have fever or while recovering from the flu or chicken pox, since salicylate use during viral infections has been linked with Reyes syndrome. The salicylate would seem to makes pink bismuth inappropriate therapy for those with H. pylori infected ulcers, but bismuth actually accumulates in the Helicobacter cell wall and destroys the organisms, while comforting the gut.

Calcium carbonate compromises protein digestion, folic acid assimilation and competitively crowds out magnesium, zinc and many other essential minerals at absorption binding sites. Magnesium lack may create irritability, spasm, pain, anxiety, and confusion, dizziness, ringing in the ears, muscle weakness, trembling, or uncontrollable movements. Zinc is necessary for skin, bone and nails and lack compromises immunity on several levels.

For occasional use, antacid milk of magnesia is a wonderful soothing coating for mucosal sores and an effective calming magnesium supplement at half the doses recommended for effectively loosening the bowels. Magnesium can be safely and easily used to regulate bowel transit time to its ideal 12-24 hours. Magnesium is the constantly-needed critical mineral (formerly nibbled on all day long as plentiful dietary green leaves and vegetables) for building bone, maintaining imperturbability, reducing sensitivity and pain, stopping arrhythmias and spasm, recycling glutathione, balancing immunity and making energy.

Safe salty tasting sodium bicarbonate acts as an antacid and also shores up primary buffering systems of the body, even extending exercise tolerance for athletes to those saddled with breathing difficulties.

Folks with advanced chronic kidney disease (CKD) tend to have low bicarbonate levels, just as those with bone loss or chronic obstructive pulmonary disease (COPD) who also express metabolic acidosis. Patients taking sodium bicarbonate daily are less likely to develop end-stage renal disease (ESRD) which causes people with CKD to undergo regular dialysis. To boot, those taking sodium bicarbonate also improve in several measures of nutrition, including bone density. And, even though serum levels of sodium rise, blood pressure rarely climbs.

Steven N. Green, DDS, 305-273-7779, sngreen.com, ddsgreen@bellsouth.net, September 9, 2009