In recent months, I have been discussing dyspepsia or the symptoms of indigestion. This column examines hyperchlorhydria, a major cause for the billions of dollars spent each year for over-the-counter remedies.

The most common causes of hyperchlorhydria according to Best and Taylor are:

*** The secretion of an abnormally large quantity of gastric juice;

*** Failure to reduce the rate of secretion during the second hour; and

*** Delayed gastric evacuation.

I am not talking about gastric or duodenal ulcerations caused by Helicobacter pylori or Giardia lamblia. The primary stimulus for increased gastric secretion of HCI is considered to be gastric distention resulting from either ingestion of an excessive amount of food or an inability of the normal gastric secretion to adequately digest the food. Heartburn can occur when the stomach is having a difficult time digesting food and must demand additional gastric secretions of HCI to complete its task.

It is important to note that the symptoms are not caused by a particularly low pH of the secretions, but rather abnormally large amounts of gastric secretion in the stomach.

Clinically the patient often presents with a history of hiatal hernia, frequent heartburn or gastric burning after eating, and/or frequent use of antacids.

Chiropractic examination usually reveals tenderness and muscle contraction in the area of the epigastrium, below the xiphoid process. Nociceptive reflexes from this will produce muscle contraction with subsequent subluxation in the T5 to T9 area of the spine. In addition, a very important upper cervical subluxation is usually present due to excessive parasympathetic irritation via the vagus nerve.

Generations of D.C.s have reported immediate diminution of the symptoms of acid-indigestion following manipulation to these areas. The problem, of course, is that the symptoms and muscle contractions return the next time the patient eats something he or she cannot digest.

The stomach serves mainly as a storage center for food prior to passage into the small intestine, but it permits some digestion. The wall of the stomach contains several different types of glands:

1. The Fundic glands secrete digestive juice which contains protein-digesting enzymes and hydrochloric acid and some mucus. When food enters the stomach these cells begin their secretions.

2. The Pyloric glands secrete mucus only.

3. The cells lining the stomach wall also secrete mucus.

Guyton states that food can remain in the upper portion of the stomach for up to an hour before the parietal cells of the stomach secrete enough HCI to drop the pH of the stomach below 4.0. The major goal of both prescription drugs and over-the-counter remedies is to reduce or eliminate the production of hydrochloric acid and protein-digesting enzymes.

While this will certainly relieve symptoms, it severely compromises normal digestion and interferes with supplying nutrients to the body to maintain health. The old axiom that "it is not nice to fool Mother Nature" was never more true than when applied here.

The stomach needs mucus to protect itself from the acid and protein-digesting enzymes. An inability to produce mucus protection obviously can be a factor in the production of acid indigestion.

Some commonly used herbs which enhance the body's ability to produce mucus and protect the gastrointestinal tract from beginning to end, not just in the stomach are: Slippery elm; marshmallow root; and aloe vera.

Since food remains in the stomach for 30-to-60 minutes waiting for the gastric secretions to be concentrated, this time could be used to assist in the digestion of the food by enzymes that are active in the acid medium of the stomach. Unfortunately, pancreatic enzymes are active only in the alkaline medium of the small intestine. Betaine HCI and Ox bile salts could not be used in this case since they both aggravate the lining of the stomach. But plant enzymes will work here.

When the stomach is secreting excessive amounts of HCI in an attempt to digest food, the plant enzymes can start the digestion of food before the gastric secretion begins so the stomach is able to adequately complete its stage of digestion with normal HCI secretion.

Unlike antacids, plant enzymes do not control abnormal gastric secretions of HCI by turning off all digestion in the stomach putting the entire stress of digestion on the pancreas. Instead, plant enzymes relieve the pancreas of some of its digestive burden by reducing the amount of pancreatic secretion required. The digestion accomplished by plant enzymes occurs early enough in the digestive process to trigger a reduction in this secretion.