CF Natural Health
  • Home
  • Online Learning
    • Classes
    • eBooks
  • Articles
  • About
  • Contact
  • Donate

Digestive Bitters for Reflux and Fat malabsorption in Cystic fibrosis

6/24/2021

1 Comment

 
PictureArtichoke leaf, a great digestive bitter.
The long term use of stomach acid-lowering drugs such as proton pump inhibitors (PPIs) in the cystic fibrosis (CF) population, both adults and children, has been common for approximately 20 years. Today, more than 50% of CFers are using PPIs[i]. They are used for two main reasons: to treat gastroesophageal reflux and to improve supplemental pancreatic enzyme activation, particularly lipase. However, there are flaws in the reasoning for use of acid-lowering drugs in both of these situations. Firstly, the cause of reflux is not excessive secretion of stomach acid but dysfunction of upper gastrointestinal (GI) motility and secretions[ii], and further reducing gastric acidity with PPIs or antacids will further exacerbate reflux, causing a dependency on the drugs and worsening symptoms over time. Furthermore, the long-term use of PPIs has significant and far-reaching side effects that can negatively affect CF prognoses. Secondly, although several preliminary studies have demonstrated that the pH of the duodenum can be too low to provide the right environmental for supplemental pancreatic enzyme activation, it is not completely clear that bicarbonate secretion is inadequate in all cases, even if steatorrhea is present. A 2014 Cochrane Review of the use of PPIs in CF found that related clinical trials were not only biased, but showed zero or overall insignificant improvement in gastrointestinal symptoms[iii]. In fact, there may be other mechanisms at play within the duodenum that cause steatorrhea and contribute to low duodenal pH, namely inadequate bile secretion, possibly due to a diet low in bitter plant constituents. Here, I will discuss the issue of gastroesophageal reflux disease (GERD) in CF and the negative consequences of using PPIs to treat it. I will also discuss the many negative side effects of long term PPI use in the CF and general populations. In addition, I will discuss the low bicarbonate theory in its relationship to pancreatic enzyme activation, and how the use of PPIs may not be helpful in this situation. Lastly, I will discuss the role of bitter plant constituents in stimulating release of GI hormones and bile in the duodenum, their relationships to macronutrient absorption, and how the use of bitter tastants in the CF population may kill two birds with one stone: addressing GERD by correcting gastric sphincter function and GI secretions, and improving lipase activation by stimulating release of bile which emulsifies fats and stimulates bicarbonate secretion.


Read More
1 Comment

    Author

    Mica (they/he) is a clinical herbalist, nutritionist, ecologist, and writer living in Abenaki territory (Vermont).

    Appreciate this work? Please consider donating!

    DONATE!

    Follow me on Medium.

    ***************************
    Disclaimer: The content of this website and blog is for educational purposes only and should not be considered medical advice. The information provided here is not intended to replace medical care.

    Archives

    September 2022
    February 2022
    January 2022
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    February 2021
    January 2020
    October 2018
    May 2017
    March 2016
    April 2015
    December 2014
    September 2014
    June 2014
    October 2013

    Categories

    All
    Announcements
    Diabetes & Blood Sugar
    Digestion
    Essential Oils
    Herbal Medicine
    Lung Disease
    Nutrition & Diet

    RSS Feed

Powered by Create your own unique website with customizable templates.
  • Home
  • Online Learning
    • Classes
    • eBooks
  • Articles
  • About
  • Contact
  • Donate