Acidity Kills the Pancreas

by Peter Melamed, PhD, and Felix Melamed, LAc, MSTCM, CHt

www.biotherapy-clinic.com

There are three main, interrelated reasons for the widespread digestive disorders in the modern world: chronic metabolic acidosis, low pancreatic function, and intestinal dysbiosis. Altogether, these create a vicious circle.¹ There is not enough time to blame the genes; therefore, many scientists and doctors pay attention to environmental factors such as food, water, stress, lifestyle, toxic chemicals, alcohol consumption, and inner ecology.

Acid–base balance

: acidity/alkalinity is a critical factor in the health and functioning of the body. Optimal health depends upon the body’s ability to maintain a slightly alkaline state. The pH (potential of hydrogen) is a marker of the acidity or alkalinity of a solution. It is measured on a scale of 0 to 14. When a solution is neither acid nor alkaline, it has a neutral pH of 7.0. The lower than 7.0 the pH, the more acidic the solution; the higher than 7.0, the more alkaline.

Normally, blood is slightly alkaline, with a pH range of 7.35 to 7.45. The constancy of blood pH is essential to the body’s ability to maintain a relatively stable internal environment. Its importance is demonstrated by the fact that a human being cannot live if blood pH goes below 7.0 or above 8.0; for example a pH of 6.95, which is only slightly acidic, can lead to coma and death.

Many bodily functions are designed to regulate the acid–base balance, including respiration, excretion, digestion, circulation, and cellular metabolism. The acid–alkaline regulation systems are interrelated and work together to prevent acute or chronic changes in acid–base balance.

What causes the body to be acidic? The main factors are:

• overproduction of acidic substances by the body’s own cells; for example, carbonic and lactic acids are formed as end products of cellular metabolism;

• overproduction of acidic substances by microorganisms within the body. Intestinal dysbiosis leads to constant, intensive fermentation with releasing toxic alcohols and other acidic compounds;

• consumption of acidifying food such as red meat, sugars, white flour and rice, bad fats, and so on;

• acute or chronic toxicity from acid-producing compounds (alcohol, environmental chemicals, some medications, etc.);

• low or improper function of the lungs, kidneys, liver, and GI organs; poor microcirculation; and dehydration. The lungs, kidneys, blood, bones, skin, liver, gallbladder, stomach, and pancreas are involved in the regulation of the body’s acid–base balance;

• low capacity of the blood buffer systems, especially the CO2-bicarbonate buffer, which is the most powerful blood buffer for metabolic acids.

lung

↨ CO₂ + H₂O ↔︎ H₂CO₃ ↔︎ H⁺ + HCO₃ ⁻ ↨

kidney

The pH of blood is constant, and the organism struggles to keep it steady to protect the life-supported organs such as brain, lungs, and heart, which completely shut down if pH drops even slightly. During metabolic acidosis, the organism chooses the wise strategy of saving the vital organs, such as the heart, lungs, and brain, at the expenses of peripheral, “less essential” organs and tissues. Those that suffer most from acidity are the alkaline digestive glands pancreas and liver because they produce pancreatic juice and bile, which are normally highly alkaline solutions.

Pancreatic juice has pH 7.1 to 8.2, and the pH of liver bile is 7.5 to 8.8.² Thus, the pancreas, liver, and gallbladder are the organs strongly involved in the body’s acid–alkaline balance. On the other hand, acidity – metabolic acidosis – changes the bile and pancreatic pH in an unhealthy way, causing serious problems for digestion and the entire GI tract.

To alkalize the pancreatic juice and bile, the liver and especially the pancreas extract minerals and bicarbonates from the blood. Bicarbonate content is a key factor of alkalinity in bile and pancreatic juice.

Content of Bicarbonate (mEq/Liter) in the Human Plasma,

Pancreatic Juice, and Bile

³

As we can see, in the bile and especially in pancreatic juice, there is much more bicarbonate than in the blood plasma. According to the literature, pancreatic bicarbonate output is strongly related to duodenum pH, and it is regulated by interaction of digestive hormones such as secretin and cholecystokinin with the nervous system.^4,7,8

Scientists found that the pancreas and liver extract bicarbonate ions primary from the blood. For example, intravenously injected bicarbonate labeled with the C radioisotope appeared promptly in the pancreatic juice.¹¹ Experiments suggested that “most if not all the bicarbonate of pancreatic juice must come from plasma.”^4–6

There is considerable evidence that in pancreatic disorders, there is a decreased amount of bicarbonate in the pancreatic juice and bile.^7,9

Duodenal acidity mainly depends on a lower amount of bicarbonate in pancreatic juice and bile. In chronic pancreatitis patients, who very often present with pancreatic exocrine insufficiency, duodenal pH may be persistently low.^7,10 It is known that pancreatic enzymes work only in an alkaline milieu. Therefore, low alkalinity in the duodenum, where digestion mainly occurs, is the primary factor in indigestion.

Research shows that there is also a direct relationship between bicarbonate concentration and pancreatic juice flow. There is also a positive relationship between the elimination of enzymes and bicarbonate concentrations.^11,12

Professor of Medicine Stephen A. McClave, MD, from the University of Louisville School of Medicine (Kentucky) considered that while healthy people have a high bicarbonate concentration in the duodenum, patients with chronic pancreatitis have a low concentration. In this case, acidic fluid builds in the duodenum and inactive enzymes. Pancreatic lipase is inactive if duodenal pH < 4.5.⁸

Giorgio Talamini from the University of Verona, Italy (2005), adds a new potential risk factor for pancreatic cancer after chronic pancreatitis; namely, duodenal acidity. Patients with chronic pancreatitis incredibly often present pancreatic exocrine insufficiency combined with a persistently low duodenal pH in the postprandial period. Duodenal acidity may increase the risk of pancreatic cancer in the course of chronic pancreatitis.¹⁰

The relationship between the rate of low pancreatic HCO⁻₃ secretion and high plasma H⁺-ion concentration was investigated in numerous experiments. A proportional opposite relationship was found between HCO⁻₃ secretion and plasma pH. Different relationships were discovered between pancreatic HCO⁻₃ secretion and plasma HCO⁻₃ concentration during metabolic acidosis. Pancreatic HCO⁻₃ secretion fell to 41 ± 4% of control during acidosis. Plasma H⁺-ion concentration, therefore, seems to determine the rate of pancreatic HCO⁻₃ secretion. ³⁵

The importance of plasma bicarbonate is also illustrated by in vivo experiments in which pancreatic secretion was studied under conditions of metabolic acidosis. Canine pancreatic secretion was halved when plasma bicarbonate was lowered to 16 mEq/L.¹³

Acidity also promotes premature activation of trypsinogen (inactive enzyme) to trypsin (active enzyme) in the pancreatic ducts. Trypsinogen, like all other zymogens, is packaged in zymogen granules, which further retards trypsinogen activation. The high pH (alkaline state) in the duct inhibits activation of trypsin.^14,15 The more alkaline the pancreatic juice, the higher the possibility of keeping trypsin inactive within the pancreas. Even neutral pH 7.0 can develop this activation.¹⁶

Niederau and Grendellin (1988), in their published article in the Journal of Clinical Investigation, suggested that acidifying of the pancreatic juice may play a role in the progression of acute pancreatitis.¹⁷

Bhoomagoud et al. from the Department of Internal Medicine, Yale University School of Medicine (2009), also suggested that metabolic acidosis may be the risk factor for developing pancreatitis. They confirmed experimentally in vivo and in vitro that decreasing pH (acidifying) increases acinar cells’ sensitivity to zymogen activation.¹⁸

Another protective mechanism to prevent premature activation of trypsinogen to trypsin within the pancreatic duct is that of quickly sweeping zymogens out of the pancreas. Flushing and draining pancreatic juice that contains inactive enzymes (zymogens; i.e., trypsinogen) to the duodenum as quickly as possible to prevent premature activation of digestive enzymes in the pancreas is highly influential in protecting the pancreas from self-damage and recurrent acute and chronic pancreatitis.

The lining of the pancreatic duct is responsible for fluid and bicarbonate secretion. A high concentration of ions, including bicarbonate, causes water to enter the lumen by osmosis. Water then flushes the contents of the duct lumen (including zymogens) out of the pancreas into the intestine. Conversely, low bicarbonate output may reduce the amount of water in the pancreatic ducts. This in turn increases the viscosity of pancreatic juice and slows its elimination.

Japanese researchers Matsuno, Sasaki, et al. (1991) pointed out that bicarbonate plays a crucial role in the viscosity of pancreatic juice. They found in patients with pancreatitis that bicarbonate secretion and bicarbonate output is decreased, and viscosity of pancreatic juice was significantly increased. They also considered that concentrated pancreatic juice may cause the progression of chronic pancreatitis.⁷

The bile secretion has similar regulation and a close pathway with pancreatic juice. If bile becomes more acidic, it becomes “aggressive.” Precipitated bile acids and other aggressive components in the acidic bile corrode and irritate the bile ducts, gallbladder, pancreatic duct, sphincter of Oddi, ampulla of Vater, and duodenum. This causes spasms, irritation, inflammation, ulcers, and so on. Irritations of the gut’s mucosa by precipitated bile acids lead to erosion, ulcers, and spasmodic contractions, which disorganize the proper motion of “aggressive” bile/pancreatic juice mixture.

“Aggressive,” acidic bile often causes refluxes – the backflow of bile into the pancreatic duct, or when bile flows upward, from the duodenum into the stomach and esophagus. Bile refluxes, which affect the duodenum and stomach, lead to further inflammation, ulcers, and cancer.¹⁹

Bile reflux often accompanies stomach acid reflux, and together they are a terrible combination, inflaming the lining of the esophagus and potentially increasing the risk of esophageal cancer.^20,21

Biliary pancreatic reflux happens when the bile goes back to the pancreatic duct, activates proteolytic enzymes inside the pancreas, and possibly initiates acute pancreatitis and/or promote exacerbations in the case of chronic pancreatitis.

Regarding Rege and Moore (1986), the acidification of bile is a main factor in the development of gallbladder stones, which have been documented as blocking the bile and pancreatic ducts and causing severe damage to the liver and pancreas.²²

When the pancreatic juice pH drops below 7.0, the antimicrobial activity diminishes. Rubinstein et al. (1985) found that the antibacterial activity of pancreatic juice was pH dependent.²³ Experiments on people with fistulas of the pancreas showed that, in healthy conditions, pancreatic juice is virtually sterile. Pancreatic juice destroys almost the entire spectrum of microorganisms.

There are remarkably few microorganisms in the small intestine because intestinal microbial homeostasis is controlled by a variety of factors. Between some of them, pancreatic juice plays a fundamental role in keeping the number of microbes in the small intestine low. There is evidence that the antibacterial activity of pancreatic juice is highly sensitive to pH, having an optimal activity at pH 8.5 (alkaline condition) and with complete cessation of activity at pH 7.0 (neutral solution).²⁴

Decreasing pancreatic secretion and acidifying of the pancreatic juice makes the pancreas more vulnerable to infection. Therefore, the restoration of the alkalinity in the pancreas is crucial for the treatment and prevention of pancreatitis.

In case of chromic metabolic acidosis, the human organism takes calcium from bones into the blood to neutralize overacidity. Concentration of calcium in the blood and other bodily fluids increases causing the deposition of this mineral in the blood vessels and internal organs (calcinosis). This may explain the common simultaneous presence of osteoporosis, arteriosclerosis, and calcification (calcium deposit in the inner organs). Calcification of the pancreas is valuable symptoms of the chronic pancreatitis ³⁴

Precipitation of calcium in the pancreatic duct leads to stones, which irritate or obstruct the pancreatic duct, causing inflammation: pancreatitis. Precipitation of calcium in the gallbladder results in stone manufacturing and obstruction of the sphincter of Oddi. This in turn increases pressure within the pancreatic duct and activates enzymes within the pancreas, causing self-digestion and pancreatitis.

Focus on acid–alkaline balance can be an important key in preventing and treating either digestive or hormonal pancreatic disorders.¹

Metabolic acidosis is widespread in society today, primarily due to the standard American diet.^25,26 Most foods that we eat now are acidic, which therefore changes the balance toward metabolic acidosis.²⁹ Many publications focus on the prevalence of metabolic acidosis in modern men.^25–27 Researchers from the University of California noted in a 2002 American Journal of Clinical Nutrition article that most health problems stem from the deficiency of bicarbonate in today’s food, compared with that of our ancestors. ²⁶ Other researchers proved that modern nutrition produces low-grade metabolic acidosis in otherwise healthy people.^25–28 Some studies found that this metabolic acidosis increases with age.^30,31

Overacidity is particularly common today and can become a hazardous condition that weakens all bodily systems. This condition forces the organism to take alkaline minerals, including calcium, sodium, potassium, and magnesium, from vital organs, muscles, and bones to neutralize acids and remove them from the body. The body has only one way to recover – to get more minerals and bicarbonate to neutralize overacidity. Where can the organism get them? Only from food, healing mineral water, and mineral supplements such as magnesium/potassium.

To prove this, let us focus on experience of European medical doctors, who have treated various digestive disorders with healing mineral waters for hundreds of years. This method of the treatment is virtually unknown in the US.

Europeans have known about the healing power of the mineral waters for 500 years. European doctors have been taught about balneology (treatment through the curative action of healing mineral water) in medical school for the last 100 years. Europeans often spend “health vacations” at a mineral spa, where the doctor, after evaluating the patient, prescribes the amount, frequency of consumption, and temperature of healing mineral water.

The small town Karlovy Vary in the Czech Republic got its hundreds of years of popularity as a famous healing mineral spa thanks to its thermal springs. In 1522, the first scientific medical book was published recommending a regimen of drinking the spring water for constipation. Since then, hundreds of clinical texts and articles have been published describing the positive effects of this water on both animals and humans. Unfortunately, most of these papers were published in Czech, German, and Russian, so they are unknown by the American medical establishment.^32,33

Demand for this water was so high that, 250 years ago, doctors developed a vaporized method to get genuine Karlovy Vary thermal spring salt. This salt is distributed all over the globe. Dissolving it in water makes it possible to use mineral water for healing at home. Water prepared from the genuine Karlovy Vary thermal spring salt has 40 essential minerals, trace elements, and bicarbonate in proportion similar to human plasma. Czech doctors determined that the water manufactured from the genuine Karlovy Vary thermal spring salt has identical healing properties as that from the spring. European scientists and doctors have confirmed the positive effects of Karlovy Vary healing mineral water on the pancreas and pancreatic digestive enzymes.¹

This water is a natural, alkalizing compound that helps the body to restore normal pH by neutralizing and removing acid radicals. Before insulin era, this water was one of the only remedies for diabetes. It has helped many Europeans with environmental toxins.

Research shows that this water decreases gas, bloating, stomach pain, abdominal spasms, and indigestion by increasing production of bile and pancreatic enzymes, opening the bile and pancreatic ducts, decreasing internal toxicity, and so on.^32,33

To determine overacidity in the body, there are many complicated tests. A simple measure is to look for positive pH changing in one’s saliva and urine by using litmus paper at home. If saliva and urine pH are less than 6.6 during one week, this likely indicates chronic metabolic acidosis.

Conclusion

Today, the medical viewpoint on digestive disorders narrowly focuses on the “hollow” organs such as the stomach and large intestines without any attention on the “solid” digestive glands such as the pancreas and liver. It is known that, without proper quality and quantity of pancreatic juice and bile, the normal digestive process in hollow chambers cannot occur.

The pancreas is the main organ of the entire digestive system. Almost all problems of the GI tract are closely related with the proper functioning of the pancreas. Therefore, a clinical diagnosis of gastrointestinal disorders de facto presumes pancreatic disorders.

Scientific research and clinical findings confirm that the pancreas and liver are more vulnerable to reduced functions due to metabolic acidosis. A primary (ex juvantibus) therapy of multiple digestive and liver disorders in Karlovy Vary and many other mineral spa resorts in Europe, and the great number of the medical papers, support the therapeutic action of the mineral/hydrocarbonate waters in digestive diseases. A pandemic of digestive disorders in the modern world connects with epidemic proportions of the metabolic acidosis and dysbiosis, which creates a vicious circle.

This article is an attempt for a fresh, deep, holistic look into the pancreas as a vital organ for the whole body. We cannot have strong digestion if the body’s system is acidic, because acidity kills the pancreas.

Notes

1. Melamed P, Melamed F. Healthy Pancreas, Healthy You. 2012. Available at https://www.smashwords.com/profile/view/healthypancreas.

2. Boron WF. Medical Physiology: A Cellular and Molecular Approach. Elsevier/Saunders; 2003:1300.

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4. Saunders JH, Wormsley KG. Pancreatic extracts in the treatment of pancreatic exocrine insufficiency. Gut. 1975;16:157–162.

5. Case RM, Scratcherd T, D’A Wynne R. The origin and secretion of pancreatic juice bicarbonate. J Physiol. (London) 1970;210:1.

6. Ball EO, Tucker HF, Solomon AK, Vennesland B. The source of pancreatic juice bicarbonate. J. Biol. Chem.1941;140:119.

7. Matsuno S, Sasaki Y, Kobari M, et al. Initial pathophysiological changes in chronic pancreatitis induced by pancreatic ductular obstruction model. Tohoku J. Exp. Med.1991;163(3):199–210.

8. McClave SA. Feeding the chronically ill patient . Audio-Digest Gastroenterology. 42nd Annual Gastroenterology Update. Cleveland Clinic, Department of Gastroenterology and Hepatology. November 2006.

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14. Whitcomb DC. Advances in understanding the mechanisms leading to chronic pancreatitis. Nat Clin Pract Gastroenterol Hepatol. 2004 Nov;1(1):46–52.

15. Bennett WS, Huber R. Structural and functional aspects of domain motions in proteins. CRC Crit Rev Biochem. 1984;15:291–384.

16. Green NM, Work E. Pancreatic trypsin inhibitor. 2. reaction with trypsin. Biochem J. 1953 May; 54(2):347–352.

17. Niederau C, Grendell JH. Intracellular vacuoles in experimental acute pancreatitis in rats and mice are an acidified compartment. J Clin Invest. 1988;81(1):229–236.

18. Bhoomagoud M, Jung T, Atladottir J, et al. Reducing extracellular pH sensitizes the acinar cell to secretagogue-induced pancreatitis responses in rats. Gastroenterology. 2009 September;137(3):1083–1092.

19. Myneni N, Minocha A. Bile acids and esophageal injury: a resolution to the controversy? Am J Gastroenterol. 1999 Dec;94(12):3649–3650.

20. Cronin J, Williams L, McAdam E, et al. The role of secondary bile acids in neoplastic development in the oesophagus. Biochem Soc Trans. 2010 Apr;38(2):337–342.

21, Roberto Penagini. Bile reflux and oesophagitis. Eur J Gastroenterol Hepatol. 2001 Jan;13(1):1–3.

22. Rege RV, Moore EW. Pathogenesis of calcium-containing gallstones. Canine ductular bile, but not gallbladder bile, is supersaturated with calcium carbonate. J Clin Invest. 1986;77(1):21–26.

23. Rubinstein E, Mark Z, Haspel J, et al. Antibacterial activity of the pancreatic fluid. Gastroenterology. 1985 Apr; 88(4):927–932.

24. Pierzynowski SG, Zabielski R. Biology of the Pancreas in Growing Animals. Elsevier; 1999:131.

25. Frassetto L, Morris RC, Todd K, Sebastian A. Chronic low-grade metabolic acidosis in normal adult humans: pathophysiology and consequences. Medical Science Symposia Series. Women’s Health and Menopause. 1999;13:15–23.

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27. Frassetto L, Morris R.C, Sebastian A. Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women. J Clin Endocrinol Metab. 1997;82(1):254–259.

28. Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr. 2002;76(6):1308–1316.

29. Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994 Jun 23;330(25):1776–1781.

30. Frassetto L, Sebastian A. Age and systemic acid-base equilibrium: analysis of published data. J Gerontol. 1996;51:91–99.

31. Frassetto L, Morris Jr RC, Sebastian A. Effect of age on blood acid-base composition in adult humans: role of age-related renal functional decline. Am J Physiol. 1996;271:1114–1122.

32. Benda J. Karlovarsky Mlynsky Pramen. Domaci pitna lecba. DTP-servis mariuuskelazue. 1997.

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34. Lesniak RJ, Hohenwalter MD, Taylor AJ. Spectrum of causes of pancreatic calcifications. Am J Roentgenol. January 2002;178(1). http://www.ajronline.org/content/178/1/79.full.

35. Raeder M, Mo A, Aune S. Effect of plasma H+-ion concentration on pancreatic HCO-3 secretion. Acta Physiologica Scandinavica. 2008;105(4):420–427.

Peter Melamed and Felix Melamed are licensed practitioners from the Biotherapy Alternative Medicine Clinic of San Francisco. They are authors of the many online articles, the book Natural European Way of Whole Body Cleansing, and the e-book Healthy Pancreas, Healthy You, available in three parts at https://www.smashwords.com/profile/view/healthypancreas. In 1975, Peter Melamed established Biotherapy as a natural, holistic approach to healing. Biotherapy combines the wisdom of traditional Russian folk medicine, ancient Oriental medical therapies, and European naturopathy with cutting-edge Western technology. Biotherapy Clinic of San Francisco specializes in nondrug healing digestive (pancreatic), liver, gallbladder, and metabolic disorders.

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