Small Intestine Bacterial Overgrowth and Metabolic Bone Disease
This is such an incredible article and has such far reaching implications that I’m not sure where to start. I would guess that the first and most important place to start is to ask why this bacteria is there in the first place. The small bowel is generally considered a sterile environment because of the high acidity of the gastric contents as they dump into the small intestine. Herein lies the crux of the matter–many patients are hypochlorhydric (not enough stomach acid) and many patients are on acid blockers. It irks me to no end how freely we hand out and advertise for acid blockers. I firmly believe that any doctor recommending or prescribing them does not fully understand the physiology of digestion. HCl is absolutely essential to our health. It digests proteins (thereby lowering possible exposure to antigens and allergies), it activates many other enzymes, it’s needed to absorb iron, Vit B12 and certain types of calcium (which is my guess why patients in this study have reduced bone mass) and it helps sterilize the small intestine. Does this sound like a physiological process we want to block without full consideration for downstream effects???