[Webinar Replay] Acid Reflux, H. Pylori, Ulcers & Upper GI Solutions with Kiran Krishnan [Part 3]

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Part 1 of this webinar series is available to watch here. Part 2 of this webinar series is available to watch here.

Post-Webinar Q&A with Kiran

  1. Q: All this talk of low stomach acid – but doctors always say we have high stomach acid. Is there a way to know for sure if someone has low or high stomach acid production? A: I think there is a confusion in terms here. One can say “high stomach acid” which likely means a high pH of the stomach acid, meaning less acidic. In addition, doctors have always confused GERD and reflux with there being too much stomach acid, when this is simply not true. There is a test you can take to see if you are producing adequate stomach acid.
  2. Q: Are there any additional benefits to taking MegaGuard with each meal vs. the instructions of taking it with lunch and dinner?A: We have people take it with virtually every time they consume food. If your system is very prone to unusual fullness, bloating, gas, etc. there is benefit in taking it more often than 2 meals.
  3. Q: I have Barrett’s Esophagus & hiatal hernia. I’d love to be able to get off the PPI’s, but I’m scared. Do you know anything about these conditions or have any suggestions? A: We cannot advise anyone to get off their PPI’s, that’s a discussion to have with your doctor. However, we have known people who have significantly reduced their use of PPIs with the help of products like this. Work with your doctor to see if he/she are willing to look at tapering down on the PPIs.
  4. Q: Is it necessary to start at 1/day with MegaGuard and work up to 2? A: Do that just for the first 2-3 days. After that, go with 2 per meal.
  5. Q: I’ve got ME/CFS for 21 years – no appetite and very little acid production – do you think this could help? A: We have not had a similar case to report from and so, we don’t have practical experience with your conditions. However, it wont hurt and is likely supportive.
  6. Q: I’ve got a hard spot under my ribs in the middle w/ severe pain, along with pain in the right side of my back when I eat too much (possibly connected to fat) – any ideas with this? A: Sound like you may need some imaging done via MRI or an ultrasound. That would be our advice.
  7. Q: Is it possible that unresolved lower GI issues could result from upper GI issues? A: Absolutely, the mouth, the stomach and the small intestines have profound impact on the lower GI system and can continue to drive dysfunction.
  8. Q: Do you know anything about scleroderma-related reflux, and if this product (MegaGuard) might be helpful? A: We have no research on this particular condition and our product, so we cant say definitively. I will say that most causes of reflux ultimately lead to the same physiological dysfunction thus, could be helped in similar ways.
  9. Q: Do you know any way to increase the tone of the lower esophageal sphincter (LES)?  A: Yeah, improving parasympathetic and sympathovagal tone will help. RHT has a whole webinar on this I believe. In addition, stopping leaky gut will help and vitamin K2-7 will help as well.
  10. Q: Are you aware of any effective treatments or ways to reverse a hiatal hernia? A: I am not aware of anything that has been shown to reverse it.
  11. Q: Does this stomach acid/SIBO/dysbiosis, etc… situation contribute in any way to low glutathione production that you’re aware of? A: All of these conditions are conditions of dysbiosis, low diversity and pathogen overgrowth. These same causes lead to low glutathione and other metabolite production.
  12. Q: Do you know anything about a herniated diaphragm and how that might relate to this situation? A: I have not seen any specific connection.
  13. Q: Do you know anything about eosinophilic esophagitis and how it might relate to the information in the webinar? A: EE could be related to chronic inflammation in the esophagus, which can be driven by GERD or reflux. Either way, SIBO and other gut dysbiosis drive chronic inflammation and chronic inflammation plays a role in all immune dysfunctions.
  14. Q: Could this cycle of dysfunction be responsible for postprandial palpitations?A: Possibly, postprandial endotoxemia, which is the ultimate result of all of these dysfunctions, can drive palpitations as well as an influx of toxins, which can also drive palpitations.
  15. Q: Does MegaGuard focus as a prokinetic? If yes, would the dosing or timing change? A: It has a prokinetic function among other things. The timing however does not need to be adjusted. Take it 10-20 mins before your meal.
  16. Q: Do you have any recommendations regarding how to heal one’s esophagus after long-term reflux damage? A: Repair is dependent on tissue turnover and that requires really good micronutrition. Make sure to get good doses of all vitamins and minerals.
  17. Q: I have no gas or bloating, but reflux no matter what I eat – taking HCL makes it worse. Would this possibly help – or do you have any other ideas? A: You likely have an issue with gastric emptying, so yes, it can help.
  18. Q: I have bile reflux. Bitters & sunflower lecithin are helping a little. Would this product make things worse, at it increases bile flow? A: You don’t have bile reflux due to too much bile and improving flow wont make it worse. Rather you have an issue with gastric emptying and with moving food down the small bowel. This will help with that.
  19. Q: If we take HCL/digestive enzymes, would we want to ween off/stop those w/ MegaGuard? If yes, any advice on how to do this? A: You don’t have to ween off, you might find that after some time you wont need HCL as much. After 30 days or so, try lowering or stopping HCL to see if it is needed. You can continue to take digestive enzymes, those are always good and beneficial.
  20. Q: Are bile sequestrants (no gall bladder) daily as harmful as long-term PPI? Can you speak on that at all? A: I have not see research on this the same as there is research on PPIs, however, theoretically sequestering bile dramatically reduces bile pool and a lowered bile pool is associated with lots of chronic conditions.
  21. Q: I have a client (I’m a nutritionist) that is prescribed PPI’s due to lesions in esophagus which increase the risk of cancer. Any advice on how to advise? A: I would not mess with the PPI as that is a tenuous reason to be taking one. Leave that to the doctor. But advise that this product can improve other dysfunctional aspects that may be driven by the PPI, like small intestine dysbiosis and poor bile movement.
  22. Q: Can Megaspore swished orally positively impact the oral microbiome, or is this a waste? A: We haven’t done a study on this but case reports indicate that yes, it helps with a dysfunctional oral microbiome. But after swishing, just swallow it as your dose of Megaspore, so you aren’t wasting it.
  23. Q: Does Megaspore affect glutamate levels/production at all that you’re aware of? A: We are not aware of this specifically.
  24. Q: I’ve read an article saying that women with PCOS have abnormally high primary conjugated bile acids in their system. Could it be problematic to increase bile in some conditions like PCOS?Study: https://www.ncbi.nlm.nih.gov/m/pubmed/30849463/A: Having “high” primary bile means a lack of microbes that convert about 5% of the primary bile to secondary bile salts. Increasing bile flow has actually been shown to increase the growth of microbes that convert some to secondary bile salts.
  25. Q: Would someone still need to take digestive enzymes and ox bile w/ this product if they have gallstones or sluggish liver? A: For a period of time they likely would. But assuming they have a gall bladder and healthy pancreas, after some time ( a couple of months) they may be able to come off those other two supplements. But its good to check with their doc on their risks.
  26. Q: With a history of diagnosed SIBO and autoimmune disease is having cholesterol polyps in your gallbladder a result of any of the stomach acid and microbe issues or is it unrelated and if so how should that be managed? A: I don’t completely understand the question as it is written. However, elevated cholesterol, gallbladder dysfunction, SIBO and autoimmune disease are all gut dysfunction related. So they can be related to the same etiology. You would pick one condition, like the SIBO and focus on that and see if improving SIBO helps the other conditions.
  27. Q: If you have no gall bladder, then trying things that stimulate bile flow aren’t for you, is that correct?  Or does the liver compensate?  Which things should we be doing in that case?  My husband has no gall bladder so it’s a bit confusing as to which tips to follow, ie lower protein intake, etc. A: Always lower protein intake. Protein should not be more than 20% of the daily calories. Without a gallbladder, you really cant increase bile flow much, but you can still improve gastric emptying, improve inflammation in the stomach and small intestines and get the bowels moving. He should look at Ox bile supplements.
  28. Q: I get painful bloating if I wait too long to eat, NOT after I do eat. Is this a clue to something about my system, and if so, what does it tell me? A: It could mean that you have an overgrowth of pathogens that feed off your mucus layer and they are increasing their growth when food is not present.
  29. Q: I have had severely painful attacks one or two times, where the discomfort (achey pain and bloating) is quite high in my body, behind my chest in the front and also makes my upper back hurt, and it persists for about 12 hours or so, ACV doesn’t help, HCL, enzymes, ginger and so on don’t help. It eventually subsides on its own but you can’t sleep and it’s distressing. Any ideas? Is this SIBO or something else and why would it happen rarely? A: Is this happening in response to eating something? Is it something that just comes on without any particular trigger? There is not enough info here to make an educated guess.
  30. Q: Why is it detrimental to have an overgrowth of positive-gram bacteria like lactobacilli in the small intestine? (I guess the main problem would be: bacteria fermenting our food before us digesting it? Are there other reasons?) A: Lactobacilli in particular increase an enzyme called BSH, which leads to the product of more secondary bile salts, which then drivers severe inflammation and even cancers.
  31. Q: What is the line between having an ok amount of lactobacilli and too much of it (how could we ascertain that?) – because as far as I know probiotics are crucial for proper digestion, for the health of microvilli, enzyme production and so on – it seems on the other hand that probiotics ARE important for a small intestine in order to be healthy. A: I think it quite rare where someone needs to supplement with outside grown lactobacilli. There may be some specific strains that have specific benefits, but for the most part the conventional probiotics with high doses of lactobacillus used as general gut health products can lead to more issues than they solve. Lactobacillus as a genus makes up about 1% of the total gut population, so its not even a significant player in the microbiome and the health of the digestive system. The best approach is to work with probiotics and prebiotics that can help create diversity and facilitate a healthy population.
  32. Q: Why is that I had very good results with taking probiotics and prebiotics (this is also a standard procedure esp. after taking antimicrobials in case of SIBO) if probiotics are generally not really desired in the small intestine? A: Likely because those prebiotics and probiotics were impacting something in your large intestine.

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2 Comments

  1. FYI the current dosing directions on the Microbiome Labs website says “Take one capsule with lunch and dinner, or as directed by your healthcare practitioner.” Just noticing the discrepancy with the answer to question 4 which suggests 2 per meal.

    • Thanks, Chris!

      Considering Kiran is the formulator of the product and head science officer at MBL, we would trust his recommendation. This was actually brought up during one of the webinars and he said the dosing on the website was more cautionary and best for when people are starting out. Hope that helps!

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