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The Antimicrobial Activity of Pancreatic Juice Is pH Dependent
When the pH of pancreatic juice falls below 7.0, the antimicrobial activity is reduced. Rubinstein et al. found that the antibacterial activity of pancreatic juice was pH dependent.23 Experiments on people with pancreatic fistulas showed that, under healthy conditions, pancreatic juice is practically sterile and 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. Pancreatic juice plays an essential role in limiting the number of microbes in the small intestine. There is evidence that the antibacterial action of pancreatic juice is extremely sensitive to pH, having an optimal activity at a pH of 8.5, which is an alkaline condition, and a complete cessation of activity at a pH of 7.0, which is neutral.24
Acidification of the pancreatic juice and decreasing pancreatic secretion makes the pancreas more vulnerable to infection. For that reason, the restoration of the alkalinity in the pancreatic glands is fundamental for the treatment and prevention of pancreatitis and further pancreatic cancer.39
If chromic metabolic acidosis occurs, calcium is leached from the bones into the blood to neutralize acidity. The amount of calcium ions in the blood and body fluids increases, leading to the deposition of calcium in blood vessels and internal organs (calcinosis). This may explain the widespread simultaneous appearance of osteoporosis, arteriosclerosis, and calcification as calcium deposits in the inner organs. Calcification of the pancreatic gland is an important symptom of chronic pancreatitis.34
Precipitation of calcium salts within the pancreatic duct leads to stones, which irritate or block the pancreatic duct, causing inflammation or pancreatitis. Precipitation of calcium salts inside the gallbladder induces stone manufacturing and the obstruction of the sphincter of Oddi. This in turn can increase the pressure inside the pancreatic duct and activate proteases within the pancreas, causing self-digestion, damage, and pancreatitis.
Discussion: Clinical Implications
The authors believe that chronic metabolic acidosis kills the pancreas and the entire digestion process. Questions may arise from this hypothesis. Is chronic metabolic acidosis a widespread condition in the modern human?
Does chronic metabolic acidosis have clinical significance in everyday practice?
The authors believe that subclinical, low-grade, chronic metabolic acidosis is a widespread condition that is considered a "disease of civilization." Focusing on the acid-base equilibrium may be key in prevention and treatment of either digestive or hormonal pancreatic disorders.1
Metabolic acidosis is rampant in modern society. Mostly, this is due to the standard Western diet.25,26 Most of what we eat now is acidic in nature and consequently changes the acid-base balance toward metabolic acidosis.29 Nutrition scientists have described the incidence of metabolic acidosis in modern humans.25,26,27
For instance, researchers from the University of California found that most health problems stem from the deficiency of bicarbonate in today's food compared with the food of our ancestors.26 Other authors have proved that current eating habits have produced low-grade metabolic acidosis in otherwise healthy people.25-28
Some authors found that metabolic acidosis increases with age.30,31
Currently, overacidity is frequent and can create harmful conditions that weaken all body systems. Chronic metabolic acidosis drives humans to leach alkaline minerals, including calcium, sodium, potassium, and magnesium, from inner organs, muscles, and bones to neutralize the acidity and to remove acid radicals from the body. The human being has only one way to recover from metabolic acidosis: to obtain extra minerals and bicarbonate to neutralize overacidity. Where can the organism obtain these minerals and bicarbonate? Naturally, people can only obtain minerals and bicarbonate from food, healing mineral water, and mineral supplements, such as magnesium/potassium.
If laypeople and medical practitioners understood that our alkaline diet requires mineral supplementation, healing mineral waters would be found in the US. Let us look at the experience of European medical doctors, who have treated a variety of digestive disorders with healing mineral waters for hundreds of years. The European public often spends their "healthful vacations" in mineral spas, where medical doctors evaluate the patient and prescribe the quantity, frequency, and temperature of healing mineral waters. In some European countries, insurance covers balneotherapy/mineral water cures.
The small town of Karlovy Vary in the Czech Republic has enjoyed 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, and a regimen of drinking water from this spring was recommended for constipation. Since then, hundreds of clinical papers have been published describing the positive effects of this water on both animals and humans. Unfortunately, most of these papers are published in Czech, German, and Russian; thus, they are unknown by the American medical establishment.32,33
The demand for this water was so high that doctors in Karlovy Vary developed a vaporizing method to obtain genuine Karlovy Vary thermal spring salt 250 years ago. Dissolving this salt in the water makes it possible to use mineral water for healing at home. The water prepared from the genuine Karlovy Vary thermal spring salt has 40 essential minerals, trace elements, and bicarbonate in a proportion similar to that of human plasma. Czech doctors determined that the water manufactured from the genuine Karlovy Vary thermal spring salt had identical healing properties to the spring. European scientists and doctors have confirmed the positive effects of the Karlovy Vary healing mineral water on the pancreas and pancreatic digestive enzymes.1
Karlovy Vary healing mineral water is a natural alkalizing compound that helps the body to restore a normal pH by neutralizing acid radicals and removing them from the body. Before the insulin era, this water was the only healing remedy for diabetes. Karlovy Vary healing mineral water helped many Europeans with environmental and professional toxicity. Scientific research shows that this water decreases gas, bloating, stomach pain, abdominal spasms, and indigestion by increasing the production of bile and pancreatic enzymes and by opening the bile and pancreatic ducts, thereby decreasing internal toxicity.32,33
There are many complicated tests to identify overacidity in the body. More simply, one can observe positive pH changes in one's saliva and urine by using litmus paper at home. If the saliva and urine pH is less than 6.6 for one week, chronic metabolic acidosis and acidic pancreas and bile may be presumed.
Currently, the medical standpoint on digestive disorders narrowly focuses on the "hollow" organs, such as the stomach and colon, without paying attention to the "solid" digestive glands, such as the pancreas and liver. It is known from human physiology that, without a specific quality and amount of pancreatic juice and bile, the normal digestive process in the hollow chambers could not occur. The pancreas is the main organ of the entire digestive system. Almost all of the problems of the GI tract are closely related to the proper functioning of the pancreas. Therefore, a clinical diagnosis of gastrointestinal disorders de facto presumes pancreatic disorders.
Another very important consideration is chronic pancreatitis. Descriptions of the symptoms of this disease, including pain, steatorrhea, malabsorption syndrome, and weight loss, are found in almost all medical books, textbooks, and articles. The medical literature refers to this state as pancreatic insufficiency. It is known that these symptoms occur when only 10% of the exocrine pancreatic function is left intact. Unfortunately, this is not pancreatic insufficiency; it is pancreatic failure, for which therapeutic opportunities are very limited.
The final stage of chronic pancreatitis does not develop overnight. Typically, 8 to 15 years occur between the first attack of acute pancreatitis and pancreatic failure following chronic pancreatitis. Similar to disorders of other organs and systems, the initial disease stage of the pancreas does not present any structural changes. Nevertheless, after this stage, longstanding biochemical, biomechanical, neurohumoral, and inflammation responses lead to structural damage of the pancreas (chronic pancreatitis) and a lowering of the exocrine pancreatic function while bringing many accompanying digestive diseases. However, if 90% of the pancreatic functional capacity is reduced, pancreatic failure occurs with steatorrhea and malabsorption syndrome, resulting in a total crash of the digestive system and the entire human organism.
For the purpose of focusing on the early functional stages of pancreatic disorders, the authors propose the functional clinical classification of exocrine pancreatic disorders, which subdivides digestive disorders and diseases into three groups:
1. acidic pancreas and bile
2. pancreatic deficiency
3. pancreatic failure
On a daily basis in medical practice, crowds of people present with digestive symptoms that are consistent with those of patients in the "acidic pancreas and bile" stage of exocrine pancreatic disorders. Their tests are usually normal, and most of these patients receive palliative, symptomatic therapy. Restoration of the proper acid-base balance in digestive disorders may be one of the natural, pathophysiological approaches for functional dyspepsia, biliary dyskinesia, GERD, sphincter of Oddi dysfunction type III, IBS, and intestinal dysbiosis (candida overgrowth, SIBO), among others.
Pancreatic functional disorders are terra incognita in medicine; there is little attention on the functional stage of exocrine pancreatic deficiency regardless of the fact that the pancreas is a key organ in proper digestion. H. Worning wrote in Digestion that the prevalence of pancreatic diseases as the cause of dyspepsia varies in clinical practice between 0% and 25% to 30%. He believed that pancreatic function and pancreatic disease are closely related to various gastrointestinal diseases.41
The connection between functional gastrointestinal disorders such as functional dyspepsia, SIBO-small intestinal bacteria overgrowth, IBS, and impaired pancreatic function to a greater extent have attracted the attention of researchers and doctors for the last decade.42-44
Goepp et al. found low pancreatic elastase (a marker of exocrine pancreatic insufficiency) in 7.1% of the patients with irritable bowel syndrome.45 Another point that low pancreatic function underlies dyspepsia and IBS is the beneficial effect of the pancreatic enzymes in these functional disorders.46,47
Smith et al. described abnormal Lundh tests in 27% of patients with functional dyspepsia. They wrote, "Pancreatic disease may explain the symptoms of some patients with non-ulcer dyspepsia."48
It is known that dyspepsia and functional dyspepsia are common conditions globally, affecting most populations, regardless of location.49 Okada et al. considered that mild functional pancreatic disorders might trigger some cases with unexplainable chronic dyspepsia.50
Lindström et al. believe that, overall, 66% of the patients with abdominal pain had morphological and functional evidence of pancreatic involvement.51
Some researchers agree that differentiation between functional dyspepsia and early stage of the chronic pancreatitis is complicated.52 Early-stage chronic pancreatitis and impaired exocrine pancreatic function are frequently misdiagnosed.
"Early chronic pancreatitis remains a diagnostic challenge as there is no gold standard for the diagnosis and pancreatic biopsy is risky and impractical. Reported data on the incidence and prevalence of chronic pancreatitis are unreliable and highly variable. Chronic pancreatitis is clearly under-diagnosed." 53
The diagnosis of the early stage of the pancreatic diseases might be missed in clinical practice because symptoms of severe exocrine pancreatic deficiency are not specific at that time. There is no malabsorption syndrome or maldigestion, there is the absence of steatorrhea, and the pancreatic and liver enzymes levels in blood are normal. Therefore, early chronic pancreatitis is seldom suspected when pain is mild or absent, and there are unspecific symptoms of "dyspepsia."
Scientific research and clinical findings confirm that the pancreas and liver are more vulnerable to reduced functioning due to metabolic acidosis. One primary (ex juvantibus) therapy for multiple digestive and liver disorders is the mineral spa resort in Karlovy Vary and other resorts in Europe, and a great number of medical papers support the therapeutic action of the mineral/bicarbonate waters for digestive diseases. The pandemic of the digestive disorders in the modern world is associated with epidemic proportions of metabolic acidosis and dysbiosis, which form a vicious circle.
This article is an attempt to present the fresh, holistic approach that the pancreas is a vital organ for the whole body. We believe that our work may provide food for thought to many young researchers and health practitioners.
We cannot have optimal digestion if the body's system is acidic, because acidity kills the pancreas!
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