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Nutritional Assessment Questionnaire & Symptom Indications:

Upper GI System examples of symptoms and signs of dysfunction…

Belching or gas within one hour after eating

• Belching or gas one hour after a meal is a strong indication of digestive dysfunction
• Hypochlorhydria or pancreatic insufficiency
• Delayed nature of belching or gas- may point to pancreatic insufficiency over hypochlorhydria
• Lack of pancreatic secretions in the small intestine can lead to purification of the proteins or fermentation of carbohydrates – giving off gas as a by-product
• Bloating is common – mid to lower abdomen
• Test for low HCL and/or pancreatic insufficiency in small intestine
• Linked to:
  • Sympathetic dominance
  • Antacid drug use
  • Excess sugar and refined foods
  • Chronic overeating
  • Constant snacking between meals
  • Excess carbohydrates and alcohol consumption
  • Nutrient deficiencies- especially zinc and thiamin
  • H. Pylori infection

• Heartburn or acid reflux
  • Symptoms of heartburn and acid reflux often due to low stomach acid secretion or hypochlorhydria
  • Can also lead to irritated and inflamed mucosa
  • Hypochlorhydria sets up ideal environment for an infection by H. Pylori which is an opportunistic bacterium -prefers chronically irritated environment of the gastric mucosa
  • H. Pylori is associated with gastric ulcers
  • Rule out H. Pylori with clients history of heartburn or acid reflux
  • Also cause of weak or sensitive esophageal sphincter -caused by over eating- causes gastric juices to enter through stretched esophageal sphincter into the esophagus
  • Other causes of acid reflux include:
    • Obesity
    • Cigarette smoking
    • Chocolate
    • Fried foods
    • Carbonated beverages
    • Alcohol
    • Coffee
• Bloating within one hour after eating
  • Indication of digestive dysfunction with either hypochlorhydria or pancreatic insufficiency
  • Quick onset of bloating shortly after eating- suggests hypochlorhydria as the cause
  • Low stomach acid can cause gas to build up in the stomach
  • Caused by putrefaction and fermentation of the stomach content

Hypochlorhydria has a number of possible etiologies:

Sleepy after meals

• Sign of blood sugar dysregulation
• Inadequate digestion – leaves heavy amount of food in the digestive system  that needs to be digested
• An increased carbohydrate load in a meal without adequate protein and fat to provide balance will lead to an increase in insulin
• Increased insulin will lower blood sugar very rapidly- leading to a concomitant lowering of blood glucose
• Causes post prandial sleepiness
• Common complaint after lunch- tends to be heavy carb meal
• Correct protein-carb-fat balance in each meal to balance blood sugar and increase energy post meal
• Digestive dysfunction- complaint of sleepiness after meals- large amount f energy being used up by the body to digest food in an environment lacking necessary gastric juices and enzymes
• Suffering from hypochlorhydria is common -leads to number of digestive complaints including-
  • H. Pylori infection
  • Bowel toxemia
  • Dysbiosis
  • Pancreatic insufficiency
  • Leaky gut syndrome
  • Zinc deficiency associated with hypochlorhydria and should be assessed

Hypochlorhydria has a number of possible etiologies:

• Sympathetic dominance
• Antacid drug use
• Excess sugar and refined foods
• Chronic overeating
• Constant snacking between meals
• Excess carbohydrate and alcohol consumption
• Nutrient deficiencies as zinc and B1 Thiamin
• H. Pylori infection
• Leads to irritation of the gastric mucosa causing decreased output of acid from the parietal cells
• Stomach pains/cramps
• Diarrhea sometimes after meals