I have a patient with gastroesophageal reflux. I’m starting to work on healing the gut and changing the diet to a Paleo reset. The patient has a history of surgically repaired hiatal hernia and was told at the time of surgery that her stomach was full of polyps. The patient has a lot of stomach pain and still has gastroesophageal reflux. I need to do some gut testing but want to start with diet and supplementing. Can I use HCl and enzymes in this case?

Dr. Amy Nett: Well, the major risk in supplementing with HCl is really if the patient has ulcers or gastritis. If they only looked at the stomach grossly at surgery and saw polyps and didn’t do a careful examination for ulcers or gastritis, it might be worth having her do an endoscopy. It also depends on the severity of the pain, so I would definitely have caution here before recommending that she start supplementing with HCl. If she did have an endoscopy in the course of this, where they more specifically looked for ulcerations and evidence for gastritis throughout the entire stomach, if they could see no evidence of ulcers, no evidence of gastritis, then if it’s only polyps, you should be safe in supplementing with HCl, but just take caution on that one, and make sure that they really looked carefully.