The Graph indicates the excess production of Hydrochloric Acid (HCL). This condition may cause Delayed, or Marked-delayed, emptying time of the stomach’s contents. In many cases, Patients with Delayed and Marked-delayed emptying, will retain food in their stomachs for 6 to 24 hours, or much longer in many cases. A Patient that has Fasted may have stomach acid level of pH 1.0 or lower–toward pure Acid, but not in all cases. The Alkaline Challenge can be accurately administered to a patient that has a fasting acid level of pH 0.0 up to pH 5.5.
When the Patients Parietal Cell are challenged with an alkaline drink we measure the time that it takes to return from the Alkaline, or Neutralized state, back to the Acid side. This determines normal Parietal Cell performance. The standard Alkaline challenge must be administered 2 or 3 additional times, and show a rapid returns (10 minutes or less) to acid levels, which verifies that the Patient is Hyperchlorhydric. The Alkaline challenge (standard: 5 cc saturated solution of sodium bicarbonate) is essential to determine the “fasting” stomach acid levels, Reacidification Time, and Parietal Cells’ capacities. Regarding the “pushing” of their highly-acid meals through into the Duodenum: The emptied or ‘pushed-through’ food will be heavy on the acid side, which will stimulate the Duodenal production of Pancreatin and Liver Bile.
However, the Duodenal buffering capacities cannot, volume wise, elevate the pH of the “pushed-through” foods (now highly saturated with HCL) to the normal Physiologic pH level into the Small Intestine. The stomach-exit pH range (under this condition) will be approximately pH 1.5 to 2.8 (rather than an optimal pH 4.0 to pH 4.5). The Small Intestine normal-to-ideal pH range would be pH 5.8 to 7.0 at this point.
One example of a delayed stomach emptying is a person who has a normal breakfast, becomes hungry at noon, orders lunch, and then has trouble eating because his stomach is full…the breakfast is still there! (And it really is, still there.) The acid condition of the food at the Duodenal Exit Region now becomes an irritant against a mucous membrane that ideally, should be ‘climbing’ close (in time) to the Neutral (pH 7.0) range. This causes incomplete Digestion,as described before, with accompanying Gas, Belching, Bloating, Flatulence and Irritable Bowels.