You can pop an OTC painkiller when your back twinges, your knees ache or your hands cry out in arthritic protest. Or you can skip the drugs and feel much better (maybe permanently!) by getting right to the cause of the pain—your digestion. Yes! Here’s what’s going on…

The connection between digestion and joint pain is inflammation triggered by changes in stomach acid. By the time we reach our 50s, our stomachs produce less hydrochloric acid (HCl), a prime component of stomach fluid. HCl initiates the breakdown of food so that the nutrients can be used by the body and kills potentially harmful bacteria in food. When there isn’t enough HCl, the body does not get all the nutrients from the food, because HCl not only starts the digestive process but also triggers enzymes in the small intestine to complete the process.  Once the food reaches the large intestine, the incompletely digested particles are often too large and too complex for the bacteria to break them down to create the prebiotics essential to good health—and which benefit the bacteria themselves. Some will putrefy, causing smelly flatulence, constipation…and inflammation.

Chronic stress also suppresses digestive fluids because blood flow gets directed away from the digestive system to other parts of the body, such as the muscles and respiratory system, which are more useful in the fight-or-flight response and digestive enzyme production decreases.

Note that heartburn most often is not an indication of too much stomach acid, as many think, but of not enough at mealtimes when it’s needed. And because HCl signals the sphincter muscle between the stomach and esophagus to close so that food stays in the stomach, low HCl levels also keep the sphincter lax, allowing stomach acid and gas to wash back up the esophagus. Less HCl during a meal means more chance of unwanted organisms setting up shop in the stomach, creating acid-producing inflammation when empty, and voilà, heartburn!

An additional challenge to gut health and contributor to inflammation is the typical American diet, high in foods that are overprocessed and full of sugars.

Result: Inflammatory chemicals, triggered by the hobbled digestive system circulate throughout the body, including to the joints, where they break down tissue and cartilage and create inflammation—setting the stage for joint problems such as osteoarthritis and rheumatoid arthritis.


Constipation at least two or three times a month…stools that vary in amount and color…feeling bloated…and passing especially smelly gas are clues that inflammation is likely brewing in your gut. Over time, this intestinal dysfunction can develop into irritable bowel syndrome or leaky gut. Fixing your digestive woes, especially if you’ve had them for years, may not undo all the damage. And if you frequently have heartburn, it’s a good idea to check with your doctor or a gastroenterologist to rule out other health issues. However, you can do a lot to improve your digestion and reduce inflammation—which will dramatically dial down joint pain.

To increase production of HCl…

Eat mindfully. Wolfing down meals doesn’t just keep you from enjoying your food. It increases stress levels, reduces production of digestive fluids and doesn’t give the enzymes in saliva a chance to start the digestive process. In addition to signaling the production of stomach acid, chewing also signals the lining of the stomach to produce the mucus that protects it from stomach acid. Take time to chew and savor all the flavors, aromas and textures!

Avoid drinking during meals. Drinking beverages while you eat dilutes HCl. A sip or two to help swallow is OK. But if you’re chewing thoroughly, you’ll produce plenty of saliva and shouldn’t need more liquid than that. Have water, wine, coffee and any other beverage either one-half hour before meals or one hour after.

Don’t cut out salt. Sodium chloride is an essential component of stomach acid and necessary for good digestion. While sodium does raise blood pressure for people who are sensitive to it, that isn’t the case for everyone…and many people do better when they consume more than the recommended daily limit of 2,300 mg (about one teaspoon of salt). But don’t go crazy with the salt shaker! A healthy diet, such as the Mediterranean, provides naturally salty foods such as seafood, olives and nuts. And do avoid processed salty foods (pretzels, chips and the like).

Take an enzyme supplement with meals. Consider taking a supplement that contains betaine hydrochloride, a precursor to HCl. I often prescribe DuoZyme, which also contains other digestives enzymes, to my patients. There are many good brands available online and in health-food stores (look for betaine HCl), but it’s best to check with a knowledgeable doctor, such as a naturopathic physician, to determine which enzymes would be most effective for you.

To help reduce inflammation…

Eat raw foods. Fruits and vegetables are full of anti-inflammatory phytochemicals. For the most benefit, make raw (or lightly steamed or sautéed) fruits and vegetables half of your diet. Suggestion: At both lunch and dinner, have a salad that contains a mixture of different-colored fruits and vegetables and a light protein, such as eggs, fish, legumes or chicken. (Beef is fine in moderation.) Add a good brand of olive oil to help your body absorb the nutrients better. You don’t have to completely give up sandwiches—or even fast food. Just have them as an occasional treat.

Get plenty of omega-3 fatty acids. Omega-3 fatty acids dampen inflammatory reactions in the body. For example, research has found that omega-3 supplements ease pain for people with rheumatoid arthritis. Foods rich in omega-3s include walnuts, salmon and sardines. You can also take a fish oil supplement. Look for one that contains 650 mg eicosapentaenoic acid and 450 mg docosahexaenoic acid, such as Nordic Naturals.

Follow these steps consistently and within weeks—if not days—you should see your digestion improve. You’ll stop degeneration of joint tissue and cartilage, and pain will diminish dramatically. Even if you still need surgery, you’ll tolerate it better, recover more quickly and have fewer problems—and less pain—going forward.

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