If you experience heartburn or acid reflux, you might reach for the antacids… but I want to stop you there! The truth is that the symptoms of gastroesophageal reflux disease (GERD), heartburn and acid reflux are usually caused by low stomach acid. Let’s dive in!
Why do we need stomach acid?
Stomach acid is an extremely important player in your digestive tract.
Also known as hydrochloric acid or HCl, stomach acid is needed to:
Break down protein in your food
Activate pepsin, the primary enzyme in your stomach
Stimulate the pancreas to release enzymes that break down food
Protect the body from potentially harmful bacteria before it reaches our intestines
What are downstream effects of low stomach acid?
Low stomach acid, also called hypochlorhydria, can be detrimental to digestive and overall health. Working on having sufficient stomach acid is one of the first steps I take when I work with my nutrition clients!
Here are a few examples of what can occur if you have low stomach acid:
GI Infections: At healthy levels, stomach acid helps prevent harmful bacteria from invading the rest of your GI tract. If you have low stomach acid, your risk of GI infections increases. This includes infections such as E. coli, salmonella, H. pylori, opportunistic (“bad”) bacteria overgrowth, candida overgrowth and more.
Systemic issues: If low stomach acid is not addressed, it can even lead to downstream conditions like allergies, asthma, autoimmune disorders, and skin problems, including acne, psoriasis, rosacea and seborrheic dermatitis.
Poor digestion: Low stomach acid could lead to low digestive enzymes and poor fat digestion, causing bloating and indigestion after meals.
If you are wondering if GI infections or poor enzyme output are contributing to your health issues, it may be worth running comprehensive stool testing, such as the GI-MAP. Let’s work together so that I can help you figure out what is causing your symptoms!
Does acid reflux come from too much stomach acid?
You may be thinking: “taking antacids provides relief of my symptoms, so the trigger must be too much acid in my stomach!”.
The problem is that the acid is in the wrong place. Because the stomach acid is too low, it isn’t signaling for your lower esophageal sphincter (LES) to stay closed, so acid splashes into your esophagus, which causes the feeling of too much acid. Any amount of acid in the esophagus is going to cause problems! This is because the esophagus has a delicate lining that isn’t protected against acid like the stomach lining is, so it feels like there is too much acid.
It’s counterintuitive, but the acidic feeling you get in your esophagus is due to too little acid in the stomach. Antacids DO provide temporary relief, but by reducing stomach acid ever more, you are at increased risk of GI infections, system issues and poor digestion.
10 signs of low stomach acid
Low stomach acid is surprisingly common! These are signs of low stomach acid:
Bloating and gas
Diarrhea or constipation
Acid reflux or heartburn
Indigestion
Belching or burping
Feeling of food sitting “like a rock” in the stomach or sense of uncomfortable fullness after meals
Undigested food in the stool
Nausea
Bad breath
Hair loss or brittle fingernails, which can signal nutrient deficiency
Are you experiencing most of the symptoms listed above? Read through what causes low stomach acid below to see if you can pinpoint what may be triggering it. Additionally, check out natural ways to increase stomach acid below.
What causes low stomach acid?
Stress. If the brain perceives there is a stressful situation, the first thing it will do is shut down functions that are not critical for survival. This can be triggered by short-term or chronic stress. If you’re chronically stressed, your normal digestion is constantly being interrupted, including inhibiting HCl secretion.
A long-term vegan or vegetarian diet
Low-protein diets
Zinc deficiency. Adequate hydrochloric acid is required to absorb zinc from our food and we also need adequate zinc stores in the body to produce HCl
Long-term use of antacids, H2 blockers and proton pump inhibitors (PPIs): these are used to treat ulcers and, ironically, acid reflux.
H. Pylori infection. With H. pylori proliferation, the parietal cells in the stomach are suppressed from releasing hydrochloric acid from the gastric lining.
Age. HCl production naturally declines as we age.
The problem with acid-blocking drugs
Acid-blocking drugs can be very beneficial to manage symptoms of acid reflux, heartburn and GERD. However, they are not getting to the root-cause of why you have these symptoms. And the worst part is that as soon as you stop taking them, the symptoms return. Additionally, the symptoms are often worse than they were before taking the drug.
Acid-blocking drugs such as H2 blockers (e.g. Axid, Pepcid) and PPIs (e.g. Nexium, Dexilant, Prilosec) promote bacterial overgrowth, create risk for infections, reduce absorption of essential nutrients, and increase the likelihood of developing IBS or other digestive disorders. More serious side-effects include serious kidney damage, bone fractures and dementia. These drugs were created to be taken for no more than 6 weeks, but people are often on them for decades because their symptoms are so severe!
Most importantly, the drugs are only suppressing symptoms and not getting to the root cause of what is causing heartburn or GERD. If you are on any of these drugs, make sure to consult with your doctor if you have questions or are considering coming off of them. If you have gastrointestinal irritation or duodenal ulcers, it is important to implement changes with caution after consulting with your practitioner.
How to increase stomach acid
Let’s talk about how simple dietary and lifestyle changes can help support acid reflux, heartburn and GERD by increasing stomach acid!
If you are struggling with symptoms of low stomach acid, there are several steps you can take to increase stomach acid production naturally:
Chew slowly and thoroughly: digestion begins in the mouth, so you want to give your stomach a heads up that food is coming to release gastric juices and stomach acid.
Eat in a relaxed state: eating under stress will suppress stomach acid; you can try taking a few deep breaths before eating and make sure you’re not distracted by your computer, phone or TV.
Eat bitter foods: foods like kale, arugula, dandelion greens, endive, watercress, broccoli rabe, ginger, grapefruit, brussels sprouts, dark chocolate and eggplant will help signal the body to secrete stomach acid, digestive enzymes, and bile. You can also try digestive bitters 10-15 min before meals.
Try apple cider vinegar or lemon juice before meals: you can mix 1-2 tbsp of fresh lemon juice or ACV into a glass of water and drink it about 15-20 minutes before a meal. This helps to stimulate your body’s own production of stomach acid.
Work with a practitioner: a nutrition therapist can help you methodically introduce HCl supplementation and help support the health of your delicate tissue, which may be damaged after too much exposure to acid. A practitioner can help get to the root-cause of your digestive issues!
Ready to increase your stomach acid and improve your gut health?
A natural approach in increasing stomach acid can be extremely effective. It’s key to investigate and figure out what might be causing low stomach acid. Your health history, diet, lifestyle, sleep, and stress are all part of the puzzle.
Working with an experienced practitioner is highly recommended.
I can help you if:
You have been diagnosed with acid reflux or GERD, but none of the medications seem to help.
You have had years of symptoms, medications haven’t helped, and new symptoms are arising.
Your GI doctor has recommended PPIs, but you prefer not to take medication for long periods of time and, in general, don't like to take medications.
You have seen many doctors and everyone has said you are fine, but you get serious digestive issues after meals.
You have been diagnosed with everything from IBS to stress to overproduction of acid, with recommendations of various medications, but nothing has worked.
Ready for a natural approach to increasing your stomach acid and support your gut health? I can help you!