Key takeaways:
- Low stomach acid (hypochlorhydria) happens when the stomach produces not enough hydrochloric acid (HCl), which interferes with digestion and the absorption of nutrients.
- It may cause symptoms such as bloating, indigestion, gas, fatigue, and nutrient deficiencies, especially in vitamin B12, iron, calcium, and magnesium.
- Common causes include aging, chronic stress, smoking, alcohol use, vitamin deficiencies, H. pylori infection, stomach surgery, and long-term use of antacids or PPIs.
- Lifestyle modifications include reducing stress, quitting smoking, exercising, and getting good sleep, which helps maintain normal stomach acid levels.
- Schedule an appointment with your doctor immediately if you experience severe pain, vomiting, bloody stool or vomit, unexplained weight loss, or difficulty swallowing.
What is low stomach acid?
Hypochlorhydria is a condition characterized by low stomach acid, particularly a deficiency in hydrochloric acid (HCl), which is the strongest acid produced by your stomach. This acid is crucial for digestion and immune defence. It aids in breaking down proteins, facilitating nutrient absorption, and combating viruses and bacteria that might infect your stomach.
Stomach acid plays a crucial role in digesting and absorbing proteins, vitamin B12, and various minerals. When your body fails to break down and absorb these nutrients effectively, it results in undigested food and nutritional deficiencies. A lack of protein and vitamin B12 can cause iron deficiency anaemia and other vitamin deficiency anaemias, which can impact your nervous system. Additionally, deficiencies in calcium and magnesium may lead to osteoporosis.
Undigested food in your gastrointestinal (GI) tract can cause immediate uncomfortable symptoms and may lead to serious health issues over time. Moreover, low stomach acid levels raise the risk of bacterial overgrowth, such as H. pylori, which is linked to chronic gastritis and peptic ulcers.
If you have hypochlorhydria, you could become more vulnerable to infections, potentially causing further harm to your stomach and digestive system.
What signs indicate low stomach acid?
Low stomach pain symptoms might manifest as:
- Indigestion
- Abdominal pain
- Feeling too full after regular meals
- Bloating
- Gas or flatulence
- Diarrhoea or Constipation
- Susceptibility to more food allergies
- Undigested food in poop
- Reflux
- Heartburn
Nutritional deficiencies caused by low stomach acid may manifest as:
- Hair loss
- Brittle fingernails
- Paleness
- Fatigue and weakness
- Numbness or tingling in hands and feet
- Memory loss
- Headaches
What are the reasons behind low stomach acid levels?
Certain factors can increase your risk of developing hypochlorhydria.
- Age: As you get older, your stomach produces less hydrochloric acid, and your body also experiences hormonal imbalances, which lead to low stomach acid. Hypochlorhydria is more common in people over 65.
- High stress levels: Chronic stress can cause low stomach acid because it disrupts hormone and neurotransmitter balance that regulates digestion.
- Eliminate foods that cause reactions: foods that trigger allergies or intolerances, such as gluten, lactose, etc.
- Smoking cigarettes and consuming alcohol: can deplete the nutrients of your body, which may result in decreased stomach acid production.
- Vitamin deficiencies: including iron, zinc, and vitamin B, are crucial for sustaining healthy stomach acid levels. An inadequate diet can cause low stomach acid, and so can nutrient loss from health issues, stress, smoking, or alcohol consumption.
- Antacids and other medications: Long-term use of antacids may cause hypochlorhydria. Drugs for stomach ulcers or heartburn can also decrease stomach acid production. Consult your doctor about changing medicines if you experience signs of low stomach acid.
- Helicobacter pylori: infection involves a bacterium that frequently causes stomach ulcers. If left untreated, H. pylori infection can significantly increase the risk of low stomach acid.
- Stomach surgery: such as gastric bypass, can cause hypochlorhydria by decreasing the number of gastric acid-producing parietal cells.
What are the methods for diagnosing low stomach acid?
If you have risk factors associated with low stomach acid, you might think that’s the problem. However, confirming this requires a stomach acid test. Healthcare professionals use different tests to diagnose hypochlorhydria.
1. At-home test:
If you get a positive result from an at-home test, follow up with a trained healthcare provider.
- The baking soda test
When baking soda reacts with stomach acid, it releases carbon dioxide (CO2), causing you to burp. For the test, drink half a glass (4 ounces) of cold water mixed with a quarter teaspoon of baking soda on an empty stomach. Then, observe how long it takes to burp. If it takes longer than three to five minutes, you likely do not have enough stomach acid. Keep in mind that the baking soda test is not definitive; it can produce false positives or negatives and should not be relied upon solely. Always consult with a doctor for a proper diagnosis.
2. Clinical tests:
- The Heidelberg pH test.
In this test, you will swallow a small capsule with a radio transmitter that monitors your stomach’s pH levels. First, you will take a baseline measurement. Then, you will drink a baking soda solution to neutralize stomach acid. Afterward, the test records how long it takes for your stomach to return to its baseline acid levels. This helps healthcare providers evaluate how well your stomach produces and secretes acid.
- The Smart Pill test:
The Smart Pill is designed to diagnose GI motility disorders by measuring pH, temperature, and pressure levels. It can also assist in diagnosing hypochlorhydria by evaluating pH levels. This wireless device is swallowed and differs from the Heidelberg test, as it not only measures pH but also tracks gastric acid levels. - The Gastric String Test:
The gastric string test involves swallowing a capsule attached to a string, then pulling it out after 10 minutes. The string is tested with pH paper to measure acidity. Normal stomach acid has a pH range of 1.5 to 3.5, indicating high acidity, with a pH of 0 being the most acidic. If your stomach pH consistently stays higher (between 3 and 5), it may indicate hypochlorhydria. A pH above 5 suggests achlorhydria, a severe condition characterized by little to no hydrochloric acid production in the stomach.
What are the common treatments for hypochlorhydria?
Hypochlorhydria treatment typically focuses on addressing the underlying cause of the symptoms. It also depends on the severity of your symptoms. Standard treatment options that your doctor will suggest include:
Antibiotics
A bacterial infection, such as H. pylori, may cause your symptoms. Your doctor can recommend a course of antibiotics to treat the infection.
Hydrochloric acid supplements and enzymes
Your doctor might recommend supplements such as betaine hydrochloride to help balance your stomach’s pH, and pepsin enzyme is another common treatment.
Changes in diet
Your doctor may advise consuming easily digestible foods rich in fibre and nutrients. They might also recommend supplements such as iron, zinc, calcium, and vitamin B complex. They could also recommend natural enzyme supplements with papaya and pineapple extracts to boost stomach acid production.
Changes in medication
Medicines such as proton pump inhibitors and antacids can reduce stomach acid. Your doctor may consider adjusting your medication. Herbs such as peppermint and gentian might aid digestion and help increase stomach acid production. It is also essential to minimize stress and ensure you get enough exercise and sleep.
Living with:
Diet alone cannot restore your stomach acid, but these tips can enhance digestion in cases of hypochlorhydria: Prioritize eating protein before drinking liquids. Include probiotic-rich foods, such as yogurt, miso, and sauerkraut, in your diet. Limit fatty and processed foods, as they are harder to digest and less nutritious. Boost your vegetarian intake by opting for smaller, more frequent meals and chewing thoroughly to aid digestion. Finish your last meal two to three hours before bedtime to ensure proper digestion before going to bed.
Frequently Asked Questions
What health conditions are linked to hypochlorhydria?
Several chronic health conditions are associated with low stomach acid, including lupus, asthma, thyroid problems, acne, psoriasis, eczema, gastritis, autoimmune disorders, osteoporosis, and pernicious anaemia.
How to prevent hypochlorhydria from happening?
Preventing hypochlorhydria requires maintaining a healthy lifestyle and proper dietary habits. Consuming a balanced diet rich in whole foods, vitamins, and minerals can help maintain optimal stomach acid levels. Good hygiene practices, such as thorough hand washing and adherence to food safety measures, help lower the risk of infections like H. pylori. Additionally, regular medical check-ups enable the early detection and management of potential health issues.
When should you see a doctor?
Although occasional bloating and stomach pain can cause discomfort, these symptoms usually resolve on their own over time. It is recommended that you seek immediate medical attention if you experience the following symptoms: blood in the stool or vomit, frequent vomiting, unintentional weight loss, difficulty swallowing or pain when swallowing, chest, jaw, neck, or arm pain, severe and persistent stomach pain, shortness of breath, sweating, jaundice, or yellowing of the eyes or skin.
Can you raise your stomach acid levels naturally?
Some studies show that you can naturally boost your stomach acid levels significantly. Your doctor might suggest trying HCL supplements, increasing zinc intake, taking probiotics, eating ginger (which has anti-inflammatory properties), limiting refined carbohydrate intake, and chewing food thoroughly.
How can you ease heartburn and acid reflux yourself?
Making simple lifestyle changes can help prevent or lessen heartburn. Consume smaller, more frequent meals, aim to lose weight if you’re overweight, and seek relaxation techniques. Stay away from foods or beverages that trigger your symptoms, avoid eating within 3 or 4 hours before bedtime, wear loose clothing around your waist, refrain from smoking, limit alcohol consumption, and do not stop taking prescribed medication without consulting your doctor first.
