Is It Acid Reflux?

by Dr. Alicia McComas, ND

If you’ve been struggling with persistent heartburn and were diagnosed with acid reflux, you’re not alone—this is one of the most common conclusions drawn in Western medicine. The usual fix? A prescription for proton pump inhibitors (PPIs) to suppress stomach acid production. While these medications may provide quick relief, they often come with long-term health consequences and fail to address the root cause of the problem. In fact, what if your symptoms weren’t caused by excess stomach acid at all? Many cases of heartburn could actually be the result of too little stomach acid, a condition called hypochlorhydria. Unfortunately, hypochlorhydria is often overlooked, and the one-size-fits-all approach to heartburn treatment may leave this underlying issue undiagnosed and untreated. Let’s take a closer look.

Hypochlorhydria: What Happens When You Don't Have Enough Stomach Acid

Many people think stomach acid is the villain, but here’s the real story: you need stomach acid! When there isn’t enough of it, a condition called hypochlorhydria, a whole set of problems can start to unfold in your body. Let's talk about why hypochlorhydria can happen, especially with aging, stress, or certain medications, and what it means for your health. Then, I'll walk you through some ways naturopathic medicine can help.

What Causes Hypochlorhydria?

1. Aging: As we get older, our bodies naturally slow down in some areas, and that includes producing stomach acid. For people over 60, stomach acid levels can drop significantly, leaving them at risk for hypochlorhydria.

2. Stress: Ever feel your stomach twist up when you're stressed? There’s a reason for that! Stress affects digestion, and the constant release of stress hormones, especially cortisol, can reduce stomach acid production. Stress also messes with how well we break down food, so if you’re always feeling “stuck” in your stomach, stress could be a part of the picture.

3. Medications: Certain medications, especially proton pump inhibitors (PPIs), which reduce acid, can contribute to hypochlorhydria when taken long-term. It’s often worth exploring other options with a healthcare provider to avoid unnecessary reliance on PPIs. Other drugs, like certain painkillers or antibiotics, can also interfere with acid levels.

Why Hypochlorhydria Is a Problem

Stomach acid helps us digest food, absorb nutrients, and kill harmful bacteria that might come along with our meals. When we don’t have enough, a lot can go wrong:

• Poor Digestion and Absorption: Low stomach acid means protein and other nutrients aren’t broken down properly, leading to deficiencies in important vitamins and minerals like B12, calcium, and magnesium. This can contribute to weak bones, fatigue, and even problems with mood or mental clarity.

• Increased Risk of Infection: Stomach acid acts as a defense barrier against harmful bacteria. With low levels, you’re more at risk for intestinal infections and digestive issues.

• Small Intestinal Bacterial Overgrowth (SIBO): Stomach acid not only kills harmful bacteria but also prevents excessive bacterial growth in the small intestine. When stomach acid is low, bacteria that would normally stay in the colon can migrate into the small intestine, leading to a condition called SIBO. SIBO can cause gas, bloating, malnutrition, and other digestive discomforts.

• Increased Food Sensitivities: Without enough stomach acid, your body may start to see undigested proteins as threats, which can trigger food sensitivities or allergies. These sensitivities can lead to inflammation in the gut and, over time, may cause more serious digestive issues.

Naturopathic Approaches to Boosting Stomach Acid

If you’re dealing with hypochlorhydria, there are several naturopathic strategies to help get things back on track. Here are a few simple, holistic approaches to support stomach acid production and overall digestive health:

1. Mindful Eating and Stress Management: Take time to relax before eating. Practicing deep breathing, gratitude for your food, or taking a few quiet moments before your meal can activate your body’s parasympathetic system, which is essential for proper digestion.

2. Bitters: Herbal bitters like gentian, dandelion root, or burdock root can naturally stimulate stomach acid production. Taking a few drops of these bitters before meals helps signal your digestive system to get ready to process food.

3. Apple Cider Vinegar (ACV): A small amount of ACV before meals can help boost stomach acidity. Try mixing a tablespoon of ACV with a little water and drinking it before meals. Start with a small amount to see how your body reacts.

4. Betaine HCl Supplements: This supplement can temporarily increase stomach acid and help with digestion, especially when taken with protein-heavy meals. 

5. Whole Foods Diet: A balanced, whole foods diet that includes proteins, healthy fats, and a variety of fruits and vegetables will give your body the nutrients it needs to support proper digestion. Avoiding processed foods and eating foods rich in zinc (like pumpkin seeds and shellfish) and B vitamins (like leafy greens and eggs) can also help with stomach acid production.

6. Addressing Underlying Issues: Sometimes, hypochlorhydria can be a side effect of an underlying issue, like thyroid problems, so it’s important to get a complete health picture. Working with a naturopathic doctor can help identify and address these root causes rather than just masking symptoms.

Takeaways

Hypochlorhydria might sound like a complicated term, but it really just means your body isn’t making enough stomach acid. And while that might not seem like a big deal at first, low stomach acid can lead to some frustrating health problems. Whether it’s due to aging, stress, or medications, understanding the root cause is key to finding the right solution.

With the right combination of mindful practices, herbs, and a good diet, you can support your stomach acid levels and keep your digestive health on track. Remember, our digestive system is truly at the core of our overall well-being, and small changes can make a big difference.

References:

• Akhondi, H., & Burns, M. M. (2023). Gastric Acid Secretion Physiology. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK532886/

• Reimer, C., & Bytzer, P. (2010). “Adverse effects of long-term proton pump inhibitor therapy.”Alimentary Pharmacology & Therapeutics, 32(1), 1-2.

• Ghoshal, U. C., et al. (2017). “Small intestinal bacterial overgrowth and its relationship with irritable bowel syndrome: A systematic review and meta-analysis.” Indian Journal of Gastroenterology, 36(1), 3-15.

• Fock, K. M., et al. (2008). “Proton pump inhibitors: Risks and benefits.” Journal of Gastroenterology and Hepatology, 23(S2), S39-S48.

• Wilder-Smith, C. H., et al. (2009). “Gastric acid secretion and healing of reflux esophagitis with esomeprazole.” Digestive Diseases and Sciences, 54(3), 583-591.