All About Acid Reflux, GERD, Heartburn

As we age, stomach cells produce less acid, called Hydrochloric Acid (HCl). Certain medications can also lower stomach acid. This can affect our ability to digest protein, absorb minerals, and protect the body against food poisoning, H. pylori, parasites, and other infections. Low stomach acid is called hypochlorhydria.⁣

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Without enough stomach acid, we are more vulnerable to decreased immune resistance and a variety of other health problems such as overgrowth of bacteria in the small intestine. ⁣

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Functions of Gastric Acid 

  • Begins the process of protein digestion

  • Conversion or activation of pepsinogen to form pepsin - hydrolysis of protein

  • Bactericidal agent: breaks down unwanted microbes

  • Increases absorption of minerals: calcium, iron, and to a lesser extent zinc, magnesium, and copper


Having enough HCI is needed to absorb vitamin B12 and several minerals, such as iron, calcium, magnesium, zinc, and copper. Low acid in the stomach can also cause indigestion. The symptoms of having too little stomach acid often mimic those of having too much stomach acid and when people take an antacid or proton pump inhibitor (PPI) it further reduces already low stock a hormone acid creating a vicious cycle. ⁣

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What increases the Risk of Hypochlorhydria? 

  • Surgery

  • Autoimmune gastritis 

  • Aging 

  • Stress 

  • Fasting

  • H. pylori

  • PPIs, H2 blockers, and antacid abuse 

  • Severe iron deficiency

  • Viral or bacterial infection (fever) 

  • Chronic condition


Signs and Symptoms Suggestive of Low Stomach Acid 

  • Bloating or belching immediately following meal (15-20 minutes) 

  • Feel like food sits in stomach 

  • Sense of fullness after eating 

  • Flatulence

  • Dyspepsia 

  • GERD-like symptoms 

  • Morning diarrhea /diarrhea after big meals 

  • Constipation 

  • Nausea, vomiting 

  • Symptoms worse after eating meat or protein 

  • OR NO SYMPTOMS AT ALL 


Low Stomach Acid: Consequences 

  • Small Intestinal Bacterial Overgrowth  (S&Sx: carbohydrate intolerance + immediate bloating) 

  • Parasitic Infection 

  • H. pylori Infection 

  • Chronic Candida infections 

  • Iron deficiency

  • Other Mineral deficiencies (Ca, Mg, Zn, Fe, Cr, Mo, Mn, Cu)

  • Osteoporosis or anemias 

  • B12 deficiency (indirect)


SUPPORTING GASTRIC ACIDITY (supplements can be found on fullscript)

Betaine HCl tablets

  • with protein-containing meal - readily releases H+ ions to decrease pH, which acidifies the stomach

  • Bitters

    • Stimulates HCl production, enzymes, and bile

    • Acts as a carminative; stimulates appetite, stimulates peristalsis

    • Generally taken 30-60 drops before meals

  • L-glutamine

    • to enhance the repair and regeneration of the cells in the mucosal lining

  • deglycyrrhizinated licorice, marshmallow root, slippery elm bark and aloe vera leaf gel extract

    • provide an enhanced protective barrier over mucus membranes, soothe irritated tissues and restore normal inflammatory balance

  • Vinegar

    • can increase stomach acid levels because its acidic properties introduce more acid into the digestive tract.

  • Digestive enzymes with acid pH range

  • Stress management

  • Acupuncture


Let’s chat more about PPI’s.⁣

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Proton pump inhibitors (PPIs) are among the most frequently prescribed medications. PPI’s are often used for Helicobacter pylori infection, erosive esophagitis, gastric ulcers, and stress ulcer prevention in high-risk critically ill patients. The current evidence suggests PPIs are often overused with 25–70% of prescriptions having no appropriate indication.⁣

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PPI’s may alter the GI microbiome and create an environment susceptible to development of clostridium difficile and pneumonia.⁣

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Other possible risks with long term PPI use include dementia, drug interactions, chronic kidney disease.⁣

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PPIs suppress pepsinogen’s conversion to pepsin, limiting the ability to break down proteins efficiently. The resulting amino acid deficiency puts people at risk of malnutrition or even anxiety-type disorders from inadequate neurotransmitter production.⁣


*not medical advice, please consult with your provider.

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Tara Woodland