A client recently asked for some help with explaining to friends and acquaintances more about how low stomach acid can cause acid reflux and other downstream dysfunctions in the body.
Hang on—LOW stomach acid can cause acid reflux?
If you’re new to this conversation, the answer is absolutely and resoundingly YES! In our practice we see people of ALL AGES suffering from this condition these days—even young children. Low stomach acid leads to poor digestion, reduced absorption of nutrients, and inefficient communications between organs and glands. If not addressed, these functional impairments lead to significant downstream effects in the entire body that can eventually take the form of diagnosed disease conditions.
We think of the stomach as the “gateway to health” because so much of our wellbeing depends on its functioning properly, especially when it comes to making enough digestive acid at the right times. But when we treat clients with acid reflux complaints, we don’t just slap them with a quick fix like over-the-counter antacids or acid-blocking PPIs (proton pump inhibitors) that will simply mask the symptoms of acid reflux.
Wherefore the burn?
We first need to investigate the causes, and for this we must look at the individual from a Whole Person perspective. In other words, we look at the bigger picture of what they eat, how they sleep, their energy levels, work and lifestyle patterns, health history, and other physiological indicators that could be contributing factors.
It’s never just one thing!
So what are some of the leading causes of low stomach acid (also known as hypochlorhydria)? Numerous scientific studies over the years have shown the following to be key factors:
Stress and trauma (suppresses acid production and digestive function)
Age (our bodies naturally tend to produce less stomach acid the older we become)
Dehydration (not drinking enough pure water daily—stomach acid is 99% water)
Alcohol (causes dehydration and suppresses digestive function)
Poor bile handling in the gallbladder leading to bile reflux (a common condition called NERD—not GERD—that accounts for 50-70% of acid reflux cases—and only 1 out of 5 people with NERD feel relief from acid blocking meds!)
Vitamin C deficiency
H. Pylori vicious circle (low stomach acid levels increase h. pylori levels and increased h. pylori levels decrease stomach acid levels)
Long-term use of acid-reducing or -blocking drugs, which further impair the body’s ability to produce stomach acid
Use of NSAID drugs like aspirin and ibuprofen
Mixing high protein, high fat foods with starches and sugars during a heavy late-evening meal, when stomach acid production is dropping off naturally for the day
Low salt diets or poor salt quality (the chloride component of salt is also a major ingredient in hydrochloric acid)
We're all affected
Anyone feeling stressed or a little older than last year? The fact is, 100% of us have experienced at least the top two causes of low stomach acid on the list above!
So why do so many people depend on antacids and acid blocking medications to treat “too much stomach acid”, when only a tiny fraction of people have been shown to produce an actual excess of stomach acid?
The main reason is probably because there is a long-established practice in the medical industry of using pharmaceutical agents to treat the unpleasant SYMPTOMS of acid reflux complaints. Familiar treatments include:
Antacids (like Tums)
Histamine-2 antagonists (like Pepcid AC or Zantac)
Acid-blocking proton pump inhibitors (PPIs like Nexium, Prilosec, or Prevacid)
But before we start popping drugs as a knee-jerk reaction to acid reflux, we really need to ask:
WHY is this reflux happening in the first place (see list above)? And,
HOW can we change the underlying conditions to stop it from recurring without relying on medications that come with a laundry list of side-effects?
While these medications and over-the-counter drugs do, in fact, reduce the reflux symptoms and acid levels in the stomach and GI tract, they don’t solve the root problem by addressing the causes of LOW stomach acid. In fact, there is mounting scientific evidence that acid-stopping drugs can make the problem worse by causing more downsides to the body than benefits, such as:
Raising toxic aluminum levels in the body, especially in the brain and small intestinal lining (aluminum is an active ingredient in antacids and PPIs)
Increasing c. difficile infections
Causing gastric cancers
Decreasing digestive function (lower absorption, assimilation, and conversion of nutrients)
Reducing bioavailable forms of essential minerals like calcium and zinc, and lettered vitamins like A, D, E, K, C, and B vitamins
The GOOD NEWS
The good news is that about 99% of us can eliminate acid reflux symptoms simply through basic dietary and lifestyle changes, along with appropriate use of stomach acid supplements. Fewer than 1% of people have been found to suffer from true acid-excess conditions, such as Zollinger-Ellison Syndrome.
If you suffer from acid reflux, GERD, or even NERD (non-erosive reflux disease), there is so much you can do to reverse this condition in a gentle, sustainable way that is free of dangerous long-term side effects.
You can start by reducing the low acid factors listed above.
Like anything done at the body’s natural pace, it takes TIME for the acid reflux condition to heal. It also helps to have a qualified practitioner to GUIDE you along the way when things become a little rough or confusing.
But don’t give up hope! Even if you have been using these acid-stopping meds for years, you can still restore your natural stomach function and put an end to reflux and horrific side-effects of acid-stoppers!
The Power of Water (which also has zero side effects)
If you have acid reflux, you might consider just taking a drink of water regularly throughout the day. Water alone has been shown in some studies to be as much as 175 times more effective at reducing stomach acidity that certain antacid drugs.
In fact, one study showed that a 6.5 oz/200 ml glass of water has been demonstrated to change acid levels by raising stomach pH above 4.0 in 1 minute or less, whereas some drugs required anywhere from 50-175 minutes to achieve the same effect! And water has NO SIDE EFFECTS!
(Source: A glass of water immediately increases gastric pH in healthy subjects. Dig Dis Sci. 2008 Dec;53(12):3128-32. Epub 2008 May 13. PMID: 18473176).
TIP: Try to drink some water about 30 minutes before and after eating, but avoid drinking too much liquid during the meal time. Water during the meal time can dilute the much-needed stomach acid. Remember, the majority of acid reflux is caused by low stomach acid, not too much acid, so you want to avoid diluting the precious acid you do have in your stomach. If you are thirsty during your meals, we recommend you chew your food more, and drink only about 4-6 oz of water instead of ordering a tall glass of water with ice (this goes for other beverages as well).