The festive period is a time where many overindulge and for some heartburn or indigestion may well be a problem. Sadly, manufacturers and advertising campanies have brainwashed us into believing that it is ok to eat whatever we want with no consequences, as long as we can pop an acid-blocking pill after our meals.
During my time in clinic, I have seen more clients on proton pump inhibitors (PPIs) than any other medication! Proton pump inhibitors such as Omeprazole, Lansoprazole, Pantoprazole, Nexium, etc. are most commonly prescribed to treat heartburn and acid-related disorders, such as gastroesophagael reflux disease (GERD). Consequently, they are the fourth most popular drug prescribed today!
So how does PPIs work?
PPIs work by blocking the site of acid production in the parietal cells of the stomach. If used for the suggested period of 4 to 8 weeks, PPIs can be incredibly effective at achieving the intended outcomes. Sadly, prescriptions are not managed well and most of the clients I see have been using PPIs for months if not years!
I genuinely believe that we can avoid the use of PPIs in the large majority of cases simply by addressing the root cause.
Your stomach needs acid!
The problem is that your stomach actually needs acid to stay healthy. In other words you need acid to keep bacteria away, activate digestive enzymes, digest protein and food and help absorb important nutrients like vitamin B12 and magnesium.
Functions of stomach acid/hydrochloric acid (HCL):
- First line of defence against ingested microbes/pathogens (bacteria, yeast, fungus found in food & the environment)
- Stimulate the production of bile and pancreatic juices (needed to break down food into smaller parts for absorption)
- Denature and digest proteins
- Absorb Vitamin B12
- Needed for the absorption of Most B vitamins
- Absorb Magnesium (but magnesium also needed for HCL production!)
- Support the absorption of other minerals such as iron, zinc, copper and calcium
What is the impact of using acid-blocking medications such as PPIs?
Taking these medications can impact your digestion and lead to vitamin and mineral deficiencies. Above all it can lead to bigger complications such as irritable bowel disease, anaemia, fatigue, nerve damage, hip fractures, osteoporosis, depression and even dementia. In addition it can also lead to an overgrowth of clostridium difficile, which can lead to life-threatening infections.
Longterm use has also been associated with kidney disease, increased mortality and pneumonia in older patients.
Unfortunately, your doctor will not test your stomach acid levels. Instead you might receive a prescription for a PPI when in-fact you are actually suffering from hypochlorhydria, insufficient/low stomach acid.
How do you know if you have too little or too much stomach acid?
Very often people with low stomach acid end up on acid-blocking medication because the symptoms that they present with can easily be confused for excess stomach acid.
Signs of low stomach acid
- Bloating, belching, burning and flatulence immediately after meals
- A sense of fullness after eating
- Burping/wind after meals
- Upper digestive tract gassiness
- Indigestion/heartburn/acid-reflux (yep!)
- Itching around the rectum
- Dilated blood vessels in the cheeks
- Chronic candida infections
- Nausea after taking supplements
- Iron deficiency
- Magnesium deficiency
- B12 deficiency
- Nutrient deficiency
- Weak, peeling and cracked fingernails
- Hair loss
- Protein deficiency
- Numbness and tingling
- Undigested food in stool
- Gastrointestinal infections
- Small Intestinal Bacterial Overgrowth (SIBO)
- Multiple food allergies
- Desire to eat when not hungry
Health conditions associated with low stomach acid:
- Autoimmune conditions
- Food intolerances
- Gallbladder Disease
- Hormonal Imbalance
- Irritable Bowel Syndrome (IBS)
- Pernicious Anaemia
- Psoriasis (an autoimmune condition)
- Small Intestinal Bacterial Overgrowth (SIBO)
- Thyroid issues
Excess Stomach Acid
Signs of excess stomach acid:
- Burning sensation immediately after eating
- Upper abdominal pain
- Frequent heartburn along with sour taste in mouth
- Vomiting (green-yellow fluid)
- Unintended weight loss
Triggers for high stomach acid
- Caffeine is known to encourage acid reflux
- Carbonated drinks
- Chocolate (I feel your pain)
- Alcohol (relaxes the stomach sphincter, which can exacerbate symptoms)
- Fried foods
- Citrus fruits
- Peppermint – despite having a reputation for soothing the stomach it can actually worsen reflux
- Being overweight
- Eating close to going to bed at night
- The standard American diet (SAD) that is high in refined and processed foods
If you are still unsure, I suggest that you consider doing the following test at home. This will give some indication and is a great starting point.
Stomach Acid Test
Upon waking, before drinking, eating or brushing your teeth:
- Add 1/8 tsp bicarbonate of soda to 100ml lukewarm water
- Mix and drink
You are looking to see how long it takes to produce wind. Don’t expect a massive belch, but just some wind moving up from your stomach. Note down the time it takes. Optimal burp time is between 1-2 minutes.
- Burping before 1 minute can indicate too much stomach acid
- Between 2-3 minutes slightly low stomach acid
- Between 3-5 minutes low stomach acid
- Anything after 5 minutes can indicate very low/no stomach acid
What to do next?
If your stomach acid levels are healthy (between 1 – 2 minutes), then continue to work on optimising them. To achieve this focus on the following key areas:
- Eat a varied and balanced diet with little/no processed foods
- Manage stress (as this can impact your stomach acid)
- Exercise in moderation (excessive exercise can negatively impact your stomach acid)
- Manage your weight as excess weight can make things worse
- Avoid food three hours before going to bed
If your levels are high (you burped before 1 minute was up), then consider the following:
- All of the above
- Limit acid-producing foods (caffeine, chocolate, tomatoes, alcohol, spicy foods etc. as mentioned earlier)
- Eat smaller, more frequent meals, at least 4 to 5 times a day
- Sit upright whilst eating
- Include stomach acid-neutralising foods, such as:
- Natural Yoghurt (no added sugar)
- Lots of green and alkalising vegetables
Ideally, you want to get this addressed as insufficient stomach acid can have significant long-term implications as already discussed. The best way to address this is to work with a qualified Nutritional Therapist or Functional Medicine practitioner, who will guide you through the different stages to reset your stomach acid. I have personally experienced just how easy it is to damage your gut if not done with the correct supervision and guidance, it took me years to fix!
I would say that around 85% of my clients have low stomach acid and as a result present with parasites, yeast, fungal infections and/or dysbiosis.
The following suggestions may be helpful.
- Start your day with 1 tbsp of apple cider vinegar with the MOTHER in a glass of water. I suggest using a metal straw to drink this with to avoid damaging your teeth
- Chew your food really well
- Add ginger to your food/smoothies/soups
- Add fermented foods (not suitable if you have issues with histamine)
- Take a digestive enzyme with each meal
- Use pre- and probiotics to rebalance the good bacteria in your gut
- Consider glutamine powder to help with healing the lining of the gut. Please make sure to avoid if you have problems with your kidneys or cancer.
- Chew a few Deglycyrrhizinated liquorice (DGL) chewable tablets 15-minutes before meals
- Try using Magnesium citrate/glycinate twice a day as this is needed to make HCL
- Add in a zinc supplement. Something like Zinc carnosine is really effective.
Looking after your gut health is one of the most important things you can do. Ensuring good stomach acid levels is the very first place to start.
Happy Wellness Wednesday all.