The Overlooked MVP: Stomach Acid and Its Crucial Role In Health

You only have to turn on the TV for about 10 minutes to find a commercial talking about how stomach acid needs to be suppressed, and how easy it is to just pop a pill to take care of it.  

Almost 14 billion dollars is spent each year on PPIs (Proton Pump Inhibitors) in the US alone!₁

Proton Pump Inhibitors are used to reduce stomach acid secretion in the stomach by blocking an enzyme normally produced in the cells of the stomach that is responsible for releasing stomach acid, or hydrochloric acid (HCl).₂

But is there more to the story?  What IS the purpose of stomach acid? 

To begin with, stomach acid is one of the MVPs of digestion.  It’s key to getting the process of digestion started and to having robust gut health. It plays several important roles in our north-to-south digestive process.

Jonathan Wright, MD, author of “Why Stomach Acid is Good for You”(published in 2001), reports that the biggest factor in indigestion is not too much stomach acid, but too little.  I know this sounds contrary to what you have probably heard.  Let’s break this down.

The Importance of Stomach Acid

The stomach was designed to have a pH between 1.5 to 3 on the pH scale (0 is high acid and 14 is high alkaline). This acidic pH is important because it serves as the body’s protection against pathogenic organisms that can cause food poisoning, helicobacter pylori, fungi, parasites, and other infections that can stir up all kinds of digestive issues.

Stomach acid helps to break down our food, especially protein, so it can be digested and absorbed later on in the digestive process. We need protein to build muscle, enzymes, and hormones.

When we don’t produce enough stomach acid, the lower esophageal sphincter, which is like a “door” from the esophagus to the stomach, fails to close letting the stomach contents move back up into the esophagus, causing heartburn and reflux.  Even though the stomach acid is reduced, even small amounts are very irritating to the esophagus. 

Signs of Low Stomach Acid

Let’s explore some of the red flags or common signs that could be pointing to low stomach acid.  

• Acid reflux
• Heartburn
• Bloating
• Nausea
• Burping 1 hour after a meal
• Hoarseness
• Loss of taste for meat
• Constipation
• Feel extra full after meals
• Feel sleepy after meals
• Feel like skipping breakfast
• Nutritional deficiencies

Effects of Not Having Enough Stomach Acid

When stomach acid isn’t sufficient, our food stays in the stomach for longer than it should.  When this happens, undigested food will begin to putrefy and ferment which causes pressure and backflow into the esophagus.   This pressure can cause not only gas and bloating but can result in heartburn and acid reflux as well.  The tissue of the esophagus is not meant to be exposed to any amount of gastric juices. 

The next stage of digestion is also affected by not having enough stomach acid.  Food normally passes through the pyloric sphincter from the stomach into the small intestine where the majority of absorption happens.  However, when stomach acid is not sufficient, the food is kept in the stomach until the right conditions can occur.  Low stomach acid will affect the entire digestive process.

Limitations of Acid-Reducing Drugs

Although acid-reducing drugs suppress symptoms, they don’t address the root cause and they can create new problems over time.  They serve as band-aids, but long-term use may cause other issues, including kidney disease, cardiovascular disease, fractures, infections, nutritional deficiencies, and dementia.₃

PPIs can also decrease microbial diversity, even more so than antibiotics.₄

Symptoms like heartburn and acid reflux are for the majority of people, a result of too little stomach acid or hypochlorhydria.  We don’t have a Nexium deficiency, but a stomach acid deficiency.

I suffered from heartburn and acid reflux for years and even experienced it many times throughout my childhood.  I got to know Alka Seltzer and Tums from an early age.  I know it can be miserable! 

Some Tips for Supporting Stomach Acid and Overall Digestion

What can you do? Here are some steps you can take to start supporting the production and release of stomach acid:

• Work on getting into a parasympathetic, or relaxed mode, before meals especially. Take 5 to 10 deep breaths, and remove distractions like screens (cell phone, laptop, TV). When you’re stressed, you down-regulate the production of stomach acid and the action of digestion.
• About 15 minutes before a meal, add one TBS apple cider vinegar to a little bit of water, or the juice of a lemon to 4 oz warm water.
• Avoid large meals at night, and allow your body several hours to digest a meal before going to bed.
• You can also add a high-quality supplement like Earthley Digest-Support, Wise Woman Herbals Bitter Tonic, or their Bittersweet Elixir.  You can also add bitter foods like artichoke, dill, arugula, ginger, lemon or lime, grapefruit, and turmeric.
• Add a pinch of Celtic Sea salt or Redmond Real Salt to each glass of water. Stomach acid production requires several minerals for cofactors.
• Minimize how much water you drink with a meal. Try to keep it to 6 oz or less. When you drink more than this, you run the risk of diluting stomach acid too much.
• Eat foods high in zinc. Zinc is a cofactor for the protection of stomach acid. Some rich sources are oysters, pumpkin seeds, hemp seeds, and animal protein like beef.

A GI MAP stool test can be a very helpful tool in providing a wealth of information about the state of the microbiome, if any pathogens or parasites are present, H pylori, how well you are digesting food, plus much more.  You can read more about the GI MAP here.

Work with a gut health practitioner who can help you pinpoint the root causes of your symptoms, create a personalized plan and protocol to address the root causes, and support you along the path to optimizing your digestion. 

If this has been helpful, please share this article with someone who could benefit!

This is not medical advice.  This is for educational purposes only. Before making any changes, talk to your medical provider.

References:

1. Liu, L., Yu, Y., Fan, Q., Wu, Z., Li, X., & Luo, H. (2022). Impact of proton pump inhibitor management committee’s multifaceted interventions on acid suppressant prescribing patterns in outpatient and emergency departments. BMC health services research, 22(1), 417.
2.  Ahmed A, Clarke JO. Proton Pump Inhibitors (PPI) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
3. Maideen N. M. P. (2023). Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors. Chonnam medical journal, 59(2), 115–127.
4. Mohajeri, M. H., Brummer, R. J. M., Rastall, R. A., Weersma, R. K., Harmsen, H. J. M., Faas, M., & Eggersdorfer, M. (2018). The role of the microbiome for human health: from basic science to clinical applications. European journal of nutrition, 57(Suppl 1), 1–14.