Most people think that indigestion, reflux and stomach pain after meals are due to over-acidity of the stomach. In a vast majority of cases, this is not true. What most people suffer from today is what is called “hypochlorhydria” which is insufficient hydrochloric acid secreted from the stomach in response to meals.

Why are adequate stomach acid levels so important?

Apart from feeling comfortable after and in between meals, hydrochloric acid (that is stomach acid) serves many purposes. First of all, it is the first line of defence between the outside world (any potential bacteria ingested) and the gastrointestinal system.

Low stomach acid does not offer adequate protection. A potential infection can lead to a lot more gut issues and an imbalance in the gut flora that can further disrupt the stomach’s delicate balance. By killing pathogenic bacteria, our stomach acid is responsible for proper immune function. This is because 80% of our immune system is found lower down, in our gut.

Stomach acid is also responsible for breaking down proteins into smaller molecules, called amino acids. Proteins cannot be digested and absorbed in the form we consume them. They need to be broken down very well by the stomach (after good mastication of course!).

Stomach acid is also responsible for vitamin B12 absorption. Compromised stomach function, like in older age, can lead to serious vitamin B12 deficiency. Many of my clients that suffer chronically from reflux and indigestion score low on the B12 blood test.

Finally, hydrochloric acid breaks down essential health minerals like calcium, magnesium and iron. 80% of the population today is deficient in magnesium.

Adequate stomach acid is required to break down protein, especially animal-based sources like meat, fish, seafood and dairy. Many people who have low stomach acid complain of feeling heavy after meals (especially protein-rich meals) and even lose their desire to eat meat.

What are other symptoms of low stomach acid?

• acid reflux and heartburn
• uncomfortable fullness after eating
• burping and bloating
• a sore/hoarse throat or cough on waking
• nausea and dizziness
• undigested food seen in stool
• bacteria overgrowth (this can be identified by a comprehensive microbiome analysis)
• bloating, gas
• a metallic taste in the mouth
• mineral deficiencies (can be identified by taking a comprehensive case history and running a nutritional profile blood/urine test)
• brittle hair and nails (due to low mineral and amino acid levels)
• poor immunity and frequent illness
• food intolerances and sensitivities
• intestinal permeability (“leaky gut”)
• IBS and SIBO
• slow gut motility that can lead to constipation (some people have diarrhoea as a result)
• acne and rosacea
• nasal polyps (silent reflux)

What contributes to low stomach acid in the first place?

Chronic intake of antacids and PPIs

While most people think that antacids can help reduce bothersome symptoms, in the long term, they make symptoms worse. Antacids block hydrochloric secretion, the body as a reaction will produce more and more antacids will be needed. In addition, antacids often lead to bloating and flatulence.

They also block mineral absorption (calcium, magnesium) and weaken bones. Long-term use can lead to kidney stones. Antacids should not be used on a regular basis. There are many natural alternatives to ease the symptoms while addressing the root cause.

Stress

Stress can weaken the oesophageal or cardiac sphincter (found between the stomach and the oesophagus) letting acids secreted from the stomach reach the oesophagus and mouth.

Other medications, like chronic use of NSAIDs, antibiotics and oral contraceptive pills

They all affect the gut flora with subsequent consequences on stomach function.

Eating too quickly and too much

It is recommended to eat until 80% full. If you are eating too fast or mindlessly, you will find yourself too full when it’s too late.

Insufficient chewing

You should chew your food until it becomes really mushy. Your stomach doesn’t have teeth. Undigested foods and proteins irritate the gut and are not absorbed properly. Start by counting 20 chews for each bite!

Low mineral intake

An imbalance in electrolytes can lead to imbalanced stomach acid secretion. Zinc and sea salt can really help.

Low salt intake

There is nothing wrong with authentic, unprocessed salt like sea salt and original Himalayan salt (Pakistan). You can add salt to your meals freely. The problem is with processed supermarket and processed foods/restaurants salt (or else called sodium chloride, devoid of all other minerals).

Too many fluids with meals

If you have a sensitive stomach, it is preferable to have your water or other drink at least half an hour or one to two hours after your meals.

Past history of vegan or vegetarian diets

Mainly because of the consumption of lots of foods that contain anti-nutrients and lack of essential nutrients.

The vicious cycle 

The problem is that low stomach acid can lead people to eat less protein (because they have a hard time digesting it, which further leads to lower stomach acid).

How to support adequate stomach acid 

• Slowly increase protein intake. When it comes to animal protein, aim to get a slow cooker. Meats will be much more digestible. Avoid hard-boiled eggs.
• Practice mindfulness around meals – We will help you with lots of great and easy-to-implement ideas.
• Deep breath before meals. There is a specific type of breathing that I find really helpful. It can be really short.
• Minimise cold fluids around meals.
• Increase zinc-rich foods (oysters, beef, lamb, pumpkin seeds)
• Add sea salt to your meals.
• Sip on warm bone broth or ginger tea with or between meals.
• Avoid soups later in the day.
• Add digestive bitters with meals – we will give you a list of bitter foods to include in your diet and if needed a tincture of appropriate herbs.
• Add small amounts of fermented foods with meals, like unpasteurised sauerkraut, kimchi, natto, beet kvass, olives in brine, capers, and pickles.

My favourite types of protein 

• collagen/ gelatin (of a good brand)
• bone broth (home-made or 24h store-bought)
• eggs (pasture-raised)
• fish/ seafood
• white and red meat (chicken, turkey, venison, wild game, beef, bison, elk, lamb, goat)
• organ meats
• organic yoghurt (goat or sheep is best)
• organic cottage cheese in moderation (probiotics)