Many patients that have been diagnosed with acid reflux and/or gastroesophageal reflux disorder (GERD), a medical condition that involves the backflow of stomach acid into the esophagus, are prescribed proton pump inhibitors (PPIs). These medications act to block the production of stomach acid.
It seems logical to think that acid reflux and GERD are a result of having too much stomach acid. So, taking a medication to reduce stomach acid would make sense. However, is it possible that this line of thinking is too simplistic? Is the focus on the wrong problem? Let’s look at this situation a little differently.
The issue is most likely too little acid
Heartburn, a symptom of acid reflux and GERD, is usually not due to too much stomach acid, but actually too little stomach acid (1). How can low stomach acid levels be connected to acid reflux and GERD? One of the main functions of stomach acid is to digest carbs, fats and proteins. Without sufficient amounts of stomach acid, food cannot be broken down properly. As a consequence, poorly digested food remains in the stomach for a longer period of time. Carbohydrates begin to ferment and proteins begin to petrify. These chemical processes produce byproducts that can then backflow into the esophagus, causing heartburn sensations.
How to determine if you have low stomach acid levels
1. Medical testing - Doctors will often use symptoms and medical history to diagnose acid reflux and/or GERD, but remember that the diagnosis doesn’t necessarily mean your stomach is producing too much stomach acid. In fact, the opposite is probably true.
A more conclusive way for your doctor to know your stomach acid levels
would be to measure the pH of your stomach over a certain timeframe. This test is called The Heidelberg Stomach Acid Test.
2. At-home Betaine HCl Challenge Test - Betaine HCl is a supplement that helps to digest food and contains hydrochloric acid (HCl). HCl is a component of stomach acid, so taking this supplement would help to increase stomach acid levels. To gain insight into whether or not you have low stomach acid levels, you can use this supplement to do the Betaine HCL Challenge Test. You simply take one capsule right before your largest meal of the day. If you get a slight pain, or feel indigestion in your upper abdomen area, this means you probably have sufficient amounts of or too much stomach acid. However, if you do not feel any symptoms, then you probably have low levels of stomach acid.
3. Presence of other symptoms - In addition to heartburn, other symptoms that you may experience if you have low stomach acid levels include:
Bloating, cramping, burping
Feeling very full after eating, despite the size of meal
Burning sensation shortly after eating (anywhere between 15-40 minutes)
Constipation or diarrhea
Food sensitivities and/or allergies
Dry skin or hair
Undigested food in stools
What to do if you think you have low stomach acid levels
1. Supplements - Bitters and Betaine HCl are popular supplements to help increase stomach acid levels. Bitters is a liquid supplement that consists of a whole bunch of bitter tasting botanicals. It helps get your body ready to digest food by prompting the release of digestive juices, including stomach acid. As mentioned above, Betaine HCl is another supplement that can help raise stomach acid levels. The ideal dosage to take will be determined on an individual basis. It is highly recommended to work with a holistic nutritionist to help you find the supplement brand and dosage that works best for you.
2. BioEnergetic Intolerance Elimination (BIE) - This is a non-invasive technology that imprints the frequency of a particular substance onto the body, so that the body can re-recognize the substance. The theory is that during a period of high stress, your body may have lost its ability to properly recognize HCl (during a BIE session, muscle testing is used to determine if your body can or cannot recognize the frequency of HCl). The body has made a negative association between HCl and the stressful event. It thinks that HCl is the culprit of stress. By identifying HCl as something as “harmful,” the body is “reluctant” to produce and/or secrete adequate amounts of HCl, resulting in lower stomach acid levels. BIE simply gets your body to re-recognize the “identity” of HCl and gets your body “re-accustomed” to it, so that the body can produce/secrete it once again. BIE is particularly useful, especially when supplementation is not effective. If your body cannot recognize HCl, taking Betaine HCl supplements will actually make you feel worse!
3. Diet - Diet can be very helpful in managing acid reflux and GERD. Removing foods that are common triggers (alcohol, caffeine, greasy foods, spicy foods, and chocolate), while following a Mediterrean diet, which is high in healthy fats, fruits, vegetables, lean meats and nuts, has been scientifically proven to help patients with acid reflux (2).
The side effects of taking PPI meds
By focusing on the wrong issue and further lowering stomach acid levels with meds, there can be some serious health consequences including the increased risk of the following:
1. Bone fractures and osteoporosis (3)
2. Infections like C. difficile infection and infections that lead to pneumonia (4)
3. Having a heart attack and developing heart disease (5)
4. Developing chronic kidney disease (6)
Managing your acid reflux and GERD through diet modifications, supplementation, and/or BIE may be great options for you to consider. By getting to the cause of your heartburn now may help you avoid further health issues down the road.
If you are experiencing acid reflux, book a complimentary 15 minute meet and greet to learn more about how a personalized protocol with BIE, diet and supplementation can help you!
Want to learn more?
Jennifer Ide is a BIE Practitioner and Holistic Nutritionist, based in Toronto. She has helped many people with eczema, acne and hives, heal their skin naturally. She is here to support you and answer any questions that you have. There are many ways to connect. You can email directly (hyperlink to email), send a message on instagram @jenniferide, or book a free meet-and-greet. Connect and see how she can help you!
Mercola, J. (2018). Acid Reflux May Respond Better to Foods Than Prescribed Pills. https://articles.mercola.com/sites/articles/archive/2018/01/03/acid-reflux-may-respond-better-to-foods.aspx. accessed July 1, 2020.
Zalvan, C.H. et al. (2017). A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux. JAMA Otolaryngol Head Neck Surg. 143, 1023-1029.
Khalili, H. et al. (2012). Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. BMJ. 344, e372.
Wei, L. et al. (2017). Acid-suppression medications and bacterial gastroenteritis: a population-based cohort study. BJCP. 83, 1298–1308.
Shah, N. H. et al. (2015). Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population. PLOS One. 10, e0124653.
Lazarus, B. et al. (2016). Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease. JAMA Intern Med. 176, 238-246.
Disclaimer: Note that content on this website is intended for informational purposes only, and is not intended as a substitute for the advice provided by your physician or other healthcare professional, nor is it meant to diagnose or treat a health problem, symptom or disease.