Every day, our stomach produces an average of 1.5 litres of gastric acid. It has a pH of 0.8 – 1.5. If we got this on our skin, it would get burned. Yet we are not normally conscious of this at all. Only when we are sick and vomit or when we experience heartburn or belching, are we reminded of this potent acid, and of course in TV ads advertising antacids and acid blockers (more on those later).
Stomach acid is produced by the parietal cells in the stomach. The stomach walls are lined with a thick layer of mucus that protects them from the acid. If the mucous thins enough, the stomach wall gets damaged. The result are painful stomach ulcers. It was once thought that these were caused by stress, but we now know that it is really infection with the bacterium Helicobacter pylori (H. pylori).
What does stomach acid do?
We need gastric acid for digestion, of course. Protein digestion begins in the stomach, pepsin, an enzyme activated by hydrochloric acid, cleaves protein molecules to increase their surface area, making them easier to digest by other proteases (protein-digesting enzymes) further down the digestive tract, in the duodenum. This is the function most of us are aware of, but stomach acid does much more.
Adequate levels of stomach acid also make sure that the stomach empties correctly. When it doesn’t do that, heartburn and belching may be the result.
It is also part of the immune system by creating a barrier function. Anything we ingest has to first part through the stomach, and most parasites, bacteria (including H. pylori), yeasts and moulds do not survive if we have good levels of stomach acid. Stomach acid helps protect us from food poisoning, and greater susceptibility to pneumonia is a side effect of acid blocking drugs.
The acidity of stomach acid aids mineral absorption, so you need it to make the most of the zinc, calcium, magnesium, iron, boron and other minerals you get from your diet. It also activates a chemical called ‘intrinsic factor’, which is required to activate vitamin B12.
Lastly, stomach acid affects the gut flora. Good bacterial thrive in the acidic environment of the upper intestine, bad bacteria don’t. If stomach acid levels are low, this changes and undesirable bacteria may get the upper hand (small intestinal bacterial overgrowth, SIBO). Symptoms can be bloating after eating, heartburn and belching.
What are the symptoms of hypochlorydria (low stomach acid)?
· bloating, belching, flatulence or heartburn immediately after meals
· feeling as if food sits in the stomach for hours after eating
· bloating in the upper digestive tract
· indigestion, diarrhoea or constipation
· multiple food allergies
· frequent food poisoning
· frequent colds and infections
· weak, peeling and cracked fingernails
· dilated blood vessels in the cheeks and nose (in non-alcoholics)
· iron deficiency
· undigested food in stools
What causes hypochlorydria?
Essentially, stomach acid is made from hydrogen atoms in very high concentration. The hydrogen is transported into the stomach by proton pumps, but it has the natural inclination to diffuse back to where they came from, which is prevented by the ‘tight junctions’ between the cells of the intestinal lining. If the tight junctions are compromised, hydrogen can escape and stomach acid production might be low as a result. Food intolerances and stress also play a role, if stomach acid is low, as does infection with the stomach bug 'Helicobacter pylori', which is known to cause stomach ulcers and potentially stomach cancer.
A common cause for low stomach acid is, however, the use of antacids and acid blockers (H2 blockers and proton pump inhibitors/PPI) even though, ironically, these are administered because stomach acid is perceived to be high. These drugs do relieve symptoms, which is why they seem to be working well, but in most cases it is not excess stomach acid that is causing the problem. Reflux may occur due to a weak sphincter muscle, the gateway between the stomach and oesophagus, which should only let food and drink in, but nothing out. It can be weakened by certain foods and drinks, particularly fizzy drinks, caffeinated drinks, citrus fruit (and citrus juices), tomatoes and tomato products, chocolate, and alcohol. Nicotine, too, can weaken sphincter tone.
What can you do?
Manage stress. Normalising your stress levels can go a long way to normalising your gastric acid levels, too.
Protect the gastro-oesophageal sphincter: If you frequently experience acid reflux, keep a food diary and monitor symptoms, especially with the foods listed above in mind.
Encourage stomach acid production using organic cider vinegar: Dilute 1 tbsp of vinegar in a large glass of water and take on an empty stomach.
Wean yourself of antacid drugs. There is no point trying to increase your stomach acid production while still taking these. If you are on prescription medication, you must discuss with your doctor how you can wean yourself off them safely. Don't just stop taking them - that could make the problem worse.
To find out how to carry out a simple home test for a rough indication of whether you are producing enough stomach acid, read tomorrow’s Nutrilicious News. It is not too late to subscribe.