"Stomach acid plays a critical role in digestion, and maintaining the right pH is essential. Low stomach acid can weaken the lower esophageal sphincter, contributing to acid reflux and other digestive problems" ― Anonymous
Introduction | Causes| Hidden Risks | GERD | Heartburn | Antacids & PPIs | Natural Approaches | Medical Support | Final Thoughts | Takeaway Points | References | Disclaimer
Introduction
Acid reflux is a fairly common ailment that, on one or more occasions, happens to most people. Its more severe form, gastroesophageal reflux disease (GERD), affects approximately 13.3% of the global population, which equates to about 1 in 7 individuals [1]. Both of these health complaints are believed to be caused by excessive production of stomach acid. However, counterintuitively, the problem of stomach contents backing up to the throat is due to too little gastric acid and the relaxed state of the LES muscle. This article delves into the real causes of acid reflux and GERD, offering practical strategies to better manage gastric health.
What Causes Acid Reflux?
Acid reflux occurs when the acid, which typically is found in your stomach, travels up your digestive tract into the esophagus and throat. At the opening to your stomach lies a valve known as the lower esophageal sphincter (LES). This muscle, when functioning properly, prevents the contents of your stomach from moving up. However, under certain circumstances, LES may not close fully or open too frequently and lead to acid reflux.
People commonly attribute acid reflux to having too much stomach acid. However, studies have linked more cases of acid reflux to lower stomach acid levels, also known as hypochlorhydria[2][3]. This suggests that impaired gastric acid secretion causes the LES to malfunction.
The most common causes and factors behind low levels of gastric acid in the stomach include:
Chronic Stress: Prolonged stress can disrupt digestion and lower stomach acid secretion[4][5].
Poor Diet: Diets high in processed foods and sugar and low in essential nutrients can impair stomach acid production[6][7].
Excessive Fluid Intake During Meals: Drinking too much water or carbonated beverages, particularly during meals, can dilute stomach acid, disrupting digestion. The decrease in acidity it causes can weaken the lower esophageal sphincter (LES), causing improper closure and increasing the risk of acid reflux.
Helicobacter pylori Infection: This bacteria can damage the stomach lining and reduce acid secretion[8][9].
Medications: Overuse of antacids, proton pump inhibitors (PPIs), or H2 blockers suppresses acid production[10][11].
Nutrient Deficiencies: Deficiencies in zinc, B vitamins (especially B1), and magnesium can impair stomach acid production[12][13].
Autoimmune Conditions: Conditions like autoimmune gastritis can attack stomach cells responsible for acid production[14][15].
Alcohol Consumption: Excessive alcohol intake can damage stomach cells and decrease acid production[16][17].
Hypothyroidism: An underactive thyroid can slow metabolism and digestive processes, including acid production[18][19].
In conclusion, the occurrence of acid reflux is caused by low stomach acid. However, to better address and treat it, we need to understand the causes of this condition. Hypochlorydria and, as a consequence, acid reflux are both symptoms of other underlying health issues, an improper lifestyle, or both.
The Hidden Risks of Too Little Stomach Acid
Acid reflux is not the only side effect of having low stomach acid. This health condition affects our bodies in ways that go beyond the unpleasant sensations. There are a variety of hidden risks associated with improper gastric secretion[20][21][22], including:
Undigested Food and Gas Formation: When stomach acid levels are low, food is not properly digested, resulting in fermentation, gas buildup, and reflux.
Nutritional Deficiencies: Low stomach acid inhibits the absorption of essential nutrients such as potassium, magnesium, vitamin B12, zinc, iron, and calcium, which can result in fatigue, brittle bones, muscle cramps, slow wound healing, hair loss, anemia, or arrhythmias.
Increased Risk of H. pylori and Ulcers: An acid-deficient stomach promotes the growth of H. pylori, a bacteria associated with ulcers and chronic inflammation.
Increases Risk of SIBO: Low levels of stomach acid can contribute to the overgrowth of harmful pathogens in the small intestine, leading to SIBO and consequently to nutrient malabsorption, gas, and bloating.
Weakened Immunity: Stomach acid is essential for killing harmful pathogens. Low levels weaken the immune system, raising the risk of infection.
These hidden risks highlight the importance of stomach acid for overall health, which extends far beyond its role in digestion. When gastric acid secretion is impaired, the digestive system's delicate balance is disrupted, which can contribute to or exacerbate conditions such as gastroesophageal reflux disease. Understanding how low stomach acid affects GERD is essential for treating this common but often misunderstood condition.
How Acid Reflux Progresses to GERD
In comparison to acid reflux, gastroesophageal reflux disease, also known as GERD, is a chronic health problem. It is characterized by persistent heartburn, regurgitation, and esophageal damage[23][24]. The undigested food and gas that form in the stomach cause the LES to remain open. This prolonged relaxation of the LES allows stomach acid to repeatedly enter the esophagus, which irritates its lining over time. When left untreated, GERD may lead to more serious complications such as inflammation (esophagitis), esophageal narrowing (strictures), and even precancerous changes known as Barrett's esophagus[25]. Furthermore, antacids cannot easily alleviate GERD. This over-the-counter go-to remedy for acid reflux does not bring lasting relief from GERD. One of the most common and recognizable symptoms of acid reflux and GERD is heartburn, which often serves as an early warning sign of underlying digestive issues.
Heartburn: A Common Symptom with Bigger Implications
Heartburn is a common symptom of both occasional acid reflux and chronic GERD. This burning sensation in the chest and throat is frequently the first indication of digestive issues and problems with stomach acid secretion. The frequency and severity of the symptoms determine whether acid reflux or GERD is present.
Heartburn is at its most severe after eating or lying down. Aside from the burning sensation, it can also leave an acidic or bitter taste in the mouth. Sometimes, people misdiagnose severe heartburn as a heart attack. The chest pain it causes can be so severe that only a medical examination can distinguish them.
Why Can Acid-Suppressing Medications Worsen the Problem?
The most common medications used for acid reflux are over-the-counter antacids and prescription proton pump inhibitors (PPIs). Both of them help mitigate the unpleasant effects of reflux but in different ways:
Antacids contain alkaline compounds, such as magnesium hydroxide, calcium carbonate, or aluminum hydroxide. Their main purpose is to raise the pH of the stomach acid to more alkaline, thereby reducing reflux.
PPIs, on the other hand, block the enzymes (proton pumps) of the stomach lining's cells. In that way, they inhibit stomach acid secretion.
However, these approaches only treat the symptoms of acid reflux rather than the underlying cause. None of them address the problem of low stomach acid. In fact, PPIs make stomach acid production even lower, while antacids make hydrochloric acid less acidic, which stops it from doing its job of digesting food. These methods of managing gastric acid do not restore the LES' proper function or improve acid secretion. Long-term, both approaches may contribute to nutrient deficiencies, increased infection risk, and immune system weakness.
Natural Approaches to Manage Acid Reflux and GERD
Natural approaches to managing acid reflux and GERD[26][27][28] focus mainly on supporting proper digestion through a variety of ways. They highlight the importance of healthy nutrition, stress reduction, quitting smoking and the use of natural digestive aids.
Nutrition: Proper nutrition plays a key role in how our body functions, including the digestive tract. A whole-foods-based diet that includes a large variety of fresh vegetables, fruits, meat, fish, and whole grains is a key component. Sufficient protein intake is especially important, as the body needs amino acids to produce stomach acid, which is essential for proper digestion and preventing reflux. Eliminating processed and fast foods, sugar, and soft drinks; limiting alcohol; and maintaining proper hydration all contribute to better digestion.
Stress: Chronic stress makes the esophagus lining and digestive tract swell, lowers stomach acid production, slows gastric emptying, weakens the LES, and makes it harder for the body to heal and maintain these areas. Therefore, resolving the underlying cause of our daily stress is essential for GERD and acid reflux. Methods such as meditation, mindfulness, yoga, and breathing techniques can help reduce the effects of stress on our bodies.
Smoking: Quitting smoking promotes better LES function and saliva production. Saliva serves as a neutralizing agent for stomach acid and helps clear it from the esophagus. Furthermore, smokers are at increased risk of delayed gastric emptying than nonsmokers.
Natural Digestive Aids: One of the best natural compounds for acid reflux is apple cider vinegar. It strengthens the acidity of the stomach and improves digestion. Additionally, bitter herbs such as dandelion, gentian, and artichoke can stimulate digestive secretions and improve stomach acid production.
Supplements: Supplementing with zinc and B vitamins, particularly B1 and B6, supports digestion and helps maintain healthy stomach lining and acid levels. Also, elements such as digestive enzymes[29] and betaine HCl[30] promote efficient digestion. Mind that betaine HCl should be taken under doctoral supervision, since its dosing needs to be carefully adjusted based on individual stomach acid levels to avoid irritation or excessive acidity.
All of these approaches play fundamental roles in preventing and diminishing the frequency of acid reflux. Adjusting our lifestyles to accommodate healthy digestion and gut health is paramount in the combat of GERD. Mindful eating practices, proper chewing of our food, not drinking water with the meals but between them, and avoiding foods that are triggers to our digestive problems can alone make a difference in how our bodies handle gastric acid secretion. While these changes can lead to significant improvements in how we feel, there are cases—especially chronic conditions—where additional medical attention may be necessary.
When to Seek Medical Help
Acid reflux can be a standalone condition, but it can also be a symptom of deeper and more dangerous health problems. If, despite lifestyle changes and your approach to treating acid reflux, you do not see any improvement or your symptoms worsen, you should consult a doctor to rule out more serious conditions.
Final Thoughts
Managing acid reflux can be done very effectively with the implementation of natural holistic methods. If acid reflux is a result of our improper lifestyle and dietary choices, changing those can bring relief and improve the quality of life fairly quickly. Prioritizing a balanced whole-foods diet, hydration, stress management, and reducing nicotine and alcohol consumption are viable practices for restoring gastric health. If these strategies do not produce results and improvement, it may be necessary to consult a physician to rule out more serious health conditions for which acid reflux is symptomatic.
Takeaway Points
Acid reflux happens when stomach acid flows into the esophagus due to a weak lower esophageal sphincter (LES), often caused by low stomach acid.
Low stomach acid can result from chronic stress, poor diet, nutrient deficiencies, medications, or certain medical conditions.
Insufficient stomach acid leads to undigested food, nutrient deficiencies, bacterial overgrowth, and a weakened immune system.
Frequent acid reflux can progress to GERD, causing persistent symptoms and esophageal damage that antacids can’t fix.
Lifestyle changes like a healthy diet, stress management, quitting smoking, and digestive aids can reduce acid reflux.
Persistent or worsening symptoms may indicate a serious condition and should be evaluated by a doctor.
References
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