Here’s something that I often hear about. Someone struggles with a burning sensation in the chest that often occurs after meals and might get worse when lying down or bending over. For quick relief, they turn to antacids. It seems logical – that burning feeling must mean there’s too much acid, right?

If this is a one-off occurrence, then that might be the case. But if you’re reaching for the antacids on a regular basis, it may indicate not too much stomach acid, but too little.

Low stomach acid (doctors call it hypochlorhydria) is much more common than we might think, especially as we age. Yet so many of us end up taking antacids or being prescribed PPIs (proton pump inhibitors) without getting to the root of the problem.

Whether your stomach acid is too high or too low, the symptoms can look remarkably similar. For instance, both conditions can cause heartburn or acid reflux, bloating, nausea and abdominal discomfort. It’s like your body is playing a confusing game of mixed signals. Understanding this difference can completely change how you think about digestive health and help you finally resolve your digestive issues.

As people get older, they often make less stomach acid, though this doesn’t happen to everyone. When scientists looked at people over 65, they found that around a third typically made less stomach acid than younger people. In fact, about 1 in 10 of the older people they studied consistently had low stomach acid levels.

This matters because your stomach acid plays several crucial roles in your overall health. It typically has a pH between 1.5 and 3.5, making it highly acidic – comparable in strength to battery acid!

Beyond just breaking down food, acidity helps your body absorb essential nutrients like iron, B12, and zinc while acting as your first defence against harmful bacteria and pathogens.

With low stomach acid, you’ll typically notice discomfort several hours after eating, as your food ferments and creates gas. High stomach acid is more likely to cause immediate discomfort during eating or shortly after.

There are several factors that contribute to low stomach acid:

1. Atrophic gastritis, which becomes more common with age
2. Helicobacter pylori (H. pylori) infection, which is a common bacterial infection globally
3. Long-term use of certain medicines, such as proton pump inhibitors (PPIs)
4. Nutritional deficiencies, especially zinc, which is necessary for stomach acid production

These factors help to explain why some people might experience digestive issues.

Professional medical testing provides the most accurate results. However, I’ve found that keeping a detailed food and symptom diary can be incredibly revealing. I recommend noting the following:

• How do you feel after specific meals
• Whether certain foods trigger discomfort
• The presence of undigested food in your stool
• Timing and patterns of any digestive distress

Whilst these observations aren’t diagnostic, they can provide insights to discuss with your healthcare provider.

Noting food triggers is a bit like being a detective of your own well-being. It’s about identifying patterns that can be helpful in working out what is going on with your digestion. Keeping careful notes means you may discover cycles that aren’t immediately obvious. 

You could also consider adding a note about how you’re feeling and your stress levels at your meal times. In my experience in working with patients, these factors can certainly impact digestion.

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 I’ve identified several strategies that may help maintain or improve stomach acid levels, particularly for older adults. For instance, regularly consuming zinc-rich foods, bitter herbs, and fermented vegetables can support stomach acid production.

Zinc-Rich Foods

Daily requirements can vary by country. Adult men require 9.5mg per day (UK), or 11mg per day(US). Adult women require 7mg per day (UK), or 8mg per day (US)

• Oysters provide the highest zinc content with 74.1mg per 75g (3-ounce) serving 
• Crab and lobster contain approximately 6mg per 75g (3-ounce) serving
• Beef and pork offer significant zinc content
• Plant-based options include chickpeas (1.53mg per 100g cooked ), cashews (5.6mg per 100g), and hemp seeds (10mg per 100g)

Plant based sources of zinc have lower bioavailability. So, to increase zinc absorption from these sources you can eat fermented or sprouted versions of vegetables, legumes and grains. Soaking grains grains before cooking and ensuring through cooking of legumes can also help.

Bitter Herbs

• Gentian root stimulates gastric juice production through gustatory nerve activation
• Wormwood supports digestion and increases gastric secretions
• Artichoke leaf helps with slow digestion and supports liver function
• Dandelion root contains beneficial lactones that stimulate digestion

Fermented Foods

• Sauerkraut contains probiotics that support digestive health
• Kimchi provides beneficial bacteria and vitamin U, which has anti-ulcer properties and is found in raw cabbage juice and other cruciferous vegetables
• Kefir and yoghurt offer probiotic benefits

Simple Habits That Make a Big Difference:

• Take time to thoroughly chew your food (ideally 20-30 chews per bite)
• Creating a calm, relaxed environment for meals
• Avoiding large amounts of water during meals
• Setting aside dedicated time for proper meals

Whilst these might seem like simple changes, I’ve seen that they can make a significant difference in how your body processes food.

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If you’ve been taking PPIs for an extended period, I believe it’s worth having a thoughtful conversation with your healthcare provider about whether you might be dealing with low rather than high stomach acid. Whilst these medications can be necessary and helpful in certain situations, they’re generally meant for short-term use. In fact, long-term use can actually perpetuate the cycle of poor digestion and nutrient absorption.

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H. pylori infection is a common underlying cause of low stomach acid, affecting approximately 50% of the world’s population. This spiral-shaped bacterium can disrupt normal stomach acid production in several ways. H. pylori can directly damage the acid-producing cells in your stomach. The bacteria specifically target parietal cells, which are responsible for producing hydrochloric acid. As these cells become damaged or destroyed, your stomach’s ability to produce adequate acid decreases.

Natural approaches to address H. pylori include:

Mastic Gum: Traditional Mediterranean remedy shown to have anti-H. pylori properties
Berberine: Found in herbs like goldenseal and Oregon grape root, known for its antimicrobial effects
Garlic: Contains allicin, which has demonstrated activity against H. pylori
Probiotics: Particularly Lactobacillus and Bifidobacterium strains, which may help reduce H. pylori colonisation
Green Tea: Contains polyphenols that may inhibit H. pylori growth

It’s important to note that while natural remedies can be helpful, it is best to have testing for H. pylori infection to enable accurate diagnosis and track treatment progress. If you suspect you have H. pylori, consider getting tested before starting any treatment protocol.

Your digestive health doesn’t have to be a mystery or a source of constant discomfort. Understanding and optimising your stomach acid levels could be the key to finding relief.

Good digestion forms the foundation of overall health. You’re investing in your long-term health and well-being by taking systematic steps to support your body’s natural digestive processes.

I offer personalised consultations to help guide you towards better digestive health – starting with a free initial chat to understand your unique situation and symptoms thoroughly.