Reflux: Could You Have LOW Stomach Acid?

Joan Haynes, NMD

It may seem counter intuitive, but strangely enough, the symptoms of stomach acid over-production and under production are very similar.  Proper stomach acid levels actually cause the sphincter muscle at the top of the stomach to close.  If there is not enough acid, the valve stays open, causing what little stomach acid there is to reflux and cause heartburn and erosion.  A healthy amount of stomach acid keeps the lower esophageal sphincter muscle tight, preventing the acid from refluxing.  Naturopathic doctors often have great success treating reflux by restoring normal stomach function.

Misdiagnosis and Mistreatment are Common

Stomach acid levels decline as we age, with poor nutrition, and with stress.  Acid-blocking medications such as Pepcid, Tagamet and Zantac are commonly prescribed control the symptoms, but do not address the underlying problem.  Studies show these medications are may lead to longer term health problems such as osteoporosis, colorectal cancer, bacterial infections and damage to both the kidneys and liver.  These medications are only palliative and are very hard to discontinue if used for a long period of time.

Symptoms of Low Stomach Acid

Acid reflux, heartburn, burping, gas, bloating, nausea are common.  Often there is an inability to digest meat well.  Feeling heavy or overly full after meals, despite eating a normal amount.  Sometimes, even if there are no gastrointestinal symptoms, I’ll screen some patients for low HCL if they have poor mineralization health conditions, such as those with anemia, osteoporosis, thinning hair, thin nails, and nervous system problems like insomnia, anxiety, and restless leg syndrome.

The Importance of Stomach Acid and Immunity

Besides being essential for digestive health, the acid acts as a natural barrier against infection – fighting pathogenic bacteria, virus and parasites.  When patients are travelling out of the country, I will often test them for low HCL, and if they can tolerate taking a little, I have them take HCL when they eat to reduce the risk of food borne illness.


When treating reflux, we need to consider several factors:

  1. Food allergy identification –   Often sensitivity to one or more foods is the cause of symptoms.
    READ MORE – Are Foods Causing Your Symptoms
  2. Heal inflammation – the reflux into the esophagus needs to be quieted before supplemental HCL is put into the stomach or until a person can tolerate their own normal stomach acid levels.  Deglycerinated licorice, marshmallow, slippery elm, aloe are all demulcent herbs that sooth and coat the lining of the intestinal tract.
  3. Test for and treat low stomach acid – I use the “titration” method of HCL testing.  I give my patients a sample of a pharmaceutical grade betaine hydrochloric acid (with pepsin) and have them increase their dose systematically with certain meals.  Then they report back to me and I help them sort out what their reaction told us and their dose if HCL is needed.
  4. Consider adding enzymes and/or bile.  The stomach makes HCL, but the gallbladder makes bile necessary for fat absorption and enzymes breakdown carbohydrates, fats and proteins.  You may need supplemental correction for those deficiencies as well.

Be Careful Treating Yourself – PLEASE READ

If you’ve been on acid blocking medication for a long time, I suggest you work with a professional to explore this issue.  If there are ulcers or erosions in your esophagus or stomach do not attempt to take hydrochloric acid – you may make matters worse.  You’ll need to heal the inflammation first and then explore discontinuing your medication.