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Why Antacids May be Making Your Reflux Worse

People dealing with GERD or acid reflux have to deal with painful burning from stomach acid entering the esophagus. Acid reflux is a result of a weakening of the lower esophageal sphincter (LES), which normally keeps the acid and stomach contents separate from the esophagus. Some factors that contribute to weakening of the LES include:

· Eating large meals

· High fat meals

· Smoking

· Stress

· Obesity

· Tight Fitting Clothes

· Medications (NSAIDS, iron pills)

· Lying down after a meal

· Certain foods

· Hyper- or hypochlorhydria

This post is focusing on hypochlorhydria:

People with reflux often automatically assume that they must be producing too much stomach acid (hyperchlorhydria), when in reality some people with reflux may be a result of too little stomach acid (hypochlorhydria).

How does low stomach acid cause reflux and a burning sensation?

  • Both high and low stomach acid production have been linked to a reduction in lower esophageal sphincter pressure, which ultimately leads to acid reflux.

  • The pH of our stomach is normally very acidic and needs to maintain an optimal acid level to aid in the digestion of our food (and in the absorption of micronutrients such as B12 and iron). If our stomachs are not producing enough hydrochloric acid (HCL), food is not able to be properly digested. This may lead to an increase in stomach pressure, which forces stomach contents (and acid) into the esophagus.

  • Even if stomach acid is not as acidic as it should be, it is still far too acidic for the esophagus to handle and can lead to lasting damage.

How to test if you have low stomach acid:

Following up with you gastroenterologist will be the best and most accurate way to test your pH levels. However, there are also a couple of tricks for an at home test in the mean time:

The baking soda test: Mix ¼ teaspoon of baking soda in 4 ounces of cold water and consume first thing in the morning before consuming anything else. If it takes longer than 3-5 minutes to burp, your stomach acid is probably too low.

Apple cider vinegar test: Drink a small amount of apple cider vinegar mixed in water before a meal with protein. It if helps with your digestion and provides some relief, its an indication that stomach acid is low. This means you may benefit from taking a Betaine HCL supplement before meals to help with digestion. If apple cider vinegar causes more worsening symptoms of reflux, it is more likely that you have too much stomach acid.

Even if stomach acid production is too low, you may get temporary relief from antacids and proton pump inhibitors. However, this may lead to an ongoing cycle and worsen the problem long term.

Ongoing acid reflux can be a serious condition and should be addressed with your doctor to rule out underlying conditions, accurately assess pH levels, and determine the need for ongoing antacids and PPIs

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