By: @drmelissa.co

The purpose of the human digestive system is to break down foods, absorb nutrients, and excrete waste; without this, humans would not be able to function. Stomach acid plays a key role in this process, allowing the body not only to survive but to thrive.

After chewing, the food we eat travels to the stomach. The stomach churns and combines broken down food with digestive fluids. Without an optimally functioning stomach, the rest of the digestive process will be compromised. A well functioning stomach produces a balanced amount of hydrochloric acid (HCl), also referred to as stomach acid. HCl serves to mix with and break down masticated food, particularly proteins, vitamin B12 and certain minerals. This sets the stage for nutrients to be absorbed during the next phase of digestion in the small intestine. Without enough HCl, a number of issues can arise: food will be inadequately broken down, nutrients may not be well absorbed, and gut inflammation can occur… all of which can lead to symptoms including bloating, indigestion and reflux, irregular bowel movements, pain and discomfort, skin issues, headaches, fatigue, brittle hair and nails, among others.  Long-term, this can lead to chronic conditions like gastritis, peptic ulcer disease, acne and rosacea,  etc.

Aside from food breakdown, another benefit of HCl is its ability to kill bacteria. When food is consumed, inevitably bacteria, viruses and other microbes are consumed along with it. Without enough HCl, bacteria may colonize the stomach or other parts of the digestive tract, causing bacterial overgrowth (like SIBO) or cause acute infection (like H. Pylori), disrupting digestion and leading to symptoms, digestive and otherwise. 

North American culture and medicine is very focused on reducing stomach acid when a focus on supporting stomach acid could be more beneficial in many cases. There are specific conditions that can lead to high stomach acid (hyperchlorhydria) and require treatment, but these are rare. Generally, when digestive disturbance is observed, a lack of stomach acid (hypochlorhydria) is very common. 

Stomach acid production can slow as we age and can become compromised with stress, a diet high in processed foods and saturated fats, poor quality sleep, certain medications, the overconsumption of alcohol, caffeine and other substances, abdominal surgery, and smoking, to name a few. Symptoms of low stomach acid vary, but can include: chronic acid reflux and heartburn, chronic cough, chronic infections, bad breath, bloating, gas, undigested food in the stool, constipation, and diarrhoea. Nutritional deficiencies can occur long-term, leading to concerns like iron deficiency anaemia and osteoporosis. HCl and its connection to the skin is something I work with patients on often. Irritated skin, breakouts, redness or rosacea — these may all be related to stomach acid levels. 

It is challenging to accurately test stomach acid levels without invasive tests done in a medical setting. One at-home test you may begin with is the Baking Soda Test. While it may not be as accurate as medical testing, it is simple and can assist you in beginning to explore your digestion.

The theory behind the Baking Soda Test is that baking soda combined with stomach acid will produce carbon dioxide, causing a belch. If there is not enough stomach acid, there will be no belch. To perform the test, consume 1 cup of water combined with 1/4 tsp baking soda on empty stomach, then time how long it takes to have a belch; 3-5 minutes is a normal result and anything longer may suggest low stomach acid.

If your test is positive, follow-up with a healthcare provider before self-diagnosing and treating. Treatment may involve dietary modification, supplements, herbal medicine, and a full-workup evaluating for underlying causes of the low stomach acid. Identifying and addressing the root cause is integral to heal any digestive concern. 

In the meantime, here are a few tips to support balanced hydrochloric acid levels gently: 

Focus on how you are eating: chewing thoroughly and eating slowly in a calm, relaxed environment is integral. This is the first phase of digestion which begins to stimulate the release of digestive enzymes and HCl. Without this first phase of digestion, the stomach will have to work harder, causing more stress on this organ. 

Limit liquids with meals: by consuming too much water or other fluids with meals, stomach acid and other enzymes are diluted. Take small sips only and reserve most of your fluid intake for between meals. 

Avoid raw, cold foods: in Traditional Chinese Medicine, cold and/or raw foods are seen as very difficult to digest, inflicting stress on your digestive system. Opt for warm, cooked foods to soothe and support healthy digestion and stomach acid levels.  

Eat breakfast daily: this first meal will help to stimulate balanced digestion for the remainder of the day. Consume within approximately 90 minutes of rising and choose nutritious foods, avoiding high fat or processed foods.

Avoid caffeine on empty stomach: this can trigger the release of more stomach acid, which can aggravate symptoms of low or high stomach acid. 

Eliminate alcohol: remove completely or reserve for very special occasions only and consume with or after food, never on empty stomach. 

If you suspect you have low stomach acid, it is best to seek medical care. It is important to see a healthcare provider who can perform testing to evaluate nutritional deficiencies and underlying causes of low stomach acid, including underlying infections; if these causes remain unaddressed, the problem will not improve.