Gastrointestinal Issues: Is Low Stomach Acid the Culprit?

Gastrointestinal issues inquiry?

I am the patient who previously inquired about probiotics.
Last night, I started feeling unwell again, and I experienced heartburn.
After researching, I found that symptoms of low stomach acid align with my current condition: lack of appetite, inability to build muscle, and overall discomfort.
I have a history of nerve damage from a previous car accident, and doctors have noted my symptoms, but no one has been able to provide a clear explanation.
One suggestion was to eat more, but after doing so, I only felt worse in terms of digestion.
Today, with an experimental mindset, I followed online advice and drank acidic beverages, such as lemon tea, after meals.
Over the past year, my stomach rumbling has completely disappeared, and I no longer experience bloating or heartburn.
Could this be related to low stomach acid? If so, what is the proper treatment? In the past, when I visited a gastroenterologist, they only prescribed medication, which did not resolve the issue.

Niming, 30~39 year old female. Ask Date: 2020/11/27

Dr. Hong Yuanbin reply Internal Medicine

Hello, the burning sensation you described is likely due to gastroesophageal reflux, which tends to occur after meals.
To confirm the diagnosis, an endoscopy may be necessary.
For treatment, I recommend starting with a diet of small, frequent meals combined with moderate exercise.
Regarding medications, certain antacids can indeed help alleviate symptoms of gastroesophageal reflux.
As for some foods, such as sour plums and lemons, although they taste acidic, certain components may react with stomach acid after entering the stomach, potentially improving reflux symptoms for some individuals.
Thank you for your question.

Reply Date: 2020/11/27

More Info

Understanding gastrointestinal issues can be quite complex, especially when it comes to the role of stomach acid. Based on your description, it seems that you are experiencing a range of symptoms including heartburn, lack of appetite, and digestive discomfort. These symptoms can indeed be associated with low stomach acid, also known as hypochlorhydria, but they can also be indicative of other gastrointestinal conditions.

Low stomach acid can lead to several digestive issues. When the stomach does not produce enough acid, it can impair the digestion of food, leading to symptoms such as bloating, gas, and discomfort. Additionally, low stomach acid can hinder the absorption of essential nutrients, which may explain your feelings of weakness and inability to gain muscle mass. This condition can also create an environment conducive to bacterial overgrowth, which can further complicate digestive health.

Your mention of drinking acidic beverages, such as lemon-infused tea, and noticing an improvement in symptoms is interesting. Acidic drinks can temporarily increase the acidity in the stomach, which may help with digestion and alleviate symptoms associated with low stomach acid. However, this is not a long-term solution and may not address the underlying issue.

In terms of treatment, it is essential to first confirm whether low stomach acid is indeed the problem. This can be done through various tests, including the Heidelberg test or a gastric pH test. If low stomach acid is confirmed, treatment options may include:
1. Dietary Changes: Focus on a balanced diet rich in whole foods, including lean proteins, healthy fats, and plenty of fruits and vegetables. Avoid processed foods, excessive sugar, and high-fat meals that can exacerbate symptoms.

2. Digestive Enzymes: Taking digestive enzyme supplements can help improve digestion, especially if low stomach acid is affecting your ability to break down food.

3. Betaine HCl Supplements: Some practitioners recommend betaine hydrochloride supplements to increase stomach acidity. However, this should only be done under the supervision of a healthcare provider, as it may not be suitable for everyone.

4. Probiotics: Since you mentioned probiotics, these can be beneficial for gut health. They help maintain a healthy balance of gut bacteria, which can improve digestion and overall gastrointestinal function.

5. Lifestyle Modifications: Eating smaller, more frequent meals can help reduce the burden on your digestive system. Additionally, avoiding eating too close to bedtime can prevent nighttime symptoms.

6. Stress Management: Stress can significantly impact digestive health. Techniques such as mindfulness, yoga, or other relaxation methods can be beneficial.

7. Consultation with a Specialist: If symptoms persist despite these interventions, it may be worthwhile to consult a gastroenterologist for further evaluation. They can provide more targeted treatments based on your specific condition.

In summary, while low stomach acid could be a contributing factor to your symptoms, it is essential to approach this issue holistically. A thorough evaluation by a healthcare professional is crucial to determine the underlying cause of your gastrointestinal discomfort and to develop an effective treatment plan tailored to your needs. Remember, self-diagnosing and treating can sometimes lead to more complications, so professional guidance is always recommended.

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