You may recognise this. You take omeprazole or pantoprazole, or perhaps you bought a packet of Rennie yourself at the chemist. Your acid symptoms disappear for a while, but after some time they come back. Every single time.
That this happens is no coincidence. Acid blockers suppress the symptom, but they do not resolve its cause. And that cause is almost always something other than having "too much stomach acid". In practice we see that acid symptoms usually come from a combination of factors that most people have never heard of. In this article I explain the four most common ones.
Your body is missing the building blocks to make stomach acid
Your body does not make stomach acid out of nothing. It needs specific nutrients for that. One of the most important is zinc. Zinc occurs naturally in everything that comes from the sea, such as fish, mussels, prawns and the edible seaweeds. If you eat few products from the sea, your body can develop a zinc shortage.
At that point most people think they have too much stomach acid. But the opposite is often true. With a zinc shortage your stomach cannot keep the composition of the stomach acid in order. That leaves you with too little stomach acid, or a composition that is off. That can give you the sour, burning feeling. You can compare it to a glass of squash. To make squash you need the syrup and water. If the proportions are off, the mixture is far too strong. Something similar happens in your stomach. And if you reach for an acid blocker at that point, you ease the symptoms for a while, but the underlying problem grows.
Having enough stomach acid also affects how well you can digest your food. With a shortage of stomach acid your food is not digested properly, which leaves you with a full feeling for hours after eating. You can experience burping and reflux as well. And when that reflux carries the acid up with it, you experience that as heartburn again. Whether the sphincter of your oesophagus closes properly to keep the acid in your stomach plays a part here too.
Stress turns your acid production down
When your body experiences stress, it switches over to the fight-or-flight mode. With this survival mechanism your body sends more energy to your arms and legs, so that you can run or fight to get yourself to safety. Your digestion and other less urgent processes are put on standby for a while. As a result your stomach makes less stomach acid, your gut produces fewer digestive juices, and your food is digested less thoroughly.
If you look at human evolution, stress was functional. It kicked in when a dangerous animal stood in front of you, or when you were short of important nutrients. These days we have many more forms of stress. Financial worries. A job that does not make you happy. A night's sleep that is broken again and again. Negative self-talk and undermining thoughts. And, just as back then, shortages of important nutrients, because that still poses a danger to your body and is therefore a major source of stress.
For as long as that stress continues, your acid production stays too low. That affects how well you can digest your food and how many nutrients you can absorb from it. As your body runs shorter and shorter of important nutrients, more and more stressors are added, so a downward spiral can slowly build in which one factor strengthens the other, and over time you feel more and more physical discomfort and less energy.
Unwanted residents in your gut lower your stomach acid
One of the factors that can contribute to a lack of stomach acid lives literally in your gut. Your gut is home to an ecosystem we call the gut flora, or the microbiome. It consists of millions of different bacteria that are supposed to be present in a particular composition, in both kind and number. When that composition is right, these bacteria help digest the fibre you eat, and in doing so they produce important substances, among them some of the body's own vitamins and the hormone serotonin.
Under certain circumstances the microbiome can be disrupted by a bacterial overgrowth, a yeast or a parasite in your gut. You can take them in through food or water, and overgrowth can develop when they get the space to do so once the microbiome is disrupted by a course of antibiotics, a one-sided diet, stress or a disturbed digestion, which acid blockers can contribute to.
Pathogens lower the level of your stomach acid, which means you digest your food less thoroughly. The undigested remains left behind in your gut serve as food for these unwanted residents. So they literally create their own food supply, at your expense. You take in fewer nutrients, your digestion gets worse, and the unwanted resident has everything it needs.
Meanwhile you notice symptoms such as a bloated feeling, stomach pain, changeable stools and acid symptoms. Suppose you reach for an acid blocker at that point. Then you lower your stomach acid even further. That may give relief for a while, but it does exactly what those unwanted residents want. On top of that, stomach acid is one of your most important lines of defence against intruders like these. Less stomach acid means they can survive the digestive step in your stomach more easily, after which they can multiply in your gut.
Histamine-related symptoms
Your body makes histamine naturally. It is a substance involved in a great many different processes in your body, and making stomach acid is one of them. Histamine stimulates your stomach to produce stomach acid.
When your stomach acid is too low, your body makes more histamine, because that is the signal for your stomach to make more stomach acid. But if the nutrients to do that are missing, or the stomach is not given permission to produce stomach acid because the stress system is active, more and more histamine is produced, which your gut then absorbs into your body. A surplus of histamine can go on to cause all sorts of symptoms, such as a bloated feeling, stomach pain and diarrhoea, heart rhythm problems, skin problems such as itching and eczema, and even headaches and migraine.
While you are taking an acid blocker your body also carries on making histamine, so these symptoms can keep increasing. That creates a downward spiral that is hard to get out of without help. This is perhaps the least known cause of persistent acid symptoms, and at the same time a common one in our practice.
What can you do about this?
What all of these causes have in common is that an acid blocker does not resolve them. The symptom is eased for a while, but the underlying cause remains and can even get worse.
The first step is understanding what is going on with you. Is it a nutritional shortage? Stress? Are there pathogens in your gut? Or is it a combination of factors? This differs from person to person, and that is why there is no single solution that works for everyone.
In the book First Aid for Your Gut, Jeroen explains step by step how your digestion works, what can go wrong, and what you can do about it. Would you like to know what is going on in your case specifically? With a stool test we can map the composition of your gut microbiome and establish whether there are pathogens present that could be causing your symptoms.
Would you like to know what we can do for you to put these symptoms right for good? Read more about our personal guidance and apply for a thirty-minute intro call. In it we map out what is going on for you and assess together whether our approach fits.