Low Stomach Acid (Hypochlorhydria) Guide

If you are suffering from low stomach acid, you may experience a variety of food-related digestive issues, including constipation, diarrhea, bloating, gas, heartburn, and indigestion. 

Strange as it may sound, the symptoms of low levels of stomach acid are almost identical to the symptoms of too much stomach acid. But the treatment is completely different. To feel better, your stomach must produce more acid, not fewer.

Undigested food in the small intestine and colon can wreak digestive havoc by causing an overgrowth of harmful bacteria, which can lead to bloating and gas.

This article will cover what you need to know about low stomach acid and how to treat it. 

What is Low Stomach Acid and How it Wreaks Digestive Havoc

Low stomach acid is a digestive disorder where the stomach has a low level of hydrochloric acid. It is also known as hypochlorhydria.

Our entire digestive system depends on having enough hydrochloric acid (HCI) to break down food in the stomach. If there’s a small amount of stomach acid, there are potentially catastrophic results. 

If you don’t have enough stomach acid, then the digestion of proteins, carbs, and fats cannot be properly completed. Hydrochloric acid protects the stomach from having bacterial overgrowth, because bacteria can’t thrive in an acidic environment. HCI also helps the body to properly digest and absorb essential vitamins and minerals.

Low stomach acid can lead to long normal small bowel transit times, which means bacteria sit inside our bodies for longer, which gives them the opportunity to reproduce faster. 

Regardless of how well you eat, low stomach acid will lead to poor digestion and malabsorption of nutrients. Dysbiosis, a toxic condition, can also result with the sufferer experience gas, bloating, fatigue, fullness, and irregular bowel habits.

Diseases Associated with Low Stomach Acid

Most of what we eat contains some form of bacteria. Stomach acid normally kills harmful bacteria and keeps diseases at bay.

People with low stomach acid have an increased risk of illness because harmful bacteria end up in their small intestines, rather than being killed by stomach acid.

There are many health problems that are associated with low stomach acid levels. If stomach acid production is low, these are potential conditions you may experience: 

  • Allergies
  • Anemia
  • Asthma
  • Autoimmune diseases like lupus, rheumatoid arthritis, thyroid disease
  • Chronic fatigue syndrome (CFS)
  • Dry skin
  • Eczema
  • Gastrointestinal (GI) infections
  • Reduced night vision
  • Rosacea
  • Stomach cancers
  • Type I and II diabetes
  • Vitamin deficiencies
  • Vitiligo

What Causes Low Stomach Acid?

Aging is one of several factors that may cause low stomach acid.

H. pylori infection and an autoimmune condition called autoimmune atrophic gastritis can be linked to low stomach acid.  

Alcohol consumption, bacterial infection, and chronic stress are tied to low amounts of stomach acid. 

Low Stomach Acid (Hypochlorhydria) Symptoms

There are a number of symptoms resulting from a low production of stomach acid. 

The most common symptom include: 

Low Stomach Acid Diagnosis

Sometimes low stomach acid is simply left untreated. There may be occasions where a sufferer is prescribed acid suppressing medication, further lowering gastric acid levels.

Accurate testing is available, but this is not used in clinical practice; it is mostly used in research settings. The Heidelberg Gastric Analysis test is precise and expensive, taking between one and two hours to complete.

The patient swallows a capsule that contains a pH meter and a radio transmitter. Next, a bicarbonated soda solution is taken in an attempt to stimulate gastric acid output. Changes in pH levels are then transmitted to a receiver and graphed. Finally, the capsule is usually passed out naturally. 

Some home tests can be used, but at your own risk. If you have tried antacids and acid-blocking medications, and they haven’t worked for you, you can try apple cider vinegar.

If you’re experiencing indigestion, drink one to two tablespoons of apple cider vinegar (or add it to a small amount of water to help you swallow it). If this helps ease your indigestion symptoms, you may have low stomach acid levels.

Low Stomach Acid Treatment

If you’ve been diagnosed with low stomach acid, you may want to tackle it with a multi-prongsed approach.

  • Digestive Enzyme Supplements – Many nutritionists and dietitians recommend taking a digestive enzyme supplement every day for people over the age of forty. To improve overall digestion, digestive enzymes are recommended. They’re best taken with meals. Choose a digestive enzyme supplement that includes betaine HCl, to maximize its effectiveness.
  • Probiotic Supplements – When taking antibiotics or experiencing digestive issues such as low stomach acid, probiotic supplements help create a healthy environment within the gut and GI tract. High quality probiotics supplements can assist in treating digestive issues and may help your body resist the various diseases that result from harmful bacteria.
  • B12 Supplements – In cases of autoimmune gastritis, B12 absorption is impaired, so a B12 supplement can be helpful.  This may require intramuscular administration. Read about what causes gastritis.
  • Ginger – Ginger is an old-fashioned, popular remedy for digestion. It helps stimulate digestion and keep the intestines toned, which is a key factor in speeding things up.

You may think taking a hydrochloric acid supplement will help, but be sure ask your doctor first if you should be taking it. 

Learn more about Digestive Enzymes vs Probiotics.

Low Stomach Acid Final Thoughts

Low stomach acid is a common condition that affects many people. However, there’s no need to suffer through it. With proper treatment, most people can enjoy their lives again without having to worry about heartburn, reflux, or other digestive problems. 

Here are other articles to learn more:

Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.