Hypochlorhydria is when you have too little hydrochloric acid in your stomach. Low levels of this acid can affect your digestion and cause symptoms such as bloating, indigestion, and nausea.
Stomach secretions are made up of hydrochloric acid, several enzymes, and a mucus coating that protects the lining of your stomach.
Hydrochloric acid helps your body break down, digest, and absorb nutrients, such as protein. It also gets rid of bacteria and viruses in the stomach, protecting your body from infection.
Low levels of hydrochloric acid, called hypochlorhydria, can have a major effect on your body’s ability to properly digest and absorb nutrients.
Left untreated, hypochlorhydria can damage your gastrointestinal (GI) system. It can also cause infections and a number of other chronic health issues.
This article reviews the symptoms, causes, diagnosis, and treatment of hypochlorhydria.
Signs and symptoms of low stomach acid are related to impaired digestion, increased susceptibility to infection, and reduced absorption of nutrients from food. These may include:
- bloating
- burping
- upset stomach
- nausea when taking vitamins and supplements
- heartburn
- diarrhea
- gas
- desire to eat when not hungry
- indigestion
- hair loss
- undigested food in stool
- weak, brittle fingernails
- fatigue
- GI infections
- iron deficiency anemia
- deficiencies of other minerals, such as vitamin B12, calcium, and magnesium
- protein deficiency
- neurological issues, such as numbness, tingling, and vision changes
Health conditions associated with hypochlorhydria
A number of chronic health conditions have been associated with low levels of stomach acid. These include:
Some of the most common causes of low stomach acid include:
- Age: Hypochlorhydria is much more common as you get older. People over age 65 years are most likely to have low levels of hydrochloric acid.
- Stress: Chronic stress may decrease the production of stomach acid.
- Medications: Taking antacids or medications prescribed to treat ulcers and acid reflux, such as PPIs, for a long period of time may also lead to hypochlorhydria. If you take these medications and are concerned that you have symptoms of low stomach acid, speak with your doctor before making changes to your medications.
- H. Pylori: Infection with H. Pylori is a common cause of gastric ulcers. If left untreated, it can result in decreased stomach acid.
- Surgery: Surgeries of the stomach, such as gastric bypass surgery, can reduce the production of stomach acid.
If you have questions or concerns about your symptoms or risk factors of low stomach acid production, talk with a doctor. They can determine what’s causing your low levels of stomach acid and develop a treatment plan that’s best for you.
To determine whether you have hypochlorhydria, a doctor will complete a physical exam and take a history of your health and symptoms. Based on this information, they may test the pH of your stomach.
Stomach secretions usually have a very low pH (1 to 2), which means they are highly acidic.
Your stomach pH may indicate the following:
| Stomach pH | Diagnosis |
|---|---|
| less than 3 | normal |
| 3 to 5 | hypochlorhydria |
| greater than 5 | achlorhydria |
People with achlorhydria have almost no stomach acid. Older adults and premature infants often have much higher stomach pH levels than average.
A doctor may also perform blood tests to look for iron deficiency anemia or other nutrient deficiencies. A doctor can also do an endoscopy to look for atrophic gastritis.
Healthcare professionals can diagnose H. pylori by a breath or stool test.
Depending upon their evaluation and the severity of your symptoms, the doctor may choose to refer you to a gastroenterologist (a doctor who specializes in the digestive or gastrointestinal system).
Treatment for hypochlorhydria depends on the cause and severity of symptoms.
Some doctors recommend an approach that is mostly based on dietary modifications and supplements. An HCl supplement (betaine hydrochloride), often taken in conjunction with an enzyme called pepsin,
Your doctor may also recommend HCI supplements to help diagnose hypochlorhydria if the diagnosis is unclear. An improvement in symptoms while on this supplement may help your doctor diagnose this condition.
If an H. pylori infection is the cause of your symptoms, your doctor can prescribe a course of antibiotics can be prescribed by your doctor.
If an underlying medical condition is the cause of low stomach acid, your doctor can help you manage the condition and its symptoms.
Your doctor can also help you manage your medications and choose the best course of treatment if medications such as proton pump inhibitors are causing symptoms of low stomach acid.
Hypochlorhydria can cause very serious health problems if left untreated.
If you have digestive changes or symptoms that concern you, contact a doctor as soon as possible. They can help determine whether you have hypochlorhydria and develop a treatment plan that’s right for you.