Welcome to the second part of our blog series on hypochlorhydria! As discussed last week, this hard-to-spell condition often goes undiagnosed or is mistaken for other health problems, causing significant issues. It is commonly referred to as low stomach acid.
During a normal, healthy digestion, proteins are broken down (denatured) in the stomach, as the enzyme pepsin is activated and protein structures are disrupted by the ions in the hydrochloric acid (HCI). HCI unravels the proteins and opens up interior structural areas for more stomach enzymes to act upon. But what happens then if you do not have enough stomach acid? Your protein breakdown and absorption will not be as efficient as it should be.
The condition can also be the result of certain medications, such as proton pump inhibitors (PPI). They are most commonly used in the prevention and healing of ulcers in the oesophagus, stomach, and duodenum. While decreasing acidity levels, they could also affect protein denaturation. Although it is not particularly pleasant, watch out for undigested food in your stool if you are worried you might not be breaking down macronutrients efficiently.
Unfortunately, low stomach acid can also have other unwanted effects, such as the proliferation of bacteria, as the acidity of our stomachs kills off many pathogens. If your stomach has a gastric pH of 4.0 or above, chances are that Lactobacillus spp. and other bacteria are multiplying. Overgrowth of these can result in nausea, bloating, and dysfunctional bile acids, even leading to diarrhoea.
And the list of issues associated to low stomach acid does not end there… Other include possible reduction in the pancreatic secretory response, reduction of gastric emptying, malabsorption of saccharides due to bacteria competition, and even increased intestinal permeability.
So what can you do? In the next blog post, we will look at ways to manage this condition and start feeling better! Stay healthy!
Berg, J.M., Tymoczko, J.L. and Stryer, L. (2002). Biochemistry. 5th edn. W.H. Freeman & Co Ltd. Available at: https://www.ncbi.nlm.nih.gov/books/NBK22600/
Freedberg, D.E., Lebwohl, B. and Abrams, J. (2014). ‘The impact of proton pump inhibitors on the gastrointestinal microbiome’, Clinics in laboratory medicine, 34(4), doi:10.1016/j.cll.2014.08.008.
Gropper, S.S., Smith, J.L. and Groff, J.L. (2009) Advanced nutrition and human metabolism. 5th edn. Belmont: Wadsworth Cengage Learning.
Sult, T (2010). Clinical approaches to gastrointestinal imbalance, in: Jones, D.S & Quinn, M. eds. Textbook of functional medicine. 3rd edn. Gig Harbor, WA: Institute for Functional Medicine. pp 435-479.