Gastric Hypoacidity and Disease
A healthy stomach secretes hydrochloric acid (HCl) and pepsin in response to ingestion of a meal or even a small amount of food. Available evidence indicates that adequate absorption of iron, calcium, zinc, copper, folic acid, vitamin B12 and other B vitamins requires the presence of HCl.
So achlorhydria, or the absence of gastric acid secretion, and hypochlorhydria, inadequate secretion of gastric acid, could result in suboptimal absorption of the nutrients listed above. Because of low or no pepsin, which is required for protein digestion, amino acid deficiencies can also occur concurrently.
Stomach acid serves as a barrier protecting against various microorganisms that might otherwise colonize the GI tract. So patients with low stomach acid are at increased risk of bacterial or fungal overgrowth, parasitic infestation of the GI tract, and general dysbiosis (imbalance of bacterial flora).
Symptoms
Symptoms of low stomach acid include, heartburn, indigestion, belching, bloating after meals, excess gas, constipation, chronic diarrhea, feeling unusually full after small or moderate sized meals, and a sensation that food (especially meat) sits for a long time in the stomach. Fatigue, depression and muscle cramping as a result of suboptimum nutrition is often seen. Some patients have no symptoms
Physical signs can include rosacea and dilated capillaries around the nose, women report poor quality fingernails, brittle hair, or excessive hair loss.
Associated Conditions
Autoimmune conditions, osteoporosis, rosacea, chronic allergy, chronic childhood eczema, eczema in adults, cholecystitis, psoriasis, chronic hives, angioedema, AIDS, type 2 diabetes, heart disease, advanced age.
Testing for Gastric Acidity
So the best test for me at my clinic is an empiric trial of HCL with specific instructions on dosing and frequency. My patients enjoy this method because when clinically indicated, they do derive relief. For severe cases we provide b12 and folic acid injections weekly, in addition.
Long Term therapy:
Some patients especially the elderly may need HCL for the rest of their lives. While some patients after achieving improvement in their symptoms will be able to wean off the HCL.