Eric Bakker N.D.May 19, 2022

Heartburn is a burning sensation in the chest that occurs directly beneath the breastbone. After eating, in the evening, or while laying down or bending over, the discomfort is usually greater. Heartburn is a regular occurrence that is not reason for concern.


Heartburn Relief

Stomach problems and various kinds of digestive issues are one of the most common reasons patients will visit me. Hypochlorhydria is the lack of adequate or a sufficient production of stomach acid (hydrochloric acid). Some people, particularly our older population, may actually have a condition known as achlorhydria, in which a person produces very little stomach acid.  Well know naturopath Dorothy Hall, once Australia’s foremost practitioner of natural medicine, told me that 50% of 50 years old persons have hypochlorhydria, 60% of 60 year old persons, and by the time you get to 90 years of age, you will have a 90% chance your stomach is quite under active, and you could even be “achlorhydric” (not really producing stomach acid) at all.

I am aware that many medical doctors would find this “hard to swallow” or even a ridiculous claim, but there is no doubt that a percentage of our population suffers from hypochlorhydria and are virtually ignored. How can you diagnose an under-active stomach as a medical practitioner? You don’t, and functional problems such as hypochlorhydria, irritable bowel syndrome, adrenal fatigue and even hypothyroidism can be quite difficult to diagnose. And, if your doctor can’t find the cause of your problem – then it probably doesn’t exist according to medicine.

zantacDo You Take Acid Blockers?

It is a known fact that doctors are quick to prescribe “acid blockers” to patients who complain of heartburn, but the unfortunate thing is that many who have in fact an under-acidity of the stomach may well have signs and/or symptoms of heartburn, which the doctor may well interpret as over-acidity. The sad reality is in addition that hypochlorhydria can and often is induced by antacids, H2 blockers and protein pump inhibitors. This can potentially substantially increases one’s risk of osteoporosis because the body simply does not have the ability to pull in sufficient minerals through the diet to build strong and healthy bone tissue. Many chronic and degenerative conditions will be therefore associated with these drugs.

Processed Foods

You may think: “Well, I don’t really have a problem here.” If you happen to eat a diet from foods you have bought from a supermarket, then you will most certainly benefit from pepping up your stomach. Especially if you like tea, coffee, alcohol, red meats and any foods containing sugars, starches or have had any form of processing.

Are you over 40 years of age? In many cases, if you suffer from heartburn you may very well benefit from digestive enzymes, end of story

By improving your stomach you will be improving your overall health and its not hard to understand why this would occur. Think of your stomach as the centre of your universe – the Chinese medicine practitioners do. With an optimal functioning stomach you will find that your body has the ability to fully break foods down and can digest and absorb the nutrients with relative ease. As soon as this process in hindered in any way, deficiencies occur. Take a look at the signs and symptoms below, and if you can relate to them then I would highly recommend that you try a course of Digestive Enzyme Tablets for about three months, you may be quite surprised at the improvement to your overall health!

Our stomachs are supposed to be acidic, so it important that it produce high concentrations of hydrochloric acid (HCl). When the stomach produces HCl it also produces bicarbonate of soda (baking soda) which protects the lining of the stomach from being damaged or eaten up by HCl. When the stomach doesn’t produce enough HCl, it also will not produce enough bicarbonate of soda so the stomach can become ulcerated.

Unfortunately, when hydrochloric acid is low it causes malabsorption resulting in malnutrition, various digestive problems such as constipation, bloating, gas, diarrhoea and more and eventually a myriad of health problems. HCl mainly digests protein, breaking it down into small molecules in your stomach and duodenum (the first part of the small intestine), the smaller molecules formed are further digested and then absorbed in the intestinal tract.

Heartburn Symptoms

  • Stomach aching/pain/discomfort or bloating after meals
  • Feel unwell/fatigued right after meals
  • Food or water ‘sits in stomach’ like a brick
  • High protein or fat foods cause nausea/stomach upset
  • Undigested food in stool
  • Reflux and/or heartburn
  • Poor appetite or feel overly full easily
  • Poor fingernail health/splitting easily/white flecks
  • Multiple food sensitivities
  • Trouble digesting red meat
  • Constipation
  • Low iron levels
  • Frequent nausea
  • Nausea/reflux after supplements (e.g. fish oil)
  • Burping after meals
  • Thin, weak or fragile hair

What Does Heartburn Feel Like?

When you have heartburn, you have a burning pain behind your sternum (breastbone) caused by your stomach. Do you have any of the symptoms above? Did the heartburn appear after any meal? There is a high degree of probability that your heartburn was caused by indigestion. But, there is always that possibility that what you are experiencing can be more sinister, and an underlying sign of heart disease.

You’ve just finished a substantial dinner with friends, had some dessert and drinks, etc, and are experiencing a burning feeling in your chest not long after. Is it heartburn? Is it a heart attack?  Probably heartburn, but there’s always a possibility your chest discomfort is caused by a blockage in your heart’s blood supply (angina) or a heart attack.

How closely do the symptoms of heartburn and a heart attack resemble each other? Heartburn, angina, and a heart attack may all feel the same. Even a doctor may have trouble distinguishing between your actual medical history and a physical exam. That’s why, if you go to the hospital with any sign of chest discomfort, you’ll be given the appropriate right away to rule out that you may be experiencing a heart attack.

What should you do if you’re experiencing chest discomfort and aren’t sure what’s causing it? Whether you’re experiencing chronic chest discomfort and aren’t sure if it’s due to heartburn, dial your local emergency number or ambulance or seek immediate medical assistance.

If you experienced an episode of inexplicable chest discomfort that went gone within a few hours and you did not seek medical help, call your doctor or medical centre. Heartburn and a heart attack may both create symptoms that go away after a time, but you need to know what is at the bottom of your heartburn, so if in doubt always seek a professional opinion and get tested appropriately.

Look at Your Fingernails

Achlorhydria_1Do you fingernails look like these in the picture on the left? These fingernails belong to a 64yr of lady who came to see me in the clinic complaining of many chronic complaints, including severe fatigue, numbness and tingling of extremities, sore tongue, constipation and many more complaints. She had been to over a dozen doctors, naturopaths and various other health-care professionals. A digestive enzyme and a Super B Complex vitamin solved most of her problems within a few weeks. I forgot to tell you, she also had a major Zinc and Vitamin B12 deficiency. This was due to the fact that her uptake of B12 was severely compromised. Zinc is required to make stomach acid.

Stomach Acid is Vitally Important

The presence of hypochlorhydria is an extremely important finding as stomach acid is responsible for two key functions.
1. The sterilisation of food against potentially harmful micro-organisms reduces our risk of being colonised by every micro-organisms we ingest daily. Stomach acid plays an important role in the digestion of protein molecules and the absorption of minerals and vitamins.
2. Stomach acid also signals the release of digestive enzymes and bicarbonate from the pancreas required for digestion. It is common for this to occur: Insufficient stomach acid also causes absorption of partially digested food molecules, leading to food allergies and sensitivities.

Food components that should be digested and absorbed in the upper intestines, when not processed properly, pass through into the lower intestines providing fuel for harmful micro-organisms, therefore increasing their numbers. Low stomach acid causes gastrointestinal overgrowth of pathogens, malabsorption of minerals, vitamins and amino acids, and food sensitivities. Low stomach acid levels can be genetic or acquired. Candida albicans can thrive in a stomach with is not acid enough to neutralise and kill it. And we discovered in the late 1980’s with Dr. Barry Marshalls’ research into a bacteria called Helicobacter pylori that the stomach certainly can harbor different bugs which can even thrive in this acid rich zone.

Health Problems Commonly Arising From Poor Stomach Function

  1. Failure to digest your food properly.  This is the one I commonly see and there are a few ways to see if this is an issue with you. Do you feel bloated after meals, a sensation of fullness? Can you see any undigested food particles in your motions? Protein mal-absorption is the common one, and this will manifest in different ways such as poor growth of fingernails, nails that are weak or flake/split easily. Your hair may be weak, thin or fragile as well. You will probably be tired with protein mal-absorption in addition, simply because your body just isn’t getting enough of the building blocks (amino acids) it requires to sufficiently “charge” it up.
  2. Failure to absorb minerals and trace elements in particular. We covered this a little in point 1. Minerals in particular are the building blocks of your body, and it doesn’t take a rocket scientist to figure out that if these macro minerals such as calcium, magnesium, sodium and potassium are somewhat lacking, then you may well be on the road to disturbing the delicate biochemistry of the body. The trace elements, and there are many of them such as selenium, boron, copper, manganese, zinc and many more, are all critical to the body’s biochemistry in the correct proportions and balance. If these are not present in their correct proportions, then the body’s systems will be impaired causing eventual dysfunction resulting in disease. Therefore, one would expect to see people getting diseases, such as cancer, heart disease and chronic neuro-degenerative conditions such as Alzheimers disease before their time. A 2015 study reveals that older adults risk chronic illness due to poor functioning stomach.
  3. Failure to sterilise the stomach contents. Not being able to sterilise your digestive system is a big problem. You will become much more susceptible to infections, parasites and over growths of pathogenic bacteria and viruses causing potentially gastroenteritis and possibly enteroviruses such as Epstein-Barr virus, Coxsackie virus, Echovirus and so on. Gastric acid is a critical part of your body’s normal defences against disease and is also absolutely essential for eliminating any undesirable bacteria and yeast that appear in your diet. Those who have hypochlorhydria in my opinion are the ones who seem to get the “tummy bugs” more easily, and are in particular much more susceptible to the more virulent strains which can easily cause simple food poisoning. The other dilemma which arises is that if there is an overgrowth of bacteria and yeast in the stomach, then foods will get much more easily fermented instead of being digested, causing fermentation dysbiosis. This produces wind and gas resulting in bloating and even the production of alcohols. I often find that those with candida yeast infections suffer from very sensitive stomachs which can become easily upset – is it any wonder, if the stomach isn’t working sufficiently and the stomach produces that little acid and enzymes that it has become more susceptible to candida albicans? Especially in candida yeast infections it is important to increase a patient’s HCL.
  4. Higher risk of Helicobacter pylori infection. The bacteria is the one implicated in over 90% of cases of stomach ulcers, and if you have hypochlorhydria long enough you increase your risk of this terrible infection which can remain in your stomach for many years giving you plenty of grief. Please be sure to read the page on Helicobacter pylori, especially if you have heartburn and take drugs daily. You could be like the 25% of Australians and New Zealanders who has a H.pylori infection unknowingly.
  5. Higher risk of stomach cancer. Having higher levels of hydrochloric acid in your stomach helps to prevent the most common type of digestive cancer – stomach cancer. The wrong bacteria, particularly Helicobacter pylori, increase you risk of this mostly fatal type of cancer.
  6. Food allergies or sensitivities. Now this is interesting, I have routinely seen patients who have very poor stomach function and multiple food allergies. If you have allergies, have you ever thought (or your practitioner) that low stomach function could be the cause? I’ll bet you have never even considered it. It makes sense, because if your stomach cannot help cleave proteins right down to their tiniest amino acid components, then you will be passing larger protein molecules into the small intestine. These are called peptides or poly-peptides, and these may slip through the digestive system and challenge your immune system. This is called Leaky Gut Syndrome (LGS), and I’d like you to read this page to see if you can relate to this problem. You may also like to read Food Allergies and Food Intolerances page.  I have found that LGS and an underactive stomach are quite common in those with food allergies, and the most common things that practitioners do is to remove the offending foods without sufficiently repairing the underlying digestive disorder. This is like painting a house while ignoring its decaying foundations. Fix the gut problem and the allergies take care of themselves, and who hasn’t got some sort of allergy nowadays?
  7. Malabsorption of vitamin B12.  It is a well known fact that Vitamin B12 has a complex way of binding to a hormone called intrinsic factor in your stomach. There are special cells called parietal cells which produce this hormone. Once B12 is bound to intrinsic factor, is travels down the digestive tract where it is absorbed at the terminal end of the small intestine. Vitamin B12 must be in a stomach producing sufficient acids and enzymes to bind properly, and by using drugs such as “acid blockers” (Omeprazole, for example) you will be reducing your absorption of B12 to less than 1% of expected! Many people already suffer from borderline B12 deficiency – this is a difficult vitamin for the body to assimilate, but essential for normal biochemistry.

wright10_1According to Dr. Jonathon Wright, one of the world’s most qualified natural medicine doctors, and the first doctor of Western medicine to see the connection with hypochlorhydria and ill health, there are many different medical condition listed which are associated with much higher rates of hypochlorhydria:

Asthma, Celiac disease, Chronic fatigue syndrome (CFS), Diabetes mellitus. Eczema, HIV/AIDS, Lupus, Macular degeneration, Pernicious anaemia, Psoriasis, Reflux, Rheumatoid arthritis, Acne rosacea, Stomach ulcers/helicobacter pylori, Urticaria (hives) and Vitiligo.

Dr. Wright saw the connection many years ago with low stomach acid being associated with a higher incidence of gastrointestinal problems like helicobacter pylori bacteria which cause stomach ulcers, acid reflux (heartburn), irritable bowel syndrome (IBS), Crohn’s Disease, diarrhoea, constipation, etc. Our stomachs need adequate acid so we can get the benefit of a good diet and the nutrients it contains, and in order for digestion to proceed like it should throughout the intestines.

How To Get Rid Of Heartburn

There are four main ways you can treat an under-active stomach in terms of natural medicine, but probably the quickest and most effective way is to take Digestive Enzymes Tablets. You would do well to have lemon juice and apple cider vinegar in your diet regularly in addition. If you are a fan of herbal medicines, take gentian. It is a powerfully bitter herb and can quickly restore hypochlorhydria.

  1. Apple Cider Vinegar The other solution is to take Apple Cider Vinegar (ACV) on a daily basis, about one dessert spoon each day in a little water. You can sip this during meals for best effect. The elderly would do well to have ACV on a daily basis, and to try taking digestive enzyme tablets in addition. ACV contains acetic acid, and it has been long used to help acidify the stomach and improve digestion. This explains why cider vinegar was such a popular treatment for many health problems. Clearly, by improving the acidity of the stomach it has the potential to affect a wide range of health conditions. The only drawback with cider vinegar is that it contains yeast and would therefore not be tolerated by many people with candida yeast infections in particular.
  2. Vitamin C Another good option is to take high dose of ascorbic acid at mealtimes. Indeed, my standard recommendations for those who want a health boost in general is to take Vitamin C at mealtimes. Ascorbic acid, combined with the minerals, reacts to form a combination of mineral ascorbates and hydrochloric acid. A good Vitamin C powder will contain the perfect mixture to optimise your stomach’s absorption because it mildly acidifies the stomach and places the minerals into the best available form to be absorbed, i.e. the ascorbate, and, of course, an acid environment.
  3. Digestive Enzymes The third approach is to take a digestive enzyme containing betaine hydrochloride. This is available in tablets or capsules, which need to be taken with food and the dose adjusted according to the response. I suggest that you start off with one capsule initially and build up to, maybe, four or five capsules depending on the size of the meal and the response to treatment. Often in the longer term with the correct diet (low glycaemic index, low allergy potential, smaller meals), getting rid of helicobacter pylori, and correct gut flora this cures the chronic gastritis and the stomach is again able to produce acid normally. You can purchase Digestive Enzyme Tablets.
  4. Gentian. The fourth approach is to take a small quantity of the powerfully bitter herb called gentian, just before meals. I love bitter foods and am not that keen on sweet things. This is something that you develop over time, and in my experience those who love sweets are not that keen on bitter things! You will get gentian from your herbalist.

Digestive Enzyme Supplementation

How much digestive enzyme supplementation do I need? The best way to determine how much digestive enzyme supplementation you require is to do the “tummy tolerance method”. Capsules or tablets are taken in increasing doses with meals until symptoms of excess acid are evident, at which time you would cut back on how many capsules or tablets taken.

Digestive Enzyme Stomach Tolerance Program

  • Meal 1 – Take 1 tablet at the beginning of your meal.
  • Meal 2 – Take 2 tablets at the beginning of your meal.
  • Meal 3 – Take 3 tablets at the beginning of your meal.
  • Meal 4 – Take 4 tablets; two at the beginning of your meal and two in the middle of your meal, and so on, up to 8 tablets per meal.

NOTE: When taking several tablets they will help you more if you take them throughout the meal (beginning, middle and end). For individuals that are daring and want more rapid results, you could increase the dose by two tablets each meal instead of one. If any irritation occurs (heartburn, stomach ache, heaviness, nausea), you can take baking soda in water to neutralise the excess acidity (1/2 teaspoon of baking soda in 250 mls of warm water), but sip it only long enough to alleviate the symptoms. At your next meal you would take 1-2 tablets less than the number that caused symptoms. Sometimes small meals (or those with little protein) do not require as many tablets as required for a larger meal. Remember that symptoms of high stomach acid are exactly the same as low stomach acid, i.e. heartburn, stomach aches, a sense of heaviness behind the sternum and low grade nausea.


Hydrocholoric acid should never be used with any anti-inflammatory medications, including aspirin, Inodicin, Motrin, or Butazolidin, because of the risk of internal bleeding, according to Dr. Jonathan Wright. If you experience any negative effects from betaine hydrochloride supplementation stop taking it and contact us.

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