Living With SIBO-C: Could Low Stomach Acid Be the Cause of Your SIBO?

It's taken me a long time to arrive at low stomach acid as a potential problem for me, because I've never had the classic complaints — heartburn or acid reflux. However, there are other symptoms that are not as readily discussed and these include bloating, slow digestive transit time, occasional belching, light-colored stools, and undigested food in stool.

I'm happy to pounce on this latest aspect of the digestive process that can go wrong, yet it irks me to learn that this may be the cause all along of my SIBO, but no doctor has ever even discussed it as a possible cause, even though it is so very common and so easily (and inexpensively) remedied.

When a person isn't producing sufficient stomach acids, a cascade of bad events is set off:

1. Food lies longer in the stomach, while the body waits to achieve proper pH level, which it never does. Without proper breakdown of food, nutrients cannot be extracted. The resulting malnutrition causes a host of symptoms that mimic serious health conditions. For example, lack of vitamin b12 alone can cause severe joint pain, numbness and burning in your hands and feet. Severe B12 deficiency can lead to depression, anxiety, paranoia, delusions, memory loss, loss of taste and smell, and more.

2. At the same time, low stomach acid creates the perfect environment for the overgrowth of bad microorganisms, which feed off the undigested carbohydrates that are fermenting. As part of their own digestive process, these bad bugs give off gas (this is what's being measured and detected in the SIBO breath test) plus they spew endotoxins into your bloodstream, eventually causing inflammation that can lead to various types of disease. Very commonly, the liver working overtime to remove the toxins becomes damaged over time leading to a condition known as nonalcoholic fatty liver disease, which destroys the metabolism and the balance of insulin and other hormones and throws your body into fat-storage mode.

Pressure builds (there's that all-too familiar bloating) and two important valves of the digestive system malfunction.

3. The lower esophageal sphincter (LES) at the top of the stomach has only one option and that is to open the wrong way, releasing up into the esophagus and causing symptoms of heartburn and acid reflux. The tissues lining the esophagus can't handle this burn of stomach acid. Frequent opening of the LES in this way will eventually weaken the valve. So, while removing known food allergens is a good idea, the underlying valve dysfunction must be reversed or it will lead to additional food sensitivities and allergies.

4. Meanwhile, another valve at the bottom of the stomach called the pyloric sphincter is waiting, waiting, waiting for the proper PH to build up. Due to low stomach acid, it never does. After a while, pressure forces the stomach to move partially digested food (chyme) through the pyloric sphincter into the small intestine, but because it's not at the proper pH, the chyme doesn't trigger the release of sodium bicarbonate or pancreatic enzymes. The small intestine is unable to break down the chyme and large, undigested particles irritate the lining of the small intestine, eventually causing it to become permeable, allowing undigested food particles to enter the bloodstream. The body’s immune response system sees large proteins, such as casein and gluten, as foreign invaders and triggers an immune response. Thus begins the vicious circle of food sensitivities, inflammation, and autoimmune response known as leaky gut syndrome.

How Do You Know If You Have Low Stomach Acid

According to SCD Lifestyle, there is an easy test you can try at home by taking an inexpensive supplement called Betaine HCL with Pepsin. I tried one by Thorne, because it's free of food additives that I'm sensitive to, but any will work.

Three Simple Steps:

1. Eat a meal that includes at least 15-20 grams of protein (about 4-6 ounces of meat)

2. Take 1 capsule partway through the meal, then continue eating until you're satisfied

3. Pay close attention to your body's response. Either you won’t notice anything, in which case you probably DO have low stomach acid. Or you'll start to feel symptoms like burning, heat, or heaviness, which are signs that you DON'T have low stomach acid.

If you do have low stomach acid, continue to take 1 capsule at every protein meal the next day or two. If you don’t notice any burning, heat, or other GI distress by the 3rd day, increase your intake to 2 capsules. Stay there for another day, then try 3 pills. Keep increasing the dose until you notice some GI discomfort. When you finally detect some distress, go back down a pill and you'll be at your ideal Betaine HCL dosage.

I started the Betaine HCL with Pepsin test a few weeks ago and I'm up to 5 capsules with every protein meal. (You can go as high as 10, according to SCD Lifestyle.) The first thing I've noticed is that I'm sleeping better at night and I'm taking this as a sign that my gut is starting to produce the proper serotonin precursors (I hope!). My bowel movements also improved a bit, so that I've been able to reduce the amount of daily magnesium I take by half, and stools are softer and darker. Best of all, there are no negative side effects so far.