The term ‘acidic stomach‘ is often used to describe the various conditions associated with hyperacidity and reflux. It is a broad term attributed to conditions like gastritis, peptic ulcer (including an esophageal ulcer) and acid reflux. Typically an acidic stomach presents with a burning chest pain or burning abdominal pain, nausea, regurgitation or vomiting and/or stomach bloating, which is often described as indigestion (dyspepsia).
The stomach produces approximately 1.5 liters of gastric secretions in a day. It is highly acidic due to presence of hydrochloric acid. The stomach has innate mechanisms to deal with the stomach acid – a mucus buffer protects the stomach lining from the action of the acid and increasing gastric emptying allows the contents to flow out of the stomach.
The duodenum is the first part of the small intestine that receives the partially digested acidic stomach contents known as gastric chyme. While the duodenum does not contain any protective layer against the acid, it does secrete alkaline bicarbonate ions and water to dilute and neutralize the incoming acid. In addition, the duodenum can secrete the digestive hormone, secretin, to reduce gastric acid production and secretion as well as delaying gastric emptying.
The esophagus, however, is not as well equipped to deal with the stomach acid. Normally, the acid should not flow backwards from the stomach into the esophagus – this is prevented by the lower esophageal sphincter (LES) and throat-to-rectum direction of peristaltic waves. If the acidic stomach contents do enter the esophagus, excess saliva is secreted which is alkaline and neutralizes some of the acid. The peristaltic waves in the stomach increase to ‘flush’ the acid back into the stomach.
An acidic stomach includes conditions that arise predominantly in these three areas – esophagus, stomach and duodenum – as a result of impaired stomach acid regulation.
Causes of Acidic Stomach
The most common causes of gastritis and a peptic ulcer is due to an H.pylori infection or the use of NSAIDs. Both of these factors increase gastric acid secretion and impair the protective mechanisms in the stomach and duodenum. It may also contribute to acid reflux to some extent. Exposure of the gut lining to the stomach acid initially causes inflammation and over time ulceration. If left untreated it can progress to more serious complications.
In acid reflux, the backward flow of stomach acid into the esophagus severely irritates the lining of the esophagus. It may eventually result in esophageal ulcers. The acid may rise as high up as the throat and cause reflux pharyngitis and laryngitis. Acute causes of acid reflux is not uncommon and may occur in any person from time to time. It is often due to overeating, excessive alcohol consumption, lying flat after eating, or exercising after meals. Chronic reflux is known as gastroesophageal reflux disease or GERD. It arises as a result of a dysfunction of the lower esophageal sphincter (LES), delayed gastric emptying, hiatal hernia or increased intra-abdominal pressure.
Symptoms of Acidic Stomach
Many of the symptoms of stomach acid problems may be similar and identifying subtle differences may help in diagnosing the most likely disorder. The common signs and symptoms include :
- Burning pain – chest or upper abdomen (stomach ache, stomach discomfort or gastric pain)
- Nausea and/or vomiting
- Stomach bloating which is a sensation of fullness or pressure in the upper abdomen
- Blood in the vomit (hematemesis) and dark blood in the stool (melena) are uncommon but may be a sign of upper gastrointestinal bleeding which is a complication of all three conditions.
More specific signs and symptoms include :
- Excessive belching may be present in all of the conditions but is more prominent in gastritis.
- Sudden accumulation of excessive saliva in the mouth (water brash) is more prominent in acid reflux.
- Pain that exacerbates when hungry and eases for a short period after eating may be a symptom of gastritis or a peptic ulcer.
- Pain that aggravates during and after eating, especially chest pain, may be a symptom of acid reflux.
- Chronic sore throat, especially a morning sore throat, is seen in acid reflux.
- Regurgitation is more frequently seen in acid reflux but may be reported in other hyperacidity conditions as well.
Diet and Remedies for an Acidic Stomach
Dietary management and lifestyle measures to help remedy an acidic stomach are discussed under :
Treatment for Acidic Stomach
Medication and surgical options for an acidic stomach are discussed under :