Indigestion, and why taking antacids could be a big mistake

You produce less stomach acid with age, and that’s the problem.

‘Indigestion’ is one of those health problems that has a range of possible causes, and just as many possible solutions, at least from a dietary perspective. The usual medical perspective is that acid is the enemy and must be neutralised. But suppressing stomach acid is frequently the last thing you need to do, especially as you get older.

Symptoms of indigestion usually arise shortly after eating and include:

• Heartburn

• Burping

• Feeling full, even after eating a small meal

• Bloating

• Bad breath

You can buy over-the-counter antacids, like Gaviscon. But if you were to get a prescription for your indigestion it would probably be for a proton-pump inhibitor, or PPI.

PPIs decrease gastric secretions. This can be effective treatment for duodenal ulcers, peptic ulcers and erosive oesophagitis. Yet the healthy stomach is a highly acidic environment. That’s the way it’s designed: like all omnivores and carnivores, humans have very low stomach pH, ranging from 1-2.

Hydrochloric acid (HCl) has many functions, including:

1. It is a major defence mechanism against pathogens, including the bacteria Helicobacter pylori and Clostridium difficile.

2. It activates pepsin, an enzyme that breaks down protein into amino acids so that they can be absorbed.

3. It is required for the absorption of important minerals, including calcium, magnesium, iron, and zinc.

4. It is required for the secretion of intrinsic factor, without which you can’t absorb vitamin B12.

An inability to secrete sufficient acid is called hypochlorhydria.

The irony is that the symptoms of hypochlorhydria are very similar to those of indigestion, for which you might be prescribed antacids. Those symptoms include:

• Feeling full after a small meal

• Heartburn

• Gas and bloating

• Acid reflux

• Diarrhoea/constipation

Other indications of hypochlorhydria include:

• hair loss

• weak, brittle nails

• fatigue

• pallor

• acid reflux and heartburn

• poor memory/focus

Many of these symptoms are due to mineral and vitamin B12 deficiency.

What causes low HCL?