What Is Hypochlorhydria?

Medically Reviewed by Minesh Khatri, MD on February 20, 2024
3 min read

‌Your stomach has hydrochloric acid in it to help you digest your food. Hypochlorhydria is a condition marked by low levels of stomach acid. Your body may not be able to make enough hydrochloric acid if you have digestive problems, a lack of vitamins, or stomach infection.

‌Hypochlorhydria happens when your stomach does not release enough hydrochloric acid, which helps your stomach break down food. It also helps your body use nutrients like protein and protects it from bacteria and viruses.

Low hydrochloric acid levels can affect your stomach’s ability to digest and absorb proteins. It can also damage your gut and lead to digestive health issues and infections.

‌Some things can make you more likely to get hypochlorhydria.

Age. Your stomach secretes lower amounts of hydrochloric acid as you age. Hypochlorhydria is more common in people over 65.

High stress levels. Long-term (chronic) stress can lead to low stomach acid.

‌Smoking and drinking. Smoking cigarettes and drinking alcohol can decrease the nutrients in your body. This can cause less stomach acid.

Lack of vitamins. Nutrients such as iron, zinc, and B vitamins are essential for maintaining stomach acid levels. A poor diet can result in low stomach acid, as can a loss of nutrients due to health problems, stress, smoking, or alcohol.

Antacids and other medication. Long-term use of antacids can cause hypochlorhydria. Medicines for treating stomach ulcers or heartburn can also cause low stomach acid production. Talk with your doctor about changing medications if you notice symptoms of low stomach acid.

Helicobacter pylori infection. H. pylori is a type of bacteria that often causes stomach ulcers. H. pylori infection can be a major risk factor for low stomach acid if it isn’t treated.

Stomach surgery. Stomach surgeries such as gastric bypass can cause hypochlorhydria.

The signs that you don’t have enough stomach acid usually show up a few hours after you’ve eaten. They may include:‌

  • Feeling like you want to eat even when you’re not hungry
  • Feeling too full after regular meals‌
  • Indigestion
  • Gas or flatulence
  • Bloating‌
  • Constipation ‌
  • Diarrhea‌
  • Soreness or burning in your mouth‌
  • Stomach upset and cramps
  • Undigested food in stool
  • Nausea
  • Heartburn

Low stomach acid can result in health conditions such as achlorhydria, autoimmune disorders, gastritis, skin problems like acne or eczema, and pernicious anemia.

‌The hydrochloric acid in your stomach has a very low pH balance of 1 to 2. Your doctor will check the level of acid in your stomach using a pH test if they suspect hypochlorhydria.

The test results can be as follows:‌

  • If your stomach pH is less than 3, you have normal acid levels.
  • If the pH is 3 to 5, you have hypochlorhydria.
  • If the pH is higher than 5, you may have achlorhydria. This happens when your stomach stops making hydrochloric acid.

Your doctor may also order blood tests to check for vitamin or iron deficiency. They might suggest that you visit a digestive specialist called a gastroenterologist if your symptoms are severe.

‌Hypochlorhydria treatment usually involves fixing the cause of the symptoms. It also depends on the severity of your symptoms. Common treatments include:

Antibiotics. A bacterial infection like H. pylori may be the cause of your symptoms. Your doctor can prescribe a combination of antibiotics to get rid of the infection.

Hydrochloric acid supplements and enzymes. Your doctor may prescribe supplements such as betaine hydrochloride to restore the pH of your stomach. The stomach enzyme pepsin is another common treatment.

Changes in diet. Your doctor may recommend that you eat easy-to-digest food that is rich in fiber and nutrients. They may recommend supplements such as iron, zinc, calcium, and vitamin B complex

They might also recommend natural enzyme supplements with papaya and pineapple extracts to boost stomach acid production.

Changes in medication. Medicines such as proton pump inhibitors and antacids can reduce your stomach acid levels. Your doctor may decide to change your medications.

Herbs such as peppermint and gentian may aid in digestion and help with stomach acid production. Try to keep your stress levels down, and get plenty of exercise and sleep.