When Too Little Acid Feels Like Too Much: The Hidden Link Between Achlorhydria and Acid Reflux

Photo by Vardan Papikyan on Unsplash

If you’ve been battling acid reflux, you’ve probably been told your stomach has too much acid—and that antacids or acid blockers are the solution. But what if the real issue isn’t too much acid at all… but too little?

It might sound backward, yet for many people, achlorhydria (a lack of stomach acid) is the hidden driver behind reflux symptoms. And the more we suppress acid, the more we may be fueling the very thing we’re trying to stop.

Let’s unpack this surprising connection and what it means for your reflux journey.

What Is Achlorhydria?

Achlorhydria means your stomach is producing little to no hydrochloric acid (HCl). This acid plays a critical role in:

• Breaking down food (especially protein)

• Absorbing nutrients like B12, iron, and calcium

• Killing harmful bacteria that enter with food

When there’s not enough acid to get the job done, digestion suffers—and so does the rest of your body.

How Low Stomach Acid Triggers Reflux

Here’s the twist: even though reflux feels like an acid overload, low acid can actually mimic those symptoms.

When digestion slows due to a lack of acid, food stays in the stomach too long. That leads to fermentation, gas, and pressure. And when the pressure builds up, the weak acid that is present can push up into the esophagus—causing the burning, bloating, and belching we associate with reflux.

In other words, it’s not the quantity of acid—it’s the misplacement of it.

When Medication Makes It Worse

If you’ve been using proton pump inhibitors (PPIs), H2 blockers, or antacids for a long time, you might unknowingly be contributing to achlorhydria.

These medications reduce or neutralize stomach acid to relieve reflux symptoms. While that can be helpful short-term—especially when healing an inflamed esophagus—long-term use may:

• Suppress acid production to dangerously low levels

• Interfere with the digestion and absorption of nutrients

• Allow bacteria and yeast to overgrow in the digestive tract

• Lead to the very symptoms you’re trying to avoid: bloating, gas, and reflux

Many people stay on acid-suppressing meds for years without reevaluating whether they still need them. In some cases, these drugs mask the real issue—that your body may already be underproducing acid.

Could You Have Achlorhydria?

Here are some signs your reflux might be due to low stomach acid:

• You feel full or bloated for hours after eating

• You burp frequently or pass a lot of gas

• High-protein meals are harder to digest

• You have nutrient deficiencies (like B12 or iron)

• You’ve been taking PPIs for a long time with little improvement

• Your stool contains undigested food

These clues often point to digestion that isn’t functioning optimally—because the acid that should be helping you break food down simply isn’t there.

The Long-Term Risks of Low Acid

If achlorhydria isn’t addressed, it can lead to:

• Nutrient malabsorption (especially B12, iron, calcium, and zinc)

• Fatigue and anemia

• Bacterial overgrowth in the small intestine (SIBO)

• Increased risk of infections from foodborne pathogens

• Continued reflux symptoms, despite treatment

What Can You Do?

If your reflux isn’t improving—or seems to get worse with acid-suppressing medications—it might be time to explore whether achlorhydria is the missing piece.

Start with these steps:

1. Talk to your doctor. You can ask about testing your stomach acid levels with a Heidelberg test or other methods.

2. Don’t self-diagnose. Some people do benefit from acid suppression—especially if there’s active inflammation—so always work with a professional.

3. Focus on digestion. Eat smaller meals, chew thoroughly, and avoid drinking too much water during meals, which can dilute stomach acid further.

4. Support stomach acid if needed. Under medical guidance, some people benefit from HCl supplements or digestive enzymes.

5. Replenish nutrients. Especially B12 and iron, which are often depleted in low-acid environments.

Final Thoughts

Acid reflux is complicated, and the causes can vary widely from person to person. But if you’ve been chasing relief and not getting results, it might be time to look in a different direction.

Achlorhydria isn’t talked about nearly enough, yet it could be the root cause of your reflux. Instead of just silencing symptoms, addressing low stomach acid may help you heal from the inside out—naturally and sustainably.