Recognizing Potential Indicators of High Stomach Acid Levels

People with elevated stomach acid levels or their complications may show the following symptoms ^{(2, 3)}: 

• Heartburn or burning sensation in the chest caused by backing up of the stomach acid into the esophagus. It occurs due to the weakness of the lower esophageal sphincter allowing the stomach acid to flow backward.
• Excess stomach acid may contribute to increased pressure leading to the reflux of acid into the esophagus. Frequent heartburn may indicate elevated stomach acid levels.
• There may be abdominal pain characterized by discomfort and distress in the stomach area, which may lead to various digestive issues. Irritation and inflammation in the stomach lining may also result in abdominal pain.
• There may be nausea and vomiting, especially when elevated stomach acid is due to an imbalance in the digestive process.
• A person may have indigestion as the elevated stomach acid levels may disrupt the normal digestive process.
• There may be a bloated feeling or tightness in the abdomen accompanied by increased gas production.

Some people may also experience the symptoms of bleeding stomach ulcers, such as: 

• Black and tarry stool
• Fainting and lightheadedness
• Blood in vomiting which may look like coffee grounds

Any of these symptoms, if experienced should be brought to immediate medical attention of the individuals to go to the nearest emergency room.

Certain medical conditions may cause a person to have high stomach levels. These include: 

• Zollinger-Ellison Syndrome (ZES): People with ZES may have one or more tumors in the duodenum, the first part of the small intestine. The tumors may cause the bodies to make more gastrin, a hormone that plays a role in stimulating stomach acid production. Less than 3 in 1 million people are diagnosed with ZES annually ⁽⁴⁾. The symptoms of ZES are similar to those of peptic ulcer disease, gastroesophageal reflux disease, and chronic diarrhea.
• Helicobacter Pylori (H. Pylori) Infections: pylori is a bacterium that infects a person’s stomach. People with H. pylori infection may have no symptoms until the complications show up ⁽⁵⁾. A person having duodenal ulcer along with H. pylori infection may have a higher stomach acid level.
• Rebound Acid Hypersecretion: Proton pump inhibitors are the medications that are known to play the role of suppressing a person’s production of stomach acid ⁽⁶⁾. High stomach acid levels may develop in a person who stops taking PPI after taking it for a few weeks ⁽⁷⁾. Research is going on about this rebound phenomenon.

Risk factors of the above-mentioned conditions include: 

• 20-25% of people with ZES are known to have a rare genetic condition known as multiple endocrine neoplasia type 1 ⁽²⁾. This may lead to tumors in the endocrine glands and affect the hormone production. Also, ZES is seen occurring more commonly in males than females.
• pylori may spread from one person to another through oral contact or via bodily fluids. It is more common in children, although complications are pelvic ulcer disease are less common in children.
• PPI, as it is prescribed to people with ZES, H. pylori infection, esophagitis, pelvic ulcer disease, and non-erosive reflux disease (a type of gastroesophageal reflux disease).

The healthcare physician takes a complete medical history regarding the symptoms, dietary habits, and lifestyle. The symptoms such as heartburn, abdominal pain, nausea, and vomiting are evaluated. The various tests performed include: 

• Laboratory Test: Serum gastrin level is measured. Elevated levels may indicate increased acid secretion. Serologic blood tests, stool antigen tests, or breath tests are done to detect H. pylori infection.
• Endoscopic Procedures: Upper gastrointestinal endoscopy is done to visualize the esophagus, stomach, and duodenum using a flexible tube with a camera. It helps in identifying ulcers, inflammation, or other abnormalities. Tissue samples taken during endoscopy are sent to a pathologist to assess for H. pylori infection or other pathological conditions.
• pH monitoring: Acidity levels in the esophagus are measured over 24 hours. It helps in assessing the frequency and duration of acid reflux episodes.
• Imaging Studies: Barium swallow is done, which includes an x-ray examination of the upper gastrointestinal tract after ingesting barium. It helps in identifying structural abnormalities or reflux patterns.
• Esophageal Manometry: It measures the pressure and coordination of muscle contraction in the esophagus. The function of the lower esophageal sphincter and esophageal motility is assessed.

Accurate diagnosis is crucial to effectively manage elevated stomach acid levels.

Elevated stomach acid levels can be treated with the following options ⁽⁸⁾: 

• Lifestyle and Dietary Modifications: Eating regular and smaller meals is encouraged and spicy, acidic, and fatty foods are advised to be avoided. Individuals are advised to limit caffeine and alcohol and eliminate tobacco use. Large meals should be avoided at bedtime.
• Medications: Proton pump inhibitors and H2 blockers are given to decrease stomach acid production. Antacids can help by providing quick relief by neutralizing stomach acid. It can be a short-term solution for mild symptoms. Antiemetics are given to provide relief from nausea.
• Treatment of Underlying Condition: Underlying conditions causing elevation of stomach acid levels are treated to bring relief from the symptoms.
• Surgical Intervention: Fundoplication is a surgical procedure to reinforce the lower esophageal sphincter and reduce acid reflux. In extreme cases, weight loss surgery may be recommended to alleviate the pressure on the stomach and reduce acid absorption.

Regular follow-up appointments are important to assess symptom improvement and adjust treatment if necessary. The potential side effects of long-term medication use should be monitored. The individuals are educated on trigger foods, proper meal timing, and stress reduction techniques. They are encouraged for sustainable lifestyle changes for long-term symptom management. 

Elevated stomach acid levels can lead to a range of uncomfortable symptoms and contribute to various digestive disorders. Recognizing potential indicators, understanding the causes, and implementing effective treatment strategies are important for restoring balance and promoting digestive health.

Maintaining a balanced stomach acid level is essential for optimal digestion, nutrient absorption, and overall well-being. A comprehensive approach is needed to manage these symptoms, which include lifestyle modification, dietary changes, medications, and in some cases surgical interventions. The patient needs to adhere to the recommended lifestyle changes and medication. Regular follow-up and monitoring are key to assessing treatment efficacy and making adjustments as needed.

In pursuit of digestive health, collaboration between healthcare professionals and patients is essential. By addressing elevated stomach acid levels comprehensively, individuals can experience relief from symptoms, prevent complications, and enhance overall quality of life.