Common symptoms and causes of excess stomach acid: managing stomach acidity

By Cristiano Antonino On Jun 8, 2023

Stomach acid is essential for digestion, but sometimes acid-producing cells in the digestive system pump out too much acid

Symptoms of high stomach acidity can include stomach ache, bloating and heartburn.

There are numerous causes of elevated stomach acid production, including bacterial infections, stress and rebound effects due to discontinuation of treatment.

This article will discuss the most common conditions associated with overproduction of stomach acid, its signs and symptoms, and ways to mitigate the resulting symptoms.

Symptoms of high stomach acid

Symptoms of high stomach acid may include:

Heartburn
A bitter taste in the mouth
Bad breath
Recurring cough or hiccups
Hoarse voice
Bloating
Nausea
Diarrhoea

What can cause high stomach acidity?

The cells lining the stomach produce hydrochloric acid, which helps break down food into its most basic components needed to sustain life.

Certain conditions can cause your body to produce too much of this acid.

These include:

Helicobacter pylori (H. pylori) is a bacterium that damages the tissues of the stomach and duodenum (the first part of the small intestine). Acute active bacterial infection with H. pylori in the stomach can lead to an increase in gastric acid, whereas chronic infection has been shown to reduce gastric acid secretion.
Stress has been shown to inhibit gastric acid emptying. Chronic stress can also deplete prostaglandins, which protect the stomach lining from acid, increasing the risk of developing ulcers.
Ulcers are common among people who are stressed, take high amounts of NSAIDs or are infected with H. pylori, all of which are independent factors for increased acid production.
Anti-H2 drugs such as Pepcid (famotidine) and proton pump inhibitors (PPIs) reduce acid production in the stomach. If you take one of these regularly, you may experience a rebound in stomach acid production if you stop abruptly.
Zollinger-Ellison syndrome (ZES) is a rare digestive condition in which neuroendocrine tumours called gastrinomas cause the stomach to produce too much acid. These tumours produce gastrin, a hormone that stimulates acid production. ESZ is sometimes present in those with rare genetic conditions such as multiple endocrine neoplasia type 1 (MEN1).
Side effects of proton pump inhibitors

Complications of excess stomach acid

Too much acid in the stomach can overwhelm prostaglandins (hormone-like chemicals that influence pain and inflammation) in the stomach and duodenum.

These hormones help protect the stomach lining, but if they are overwhelmed, they can cause ulcers and a myriad of other symptoms.

Excessive amounts of stomach acid cause the following three conditions:

Peptic ulcers: sores resulting from acid eroding the stomach lining.
Gastroesophageal reflux disease (GERD): GERD is a medical condition characterised by the reflux of stomach acid into the oesophagus.
Gastrointestinal bleeding: acid leaking into the gastrointestinal tract can cause sores and bleeding, especially in organs associated with digestion such as the small intestine and pancreas.

How high stomach acidity is treated

There are a number of medications you can take to reduce the production of acid in the stomach, helping to relieve the symptoms of heartburn.

Medications include:

Histamine 2 blockers (H2 blockers): these drugs block histamine receptors, which produce stomach acid along the stomach lining. They act quickly, often within 15-30 minutes, and the effects can last for about 12 hours. Examples are Axid AR (nizatidine), Pepcid Complete or Pepcid AC (famotidine), Tagamet (cimetidine) and Zantac 360 (famotidine).
Proton pump inhibitors (PPIs): these are another class of powerful acidity-reducing drugs, except that their effects last longer than H2 inhibitors, producing relief for up to 24 hours. The effect increases when they are taken for several consecutive days. Some commonly sold PPIs are: Dexilant (dexlansoprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole) and AcipHex (rabeprazole).
If you have persistent symptoms that are worsening or do not go away with treatment, consult a doctor immediately.