Digestion is a complex process that depends on many factors. Two crucial substances that are often overlooked are stomach acid and bile acids. A deficiency in these can not only impair food absorption but also disrupt the health of the entire digestive system.
Symptoms
Stomach acid deficiency often manifests itself through symptoms such as bloating, reflux, bloating, nausea after eating and SIBO (small intestinal bacterial overgrowth). Interestingly, many people suffer from stomach acid deficiency but think they have too much acid because the symptoms are often confused with classic heartburn symptoms.
People with bile acid deficiency often complain of fatty stools, diarrhea, bloating, fat intolerance and nutrient deficiencies, especially in fat-soluble vitamins. Both deficiencies can also lead to a general feeling of unwellness, significantly impairing quality of life.
Causes
Stomach acid deficiency can be caused by various factors, including chronic stress, dietary deficiencies such as a diet too high in sugar or fat, or the long-term use of acid reducers (e.g., proton pump inhibitors) and other medications. Zinc deficiency or hormonal disorders such as hypothyroidism can also suppress stomach acid production.
Bile acid deficiency often develops after gallbladder removal (cholecystectomy) or due to liver conditions that impair bile synthesis. Chronic inflammation, insufficient intake of bitter foods, and difficulties with fat digestion can likewise contribute to inadequate bile acid levels.
Diagnosis
Stomach acid and bile acid deficiencies are identified through various functional tests. A common assessment for low stomach acid is the betaine HCl challenge test, which evaluates the stomach’s ability to produce sufficient acid. The gastric pH can also be measured during a gastroscopy for a more direct assessment.
There are, however, simpler at-home methods that can provide initial indications of low stomach acid. One widely used approach is the betaine HCl self-test, performed by taking betaine HCl capsules with a meal. Improvement in digestion or a reduction in symptoms such as bloating and gas may suggest insufficient stomach acid production.
In the case of bile acid deficiency, a stool analysis is typically used to measure bile acid excretion. Additional diagnostic markers, such as liver enzymes (e.g., GGT, ALP) and ultrasound imaging, can help identify possible underlying liver or gallbladder conditions.
Together, these tests offer a quick and practical way to detect imbalances before a full medical evaluation is carried out.
Therapeutic Approaches
Therapy typically begins with a diet rich in bitter compounds (such as artichoke, dandelion, and chicory), which help stimulate the natural production of both stomach acid and bile. Digestive enzymes or betaine HCl can further support stomach acid levels, while bile salts and herbal remedies like milk thistle and yarrow promote healthy bile flow.
Additional botanicals such as ginger and cinnamon can enhance overall digestive activity. Research shows that bitter substances particularly artichoke and gentian may significantly improve digestive function and increase bile secretion.
