Hydrochloric Acid: SIBO Wants You.

Here's a trick question for you. We all know the acronym SIBO refers to an overgrowth of bacteria, in a place it does not belong (the small intestine). But how and why did that bacteria overgrow there in the first place? The answer is: it depends.

Many cases of SIBO are caused by infection. Some nice person traveling in South America catches a stomach bug, and the next thing you know, they’ve got post-infectious IBS and SIBO. For others (*blush*) it’s long-standing IBS with chronic constipation that gets the ball rolling. And then there’s that little-discussed culprit: eating disorders. The research may be scant, but in my personal experience, as a clinical nutritionist and through my involvement with various IBS discussion groups and boards, it appears that many SIBO sufferers have experienced anorexia, bulimia or binge eating. (You can count me in there, too. Full disclosure.)

Eating too much too fast isn’t good for anyone, but it’s especially problematic when what goes in doesn’t come out. Folks with eating disorders seem to develop IBS or other digestive problems across the board. Those who develop acid reflux are often prescribed drugs like Proton Pump Inhibitors (PPIs) to inhibit hydrochloric acid production (makes sense, right?). But, surprise! People taking PPIs are at high risk of developing SIBO.

The thing is, not only do we NEED hydrochloric acid to properly digest our food, we need it to digest (i.e. kill) germs. Stomach acids help to maintain proper gut pH levels in the gut and subsequently prevent the overgrowth of pathogens and bad bacteria. The less gastric acid we produce, the more alkaline our GI tracts become, and the more likely that Small Intestine Bacterial Overgrowth will follow.

Reduced acidity in the stomach may be caused by PPIs and antacid drugs like Tums, but that's not all. Low stomach acid also results naturally from the normal decrease in gastric HCl production that occurs with age. And low stomach acid essentially cripples the antimicrobial effects of healthy gastric phase digestion. Bacteria, parasites and yeasts that survive gastric phase digestion due to low levels of hydrochloric acid go forth, thrive and multiply in the warm, dark moist environment of the small intestine. 

Meanwhile, poorly broken down food particles (notably carbohydrates) that linger in the small intestine without sufficient acids and enzymes to digest them—but plenty of bacteria to frolic with—undergoes fermentation. Fermentation inside the closed tube of the intestine creates trapped gas, and from there you get symptoms such as pressure, stabbing pain, increased feelings of fullness, embarrassing flatulence and belching.

Hello, SIBO.

Now for the good news. You can boost your hydrochloric acid levels by taking a Betaine HCL SUPPLEMENT. Betaine HCL comes in tablets or capsules, and it’s not expensive. Look for a product like this one that delivers 750 mg or so per pill, and ALWAYS TAKE WITH FOOD. Betaine HCL will help boost protein digestion, increase vitamin and mineral absorption, lower gastric pH and kill off bad pathogens in your stomach and upper GI tract.

Dosing Betaine HCL is a bit of an art. To find out the actual dosage that’s right for you, start by taking one pill per meal. Then, increase your dose gradually, day by day (2 pills per meal, then 3 pills per meal, etc.) until the point where you start to feel a slight burning sensation in your gut. That is the sign you’ve reached your tolerance level. Once you’ve determined your tolerance level, drop back to the next level down and take that many going forward. (Or you can just do what I do: use your intuition and, depending on the size of your meal, take 1, 2 or 3.)

Geeky Note: Isn’t it weird to think that hydrochloric acid, one of only six strong acids on earth, is made INSIDE of our bodies? And that it can be contained in a pill, which you can safely put in your MOUTH?! Click here to see what HCL does to an apple...