Quick answer: The most common symptoms of excess stomach acid are heartburn, acid reflux (regurgitation), epigastric pain (pain around the pit of the stomach) and a feeling of fullness. These symptoms often worsen after meals or at night. A gastroenterological examination is recommended to identify the exact cause and ensure appropriate treatment.
Stomach acid plays an important role in digestion: it helps break down proteins and protects against pathogens. Problems arise when too much acid is produced or when it flows back into the oesophagus. This can lead to unpleasant, even painful symptoms, which can significantly impair quality of life.
This article outlines the symptoms to look out for, what might be causing them, and what tests can be used to reach an accurate diagnosis. You can also find out how Endomedix’s specialists can help identify the cause of your symptoms and treat them.
What are the most common symptoms of excess stomach acid?
Excessive acid production and acid reflux cause characteristic symptoms. The most common symptoms are as follows:
- Heartburn (pyrosis): A burning sensation behind the breastbone, which may radiate upwards towards the jaw. It often intensifies when bending forwards or after eating certain foods.
- Acid reflux (regurgitation): A small amount of acidic or bitter stomach contents flows back into the mouth.
- Abdominal pain: A dull or burning pain in the area around the pit of the stomach, which, in the case of peptic ulcer disease, typically worsens at night between 11 pm and 2 am.
- Feeling of fullness and belching: A feeling of fullness that increases after a meal, feeling full too soon, and difficulty tolerating fatty foods.
- Nausea: Occasionally accompanied by vomiting, particularly in the case of a stomach ulcer.
Symptoms vary from person to person. In some patients, the symptoms are mild; in others, they are more severe. It is important to note that the severity of heartburn does not always reflect the actual condition of the mucous membrane.
What other (non-typical) symptoms might occur?
Acid reflux can cause more than just the classic heartburn. The so-called extra-oesophageal (outside the oesophagus) symptoms can be misleading:
- chest pain not related to the heart
- persistent hoarseness and a sore throat
- chronic cough or earache
- dental problems and bad breath
- difficulty swallowing (dysphagia)
As chest pain may be caused by a heart condition, this symptom must always be investigated during a medical examination.
What causes excessive acid production?
There may be several factors underlying high stomach acid levels. The most common causes and risk factors are:
- Helicobacter pylori infection: This bacterium can cause inflammation and ulcers. It is responsible for 70–90% of duodenal ulcers and 30–60% of gastric ulcers.
- Medicines: Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin increase the risk of ulcers by an average of four times.
- Lifestyle factors: Smoking, excessive alcohol consumption and stress can contribute to the development of these symptoms.
- Gastro-oesophageal reflux disease (GERD): Due to a temporary relaxation of the lower oesophageal sphincter, acid flows back into the oesophagus.
- Other conditions: Less commonly, Zollinger-Ellison syndrome (a tumour in the gastrointestinal tract) can also cause excessive acid production.
Gastro-oesophageal reflux disease affects 10–20% of the Western population. Many people experience symptoms on a weekly basis, whilst for some they occur daily, and the incidence increases with age.
When should you see a doctor?
In the case of certain symptoms, a consultation with a specialist is definitely recommended. These are known as warning signs, or ‘alarm symptoms’:
- difficulty swallowing (dysphagia) or painful swallowing
- unexplained weight loss
- anaemia or iron deficiency
- black or bloody stools
- recurrent vomiting
- fever associated with gastrointestinal symptoms
These symptoms may indicate a more serious condition, so you should not delay getting checked out. Anyone experiencing persistent heartburn, acid reflux or upper abdominal pain should a specialist gastroenterology consultation ask at Endomedix, where they will thoroughly investigate the cause of your symptoms.
How can excessive acid production be diagnosed?
There are several types of tests available to help establish an accurate diagnosis. The specialist will decide which is most appropriate based on the symptoms and medical history.
Gastroscopy
An upper gastrointestinal endoscopy is the most important examination for investigating acid-related symptoms. It allows direct visual inspection of the mucous membranes of the oesophagus, stomach and duodenum, assessment of the severity of inflammation or ulcers, and the taking of tissue samples. The presence of Helicobacter pylori can also be detected during the examination.
Many patients are afraid of this examination. The good news, however, is that at Endomedix, in order to avoid any discomfort, for professional reasons we exclusively gastroscopy under general anaesthesia We carry out the procedure – we do not simply sedate you, but work under safe anaesthesia supervised by an anaesthetist. This means you will not feel a thing during the procedure and will wake up after a restful sleep.
Further diagnostic methods
- 24-hour pH monitoring: It directly measures the number of acid episodes and their correlation with symptoms.
- Empirical PPI test: In young patients with no warning symptoms, a favourable response to acid-reducing medication may confirm the diagnosis.
- Helicobacter pylori screening: This can be done using a breath test, a faecal antigen test or a sample taken during a colonoscopy.
What treatment options are available?
The treatment of excessive acid production depends on the underlying cause. The most common approaches are as follows.
Medication
- Proton pump inhibitors (PPIs): These are the gold standards for acid secretion inhibition. In typical cases of reflux disease, a once-daily dose for eight weeks is generally recommended. For optimal effect, they should be taken 30–60 minutes before a meal.
- H2 receptor antagonists: They can be used for milder symptoms.
- Antacids and alginates: They neutralise stomach acid and provide rapid, symptomatic relief.
- Eradication of Helicobacter pylori: If the test result is positive, a combination of antibiotics and PPIs is prescribed, typically for 14 days.
Lifestyle changes
As well as medication, lifestyle changes can also be of great help:
- avoiding foods that increase acid production (fatty, spicy and acidic foods)
- eating smaller portions
- weight loss in cases of excess weight
- avoiding smoking and excessive alcohol consumption
- avoiding eating before going to bed
Frequently asked questions
Can high levels of stomach acid be dangerous if left untreated?
Yes. Persistent acid reflux can lead to complications such as oesophageal ulcers, oesophageal stricture or Barrett’s oesophagus, which is a precancerous condition. It is therefore important to have any symptoms investigated in good time.
Does a gastroscopy hurt?
At Endomedix, we carry out gastroscopy under general anaesthesia, so the patient feels nothing during the procedure. For medical reasons, we do not use sedation; instead, we use safe general anaesthesia supervised by an anaesthetist.
How long should I take acid-reducing medication?
This depends on the type and severity of the symptoms. In typical cases of reflux disease, a course of eight weeks is often recommended. Long-term use and the gradual tapering off of the medication should always be discussed with a specialist.
What is the difference between reflux and an ulcer?
Reflux refers to the backflow of acid into the oesophagus, which causes heartburn. An ulcer is a lesion in the mucous membrane of the stomach or duodenum, most commonly caused by Helicobacter pylori infection or the use of NSAIDs. Both may be linked to excessive acid production.
Don’t put off getting checked out
The symptoms of excess stomach acid are unpleasant, but in most cases they can be managed effectively. The key is an accurate diagnosis. If you experience persistent heartburn, acid reflux or upper abdominal pain, don’t be left in the dark.
Endomedix’s experienced gastroenterologists are here to help you, using state-of-the-art equipment and a personalised approach. Book an appointment for a gastroenterology consultation, and take the first step towards resolving your complaints.
