So WTF is Hypochlorhydria (HCH)?
I’ll talk about how I learned I have HCH in a bit, but first: not many people must have it, ’cause it doesn’t even have its own Wiki entry!
The dictionary defines it as a “deficiency of hydrochloric acid in the gastric juice,” or underactive stomach.
ScienceDirect’s definition is: “A pathological condition characterized by reduced or even absent (achlorhydria) acid secretion through parietal cells of the stomach.”
Initially when I discovered my symptoms, I thought I had an overactive stomach and that it was too much acid that was causing the pain, because I barely drank water as a child. There was that one time I was Googling and gulped down a teaspoon of baking soda thinking I needed to balance out the acid with alkaline, and I threw up right after. So do not do, and ask your doctor for an overactive stomach test instead.
Common causes of HCH
Diet high in animal products
Pretty much me until 2007 when I watched Earthlings and began my transition to eating vegetarian, then finally gave up seafood in 2017 and dairy in 2018.
Diet high in processed and refined foods
Again, pretty much me until I started getting better at cooking. I’d say I was still eating quite a few frozen foods and using jarred sauces up until 2011.
Eating too fast, or when stressed or distracted
That’s happened, and you can thank our modern work day for that!
Not chewing properly
When I first saw my naturopathic doctor around 2013, she said I might not be chewing enough…and I’m still working on this, more than ever.
Drinking with meals, or drinking ice cold drinks within 30 minutes before meals
Growing up, drinking with meals was very typical, and it wasn’t until I took a vegetarian nutrition course in 2011 when I learned you should drink water at least 15 minutes before eating meals, or else later.
- Improper food combining: more on this later.
- Aging: Stomach acid naturally decreases after the age of 40. Yay!
- Malnutrition: lacking in the building blocks for producing stomach acid and enzymes.
- Constrictive clothing: As my ND noticed, I also think that wearing bras and pants that are too tight also causes the symptoms as it constricts the entire area.
- Genetics? HCH is also linked to rheumatoid arthritis, which my dad has. In recent years, I’ve had conversations with my mom – a Registered Nurse – about my symptoms, and she would talk about her own, which led me to think that my condition is partially genetic.
Common symptoms of HCH
Bloating and fullness after meals
I’m really lucky my mother was a nurse, because I never seemed to miss school for that long when I was sick. I remember being bloated (or “kabag” in Tagalog) as young as four years old, and she’d put a rubber pack filled with hot water on my belly to comfort me.
In 1994, 15 year-old Aaliyah came out with her first album and her distinct look was the crop top with baggy jeans and all the girls in school envied her six-pack and started doing sit-ups. No matter how many reps I was able to do (and I think my core strength was pretty good in the eighth grade), my stomach was always still bloated.
In 2011, I was gifted with Kathy Freston’s Quantum Wellness and tried out her three-week cleanse, which included eliminating gluten. It was then I first learned what it felt like to have a flat, “washboard” stomach.
Abdominal distention and discomfort
2009 was when I started to notice more painful symptoms, which occurred if I had beans or a combo of hard-to-digest foods, and ate dinner too late (past 9pm). The pain would ALWAYS be right in the centre of my chest, in my upper abdomen just below my breasts, and I’d have to sit up for a while in the middle of the night until the pain went away. I remember my husband (then boyfriend of two years) would get up to get me a mug of hot water. God bless his soul.
I started a rule of eating dinner ideally before 8pm and not eating anything after 9pm, which I still pretty much follow.
If I notice extreme bloating or pain earlier in the day, I cut out dinner altogether, since intermittent fasting can be a good thing every now and then.
Heartburn and acid reflux
When vegan nutritionist Shawna Barker introduced me to HCH, she described a constriction in the stomach, which prevents food from going into the smaller intestine. This is why acid gets pushed up into the esophagus and causes that abdominal pain.
Healthygut.com says: “…the food is still in your stomach when it should be in your small intestine. The pH levels aren’t low enough to begin dumping the food into the intestines.”
Someone really needs to do an animated video on how this happens!
Belching and Gas
Feeling heavy, sleepy, or nauseated after meals
I describe the feeling of having food in your stomach that won’t go down as having a brick just sitting there. It’s not fun.
- Longitudenal striations on fingernails
- Undigested food in stool
- Vomiting: While I don’t have all of the symptoms mentioned, I’m adding this to the list. I can’t remember when it first started happening, but I noticed that immediately after doing so, I’d feel better. And it’d always be in the middle of the night, at 1, 2 or 3 a.m.
Solutions for treating HCH
- Eat smaller, more frequent meals.
- Avoid drinking too much during meals.
Avoid ice cold drinks within 30 minutes before and during meals
I’m no expert in ayurveda, but last year my ND recommended that while cleansing from my food sensitivities, I also do a vata-pacifying diet to eliminate the foods that are high in air. I did an online test at one point and my dosha is pitta, which is why I could never do a raw vegan diet. Everything’s gotta be cooked and on FIRE for me — and that includes drinks! (Click here to see a hand analysis I did in 2015 that also indicated too much air, not enough fire.)
Follow proper food combining
Shawna says fruit should be eaten alone, and at least 15 minutes before eating other foods. I learned about this in my nutrition course, as fruit pretty much ferments RIGHT AWAY and you don’t want it to compromise the digestion of other foods.
It wasn’t until 2016 when learned about Kimberly Snyder’s The Beauty Detox Solution and started following the rules of carbs during the day (with vegetables) and protein ONLY at night, making sure carbs and proteins weren’t mixed. You can mix carbs (eg. potatoes and rice), but you can’t mix proteins (eg. lentils and beans) as it’s difficult to digest. This is something I still adhere to.
Mindful eating practices
Unlike the sympathetic nervous system which controls our fight-or-flight stress response, the parasympathetic system should be active when eating. Mindful eating practices include:
- Deep breathing before meals
- Chewing food thoroughly
- Sitting down to eat
- Eating without distractions. Gathering at the table sans phones is good for your health, people!
Even though I was never really a stressful eater, I was most definitely a stressful cook in the kitchen, and always hated that prep and washing cut into my work day. It’s interesting that the most successful years I ran my business were also the times I was most in pain.
Since batch cooking at the start of the week and accepting the amount of time it takes to prep and clean, I have been a lot less stressed in the kitchen, and so has my husband!
Most of the things I discovered I could improve on are habitual, and since learning more about HCH, I’ve been deep breathing before meditating (twice a day) and chewing my food a lot more. I’m trying to re-start my gratitude practice before meals as well.
Take apple cider vinegar before meals (or HCL capsules)
Shawna suggests 1-2 tbsp of apple cider vinegar in 1/4 cup of water before meals.
Since last year I’ve been consuming 3 tsp of apple cider vinegar just before lunch and dinner as recommended by my ND.
Shawna recommends avoiding large amounts of red meat and dairy, and balancing the gut microbiome by eating a large diversity of plant foods, increasing fibre, and incorporating fermented foods.
In 2018 on my mostly vegan diet, I only vomited ONCE after seven instances of pain. It was a record, so I know that staying away from dairy and other food sensitivities was working. Even though I’m sensitive to wheat, it doesn’t seem to cause any symptoms but every now and then I’ll opt for a gluten-free burger bun or pizza crust. I’m also sensitive to brewer’s yeast, so I even started smoking cannabis this year and drastically cut down my alcohol intake, which was already pretty damn low due to my intolerance.
I’ve also been eating more sauerkraut — if anyone’s got a great kefir water brand they swear by, LMK! Trying to stay away from kombucha as it’s cold and carbonated. I also hate kimchi. So I could stand to take in more fermented foods.
As the year comes to a close and the season for food temptations increases, I insist on keeping my new record of ONLY FOUR INSTANCES OF PAIN in 2019, and have a goal to reduce this altogether in future years.
Stimulate the vagus nerve
What I loved about the presentation at Plant Life Nutrition is that the speakers mentioned the relationship between the brain and the gut. Shawna said, “supporting the vagus nerve and overall stress management is very important.”
They should really be teaching brain science in the eighth grade instead of in Psych 100.
You can also support the stimulation of the vagus nerve of the brain by doing the following:
- Singing, humming, chanting
- Splashing cold water on your face
- Doing yoga
- Slow, deep breathing
…pretty much all that good yin stuff. I have been a long-time meditation and yoga practitioner, and I sing when I practice my keyboard. I’ve also been taking cold showers for 30 seconds daily, and since closing my agency last year, I’ve definitely noticed that my stress levels have decreased, which has likely reduced my symptoms too.
When I’m bloated, it’s hard to keep my attention on anything else. In times of stress the body tends to go out of whack… think about the butterflies your stomach gets when you have to perform in public. The gut-brain relationship isn’t woo-woo, it’s science!
Make sure your zinc intake is 8-11 mg/day (for women)
I asked the presenters if they recommended zinc supplements, but they weren’t cheerleading for it, so I decided to see if I could step up my zinc intake through food first. I looked into high zinc foods, and then went through ALL of my lunch and dinner recipes to see where I could add food as an ingredient or garnish, without making it difficult to digest. Even oatmeal is going to get an upgrade of sesame & pumpkin seeds and cocoa, which has long been sitting in my cupboard neglected!
Notice that this list only has certain types of nuts, seeds, and potatoes because I am sensitive to a few others, but generally all nuts are high in zinc.
Last week I made Boozy Tomato Spaghetti and added nutritional yeast (below), and added black beans to my Jambalaya. So most of the recipes I’ve posted here have been upgraded to include more zinc. Feel free to message me if you want to know if & how I changed any of them!
Form a health team
I recently finished Lissa Rankin’s two books, which both talked about having a good number of people on your health team.
There are so many ways to help yourself if you have a condition that is undiagnosed. I probably could have searched more online or sought out books, and also asked colleagues who work in the health industry.
Whenever I talked to someone about my condition, I’d say I was in pain but never talked about the symptoms fully. So they either could not empathize, or had empty theories about what was going on. A friend of mine, who possesses a doctorate degree in nutrition, says that the gut is the most misunderstood area of the body because we just can’t see what’s going on in there. I mean, there are colonoscopies, but you can’t swallow or send a micro-camera (yet) ’cause it’d get dissolved by the stomach acid. (Or would it if I have HCH?)
Support from my general physician
When I went to my doctor for the first time in 2010, she gave me Nexium to take for 30 days straight, and I didn’t happen to have any symptoms during that time. She offered to give me a permanent prescription, but as I was already taking three supplements for my diet, I didn’t want to be on another one (and a pharma drug at that), and I’m glad I didn’t take it. I also did a blood and breath test and an X-ray, which all came out normal.
Three years later, I started keeping a food journal and bought a microwaveable heat pack (made of beans) from the Make It show. I remember asking my GP whether I should see a nutritionist and showed her the food journal I was keeping, but she said not to consider diet yet. I also asked her whether it might be my iron supplements or birth control that might have been it…but she pretty much ruled those out.
Oh! But that hemangioma thing
Last year she tested me for H. pylori (which causes ulcers), and that was negative. I also took a urine test and an ultrasound, which detected some possible blood clots in my liver. So I had to go for a CT scan out at UBC — which was annoying — but confirmed that I have hemangioma, which is a benign collection of blood vessels in my liver that are less than about 1.5″ (about 4 cm) wide.
In a small number of people, it could grow and cause complications, and some of the severe symptoms I already have — so despite my husband’s theory that hemangioma may be the cause of my pain, I can’t find a clear link to hemangioma and HCH online. I argued that my digestive issues could be the cause of the blood clots since it occurs higher up in the body. Again, hard to tell until we have better tech for diagnosis, unless a gastroenterologist can tell me otherwise!
Support from a Naturopathic Doctor
Thanks to an “Ethical Deal” I visited Dr. Alexina Mehta for the first time in 2013, without having extended health coverage. We talked about having some sort of hormonal imbalance because my periods aren’t regular, and a number of things to try to deal with my symptoms, from taking naturally-derived supplements (which I denied again), to wearing tight clothing. She did some acupuncture on me and in 2014 I took a biofeedback test (similar to a food sensitivity test but with less conclusive results). Then I went on a three-month cleanse to test out the food triggers. That year, I had only vomited twice but was in pain a lot more than in 2013.
I would also highly recommend a food sensitivity test to anyone with digestive issues as well. The test is expensive and annoying (you have to draw the blood out from your finger), but you can get some of it covered by extended health insurance.
IMO, food sensitivity tests should be mandatory every five years since we enter adulthood, since we’re already eating contaminated foods, and this is the next best thing we can do to stay healthy.
Nutritionists can be heroes
Up until now I’d never bothered seeing a nutritionist — not even one who was vegan.
Even though I had taken a nutrition course in 2011, I don’t regret not seeking out a nutritionist earlier, because had I then, I might not be vegan now. There’s so much conflicting information online, even within the medical profession. For example, meat and dairy are high in zinc, but they also exacerbate HCH. Every body is different and everyone’s going to have their own health maintenance plan. But if you have undiagnosed digestive issues, it may be worth seeing a nutritionist sooner than later, especially if your doctors can’t help.
After writing this post a few weeks ago, I got a Facebook message from the organizer of the Meatless Meetup I’d attended, Julia Di Bona. (Sidenote: She runs the Think Plant-Based! podcast.) She informed me about an event series that Plant Life Nutrition was running on Vegan Nutrition, and I had already seen it on Facebook but noticed that the final one on November 20 was on Digestion, so I decided to trek out to East Hastings and attend. It would only be an hour long, so I honestly didn’t think I was going to learn much.
Dr. Matthew Nagra talked about a few of the lower-residing conditions, which was interesting. Contrary to the positive attributes of the vegan diet to high fibre, I learned that too much fibre also isn’t good. He mentioned gastroenterologist Dr. Angie Sadeghi, who has a digestion program that includes elimination of alcohol, sugar, and refined oils.
Then Shawna Barker of Synergy Nutrition spoke and talked about anti-nutrients like lectins and oxalate (oxalic acid), which prevent protein breakdown & absorption. She said this is why vegans need to make sure they are getting enough zinc and calcium, and that boiling could be a better method of getting rid of anti-nutrients in food than steaming or baking/roasting. (I’d just rather avoid cooking brussels sprouts altogether!)
Then she described the causes of Hypochlorhydria and possible solutions, and I had my eureka moment, holding back tears of both relief and anger, thinking about my decade of painful symptoms without a single mention of this condition by anyone I knew.
I told her I wanted to give her an award (the 2019 Lifesaver Award, to be exact) for the information she provided me. Her blog post is a great primer on causes, symptoms, and solutions, most of which I’ve outlined here.
Knowing that I have HCH is empowering and relieving. I now have more tools and supportive health professionals who are available to help me become well, and I wish that for everyone. I know Angel Ariel was gently pushing me to attend the event where I met Shawna, and had it not been for the Meetup, I wouldn’t have met Julia and she wouldn’t have messaged me about it. I’m thankful for the journey, and I know there is a reason for everything I’ve been through, even if the lessons are physically painful!
Visit Plant Life Nutrition — Vancouver’s ONLY plant-based nutrition store — at 2140 E Hastings Street in Vancouver or plantlifenutrition.ca.
I’m also happy to send the content of the Nutrition on the Go course I took in 2011, which is still valuable — please contact me if you’d like it.