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Stomach Acid & Hunger

Stomach Acid & Hunger
August 23, 2011 Patrick Nemechek, D.O.


It is not uncommon for individuals to occasionally feel hungry, weak and shaky or develop a ‘sour stomach’ between meals. Sometimes these symptoms can be so intense that it wakes them from their sleep. The symptoms quickly resolve after eating a snack. Their rapid improvement with food is understandably interpreted as a sign they must have “low blood sugar”.

Watch Dr. N’s CoffeeTalk on Heartburn

In spite of the fact these symptoms often improve with food, they have little to do with our biological need for nutrients or energy.  What you are about to learn is that these symptoms are due to an abnormal buildup of stomach acid due to poor functioning of your stomach and intestinal tract or a drop in brain blood pressure and oxygen levels (discussion of this topic is discussed under Lightheadedness, Headaches and Fatigue).

How Does the Intestinal Tract Normally Function

Throughout the day and night, we constantly produce stomach acid. We produce even more when we eat a meal.  Stomach acid is required to assist in digesting food, killing potentially harmful bacterial and is also helpful in activating various digestive enzymes.

Think of your intestinal tract as a conveyor belt that constantly pushes our intestinal contents forward throughout the day.  Our esophagus pushes food into the stomach, the stomach pushes stomach acid and partially digested food into the small intestine, the small intestine absorbs ours nutrients and pushes the non-absorbable material (fiber) into the colon and the colon pushes material to the rectum.

This conveyor belt action of the intestinal tract is primarily under the control of neurological network referred to as the Autonomic Nervous System (ANS).  The ANS is responsible for the contractions that empty the stomach and propel food along its course through the small and large intestines.  Sometimes the autonomic system won’t work correctly due to autonomic dysfunction.

Take ANS Quiz 00001The conveyor belt action of the intestinal tract works 24 hours per day emptying the stomachs contents and passing it further along the way.  When we eat food, the stomach is stimulated to produce even greater amounts of stomach acid and to empty even faster.  This is an extremely important point because slowed emptying of the stomach triggers the single most common mimic of hunger, an excessive accumulation of stomach acid known as dyspepsia.

What’s the Difference Between Dyspepsia and Heartburn?

Heartburn occurs when the esophagus is exposed to stomach acid.  The valve between the esophagus and the stomach is designed to allow food and liquid to pass downward from the esophagus into the stomach as well as to prevent the backwash of acid into the esophagus.

Occasionally, the valve relaxes and allows stomach acid to reflux backwards into the esophagus.  The acid stimulates nerve endings in the esophagus and causes the symptoms commonly referred to as heartburn or gastroesophageal reflux disease (GERD).  GERD can be associated with a burning sensation in the chest, belching, a bitter taste in our mouth, coughing and wheezing.

Dyspepsia is a term reserved for the symptoms we might think of as a sour stomach, slight nausea or an upset stomach.  These symptoms don’t result from acid splashing back into the esophagus as in heartburn.  The symptoms of dyspepsia are from an abnormal accumulation of acid in the stomach.  The acid accumulates because it is not being emptied normally, not because our stomach is producing too much.

To review, the symptoms of GERD are from stomach acid splashing backwards into the esophagus and dyspepsia is from too much acid accumulating in the stomach.

Confusing Dyspepsia with Hunger

We often confuse dyspepsia with hunger because you may feel shaky, slightly nauseated or weak and eating food makes the symptoms disappear.  They go away because food stimulates the stomach to empty.  The food, therefore, causes the excess acid to be emptied into the small intestine and your symptoms resolve.

The symptoms would also go away if we took an antacid such as Tums since they are truly the result from excess stomach acid.  But since they go away after you eat food, you draw the reasonable conclusion the symptoms were due to low levels of blood sugar or some other nutrient. Consequently, we believe the symptoms were a sign of hunger.  So the next time we feel similar symptoms, we’ll eat food again and the symptoms go away again.  After a while, it becomes almost second nature.

When the stomach doesn’t empty as readily as it should, acid accumulates making us feel uncomfortable, bloated, slightly nauseated or even a little shaky.  We eat some food and our symptoms seem to disappear.  This happens because eating food stimulates the stomach to empty its acidic contents and this is the reason snacking relieves our symptoms.  We only refer to these symptoms as hunger because food helps make us feel better.

But why doesn’t the stomach work properly to empty the stomach acid in the first place?   To understand why this happens, you’ll need learn about a condition called insulin resistance and understand a little about the negative impact carbohydrates have on your body and specifically your autonomic nervous system.

Obesity, Insulin Resistance and Carbohydrates

The increasing rate of obesity in the United States is associated with a growing incidence of insulin resistance.  Insulin resistance is the metabolic disturbance that causes a wide variety of medical problems such as type 2 Diabetes, Hypertension, abnormal cholesterol, heart disease and strokes, Sleep Apnea, many forms of cancer and Polycystic Ovarian Disease.

Insulin resistance was originally thought to be consequence of obesity but its cause seems to be more complicated than simply being overweight.  Accumulating evidence suggests that insulin resistance is more the consequence of the type of foods we ate in excess while becoming overweight or obese than simply eating too many calories. More specifically, insulin resistance is caused mainly by the excess of carbohydrate consumption in our diet and not to simply being overweight.

If carbohydrates are the primary cause of insulin resistance then why does weight loss improve insulin resistance as well as the bloating, heartburn, bloating or a nagging sense of persistent hunger?

The reason weight loss helps with these conditions is because people significantly reduce their carbohydrate intake when reducing their calorie intake when losing weight.   In a recent study that showed significant improvement in insulin resistance because of weight loss, the study participants had decreased their carbohydrate intake by about 100-150 grams per day.  That’s a reduction of the average American’s carbohydrate intake by 1/3 to 1/2.

I have many patients who have successfully treated their symptoms from excess acid accumulation by simply reducing their carbohydrate intake.  Most didn’t lose a significant amount of weight but still had significant improvement in their symptoms with carbohydrate reduction alone.  Many were able to stop taking the antacids they had previously been prescribed.

Countless studies demonstrate the ability of weight loss to reverse diabetes, high blood pressure, sleep apnea and the risk of stroke, heart disease and cancer.  Again, what these countless studies were seeing was not the sole beneficial effects of weight reduction per say but also the beneficial effects of reduced carbohydrate intake associated with the decreased caloric intake that is necessary for weight loss.

When viewed in this respect, it’s easy to understand why some individuals at a normal weight who eat relatively high proportion of carbohydrates still can develop dyspepsia as well as disorders related to insulin resistance such as high blood pressure, diabetes or heart disease.

Remember, it’s not really their weight that makes the difference; it’s the proportion of carbohydrates they eat, their age (we become more sensitive as we get older) and genetic differences in their sensitivity to the toxic nature of excessive carbohydrates.

How Carbohydrates and Insulin Resistance Lead to Heartburn and Hunger

The intestinal tract is primarily under the control of the parasympathetic branch of the Autonomic Nervous System (ANS).  The parasympathetic branch is primarily responsible for the contractions that empty the stomach and propel food along its course through the small and large intestines.

As I have discussed in other articles on my website, the ANS is a neurological network connecting your brain, spinal column and nerves to every organ in your body.  This connectivity allows the ANS helps regulate and coordinate the function of all your body’s organs.

For example, the ANS is responsible for maintaining your blood pressure, helping your digestive tract to function correctly, assists in maintaining various hormonal levels in the body, helping our pupils to dilate and constrict, regulating your body temperature with the amount we sweat as well as coordinating bladder function.

The ANS is particularly involved with the control and flow of the acid within our stomachs.  The stomach is constantly producing acid throughout the day and acid production is increased when we eat.. When we swallow food, it passes through the esophagus down into the stomach.  There is a valve between the esophagus and the stomach meant to prevent acid from splashing backwards into the esophagus when the stomach begins contracting in its effort to begin digesting our food.

While the stomach is contracting, the valve between the esophagus and the stomach needs to remain tightly closed otherwise the acid can splash backwards and cause the symptoms of burning, belching and bitter taste we associated with heartburn or GERD.

Scientific studies show that dysfunction of the parasympathetic branch of the ANS is the cause of poor esophagus-stomach valve function.  Throughout your life you’ve heard multiple medical explanations for heartburn such as hiatal hernia, acidic foods, caffeine, alcohol and being overweight.  These reasons have either been proven incorrect (e.g., hiatal hernia), contribute to excessive acid production (e.g., large meals) or have been discovered to contribute to the poor functioning of the autonomic nervous system (e.g., alcohol, caffeine).

How Do Carbohydrates Harm Our Autonomic Nervous System?

The precise mechanism of how excessive carbohydrate intake results in damage to the ANS system is not fully understood.  There are many studies demonstrating that weight reduction (read carbohydrate reduction) improves the medical disorders associated with insulin resistance and insulin resistance is caused by excessive carbohydrate intake.

Likewise, weight and carbohydrate reduction improves many physical symptoms of autonomic dysfunction such as urinary frequency, heartburn, bloating and lightheadedness. Many researchers now believe that the high levels of carbohydrates in the typical American diet are in excess of a threshold that the brain can tolerate.

Another example of a food item that can cause toxic effects when consumed in excess is alcohol.   Many studies have shown that drink 1-2 alcoholic beverages such as wine per day is seemingly harmless to our health.  But it’s common known that drinking 1-2 bottles of wine per day more than likely will lead to cirrhosis (permanent loss of liver function) of the liver as well as damage to our heart muscle leading to a condition known as cardiomyopathy.

Also, people falsely believe they needn’t worry about eating too many carbohydrates if they exercise regularly.  They will simply “burn them off”.  The toxicity of excessive carbohydrates is not due to the excessive calories they may provide but more due to the toxic effect.

Thinking that exercise can rid one of the toxic effects of carbohydrates is similar to an alcoholic thinking that drinking a bottle of vodka is harmless since they will exercise enough to burn off the calories in the vodka.  Exercising more may burn off more calories but will not affect the potential toxic nature of either alcohol or carbohydrates.

The amount of carbohydrates in the American diet over has crossed a toxicity threshold in many individuals.  The toxicity excessive carbohydrate consumption is resulting not only in the diseases associated with insulin resistance but is also damaging our autonomic nervous system.

Remember, the autonomic nervous system controls the function of every organ in your body.  And when the autonomic system is damaged and not functioning properly, we experience symptoms such as bloating, heart burn, lightheadedness, fatigue, excessive sweating, flushing of our skin, constipation as well as urinary frequency, urgency and incontinence.  Reduce your carbohydrate intake and you can eliminate these symptoms.

How Many Carbohydrates Should We Eat?

To answer this question we need to look at the evolution of our Stone Age ancestors and the amount of carbohydrates they consumed.  Scientific evidence suggests that our primitive ancestors ate a diet that consisted predominantly of animal tissue (protein and fat) and plants known as browsing foliage (dark green leafy plants).

During the Stone Age, carbohydrates were very uncommon in the wild and consisted of occasional roots, wild fruit or honey. Overall, the availability of carbohydrates was uncommon.  Other than being on a tropical island, when was the last time you saw some fruit such as an apple or orange when walking in the woods?  These foods do not grow commonly in the wild.  They are cultivated plants that became more readily available after the agricultural revolution.

Many Americans consume more carbohydrates per day than our Stone Age ancestors consumed in a year.  The amounts of carbohydrates available for human consumption didn’t begin to increase until the agricultural revolution (5,000 -10,000 years ago) when man learned to grow grains such as wheat, barley and millet.  The domestication of livestock and the consumption of livestock milk became an additional source of carbohydrates (milk sugars) as well.

But 10,000 years is a very small span of time from an evolutionary perspective.  Although there may have been a few beneficial evolutionary mutation associated with protection from infectious diseases in the last 10,000 years, science has failed to demonstrate any adaptive genetic mutations that might have changed with the subsequent marked increase in carbohydrates in the human diet.

To put the evolutionary time span into perspective, if the entire span of human evolution is represented by a 100-yard football field, the last 10,000 years would encompass only the final ¼ inch of the entire 100-yard field.  As you can see, 10,000 years is not a significant amount of time compared to the millions of years required for human evolution.

The point of this is to help you understand that we were designed through evolution to adapt to eating predominantly animal tissue (protein and fat) and low amounts of carbohydrates.  We did not develop the metabolic ability to handle such large quantities of carbohydrates in our diet and our bodies are suffering because of it.

To put it another way, the average American consumes more carbohydrates in a day than our Stone Age ancestors consumed in a year.  It’s the excessive amount of carbohydrates in our diet that are having a toxic effect on our nervous system.

Carbohydrate Reduction and the Theory of Neuroplasticity

Neuroplasticity is a relatively new scientific concept that our neurological tissues (brains, spine and nerves) has some ability to recover function from at least mild levels of insult or damage.  Neuroplasticity means ‘nervous tissue’ that has the ability to ‘regain its function’ after being altered just as plastic regains it shape after being bent.

After a stroke, patients have the ability to regain some neurological function.  After a nerve or the spinal column is damaged by an injury, remarkable degrees of recovery have been known to occur.  The recovery in these cases may not be complete in severe cases but can often be complete with mild injuries to the nervous system.

After the Autonomic Nervous System (ANS) is damaged, it too shows a remarkable ability to recover from the toxic effects of excessive carbohydrates.  I have many patients who have completely recovered from the neurological damage that causes heartburn, erectile dysfunction, lightheadedness and urinary disturbances after reducing their carbohydrate intake.

One exception to neuroplasticity of the ANS is in patients with long standing type 2 Diabetes Mellitus.  In this circumstance, the nerves have been severely damaged by the toxic effects of excessively high blood sugar and insulin levels as well as the damaging effects of inflammation associated with insulin resistance.  Fortunately, most patients who have worked at controlling their diabetes still have a good chance of reversing the their ANS dysfunction.

Bacterial Overgrowth, Another Cause of Heartburn

Bacterial overgrowth occurs when the balance of bacteria within the distal colon becomes altered.  Harmful bacteria grow out of control and migrate up to the small intestine where they are able to send signals backwards up the vagas nerve and change autonomic functioning often leading to heartburn.  The presence of large numbers of bacteria in the small intestine has also been referred to SIBO (Small Intestinal Bacterial Overgrowth) .  The bacterial also cause an systemic wide inflammatory condition often referred to as leaky gut.

A simple method to reverse bacterial overgrowth is through supplementation of a prebiotic fiber called Inulin once or twice daily.  Re-balancing intestinal bacteria often results in symptomatic improvement of autonomic function (less heartburn, urinary frequency, fatigue and lightheadedness) and also reduces systemic inflammation leading to decreased blood pressure, decreased blood sugar and improvement in conditions such as eczema, psoriasis and rosacea.

How Many Carbohydrates Are Too Much?

What should you reduce your total daily carbohydrate intake to?  The average American diet now consists of 50-60% of calories from carbohydrates.   Scientific studies suggest that you can greatly improved health if you reduce your carbohydrate intake to about less than 100 grams of carbohydrates per day for women and men.

First start by reducing the larger amounts of carbohydrates from your diet; start with the frequent servings of potatoes, rice and pasta and the sugar containing drinks.  Replace these with more protein and low carbohydrate vegetables.

After a week or 2, count the grams of the remaining carbohydrates in your daily diets for a few days.  You will quickly realize the high amount of carbohydrates you had been consuming on a regular basis.

Reducing your carbohydrate intake to less than 100 grams per day has a dramatic improvement in the diseases arising from insulin resistance as well as improving your neurological functioning.  Your triglyceride and HDL cholesterol levels improve, your blood pressure will be greatly reduced and your blood sugar levels will normalize as your body’s response to insulin to improves.

Carbohydrate reduction has been calculated to have 6-8 times greater power of reducing the risk of cardiovascular disease (strokes and heart attacks) than do the statin medications that are commonly prescribed to lower LDL cholesterol levels.  Why treat these conditions with potentially toxic medications when your can prevent and even reverse these conditions by simply reducing your carbohydrate intake.

Autonomic Testing Guides Treatment for Improved Autonomic Function

The autonomic nervous system (ANS) can be tested and evaluated through a process known as spectral analysis.  This simple, quick (15 minute) and painless test can provide the ritical understanding that helps your physician for their treatment plan.

The ANS can become imbalanced in many different ways.  Some ANS dysfunction requires a short course of medication (3-6 months) alone or in concert with nutritional strategies to reduce systemic inflammation and oxidative stress in order for the brain to regain maximal function.  The safest way to reverse heartburn is with a map of your autonomic nervous systems to guide treatment.

Dr. Nemechek often performs autonomic testing prior to initiating treatment for heartburn and other autonomic symptoms (lightheadedness, headaches, fatigue, constipation, frequent or urgent urination).  To learn more about this technique visit his website at

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  1. Eulalia 1 year ago

    My 11 year old daughter Has been experiencing acid reflex . She has develop some kind of a cold or allergies that won’t go away. She has been having this problem for about a year. Doctor put her on ranitidine for a month but it didn’t take care of the problem. She wakes up in the mornings with her nose very congested too and sometimes when she is eating her nose drips and gets congested too. What would you recommend?

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Maybe try a little inulin to see if this helps.

  2. Melissa 1 year ago

    I have had stomach burning for a year – EGD and biopsy normal – stomach was slightly red. Will protocol help? And I should work on reduction of carbs, correct?

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Yes the protocol can help as can a reduction in carbs (less than 100 grams is all that is necessary)

  3. milda 1 year ago

    I feel puzzled. How comes that carbohydrates “makes you fat”? I was eating only plant based for 4 years, and many of my friends were/are also. Ofcourse when you eat plant based you eat mainly carbs. And i can assure you that is impossible to gain weight! In my opinion , the most “fat” people i see , eat a lot of processed, fatty foods and a lot of animal protein. I myself managed to gain weight only when started to eat animal proteins. Before i could literally eat buckets of food and i was really slim, because i was eating mostly grains. Maybe sugar makes you fat, but all other carbs – grains, vegs, potatos ( well maybe if you eat greesy fried potatos you can gain weight from fats) are safe, you wont gain weight from them. it seems like a strange myth about this “carbs makes you fat”…
    Can you explain this?

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Some people have hypothalamic dysfunction (probably from vegetable oils) and they are unable to make regardless of caloric intake.

  4. Anne 1 year ago

    Hi – I’m about to start your Protocol for years of heartburn and constipation. I’m struggling to find the doses for these conditions. I live in the UK and am 74 years of age and am extremely fit. Please can you just give me a quick breakdown of the dosage for EVOO, FO and Inulin? thank you.

    • Author
      Patrick Nemechek, D.O. 1 year ago

      My book contains the dosages I use in my practice.

      As a reminder, the dosing for adults with autism was developed over 10 years in adults without dosing prior to the publication of the book.

      A copy can be purchased on

  5. Eslam 2 years ago

    Sorry, but you are saying that food stimulates stomach to empty it’s contents. I thought the migrating motor complex is the one that is responsible for that and it works every 90 minutes or something and that happens only when we stop eating. Am I right?
    Second part I don’t understand, why acid accumulation would make me feel shaky and hungry?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      MMC most importantly drives the basal state of motility. Food can activate neurological pathways to stimulate emptying.

      The shaky sensation is an early sign of what could be called nausea if it worsens.

  6. Katie 2 years ago

    My GI has diagnosed me with “functional dyspepsia” My main symptom is feeling hungry about an hour after eating dinner every night and my lower abdomen feels tense. I mostly feel this way only in the evening.. I’ve been on PPIs for over a month but they don’t seem to help all that much. I’ve cut out caffeine, coffee, spicy and fatty foods. I also burp a lot and the burp causes a small burning feeling in the right side of my back. I don’t think I have classic reflux though. I’m exploring coming off the PPIs and doing a more natural route like you describe. Would love to hear though if you think my issues are something else besides dyspepsia. Thank you!

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Especially considering the fact that antacids do not help, your symptoms are due to a drop in blood pressure after a meal. This is common and is from autonomic dysfunction.

      My protocol is designed to help with this.

  7. Dan 2 years ago

    I have been experiencing dyspepsia symptoms since I tried Intermittent Fasting as a weight loss technique. I am hungry shortly after eating, sometimes mixed with nausea. I have Celiac disease as well, but I know I’m not cheating or accidentally contaminating myself. If it’s a big meal, I tend to get hungrier later then sooner. I had an endoscopy and it came back negative for an ulcer. I do notice that eating a meal without carbs generally fares better than without. I also have had labs to rule out prediabetes and I also have monitored my blood glucose before and after eating and can be confident.

    Besides lowering carbs, is there anything I can do to make my stomach dump properly?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      The great proportion of people diagnosed with Celiac Disease also have small intestinal bacterial overgrowth and autonomic dysfunction – this is probably where your issues are coming from.

  8. Gypsy Garner 2 years ago

    I have not been diagnosed with anything but I have a constant feeling of something in my throat and when I try to swallow I can feel a narrowing feeling in my throat and the feeling like my swollowing is constricted. Could this be LPR since I do not have any symptoms of acid reflux just throat issues? Could this be related to ANS dysfunction and could this be part of having POTS???

    • Author
      Patrick Nemechek, D.O. 2 years ago

      LPR and POTS are both signs of autonomic dysfunction

  9. Anonymous 2 years ago

    How to reduce the amount of stomach acid creation?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      I don’t believe you can reduce the production of acid.

      You need to repair your autonomic nervous system so you can empty your stomach better.

      See my YouTube video on this.

  10. Stacey 3 years ago

    Would Rifadin work to treat SIBO? Xifaxin is very expensive.

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Absolutely not, Rifadin is rifampin, a tuberculosis drug.

  11. Mazzy 3 years ago

    My stomach wake me every night it dependent on what time did I sleep on that night, what happened is that there is something like a ball that is pushing my stomach, its painful after that I wake up, and take 2 slice of bread after that I feel better as a normal person, also there is something that is coming out from my anus its like a water every time its wet my underwear, so I usually put toilet paper to calm it down, please help me or what should I take before it get worse.

    • Author
      Patrick Nemechek, D.O. 3 years ago

      I’m sorry but I think you will be better served by an examination by a local physician.

  12. Michelle 3 years ago

    I am not sure if my last post went through as I realized that I typed my e-mail wrong.
    I have had some low lying gut issues for years. I had a miscarriage and then became nauseated after every meal. I had an barium swallow and they said I had the worst case of reflux they had ever seen. I did not experience heartburn, though, and so they said I was a silent refluxer. They prescribed PPIs which I stayed on for years, because they said there were no side effects. Then I broke my femur and my surgeon who repaired it said that it was healing slower than expected. I thought this was alarming since I was healthy, thin, active and in my 40s. I did research and saw the bad side effects of the PPIs and quite taking them. I really for several years had little to no symptoms. Then several years ago my Husband and I tried the ketogenic diet. I felt just awful on it. I kept trying to stay on it but after 3 months had the worst case of heartburn, nausea, rapid weight loss, pain, etc. I had to stop the diet and started feeling much better right away. I went to my GI doc and all they kept telling me to do was go back on the PPIs. Long story short I have been working with several Naturopaths to treat SIBO. I am off of the PPI, but had to wean off slowly. I dropped a lot of weight and was underweight. I still have SIBO but have very little symptoms. However now my weight has gone the other way. The way I always controlled my weight in the past was to go on a low fat diet, count calories, and increase my daily exercise. Now I don’t know what to do because if I do that I think I will flare up my SIBO. How do I treat my SIBO, loose the excess weight and eat so that I don’t feel bad? I am trying to stay somewhat Paleo in my diet but am afraid of the Keto diet.

    • Author
      Patrick Nemechek, D.O. 3 years ago

      SIBO prevents your brain from recovering from injuries (physical, emotional and inflammatory).

      Assuming your general lab panels are OK, you more than likely have some damage to the sympathetic branch of the autonomic nervous system. This makes it hard to generate the proper level of blood and oxygen delivery to the brain, and foods rich in carbs or salt will boost pressure making you feel better.

  13. jafar Suleiman 3 years ago

    i have been experiencing sudden hunger, dizziness, sweating and stomach upset for years. I was never able to do anything about it due to my disposable status… Really i have been on foods that are carbohydrate base in fact its just the available option… thanks for this article.

  14. Nick Jolly 3 years ago


    This is interesting information ( do you have any links/references to the claim that “Scientific studies show that dysfunction of the parasympathetic branch of the ANS is the cause of poor esophagus-stomach valve function.”). What are your thoughts on the very common theory that Acid Relfux is caused by Low stomach acid?

    I have had Acid Reflux for almost 10 years, however until recently it seemed mostly under control (including sleeping on a pillow edge on a bed that is propped up 6 inches) but I wish I did not have to do this and it has been constant 24/7 for a month. I am skinny, healthy, do not drink or smoke, eat quote healthy and do not eat within 3 hours of bedtime.

    In the past, doctors just push PPI’s or Surgery on me. I tried Naturo/Homeo paths and they just push food intolerance theories without any tests to confirm this (elimination diets seem to make things worse in the long run for Gluten or Dairy).

    Last time I had issues, I started taking probiotics, and digestive enzymes and it seemed to help, however if I am stressed, it doesn’t seem to matter what I do, is this normal? Is there anything that can help, or any vitamin deficiencies you recommend other than the Inulin?

    I am trying GDL chewable licorice now as well, as I have read many good reports but does not seem to be helping yet.

    I just don’t know what to do anymore.

  15. Shelley Martin 3 years ago

    Can you take prebiotic and prohibitive at the same time?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Many people do but in my experience, I don’t recommend it.

      See my recent post of Probiotics.

  16. Anonymous 3 years ago

    Can you take prebiotic and sinusitis together?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      If you mean with medicine for sinusitis, then yes.

      Inulin is just a plant fiber and can be taken with any form of medication

      Dr. N

  17. Cyndy 4 years ago

    Is there a particular brand of inulin fiber you can recommend? I also noticed when researching for inulin many sites represent it as something that causes digestion problems and warn consumers of companies sneaking it into products as a sweetener.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      A lot of it can cause bloat but not at the small amounts I suggest.

  18. marie 4 years ago

    so I should be looking for a PRE BIOTIC Instead of PROBIOTIC?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Yes, inulin fiber. 1/2 – 1 tsp 1-2 times per day

  19. marie 4 years ago

    diagnosed with sarcoidosis
    have miserable acid reflux my head is swimming trying to get things lined out to reduce my carbohydrate intake. have a cough attributed to the acid affecting my lungs. help what can I do immediately to get rid if this heartburn/acid reflux….trying not to take prescribed omeprezol or ranitidine.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Supplementing with a prebiotic such as inulin helps a number of my patients

  20. Natalya 4 years ago

    Since 2015 when all this began, I have loss of appetite and thirst, fullness sensation in my stomach, no food cravings, hair loss, sudden weight loss at beginning, but now have trouble gaining my normal weight, stomach bloats when I drink or eat a little, irregular periods which lasts for only 2 or 3 days with painful cramping, used to have a regular 7 day cycle. In the beginning when this all started so suddenly I had a whole list of physical, and emotional symptoms that popped up every day. I am a 30 yr old woman, but was 29 when all this took place. I am petite and small and used to weigh a healthy weight of 107 or 106, oh and I have a super fast metabolism so I always ate a ton of food and never gained much weight, but my weight was always balanced. bowl movement once a day. Please do you know what may be wrong with my body?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Yes, you complaints are not that unusual for the type of patient we see.

      It’s very complicated but suffice to say that we can turn things around for you but you’d need a full autonomic evaluation in our Phoenix office. Call 623-208-4226 if you are interested in getting more info. — Dr. N

  21. Mike 4 years ago

    Glad to have come across this article. It really shines a light on what has been going on with my acid reflux. I’ve been experiencing acid reflux since 2011 and it has made my life miserable.

    It has been chronic, every minute of the day, constant belching with burning sensation. I couldn’t even drink water without getting reflux. Looking back now, I know how it all started.

    Because of my job, I was doing constant shift work. I got addicted to fast food and was eating the stuff everyday. Double quarter pounders, whoppers, large french fries, and washed down with sprite or coke. This went on for close to a year until I began feeling acid reflux. I put up with it for a while by eating TUMS but that only helped a little. I kept guzzling down the fast food until one day my body just slapped me in the face with horrible reflux and intestinal pain.

    After the endoscopy and colonoscopy, I was told to take Nexium but it did nothing. I suffered on and wishing for death. Then October of last year, I got blood work done and I found out I had high insulin levels, fatty liver, high blood sugar, high cholesterol, high triglycerides. Doctor wanted to put me on meds but I went to my chiropractor instead.

    He looked at my blood work and said I was pre-diabetic. He put me on some high powered supplements like Alpha Lipoic Acid with Berberine, red yeast rice, niacin, omega 3s and CoQ10. I’ve been taking the supplements along with severely restricting sugar and carbohydrates. Water, high protein, moderate fat and vegetables has been my diet for several months now on top of the supplements.

    Finally, after 6 years of suffering with reflux, I am getting relief. My sleep and energy levels are much improved but I am so happy my reflux is finally waning. I though I would have to suffer like this for the rest of my life but it feels like full recovery is possible.

    Apologize for such a long post. I wanted to share my experience and attest to the harmful impacts of refined sugars, refined carbohydrates and refined fats. I will never abuse my body with those awful poisons ever again.

    • Author
      Patrick Nemechek, D.O. 4 years ago


      Thats great news. Carb reduction is a great first start.

      You should come see us so we can turn things around completely.

      There is a lot more you can do. – Dr. N

  22. Bee 4 years ago

    This is a great article, thank you Dr Nemechek… I have cut out the daily white wine, lowered my carbs drastically and don’t touch sugar. No more heartburn or the related cough (apparently due to acid fumes rising from the stomach).. What a relief 🙂

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Great news. Thanks for sharing!

  23. Sara Biggs 4 years ago

    I have been experiencing what feels like severe hunger pains for the past 4 days that hardly subside with eating. It’s the worst thing I have ever experienced because nothing I do has relieved it. I’ve been dealing with severe adrenal fatigue recently also.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      You should see your doctor. Increased hunger such as this can be a sign of a stomach ulcer.

  24. ayran 4 years ago

    I drink very slightly warm water every morning and never skip breakfast to manage my acidiy problems.

  25. ayran 4 years ago

    Also, I drink 1-2 glasses of water every morning to help me with acidity problem. I make the temperature of my water around 20-30 degrees C, just a bit lower than a temperature of body. And I never skip breakfast, otherwise i am guaranteed to have a stomach problems.

  26. ayran 4 years ago

    My comment above regarding kamed was concerning gastritis only, not the excessive acid levels problems!!!

  27. ayran 4 years ago

    When i had pains in my stomach caused, i think, by gastritis, i ate kamed (slowly chewed until it melted) not sure how it is called in English, it’s a soft tree resin, this amber colour substance that appears when trees are wounded. The tree it is collected from is called larch, maybe also pines. Those trees grow in many places. Maybe resin from other trees can also help, i don’t know.

    It is soft when fresh, and hardens later. You need to distinguish it from hard resin.

    It is called in russian kamed listvennitsy, – камедь (лиственницы)..

    I think it is a great natural homeopatic aid, it certainly helped me. I am not a doctor though, just sharing my small knowledge. You need to consult your doctor first.

  28. ayran 4 years ago

    Thank you so much! This was an amazing article, i agree completely with it, your recommendations are something that i came to using my own intuition and experience of my body reacting to different foods. But i still learned a lot additionally.

    Have a nice day,


  29. Jason 4 years ago

    I had SIBO, but took Xifaxan and felt a lot better. I still have a candida overgrowth, and I am doing better to the point where I am off my IBS meds. I follow the GAPSdiet, and have ADD. My problem is if I go 5-6 hours without eating, then eat a few pieces of chicken or meat, I get a feeling of undigested food and have a feeling of mucus or gas. I feel like it might be a build up of stomach acid not emptying correctly. Any advice on the matter?


    • Author
      Patrick Nemechek, D.O. 4 years ago

      You more than likely have residual autonomic autonomic damage causing your symptoms. SIBO will causes microglia in your brain to shift to a M1 phenotype. M1-microglia prevent your brain from full recovering after physical, emotional and inflammatory traumas.

      You’ll need to see someone like me to help you shut off these microglia. My Nemechek Protocol is designed to reduce the production of pro-inflammatory cytokines and shift microglia to the healthy, neuron-repairing M2 phenotype.

      Once shifted, your autonomic dysfunction (i.e.,ADD) will resolve over 6 months.

      Dr. N

  30. Rosie 4 years ago

    Hi I’ve had this hunger issue since February. Thought it was low blood sugar. So I would get anxiety. And it got worse it got to the point where my upper stomach burnt so bad I was rushed to emergency on aug 19 had a scope done aug 22 results back on aug 25 they said I had Hpilori bacteria and Lots of stomach acid. I had weeks courseof antibiotics. He also told me I had gastritis it’s getting really bad. I’m more gassy now no matter what I eat And on Prevacid. And gaviscon. So much of it. Still feeling hungry lots of stomach acid. My bowels are not right. My docs suggested I go on antidepressants. I’m still sick with lots of stomach acid. I’ve been to natural path she put me in some natural stuff. I just want relief. I do worrie lots I know that’s my problem. I need help. Please help. Thanks Rosie

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Your intestinal issues may be from SIBO which then makes you prone to autonomic dysfunction which probably is the cause of your hunger.

      No easy answers but very fixable. I’d need to see you IN Arizona for some testing before knowing what to do.

      Dr. N

  31. Arthur Yagudayev 4 years ago

    If I don’t eat for more than 6 hours, especially in the morning I feel this burning sensation in my stomach and then I hear this bubbly and fizzy sound like pop rocks in my throat. It is usually resolved when I have a meal or when I put something in my mouth. It is worst in the mornings and if I skipped a meal. What is this?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Most likely a build up of acid in the stomach because your autonomic nervous system is not emptying the stomach.

      If taking a quick-acting antacid such as TUMS helps, then the problem is a build up of acid. See my video on this at

  32. John 4 years ago

    I had a pretty bad 24 hr stomach bug about 3 months ago. I was vomiting and had pretty bad diarrhea. About a week later I was experiencing heart palpitations (PVC’s) along with a LOT of upper GI gas along with a feeling of a lump in my throat. I had my heart checked out and it is fine, but I still am experiencing the GI symptoms. They have gotten better, but are still there. My doc says anxiety, but I just don’t buy it. I just feel like something is off. My symptoms definitely go away with eating, but then I feel very full even though I may have only eaten a little.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      SIBO (small intestinal bacterial overgrowth) can cause anxiety. You need to check into treating SIBO and maybe have your autonomics looked at. SIBO can cause secondary autonomic dysfunction that does not resolve with reversal of SIBO by Xifaxan.

      Dr. N

  33. Michelle 4 years ago


    I have had swollen nasal turbinates for the past 7 months which don’t reapond to any sprays and antihistamines.I have also done allergy tests twice and all were clear.I also have sever headaches which only reapond to months of antidepressants(trypitzol).Two months I was experiencing a sore throat and as something is stuck in my throat.I got an endoscopy done and the doctors confirmed acid has been damaging my throat for years.

    I am currently on 6O mg dexilant and 150mg Zantac at night and sometime I see improvements in my nose but side effects are constipation and I feel my acid is getting worse as I am now sensitive to a lot of foods.

    I have seen over 12 doctors please I need your help any suggestions.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Read my posts on gut bacterial overgrowth and SIBO.

  34. Doctorsahaab 4 years ago

    Nice share on stomach acid

  35. Amy Ransom 4 years ago

    Looking at your web page it seems I might be suffering from your description of dyspepsia.
    For more than two months I have experienced bloating and an urge to fill the stomach soon after eating. My condition seems to be getting worse and for the past couple of days I’ve been feeling a sour taste in my mouth and throughout my whole body. I also sometimes shake. The shaking can go on and off throughout the day. There’s also tension in my neck muscles and this feeling goes right down to my leg – usually on my left side.
    I have been taking 20mg Omeprazole an hour before breakfast and 10mg an hour before my evening meal as directed by my doctor.
    Do you think moving to your recommendation of a low-carbohydrate diet might help me return to health, and is there any other advice or medication that might help?
    Thanking you for your free advice and kind consideration.

  36. Sue 4 years ago

    Hi, thank you for the article. If I have acid stomach symptoms as you have described even on fasting but a pretty low carb diet, could alcohol be the culprit? If I cut it down or out completely, is the condition reversible or is my liver shot? And how long might it take to be symptom free, please?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Could be your GERD is coming from parasympathetic dysfunction due to autonomic damage. Take the quiz and see what you think.

  37. Amina 4 years ago

    Sometimes during these headaches defecate more than normal like twice a day and still feel constipated. At other times it is accompanied by constipation.

  38. Amina 4 years ago

    Hi, I suffer from severe headaches almost every month. Sometimes they coincide with my periods but not always. The headache is mostly towards one side of the head. It is always accompanied with stomach distress like bloating, sour throat, lots of gas that doesn’t seem to pass out easily. I also feel heartburn. Nothing seems to alleviate the pain my stomach feels very tight and heavy. I need to urinate frequently. I feel very uncomfortable and sometimes nauseated Its actually now affecting a normal daily routine. Can you please suggest what I should do? I have been treated for h pylori a few months back and the retest showed no h pylori anymore.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Take the brain quiz – you sound as if you have autonomic dysfunction.

  39. Bong Kim 4 years ago

    Your is an exact description of myself.I will definitely follow your suggestion to lower my carbs intake. I was just wondering , would you reccomend I take apple cider vinegar? i heard it is good for weight loss and acid reflux

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Its harmless and seems to control the symptoms of GERD but doesn’t fix the underlying problem.

  40. Clementine 4 years ago

    For the past few weeks iv been burping, with loss of appetite. My stomach hurts and feels full accompanied by nausea…my BP is 103 per min…please help

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Try some of the things suggested in this article or the one on SIBO.

  41. faisalin 4 years ago

    i have a severe headache that comes within a month and it is connected to my eyes sometimes left and sometimes right that gets blurred and it happens to connect also in my stomach that makes me vomit of what i have eaten and it also go worse the headache if i eat foods or drink a couple of water..i already go to my doctor and say that it is a severe migraine…pls sir i need your kind response

    • Author
      Patrick Nemechek, D.O. 4 years ago


      An imbalance of intestinal bacteria might be the cause of your headaches and not necessarily a secondary consequence of the pain.

      You should investigate getting treatment for SIBO. Take my SIBO quiz in the left column and check out my post “Got SIBO?” several months back.

      Dr. N

  42. Angela 4 years ago

    Whenever Im hungry or havent eaten in hours I feel like throwing up.. I thought this was normal for everyone because my parents and siblings algo get this feeling..
    Lately I get super hungry, with nauseas, then I eat but the hunger never goes away, the nausea does though, but I still feel as hungry as if I hadnt eaten anything.
    Other than that, I have no discomfort. Except when Im under a lot of stress at work I suffer from gastritis, then I dont feel like eating anything until it goes away and it takes several days.
    Do you suggest I go to the doctor or decreasing my carbohyfrate intake will I feel better?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      I suggest you see you doctor first to make sure you don’t have something common like anemia or low thyroid function.

      As a second step, cut your carbohydrate intake and read my other post about SIBO – I think that’s what you and your family members may have.

      Dr. N

  43. Anonymous 4 years ago

    I have bad reflux over the last few months i’ve gotten it under control until a few weeks ago. I started having the feeling that i’m starving when I try to eat something I gag so then I take some Pepto and once I feel better I can eat about 20 mins later I feel like i’m starving again then comes the nausea, light headness and shakieness. I also have AIG deficiency . What would you suggest?

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Increased hunger can be from poor blood pressure regulation and low oxygen levels in the brain. Your subconscious brain learns that eating carbs and salt will improve the delivery of oxygen to the brain. This is a common reason why people excessively feel hungry.

      If your labs and neurological eval are normal, a common cause for this is dysfunction from the autonomic nervous system.

      I specialize in autonomic dysfunction and have developed a method to get the brain to repair the underlying damage you may be experiencing.

      Dr. N

  44. Victoria 4 years ago

    I have silent reflux and a terribly painful sore throat.. Would the prebiotic insulin fiber help me heal my throat? I’m taking prescribed Zantac and eating a mild diet.. Can not eat meat or anything that’s not soft until my throat heals..I know I’m eating too many carbs as my husband tells me all the time but now I’m in a crisis..don’t want to get a biopsy or go the route of the ENT ..I have had many test in the past..they say sinusitis is the problem.. I like your approach. Suggestions? Thank you

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Silent reflux is a common source of chronic sinus inflammation.

      The prebiotic fiber might help a great deal.

      Dr. N

  45. Author
    Patrick Nemechek, D.O. 4 years ago

    You have too much stomach acid not because you make too much but because your brain is not emptying the normal amounts you make thereby causing it to overfill.

    Treatment of SIBO with the pre-biotic fiber inulin might help. If not, you more than likely have underlying autonomic issues. Try taking the test noted in the left column.

    Dr. N

  46. Lynda 4 years ago

    Thank you so much for that information. I get that uncomfortable hunger feeling even when I have just eaten sometimes. How can I still be hungry I ask myself.? I have noticed that too much white carbohydrate,coffee, bananas, pastry will give me heartburn. I remedy this with green leafy vegetables especially lettuce in a salad with olive oil dressing and raw grated carrot. Cooked Beetroot(not in vinager) is the KING and will completely knock out heartburn. What I would really like is a day’s typical meal sheet of eating in the way you suggest. Half the time I just do not know what to eat!

    • Author
      Patrick Nemechek, D.O. 4 years ago

      I would have someone look into diagnosing and treating SIBO

  47. Simone Winters 4 years ago

    I was recently told that I have Gerd from my visit to the ER. I was also told to eat a low calorie, low acid diet; however, I have been unable to eat anything for three days and I have only consumed small amounts of warm water. Everytime I try to eat something small (piece if cantaloupe), the pain in my stomach radiates to my chest and is unbearable. Today I ate half a piece of toast and did not feel any if the same symptoms. Am I damaging my stomach more by only eating carbs like bread.

    • Simone Winters 4 years ago

      Also…can I cause more damage by only drinking small amounts if water. My stomach has intense hunger pains but Im scared to eat. I have a GI appt in two weeks.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      You won’t cause problems for now.

      Go to the GI doc and let them make sure there is nothing serious going on. If not, consider trying a treatment for SIBO (Xifaxan, Inulin fiber). If those don’t help much, consider getting an autonomic evaluation.

      Remember, heartburn and reflux are not because you MAKE too much acid, it’s because you CAN’T EMPTY the acid you make. It’s often from autonomic dysfunction which is something I can fix

      Dr. N

  48. Natalia Saldana 4 years ago

    My son is 10 but very tall (5’2″)and overweight(137) . He plays tons of sports but eats all day ( mostly looks for carbs). He had an ulcer in his esophagus about 2 years ago which is now cured but he still experiences acid reflux almost daily and is always hungry. What should i be feeding him ( mostly lean protein , etc?)and would Raw apple vinager help? i cook home meals daily and try to keep dinners low carb usually a protein with a vegetable and a fruit for desert.he eats at school for lunch and at breakfast he eats a grilled cheese sanduich with one slice of whole wheat bread and one slice of organic low fat cheese plus some berries…i also give him VSL3 2 to 3 times per week.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      He may have underlying SIBO and potentially a unresolved concussion. Focus on those 2 things

  49. Stella 4 years ago

    Dr. N,

    This is all very interesting! For decades, if I delay my lunch I get really queasy in my stomach, with nausea and even lightheadedness. At times I feel like throwing up. I’ve postponed my colonoscopy because I don’t know how I’ll be able to do it without eating solid food! Ok, now I am on a number of medications and I am a diabetic – but very well controlled. I still suspect there’s too much acid in my stomach. I feel 100% better after eating.

    Here’s my question. You mention adding more protein to the diet. That is great but I’m trying to avoid red meat and my only meat now is fish and humanely raised poultry. I’m trying to become a vegetarian on humanitarian grounds but with diabetes and this “I have to eat every few hours” condition how hard would it be with severely limiting carbs and increasing protein in my diet?? BTW I have several relatives who are diabetics so your response is truly welcome and will be shared.


    • Author
      Patrick Nemechek, D.O. 4 years ago

      The metabolic damage that leads to diabetes ultimately leads to a state of carbohydrate poisoning. Although admirable, your vegetarianism only leads to a higher intake of carbohydrates and will worsen your condition. I recommend to my diabetic patients to reduce their total carbohydrate intake to less than 100 grams of day. May have marked improvement within a few months.

      Dr. N

  50. Ted 4 years ago

    Hi, I have this chest pain problem but it all started with hunger. I travel from home to work to at least 2 hrs which makes me feel hungry until 1 day I feel a sudden chest pain but relieved after burping and I began having anxiety so I had a check up. Now, the doctor saying that I might have too much acid which I thought as well since I am relieved with taking PPI which also he adviced. But now I constantly feel hungry and still this discomfort always returns after I stop medication. I really don’t feel a heartburn before but instead a sharp pain in my chest. Yesterday, I’m having this stomach burn pain after stopping PPI for a while due to constipation and so I continued taking my omeprazole again just to relieve this burning sensation. Im confused now.

  51. Patti McCullough 4 years ago

    I have had excess gas in stomach causing belching and nausea since drinking a bottle of mag citrate almost one week ago. The mag citrate gave me very frequent diarrhea or lose bowels for many hours throughout the night and the next day 3 more times. That was a Thursday night. On Saturday I developed bad nausea and finally vomited 3 times. I was surprised that food was still in my stomach having eaten 8-9 hours earlier and what I last ate came up. I know this was too long for food to still be in my stomach. Can you tell me did the mag citrate mess up my system and if so how? I am still nauseous daily especially with the hunger/empty stomach feeling. I have had mag citrate before this but never caused diarrhea this long. Constipation was caused by dieting, weight loss of 5 pounds. I am only 10 pounds overweight, and probably don’t eat enough carbs when dieting. I just want to know if I need to see a doctor with the nausea continuing now 5 days. Thank you.

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Might be a good idea since it is not getting better

  52. Kaileigh 4 years ago

    Hello! After reducing carbohydrates do you recommend any other steps to take to help the stomach empty it’s acid properly and normally.
    I have reduced carbs for 1 month and still experiencing upsets. Dr says I have TOO much stomach acid, of course. Any help is appreciated!!!!

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Supplementing with high concentration DHA fish oil helps with a little time, about 3000 mg of DHA per day does the trick.

      Dr N

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