Having an upset stomach once in a while is very common. Indigestion or an uncomfortable feeling of fullness, pressure, burning, or pain in your upper abdomen can happen to all of us. But what happens when these feelings become more frequent or severe? Could too much stomach acid be causing other issues like heart palpitations?
What is stomach acid?
Stomach acid, also called gastric acid, is made up of hydrochloric acid (HCI), potassium chloride (KCI), and sodium chloride (NaCI). This highly acidic environment helps kill bacteria and parasites that could otherwise enter your body through the foods you eat. It also denatures proteins, making them easier to digest. The stomach lining protects the rest of your body from this potent acid.
Your stomach constantly produces stomach acid, even when you aren’t eating. When you eat, your stomach ramps up production to aid digestion. Proton pump inhibitors, antacids, and other medications reduce the amount of acid your stomach creates.
Normal Stomach Acid Levels
Your stomach needs enough acid to maintain proper levels, but too much can cause problems. Normal amounts are:
- Total acidity of pH 1-3
- Up to 160 mmol/L of stomach acid when the stomach is empty
- Up to 80 mmol/L of stomach acid following a meal
Factors like H. pylori infection, pernicious anemia, chronic gastritis, acid bile reflux, stress, and autoimmune conditions can all increase stomach acid production. Hypochlorhydria, or low stomach acid, may also create similar symptoms as hyperchlorhydria, or too much stomach acid.
Can too much stomach acid cause palpitations?
Palpitations make you feel like your heart is racing, fluttering, pounding, or skipping beats. They happen when you have extra heartbeats that make your heart rhythm feel irregular. While palpitations are rarely serious, the uncomfortable feeling and anxiety they can create are understandable. But can too much stomach acid cause palpitations?
The Vagus Nerve Connection
There does appear to be a connection between excessive stomach acid, acid reflux, and heart palpitations. That link is the vagus nerve.
The vagus nerve is the longest cranial nerve, extending from your brainstem through your neck, chest, and abdomen. Along its path, it stimulates muscles used in talking, swallowing, and controlling the heartbeat. The vagus nerve also controls stomach acid production and function.
When you have more stomach acid buildup, it can stimulate the vagus nerve. That stimulation could potentially trigger heart palpitations in some people. Acid reflux may have a similar effect on the vagus nerve.
Other Possible Causes
While the vagus nerve represents one connection, other causes could be behind palpitations if you have excessive stomach acid as well:
- Gastroparesis – This condition affects the muscles of the stomach, delaying emptying. That allows acid to build up.
- Medications – Some medications like theophylline, albuterol, and digoxin can aggravate heart arrhythmias.
- Dehydration – Vomiting and diarrhea from acid reflux can cause fluid loss and dehydration. Electrolyte imbalances may then impact heart rhythms.
- Stress and anxiety – High anxiety not only makes you notice palpitations more but also often makes them feel stronger. Stress can also increase stomach acid.
The key is identifying whether excessive stomach acid is an underlying cause or if other factors are present. Treating stomach issues may relieve palpitations, but you may also need other interventions if the palpitations persist.
Symptoms of Too Much Stomach Acid
Since stomach acid imbalance can create palpitations and other symptoms, it helps to know the signs of excess acid production. Symptoms may include:
- Frequent heartburn
- A burning feeling rising from your stomach to your chest and throat
- Regurgitation of food or sour liquid
- Feeling bloated after eating
- Burping
- Gas
- Belching
- Feeling uncomfortably full during meals
- Upper abdominal pain, especially right after eating
- Nausea
- Vomiting
- Diarrhea
- Weight loss
- Loss of appetite
- Sensation of a lump in the throat
Pay attention to any symptoms that frequently occur after meals, interrupt sleep, or affect quality of life. Severe symptoms may require prompt evaluation by your doctor. Milder or intermittent issues can be discussed at your next appointment.
Diagnosing High Stomach Acid
To check for abnormally high stomach acid, your doctor may:
- Ask about your symptoms and do a physical exam
- Recommend eliminating certain foods to see if this reduces symptoms
- Order lab tests to look for H. pylori infection
- Order an upper endoscopy to examine your esophagus, stomach, and small intestine
- Perform a gastric acid secretion test to measure stomach acid levels following administration of a gastrin hormone
- Conduct pH monitoring by placing a small tube into the esophagus to measure acidity for 24 hours
- Order an esophageal manometry to measure muscle contractions in the esophagus
- Recommend a gastric emptying scan if gastroparesis is suspected
Identifying or ruling out an underlying condition can help guide treatment approaches.
Treatments for Excess Stomach Acid
If you have increased stomach acid levels, reducing acid production and increasing protection of your stomach lining are common treatment approaches. Options may include:
1. Dietary Changes
Eating smaller, more frequent meals to reduce acid buildup may help. Your doctor may also recommend eliminating triggers like:
- Coffee, tea, and other caffeinated beverages
- Alcohol
- Citrus fruits
- Tomatoes
- Spicy foods
2. Antacids
Over-the-counter antacid pills and liquids contain bases like magnesium hydroxide, calcium carbonate, aluminum hydroxide, and sodium bicarbonate to neutralize stomach acid.
3. Acid Reducers
Acid reducers like H2 blockers (Tagamet, Pepcid, Zantac) and proton pump inhibitors (Prilosec, Nexium, Prevacid) limit acid production. PPIs also help heal damage from excess acid.
4. Prokinetics
Prokinetic medications like Reglan and erythromycin promote motility to help empty the stomach faster.
5. Sucralfate
Sucralfate coats and protects damaged stomach tissue from acid. Antacids should be taken at least 1-2 hours before sucralfate as they can interact.
6. Surgery
In severe, untreatable cases, nonsurgical procedures like Stretta or surgically altering anatomy may be considered.
Prevention
You can reduce excess stomach acid without medications by:
- Avoiding triggers like coffee, alcohol, smoking, greasy foods
- Losing excess weight
- Eating smaller meals
- Wearing loose-fitting clothing
- Remaining upright for 3 hours after eating
- Taking antacids as needed
- Reducing stress
When to See Your Doctor
Make an appointment with your doctor if you experience:
- Frequent or severe symptoms
- Symptoms lasting more than 2 weeks
- Palpitations, dizziness, nausea, vomiting
- Trouble swallowing
- Unexplained weight loss
- Black or bloody stool
- Fever over 101°F (38.3°C)
Prompt medical care is crucial for identifying complications like ulcers, strictures, Barrett’s esophagus, or stomach cancer.
Conclusion
There does appear to be a link between excessive stomach acid, acid reflux, and heart palpitations due to the impact on the vagus nerve. Identifying this relationship and treating any underlying gastric issues may help relieve uncomfortable palpitations.
However, heart palpitations can have many causes. Your doctor can help pinpoint factors and recommend optimal treatment approaches. Proper diet, medications, and stress reduction may help control both excess stomach acid and any associated palpitations.