By Shamard Charles, MD, MPH 

 Medically reviewed by Brian H. Wetchler, DO

Stomach acid is essential for digestion, but sometimes acid-producing cells in your digestive system pump out too much acid. Symptoms of high stomach acid can include belly pain, bloating, and heartburn.

There are a number of causes of high stomach acid production including bacterial infections, stress, and rebound effects from medication withdrawal.

This article will discuss the most common conditions that are associated with an overproduction of stomach acid, its signs and symptoms, and ways to mitigate the symptoms that come about as a result.

Symptoms of High Stomach Acid

High stomach acid symptoms can include:1

  • Heartburn

  • A sour taste in your mouth

  • Bad breath

  • Recurrent cough or hiccups

  • Hoarse voice

  • Bloating

  • Nausea

  • Diarrhea

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What Can Cause High Stomach Acid?

Cells that line the stomach produce hydrochloric acid, which helps break down food into its most basic components needed to sustain life. Certain conditions can cause your body to produce too much of this acid. These include:

  • Helicobacter pylori (H. pylori) is a bacteria that damages tissues in your stomach and duodenum (the first part of your small intestine). Having an active acute H. pylori bacterial infection in your stomach may lead to an increase in stomach acid, while chronic infection has been shown to reduce gastric acid secretion.2

  • Stress has been linked to delayed gastric emptying of acid. Research shows that chronic stress may also deplete prostaglandins, which protect the lining of the stomach from acid, increasing your risk of developing ulcers.3

  • Medications such as H2 blockers such as Pepcid (famotidine) and proton pump inhibitors (PPIs) decrease acid production in the stomach. If you take one of these regularly, it is possible that you may experience a rebound in stomach acid production if you stop abruptly.

  • Zollinger-Ellison syndrome (ZES) is a rare digestive condition in which neuroendocrine tumors called gastrinomas cause your stomach to make too much acid. These tumors produce gastrin, a hormone that stimulates acid production. ZES is sometimes present in those who have rare genetic conditions like multiple endocrine neoplasia type 1 (MEN1).4

Complications of Excess Stomach Acid

Too much acid in your stomach can overwhelm the prostaglandins (hormone-like chemicals that influence pain and inflammation) in your stomach and duodenum. These hormones help protect the lining of your stomach, but if they are overwhelmed, it can cause ulcers as well as a host of other symptoms.

Excessive amounts of stomach acid cause the following three conditions:5 

  • Peptic ulcers: Sores that result from acid eating away at the stomach or duodenum lining. 

  • Gastroesophageal reflux disease (GERD): GERD is a medical condition characterized by the backflow of stomach acid into the esophagus.

  • Gastrointestinal (GI) bleeding: GI bleeding can occur when the acid breaks down the lining of the GI tract and injures the underlying blood vessels. Acid induced injuries most often occur in the esophagus, stomach, and proximal portions of the small intestine. Peptic ulcers can also be a cause of bleeding.

How High Stomach Acid Is Treated

There are a number of medications that you can take to reduce acid production in the stomach, helping to alleviate heartburn symptoms. Medications include:

  • Histamine 2 blockers (H2 blockers): These drugs block histamine receptors, which produce gastric acid along the lining of the stomach. They work quickly, often in 15 to 30 minutes, and the effects may last for about 12 hours. Examples are Axid AR (nizatidine), Pepcid Complete or Pepcid AC (famotidine), Tagamet (cimetidine), and Zantac 360 (famotidine).

  • Proton pump inhibitors (PPIs): These are another class of potent acid-reducing medications, except their effects last longer than H2 inhibitors, producing relief for as long as 24 hours. The effect is increased when they’re taken for several days in a row. Some commonly sold PPIs are: Dexilant (dexlansoprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole), and AcipHex (rabeprazole).


If you have persistent symptoms that are getting worse or don’t go away with treatment, seek immediate medical attention.

Preventing High Stomach Acid

You can prevent high stomach acid output for some conditions more easily than others. For example, if the cause of your excessive stomach acid is due to H. pylori infection, antibiotics can clear your infection resolving your symptoms.

If you have ZES, it might be harder to control stomach acid production. Your healthcare provider may recommend having tumors surgically removed and undergoing chemotherapy. You can also use PPIs to block the action of the tiny pumps that secrete acid into the gut.

Summary

Stomach acid is a natural part of the digestive system that helps the body break down foods into basic components that your organs can use. When it’s produced in high amounts, it can lead to various symptoms, such as heartburn, nausea, and a sour taste in your mouth.

Causes can include H. pylori bacteria and stress. Medications such as PPIs and H2 blockers can help reduce acid production in the stomach to relieve symptoms. With H. pylori infections, antibiotics may be prescribed.

Sources

Woolf A, Rose R. Gastric ulcer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.

Waldum HL, Kleveland PM, Sørdal ØF. Helicobacter pylori and gastric acid: an intimate and reciprocal relationship. Therap Adv Gastroenterol. 2016;9(6):836-844. doi:10.1177/1756283X16663395

Lee YB, Yu J, Choi HH, et al. The association between peptic ulcer diseases and mental health problems: A population-based study a STROBE compliant article. Medicine. 2017;96(34):e7828. doi:10.1097/MD.0000000000007828

National Institute of Diabetes and Digestive and Kidney Diseases. Zollinger-Ellison syndrome.

Greenwood-Van Meerveld B, Johnson AC, Grundy D. Gastrointestinal physiology and function. Handb Exp Pharmacol. 2017;239:1-16. doi:10.1007/164_2016_118

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By Shamard Charles, MD, MPH
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.