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A Disgusting Taste in Her Mouth

Here’s another persistent patient story, a woman who endured years of symptoms and no definite answers. Then, six months ago, when her symptoms went into high gear, she knew she had to do something.

I first met Claudia, a bright, healthy looking woman, just a few weeks ago. She told me her longstanding digestive symptoms had started in her teens, manifesting as bloating, gas, and nausea after meals. Despite being written off as irritable bowel syndrome, she could detect no correlation to stress or food sensitivities. For Claudia, eating itself was never a pleasurable experience. In fact, once after a particularly stressful relationship when she became depressed and briefly stopped eating much at all, her digestive symptoms actually went away.

In her thirties, by avoiding junk foods she did a little better, but she was never “just fine.” Then, out of the blue, about six months ago, she began having a truly awful taste in her mouth, described as “bitter, sour, acid-y, disgusting!”

Again she played detective and tried to locate culprit foods, but she could find nothing consistent. By eating small meals, the vile taste would relent for a couple hours, but inevitably it would return. Claudia also mentioned she’d been having chronic vaginal yeast infections every four or five weeks, each severe enough to require treatment.

She took her problems to a gastroenterologist who suggested she take Nexium (to block acid production), but it had absolutely no effect. Then she underwent a gastroscopy, the doctor finding some redness in her esophagus consistent with gastroesophageal reflux disease (GERD, aka acid reflux or heartburn). He told her to double her Nexium. When Claudia tried it, her symptoms dramatically worsened. He suggested she keep taking the Nexium, but she chose not to and cancelled further appointments with him.

Next Claudia went to her colon therapist, my friend Alyce Sorokie at Partners in Wellness, who, after listening to her symptoms, suggested she try a particular supplement. Within a few days Claudia felt fine, the vile taste gone and her digestive misery also a memory. She felt better than she had in years. Not to disparage her gastroenterologist, but if he’d seen the supplement, he would have had his own “Aha!” moment and understood why his Nexium made everything worse. He also might have suggested some additional testing that would have been both uncomfortable and expensive, but wouldn’t have changed Claudia’s treatment one iota.

Claudia had made an appointment with me prior to receiving her supplement from Alyce, wanting an MD to explain just what was going on and why she needed this particular supplement. I explained that what she had was called hypochlorhydria, the medical term for when a person’s stomach isn’t producing enough acid to digest food. It’s actually far more common than people realize. The cause can be genetic or secondary to a separate condition, like hypothyroidism (low thyroid) or an autoimmune disorder that destroys the acid-producing cells in the stomach.

Most often, because people have varying amounts of stomach acid, hypochlorhydria just appears, sometimes starting early in life as mild chronic indigestion and then slowly worsening.

The condition is not all that easy to diagnose, and probably explains why hypochlorhydria is often overlooked as a possible cause of digestive symptoms. Strictly speaking, to diagnose it the doctor needs a rather expensive device called a Heidelberg machine that measures the acidity (pH) of the stomach. When I telephoned two gastroenterologists, neither owned one. Interestingly, when gastroenterologists are down there in your stomach with their gastroscopes, they’re endlessly looking for evidence of too much acid (“redness,” “ulcers”) and hunting for the ulcer-causing bacterium Helicobacter pylori (H. pylori), but they don’t check for insufficient acid.

Also, probably in response to the bloated advertising budgets of Big Pharma, gastroenterologists (and family practitioners and internists as well) routinely prescribe the acid-reducing drugs called proton pump inhibitors (PPIs)—including Nexium, Prevacid, AcipHex, and Dexilant–for just about every digestive symptom known.

As you might have guessed, because the job of PPIs is to reduce stomach acid, giving a PPI to someone with hypochlorhydria only makes matters worse, as it did when Claudia doubled her Nexium dose. In addition, deigning to recommend something as mundane as a nutritional supplement is beneath the dignity of most gastroenterologists, so patients with hypochlorhydria often go untreated for years.

Your impressive GI tract
To understand Claudia’s symptoms, picture your gastrointestinal (GI) tract as the long continuous tube it is, one end of which you wipe with a linen napkin, the other with Charmin. The GI system is really an external organ, a continuation of your skin (note how it turns inward at your lips). Gastroenterologists jokingly think of themselves as hard-working dermatologists.

When you take a bite of anything–from a Big Mac to that $500 meal over at Alinea–your teeth grind the food to a pulp that your mouth mixes with digestive enzyme-laden saliva, and after a few seconds it all plunges southward toward your stomach. Yes, there’s something undeniably ephemeral about fine dining. Once in your stomach, the whole mess is churned with pure hydrochloric acid and still more enzymes into a thick sludge called chyme (pronounced kim with a long i). Burger King chyme and Alinea chyme would be visibly indistinguishable from each other, but fortunately everything is far removed from your visual field and you can continue to enjoy your meal.

Your stomach then forces the chyme into the 22 feet of your small intestine for further digestion plus the absorption of all the nutrients you need to keep going in life. Once the nutrients have been extracted, the chyme is propelled into your large intestine, where excess fluid is extracted and…you know the rest.

With hypochlorhydria, the whole process grinds to a halt. Your chewed-up food is held in your stomach, feeling like dead weight, needing more acid to break it down and convert it to chyme. As Claudia described, the act of eating becomes distinctly unpleasurable. The vile taste she experienced comes from slowly putrefying food, sitting there. Vaginal Candida overgrowth is a common side effect of hypochlorhydria because inadequate acid throws off the balance of good and bad bacteria, allowing yeast to flourish. Not surprisingly, certain nutritional deficiencies also develop, notably vitamin B-12, which requires stomach acid to be absorbed.

A simple supplement restores Claudia to balance
The supplement Alyce handed Claudia was Betaine Hydrochloride (Betaine HCL). When taken about 30 minutes before a meal, it converts into enough stomach acid to digest food. Both Alyce and I often add digestive enzymes as well, and might also suggest beginning each meal with a teaspoon of bitter herbs to stimulate the body’s own acid and enzyme production.

One interesting sidelight of betaine is its use for people whose GERD has failed to respond to PPI acid blockers. While it’s extremely counterintuitive to add still more acid for a condition that seems to be caused by too much acid, when Alan Gaby, MD, author of Clinical Nutrition explains it, betaine makes sense. With hypochlorhydria, there is some acid present, but the stomach retains the chyme awaiting more. As the stomach keeps churning the food, even though the overall amount of acid is small the excessive churning causes some backflow of acid that’s experienced as reflux.  Adding more acid (using betaine) signals your stomach to release the chyme into your intestine.

Thanks to a simple and inexpensive supplement, Claudia’s vile taste is now history. And her yeast infections too.

Be well,

David Edelberg, MD 

Leave a Comment

  1. Amie says:

    Thanks dr, I’m still confused about what to take. I get a salty taste which is making throat sore. One minute I’m taking apple cider vinegar then next enzymes, but very confused what to use. I found apple cider helped but hurts my throat. I have trouble digesting meats & fats. My stomach isn’t working right it’s like everything I eat causing it, I eat do healthy. Sometimes I find undigestive food in stools. I’m currently taking probiotics aswell. It’s affecting my life, I gave up bread & dairy but I don’t think it’s what I’m putting in its how it’s not digesting

  2. cliffmaurer says:

    Hi Amie – It’s not entirely clear what type of therapy you need to be pursuing, and very difficult to help guide treatment over a forum like this. Seeing your physician and going over your history, symptoms, and testing makes the most sense. If you don’t feel like you’re getting anywhere with your current doc, perhaps seeing one of our medical physicians here at WholeHealth would be a good next step. If we’re not convenient to your location, please take a look at the physician referral site at The Academy for the Advancement of Medicine at http://www.acam.org/ or at the American Holistic Medical Association’s practitioner referral site at http://www.healthy.net/scr/PractitionerSearch.aspx?AssocId=36.
    -Dr. M

  3. Renee says:

    My son has this acid taste in his mouth all the time and his tounge get numb. He was checked by a functional medicine doctor and told he had low stomach acid and given the betaine/pepsin & digestible (enzymes). He took these under the doctor’s care for 2 months but his symptoms only got worse. He is off everything now. His stools are completely undigested and move through him extremely quickly. Over the past 2 years we have been to gastrointerologists, herbalists, functional medicine doctors. We don’t know where to turn. Can you help us?

  4. Dr E says:

    Hi Renee
    Two tests would be helpful
    1. intestinal transit time (how quickly xray contrast material goes from stomach to large intestine)
    2. breath test for SIBO (small intestine bacterial overgrowth).
    As you can see from this link, the symptoms of SIBO are numerous

  5. Sandy Matuschak says:

    What is the recommended dose of Betaine HCL? Also, you mentioned to take it 30 min before eating, but the directions on various brands that I’ve seen say to take with food and never on empty stomach? It also says not to take if only eating a salad or fruit and mainly with protein (generally some sort of meat) so I’m confused. I’ve had this same history and strong acidic taste in mouth over last few years, the taste has recently become worse and for most of the day (I’m usually okay upon waking and it increases throughout the day). I just purchased this product which includes pepsin and opted for the 250mg capsules as could increase. I ended up taking 2 with dinner last night & 2 with breakfast/lunch. Cannot notice a change yet but less than 24 hrs since first dose and uncertain of the usual starting dose?

  6. Penny says:

    Where can i get this from? I too have a vile taste, everything tastes bitter even inhaling fresh air ! Blood tests are normal . Oral hygiene is good.at my witz end please help!

  7. cliffmaurer says:

    Hi Penny – Which supplement are you looking for? I’d be happy to help you find a resource.
    Dr. M

  8. Dr E says:

    Hi Sandy
    Take your new supplements right when you start eating and generally they’re recommended for meals containing protein, fats, complex carbs (which is actually then most meals). A salad really doesn’t need enzymes. If you’re not getting satisfactory results by the time you finish the bottle, don’t buy another. Review all your current meds and supplements to make sure none has bad taste as a side effect. Finally, consider getting yourself tested for SIBO (small intestine bacterial overgrowth) which is turning out to be a much commoner cause of bad taste than we thought a few years ago

  9. Amie says:

    Hi, is the sibo test different to the H pylori test ? I also keep having a salty taste in mouth after everything I eat. I’m taking l-glutamine at mo. I’ve been trying apple cider vinegar but it doesn’t help my sore throat. Do u think I should try hcl next ? I’ve researched digestive enzymes do u only need them if constipated a lot ?

  10. Dr. R says:

    Amie. It would be worthwhile to try HCL or digestive enzymes as discussed in the article to see if they might alter your symptoms.

  11. Amie says:

    Hi, I’m taking hcl with pepsin with fish & meat meals. It is helping my symptoms. When do u know when to stop taking these ? Also I think I need to take digestive enzymes as my food is not breaking down in stools. Can u take these along side hcl ? Is it ok to take a the same brand for hcl & digestive enzymes not one that’s combined with hcl ?

  12. Dr. R says:

    Amie. Either two separate products or a combination product would work.

  13. Amie says:

    Dr R when do u stop taking hcl supplements ? Also I’m taking one just with protein meals, shall I use enzymes for other meals such as carbs ? Also I only take one hcl with meals & get no discomfort do I need to try taking more than one ? The salty taste in mouth is improving.

  14. Doris says:

    Thanks for this posting. I was just recently diagnosed with hypochlorhydria after finally seeing a Naturopathic Doctor. The first symptoms I endured for months were of not properly digesting my food. Every time I ate the food would just sit in my stomach and I would get major nausea – every single time. After seeing my naturopath I started taking digestive bitters before meals and also increased my protein consumption because I was a vegetarian for many years. They say that not eating meat/protein can cause this condition. After two months I am still feeling some symptoms, such as a burning/acidic feeling in my stomach gas and bloating. I am working with my naturopath to focus on food combining and see if this helps. I am hoping to get my HCL back on track as naturally as possible because stomach and intestinal diseases run in my family.

  15. paulrubin says:

    Amie. It sounds like things are working. You may need to take HCL for sometime. Play with decreasing the dose over time based on your symptoms.

  16. Linda says:

    Hi I have suffered with acid reflux since I was a child my would give baking soda for it.I a much older now and still suffer with the problem bitter taste bad breath when I talk people cover nose

  17. Linda says:

    Hi Linda here I have suffered with acid reflux since child hood I take omeperzoal for my reflux it helps somewhat it seems everything I eat goes down slow nasty taste in my mouth.

  18. Betsy says:

    Does anyone here also have orange tongue with the bad tasting mouth?

  19. Amie says:

    I saw a gastro consultant & he said I have functional dyspepsia. I keep getting a salty taste in mouth, as I’m not in pain or get heartburn he said I don’t have a normal acid reflux problem. I feel I av silent reflux as something is affecting throat. He has never heard of low acid, but I think I have as I get no burning after taking two hcl tabs. I don’t no what to do next ?

  20. Dr E says:

    Hi Arnie
    I would order three tests, all available from Genova Labs”
    Breath Test for SIBO
    Comprehensive Stool Digestive Analysis, adding on the test for Helicobacter Pylori.
    You can order these directly from the company or ask them for some doctors in your area who can order them for you

  21. Tosin says:

    Hello doctor,I was tested positive for her pylori, got treated with antibiotics and I’ve not been myself since then. Gas, bloating, indigestion, numbness, tingling sensation, burning sensation. Tested positive again . I’m allergic to some foods and food sit in my stomach for a long time before digesting. What can I do?

  22. Dr E says:

    Hi Tosin
    From your description of symptoms, this sounds like small intestine bacterial overgrowth. Have your doctor order a breath test for SIBO or order it yourself from Genova Labs
    If you are positive, this is easy to treat with Xifaxan

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