Dealing with a Sour Stomach?

 What is a sour stomach?

 Sour stomach generally refers to gastroesophageal reflux although for some patients this may also be a manifestation of functional dyspepsia or other more serious disorders.

 How long do sour stomachs last?

 Acid reflux events generally last for several minutes, and even as long as 2-3 hours.

Other symptoms include nausea, bloating, belching, and a general feeling of discomfort in the upper abdomen.

 What causes a sour stomach?

Symptoms can be caused by a variety of factors including consuming too much food, spicy or acidic foods, stress and anxiety, and underlying medical conditions such as gastroesophageal reflux.

 When should I be concerned about a sour stomach?

Problematic acid reflux generally occurs more than twice per week.  You should see a health care provider if your episodes are increasing in frequency or in severity.  The following symptoms should prompt you to make an appointment with your doctor:

• Vomiting – especially large volumes or forceful vomiting
• Spitting up blood or passing blood in the stool
• Involuntary weight loss
• Chest pain
• A family history of stomach or esophageal cancer
• Painful swallowing or the sensation that food is getting stuck when you swallow
• If you are using prescription anti-reflux medications and you feel they aren’t working

 In these instances, your health care provider may refer you to a Gastroenterologist or for x rays, blood work, or even upper endoscopy.

 What bacteria causes sour stomach?

The most common bacterial infection associated with reflux and dyspepsia is Helicobacter pylori.  Your health care provider can assess for the presence of this infection using blood or stool tests, a specialized breath test, or stomach biopsies.  This may require a specialized course of antibiotics to treat.  There are increasing rates of antibiotic resistance for Helicobacter infections, so discuss this with your physician directly.

Less commonly, small intestinal bacterial overgrowth and gut dysbiosis (altered bacteria) can contribute to a sour stomach.  These may be treated occasionally with antibiotics, however as a general rule I would advise you to avoid antibiotics and focus on a strategy to achieve a thriving gut microbiome instead.  

 How should I treat a sour stomach?

 Treatment options depend on the underlying cause of the symptoms.  General options include:

1. Over-the-counter medications: Antacids, such as Tums or Rolaids, can help neutralize stomach acid and provide relief from heartburn and indigestion. 
2. Prescription medications, such as H2 blockers or proton pump inhibitors, can help reduce the amount of acid produced in the stomach and provide longer-lasting relief.
3. Dietary changes: Avoiding foods and beverages that are known to trigger digestive symptoms, such as spicy or acidic foods, caffeine, and alcohol, can help ease symptoms.  Eating smaller, more frequent meals throughout the day will help.  Avoid eating 2-3 hours before bedtime.
4. Stress reduction techniques: Stress can exacerbate digestive symptoms, so incorporating stress-reducing activities such as deep breathing, meditation, or yoga may be helpful for some people.
5. Lifestyle modifications: Lifestyle habits, such as smoking and alcohol use, can worsen digestive symptoms
6. Maintaining a healthy weight can also help reduce symptoms

 Do probiotics help with a sour stomach? 

Probiotics may be helpful in improving the overall gut microbiome and relieving symptoms.  However, if you are not getting relief with probiotics after a few weeks, I would advise you to further discuss with your physician.

Well Sunday will be releasing a course "Reflux Revolution: Empowering Yourself with Nutrition and Lifestyle Management of GERD" in May 2023.