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Dr. David Brownstein, M.D., writes: 

Many patients suffering from thyroid deficiency, or hypothyroidism, do not produce enough stomach acid. Stomach acid is necessary to properly digest food as well as eliminate bacteria from food.

Low stomach acid production can result in bacterial overgrowth in the small intestine. One study found 54 percent of patients with hypothyroidism had bacterial overgrowth in the small intestine.

Not surprisingly, the symptoms of such overgrowth are the same as irritable bowel syndrome (IBS) — bloating and abdominal discomfort. Some patients with hypothyroidism also suffer from delayed gastric emptying. This means that food literally stays in the stomach for too long, which can result in bacterial overgrowth in the gastrointestinal system as the food decays.

I ask hypothyroid patients who complain of IBS symptoms, “Do you feel food sits in your stomach for too long?” If the answer is yes, I have the patient undergo a Heidelberg test or give them a trial of hydrochloric acid therapy.

In the Heidelberg test, a patient swallows a small capsule that transmits stomach pH. Once the capsule is in the stomach, it sends back readings that can be recorded. While the capsule is in the stomach, the patient is challenged with different substances to see how the stomach will respond.

For example, if you give someone sodium bicarbonate (baking soda) to drink, as the pH of the stomach increases, you expect the stomach to excrete more hydrochloric acid to bring the pH down.

If the stomach is unable to produce hydrochloric acid, a diagnosis of hypochlorhydria (low stomach acid production) is made. In this case, the treatment is capsules of stomach acid to aid the digestion process.

If a Heidelberg test is not available, it is reasonable to give the patient a therapeutic trial of hydrochloric acid pills to supplement their natural production of acid. Usually, I start with 10 grains (600 mg) of hydrochloric acid.

I tell my patients to take one with a meal. If you use hydrochloric acid pills, you should only take them with food in your stomach.

If any burning or discomfort occurs, you must stop taking them immediately, as they have the potential to irritate and even ulcerate the stomach lining.

However, in nearly 20 years of using hydrochloric acid pills, I have yet to see a patient ulcerate their stomach lining. It is best to use hydrochloric acid pills under the supervision of a knowledgeable healthcare practitioner.

If you suffer from bloating, diarrhea, constipation, and abdominal pain, you meet the criteria for a diagnosis of IBS. However, keep in mind that a diagnosis of IBS does little to describe what underlying problems are causing these symptoms.

A thorough search for the underlying cause of IBS can often identify the causative factors. In looking for underlying causes of IBS, the appropriate testing includes a colonoscopy, comprehensive stool digestive analysis, and perhaps a Heidelberg test. The colonoscopy will rule out a mechanical problem with the gastrointestinal tract.

The comprehensive stool digestive analysis looks for bacterial, fungal, and parasite overgrowth. A Heidelberg test can be undertaken to ascertain the ability of the stomach to produce adequate amounts of hydrochloric acid and maintain a normal acidic pH of the gastric contents.

My experience with treating IBS has clearly shown the value of eliminating refined foods from the diet. This includes eliminating refined sugar, flour, salt, and oils. Eating a healthy, whole food-based diet can provide the body with the raw materials to heal.

Dr. David Brownstein, M.D., editor of the Natural Way to Health newsletter, is a board-certified family physician and one of the nation’s foremost practitioners of holistic medicine. In addition to his practice, Dr. Brownstein has lectured internationally to physicians and is the author of six very popular books.