Although it may seem contradictory, low stomach acid can also lead to gastric reflux (heartburn).  Closure of the valve at the top of the stomach is stimulated by the hydrochloric acid that is released in response to food intake.  In an individual with low stomach acid the valve does not close and allowing the remaining acid to push up into the esophagus and cause a burning sensation.  Betaine hydrochloride is recommended for indigestion, low stomach acid and gastric reflux.

Betaine HCl can be purchased in capsules.  It is found on its own or as a component of a digestive or multi-enzyme formula.  It should be taken with meals and more may be necessary with large meals or those containing protein.  To assess you need for HCl some practitioners recommend an HCl challenge test.  The number of HCl capsules taken each day is increased by one until a slight burning sensation is felt in the stomach.  The appropriate daily dosage is slightly lower than the amount that causes burning.  This test should be done cautiously and under medical supervision if you have a gastrointestinal condition.

Do not take betaine HCl if you have active stomach ulcers.  Betaine HCl counteracts H2 antagonists, proton pump inhibitors and antacids.  High doses of betaine HCl can cause stomach irritation.