Can Baking Soda (Sodium Bicarbonate) Blow A Hole in the Stomach?

People have been using a natural antacid (sodium bicarbonate, aka baking soda) for a very long time. It is cheap and surprisingly effective for easing symptoms of indigestion. But too much of a good thing, especially after a big meal, can be disastrous! You will read about a case of rapid carbon dioxide buildup in the stomach and the resulting damage it created. There’s another complication of too much sodium bicarbonate: hypokalemia! That’s doctor talk for very low potassium levels.

Will Baking Soda Cause a Violent Reaction in the Stomach?

Q. My dad passed away at the age of 75. He was notorious for taking a small amount of baking soda from the kitchen cupboard to eliminate stomach acid or heartburn. He would let out a loud burp and bingo, his indigestion was gone.

I know how violent the reaction is between baking soda and battery acid. When you put baking soda into stomach acid, is the resulting reaction just as violent?

A. Usually a person taking a small amount of sodium bicarbonate as an antacid suffers no harm. Gastroenterologists have estimated that 1/2 teaspoon of sodium bicarbonate (bicarb) would release only a small amount of gas (Gastroenterology, Nov. 1984).

Too Much Sodium Bicarbonate Could Disastrous:

The authors of this report note, however:

“Some people selected doses of bicarbonate that would result in several hundred milliliters of gas release within 3 min; it seems likely that such injudicious ingestion of sodium bicarbonate, if taken when the stomach was distended with air, food, and liquid, could be an important factor in spontaneous gastric rupture.”

Ruptured Stomachs from Bicarb and Overindulgence:

There are about 15 cases in the medical literature in which people ruptured their stomachs by taking large doses of baking soda after eating too much. In one notorious case, a man ate a large meal, accompanied by margaritas, at a Mexican restaurant (Annals of Internal Medicine, Nov. 1984).

A reader of our syndicated newspaper column shared this story of excess:

Q. Although it says right on the package of baking soda that you can use it for heartburn, if you choose to use it you must follow the directions exactly.

My husband had chronic indigestion due to an ulcer. He insisted this could be treated with baking soda, but he was not careful.

He drank much more baking soda in water than you’re supposed to, and he didn’t dissolve it first. Eventually, it made him throw up, so he took more to counteract that.

When he landed in the hospital, his potassium level was 1.9, the lowest the ER doctors had ever seen. His electrolytes are still messed up. That’s why, if you want to use baking soda, I think Alka Seltzer is safer because the dose is regulated.

A. Taking large doses of sodium bicarbonate (baking soda) can be dangerous, as your husband discovered. This is especially true if the baking soda is not fully dissolved before it is swallowed.

In addition to the scary drop in potassium (hypokalemia), there is the risk of a ruptured stomach. For more information on using baking soda safely and many other strategies to manage indigestion, you may wish to consult our eGuide to Overcoming Digestive Disorders. This online resource can be found under the Health eGuides tab. Very low potassium levels can trigger cardiac arrest (Anestezjologia Intensywna Terapia, Jul-Sept 2008).

Alkaline Water and Hypokalemia:

Alkaline electrolyzed water (AEW) has also become quite popular. Some people drink “alkaline water” to ease heartburn symptoms. A recent report in the American Journal of Emergency Medicine (Feb. 2024) describes a woman who  drank 5 liters of alkaline water daily for a month. Her potassium levels dropped to 1.6meQ/L. That resulted in serious arrhythmias.

The authors note:

“This case report illustrates severe metabolic alkalosis and hypokalemia in the setting of chronic alkaline water exposure.”

Debbie in Georgia has a worry about regular use of baking soda:

“My grandfather used baking soda daily. He developed Alzheimer’s.

“My husband also had to use baking soda daily, 1 teaspoon morning, 1 teaspoon evening. He now has Alzheimer’s.

“My son-in law’s grandmother was also a heavy user of baking soda. She developed Alzheimer’s. Can’t help but wonder about its use and connection.”

We have no idea if there is a connection between heavy use of sodium bicarbonate and dementia. But there is a lot of sodium in baking soda. Used occasionally for mild heartburn, we wouldn’t worry. Used daily, however, we would be concerned.

Doug in Lucas, Texas, changed from bicarb to yellow mustard:

“I used to take baking soda occasionally for heartburn at night. One night I took a teaspoon of yellow mustard for a cramp in my foot then realized that my heartburn was instantly gone! Now if I have heartburn I use the yellow mustard instead of the baking soda.”

What Do You Do for Heartburn?

Please share your own experience with baking soda or any other antacid for mild indigestion in the comment section below.