Acidity

Symptoms Of Acidity

The symptoms of acidity occur when some of the acid content of the stomach flows back up into the esophagus or the food pipe, which connects the mouth to the stomach. Normally, a ring of muscle called the lower esophageal sphincter (LES) acts as a valve that lets food enter the stomach but does not allow it back up into the esophagus. When this valve fails to function properly, stomach contents are regurgitated into the esophagus and the following symptoms of acidity can be experienced:

1. Heartburn

Despite the name, heartburn has nothing to do with the heart. It is a common symptom of acidity that is caused when the excess stomach acid leaks out into the esophagus, leading to a burning sensation in the chest. This feeling can last for a few minutes to several hours. 

2. Regurgitation

Some people with acidity may experience regurgitation. It is a feeling in which the person may feel liquid undigested food, bile, or stomach acid moving up and down in the throat. This sensation is somewhat similar to the feeling of being pukish and usually occurs post meals, exercising, or bending right after eating.

3. Sour taste in the mouth

Another common symptom of stomach ailments, a sour taste in the mouth, is also a symptom of acidity. It happens when food, along with stomach acid and bile, rises up to the back of your throat, causing a bitter taste. This usually happens along with regurgitation.

4. Difficulty in swallowing

Difficulty in swallowing, also known as dysphagia, happens when excess acid in the stomach causes a feeling of fullness. It also causes a delay in the movement of food through the food pipe and impedes digestion.

5. Sore throat

When the stomach acid moves up to the mouth it can irritate the vocal cords or the voice box, leading to sore throat or hoarseness. 

6. Indigestion

Indigestion, also known as dyspepsia, can also be a key sign of acidity and other digestive problems. It can lead to a feeling of discomfort and a burning sensation in the upper middle part of the stomach. 

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Causes Of Acidity

The stomach produces gastric acids that help in digesting food. However, due to some causes, there are times when gastric acids are produced in excess, leading to acidity. Factors affecting the function of the lower esophageal sphincter (LES) are also responsible for acid reflux.

Some of the common causes of acidity include:

1. Food and dietary factors

• Eating foods containing excessive amounts of chillies, pepper, vinegar, and paprika

• Deep fried and oily foods

• Excessive intake of caffeine in the form of tea, coffee, and chocolate

• High intake of table salt

• Diet low in fiber

• Overeating or eating at irregular intervals

• Unhealthy habits, like lying down just after eating

• Eating just before strenuous physical exercise

2. Lifestyle factors

• Frequent smoking

• Excessive intake of alcohol, soda, or carbonated drinks

• Lack of sleep

• Lack of physical activity

3. Ailments and medications

• Excessive stress, anxiety, or depression

• Stomach diseases, like peptic ulcer, gastroesophageal reflux disease, and stomach cancer

• Medications, like painkillers, antibiotics, chemotherapy medications, and antidepressants 

Risk Factors Of Acidity

The following conditions are related to increased risk of acidity:

• Medical conditions, such as asthma, diabetes, celiac disease, and connective tissue disorders, like scleroderma

• Hiatal hernia

• Delayed stomach emptying

• Overweight/Obesity

• Pregnancy

• Women who are nearing menopause

• Women on hormone replacement therapy

Diagnosis Of Acidity

If you experience any symptoms of acidity, such as burning pain or discomfort (also called heartburn), regurgitation or bloating or burping (with a sour taste in the mouth), then it is wise to consult a doctor. Your doctor might do some physical examination followed by a few questions related to your daily routine to know the cause of it.

If your symptoms are mild, your doctor might not recommend any tests. However, if your symptoms fail to show any improvement post-treatment or if you experience symptoms such as internal bleeding or difficulty in swallowing, then your doctor might recommend further investigation.

The tests include:

1. Upper GI endoscopy: In this, a small flexible tube (known as endoscope) is inserted down the throat to examine the lining of the esophagus, stomach, and small intestine.

2. pH monitoring: This test helps measure stomach acid by checking how much stomach acid enters through the food pipe and how long it stays in the stomach. 

3. Barium swallow test (esophagram): In this, you need to drink a liquid barium mixture and get an X-ray of the chest and upper abdomen done to help identify any physical abnormalities in the stomach or esophagus.

4. Esophageal manometry: It is a test that helps check the function of the lower esophageal sphincter (LES) and the muscles of the esophagus. It will tell your doctor if the food you eat can move through the esophagus normally or not. 

5. Electrocardiogram (ECG): In some cases ECG is also recommended if you report severe chest pain or discomfort to check your heart condition. Additionally, other tests, such as biopsy, can also be recommended based on your condition and the symptoms.

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Prevention Of Acidity

There are few simple tips and tricks that can help you to prevent and manage acidity. These include: 

1. Eat small, frequent meals

One of the simple tips to lower your risk of acid reflux is to eat small yet frequent meals. This is because overeating puts extra pressure on the lower esophageal sphincter (LES), a valve-like muscle which prevents the acid content in the stomach from entering the esophagus.

2. Eat a low-carb diet

A study has reported that a low-carb diet can improve heartburn symptoms, especially in obese individuals. It may be because excess carbohydrates can make you gassy and bloated, which in turn can lead to heartburn. 

3. Chew your food properly

When you eat slowly and chew your food properly, it provides sufficient time for the digestive juices to break down the food and digest it. This, in turn, can help you beat indigestion, acidity, and heartburn.

4. Avoid eating late at night

Unhealthy eating habits are one of the leading causes of digestion-related problems. Eating late at night because of work pressure or snacking heavily in the evening can, in turn, make you more prone to heartburn. Therefore, avoid this habit of late-night snacking or eating close to bedtime.

5. Limit consumption of spicy and deep-fried foods

Regular intake of highly spicy food can stimulate excessive gastric acid production. Similarly, deep-fried foods are slow to digest and trigger more acid production. Hence, these kinds of food should always be consumed in moderation.

Do you know what foods to eat and what to avoid in acidity?
Are you aware of the common home remedies for acidity?
Do you have an idea about what lifestyle changes can be made to improve acidity?

Watch this video to know the answers from our expert doctors.

6. Limit caffeine and carbonated beverages intake

One of the key ways to prevent heartburn is to avoid foods that trigger acid reflux. Caffeine-containing food and drinks, like tea or coffee, are highly acidic in nature and stimulate excessive gastric acid production. Likewise, carbonated beverages increase acidity because carbonation bubbles expand in the stomach and put pressure on the LES to open in the wrong direction and cause regurgitation of gastric acid.

7. Limit your alcohol intake

It goes without saying that drinking alcohol is bad for your health, especially, if you suffer from heartburn. Alcohol increases your risk of acid reflux and also worsens the condition. It irritates the lining of the stomach and impairs the ability of the LES to clear up acid. Hence, avoid alcohol to ease the symptoms of heartburn.

8. Quit smoking

Nicotine in cigarettes can relax the LES and trigger acidity. Hence, for the prevention of acidity and many other health benefits, it is always advisable to quit smoking.

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9. Avoid strenuous physical activity right after eating

Strenuous physical activities like exercising or bending right after meals can hinder the process of digestion and can lead to a build-up of acid in the oesophagus. This can lead to acidity and worsen the condition if you already suffer from it. So give your stomach some time to empty its contents before you start exercising.

10. Do not sleep immediately after meals

It is important to maintain a gap of at least three hours between eating meals and hitting the sack. Lying down immediately after eating can increase the pressure on the LES which can make you vulnerable to acid reflux. Maintaining a gap can help the stomach to digest the food and prevent heartburn.

11. Raise the head of the bed

Elevating the head of the bed by about 15-20 cm can reduce symptoms of acidity and improve quality of sleep. This can be achieved by using a foam wedge to support the upper body. Stacking of pillows usually does not provide the uniform support one needs.

12. Try to lose weight

If you are overweight and suffer from acid reflux, then losing weight should be a priority. This is because excess fat, especially in the abdominal region, puts pressure on the stomach and the LES. This pushes the stomach acid upwards, which leads to acid reflux.

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13. Check your medicines

Certain medicines can cause acid buildup or inflame the oesophagus, which can lead to heartburn or worsen the condition. Hence, talk to your doctor about the medicines you are recommended to be doubly sure of its side-effects such as heartburn.

Specialist To Visit

The symptoms of acidity are often easy to deal with by using over-the-counter medications and making lifestyle changes. However, if you experience severe chest pain or chest discomfort or heartburn that seems different or worse than usual, then consult a doctor. Also, if you experience these symptoms more than twice a week or on a regular basis, do not think twice before visiting your doctor’s clinic to know the exact cause and get it treated. 

Specialists who can help manage acidity include:

• General Physician

• Gastroenterologist

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Treatment Of Acidity

The medications used to treat heartburn work either by blocking the production  or aiding in the neutralization of the stomach acid. Based on their action mechanism, these drugs are classified into three main categories, namely: 

1. Antacids

Antacids, also known as stomach acid neutralizers, neutralize the stomach acid to provide quick relief from acidity. These are available in the form of tablets as well as syrups.

Examples include:

• Aluminum hydroxide

• Magnesium hydroxide

• Magnesium trisilicate

• Magnesium carbonate

• Calcium carbonate

The side effects of antacids are based on their ingredients. For example, antacids containing aluminum hydroxide might cause constipation as a side effect, whereas those containing magnesium hydroxide can lead to diarrhea. The long-term effects include gas (belching), swelling of the feet and hands, constipation, and diarrhea.

2. H2-receptor blockers 

These medications block specific receptors on the stomach cells that release gastric acids, thereby helping fight acidity. They are also known to aid in the treatment of damaged tissues in the stomach caused by peptic ulcers, gastritis, or stomach inflammation.

Some of the common side effects of drugs belonging to H2-receptor blockers class include abdominal pain and diarrhea. These drugs should not be taken by pregnant women as they can cause abortion and teratogenic (fetal defects) side effects.

Examples include:

• Famotidine

• Ranitidine 

• Nizatidine

3. Proton pump inhibitors (PPIs) 

PPIs block and reduce the production of stomach acid to relieve acidity. They are available both as over-the-counter and prescription drugs. These drugs are usually prescribed to people who do not show any improvement post diet and lifestyle changes or experience gastric symptoms regularly.

Side effects of these medications are rare but may include headache, diarrhea, and upset stomach. The long-term health effects of these medicines are not yet known, so talk to your doctor if you are taking PPIs for a long time or in high doses.

Examples include:

• Omeprazole

• Pantoprazole

• Rabeprazole

• Esomeprazole

• Lansoprazole

4. Coating drugs

Coating drugs, also known as ulcer protective drugs, protect the esophagus and stomach by forming a protective layer over the surface. These drugs are mostly recommended for short-term action and considered to be safe.

They are mostly recommended for use in people suffering from stomach ulcers and peptic ulcer disease.

Examples include:

• Sucralfate

• Carbenoxolone

• Colloidal bismuth (CBS)

5. Prokinetic drugs

This class of drugs are prescription drugs and are known to act by promoting normal contraction of the esophagus and helping in the emptying of the stomach.

These are commonly recommended for people with GERD and mostly in combination with medications that lower acid production in the body, such as PPIs and H2-receptor blockers. 

Some common side effects of these drugs include diarrhea, drowsiness, and agitation.

Examples of drugs belonging to this class are:

• Domperidone

• Metoclopramide

• Mosapride

• Levosulpiride

Home-care For Acidity

Diet plays a key role in managing and treating acidity. Here are some dos and don’ts you need to follow to keep your acid reflux under control and fight acidity.

Dos:

• Eat foods rich in fiber, as fiber aids in the process of digestion.

• Have small, frequent meals throughout the day to avoid excessive acid secretion.

• Water is the best natural remedy for acidity. You must aim to consume close to 7-8 glasses (2-3 liters) of water every day.

• Include foods such as oatmeal, ginger, salad, banana, melon, and fennel seeds in your daily diet.

• Herbs, such as cardamom and mint, serve an immediate relief from acidity and associated pain.

 Don’ts :

• Avoid excessive intake of oily and spicy foods.

• Avoid excessive intake of caffeinated drinks, such as tea and coffee.

• Say no to alcohol and carbonated beverages.

• Do not overeat. It puts a direct load on the digestion process and causes the body to secrete acid in excess.

Complications Of Acidity

Acid reflux or acidity usually does not cause any serious or long-term health problems when it occurs on an occasional basis. But if it happens frequently and is left unattended, it can lead to various stomach problems, such as:

1. Gastroesophageal reflux disease (GERD): It is a condition in which the lower esophageal sphincter (LES), which is a ring of muscle between the esophagus (food pipe) and stomach, is affected. Acidity or heartburn is one of the most common symptoms of GERD.

2. Erosive esophagitis: As the name suggests, this condition is the inflammation in the esophagus, which may lead to ulcers as well as bleeding.

3. Ulcers: Acidity, if left untreated or unattended, can lead to stomach ulcers. This in turn can increase the risk of peptic ulcer disease.

4. Barrett’s esophagus: It is a condition in which the tissue that is similar to the lining of the intestine replaces the esophageal lining. In some cases, this condition can also increase the risk of esophageal cancer.

5. Esophageal stricture: In this condition, the esophagus becomes narrow, which leads to problems with swallowing.

Alternative Therapies Of Acidity

Home remedies for acidity

Here are a few quick fixes to control and get relief from acidity.

1. Holy basil (Tulsi) leaves

Tulsi leaves have antiulcer properties that help in lowering the acid level in the stomach. They also stimulate the stomach to produce more mucus, thus neutralizing excess gastric acid in the stomach. Chew 4-5 leaves and swallow their juice to fight the burning sensation in the stomach and chest.

2. Cinnamon (Dalchini)

Cinnamon contains phytochemicals that help in the process of digestion, thus relieving acidity. Add a pinch of cinnamon powder to a teaspoonful of honey or water and consume it after meals to eliminate acidity.

3. Cumin seeds (Jeera)

Jeera seeds contain compounds which act as natural carminative and digestive agents and aid in relieving acidity caused due to indigestion and flatulence. Moreover, these seeds also help relieve the symptoms of acidity, such as stomach pain and discomfort. 

Add 1/4-1/2 teaspoon of cumin seeds to a cup of water, and let it boil till the water becomes slightly dark in color. Strain, cool, and sip this tea at regular intervals throughout the day if you experience frequent bouts of acidity.

4. Cold milk (Doodh)

Milk contains high amounts of calcium, a mineral which plays a key role in preventing acid buildup in the body, and hence, causes immediate relief. It also absorbs the excess acid produced in the stomach, thus nullifying its effect on the intestinal lining.

It is advised to drink cold (and not warm) milk to get rid of acidity. Remember to drink it plain, and avoid adding anything such as honey, sugar, and turmeric.

5. Buttermilk (Chaach)

Buttermilk neutralizes the excess acid in the stomach. It also contains lactic acid, which improves digestion and helps you fight acid reflux and gas trouble at home.

Drink a glass of buttermilk everyday after meals if you are prone to frequent acid attacks. You can also add a pinch of black pepper and coriander to it.

6. Carom seeds (Ajwain)

Ajwain contains a compound, thymol, that helps in secreting gastric juices, which in turn ease indigestion and gas.

Add a teaspoon of ajwain seeds or 3-4 fresh ajwain leaves to 2-3 glasses of water and boil. Strain it and drink this water regularly post meals/breakfast for quick relief.

Yoga for acidity

Some of the simple yoga asanas that can help relieve acidity include:

• Pawanmuktasana 

• Vajrasana

• Virabhadrasana

• Shashankasana

• Trikonasana

Living With Acidity

If you experience acidity once in a while, it can be managed with a few lifestyle changes and diet modifications. However, if you suffer from chronic acidity, then in addition to diet and lifestyle changes, you may also need to take medications to manage and prevent any long-term complications.

Also, if you are taking over-the-counter medications, then it is wise to talk to your doctor to know about the severity of your condition and the right treatment approach to fight and prevent the acidity from worsening. 

Additionally, here are a few changes that can help you manage and prevent acidity:

• Avoid foods that can trigger and worsen symptoms of hyperacidity, such as coffee, chocolate, carbonated drinks, deep-fried food, fat-rich dairy, meats, citrus fruits, and alcohol.

• Avoid eating right before bed and going to bed with a full stomach. 

• Say no to eating large meals. Eat small and frequent meals.

• Drink more water and shed some weight (if you are overweight/obese).

• Keep a diary to record and know about your triggers, and work on them to prevent another episode of acidity.

• Try home remedies or over-the-counter antacid medications if you experience the symptoms of acidity.

Remember, chronic acidity can also indicate an underlying health problem, such as gastroesophageal reflux disease (GERD). Therefore, consult your doctor if your symptoms fail to subside with medications and at-home treatment.

Heartburn vs Acid reflux vs GERD

Although used interchangeably, these three terms have different meanings.

• Acid reflux, also known as acidity, is a digestive disorder characterized by excess acid levels in the stomach.
  
  
• Heartburn is a symptom of acidity or acid reflux that is caused when the excess stomach acid leaks out into the esophagus, leading to a burning sensation in the chest. This feeling can last for a few minutes to several hours.
  
  
• Gastroesophageal reflux disease (GERD) is a chronic form of acidity in which the stomach acid causes inflammation of the esophagus and/or intestinal lining. You may require medications to neutralize or stop the production of the acid in the stomach to treat this condition.
  
  

Heartburn in pregnancy

Heartburn is one of the most common gastrointestinal symptoms in pregnant women, with an incidence of 17% to 45%. The cause of heartburn during pregnancy is multifactorial.

It is attributed to the increase in the levels of the hormone progesterone or its metabolites, which cause the relaxation of smooth muscles and a decrease in lower esophageal sphincter pressure.

Also, during pregnancy, food and gastric acid tend to pass from the stomach into the esophagus, leading to inflammation and a burning sensation in the esophagus. The pressure of the growing uterus on gastric contents as the pregnancy progresses may also worsen the heartburn.

Most cases of heartburn can be improved with lifestyle modifications, such as consumption of smaller meals, not eating late at night, avoiding known triggers, and cessation of smoking/alcohol during pregnancy. If not relieved, your doctor may recommend medications that are safe for use during pregnancy.