Acidity

Dr. Rajalakshmi VK (AIIMS)MBBS

July 10, 2017

January 29, 2024

Acidity
Acidity

Summary

Acidity or heartburn is a very common phenomenon often experienced by many people globally irrespective of their gender and age groups. It is mainly detected because of a distinctive burning sensation inside the chest and nearby regions. Sometimes it also causes irritation and burning in the upper abdomen along with mild to moderate pain. Research strongly suggests that one of the major causes of acidity is acid reflux. Acid reflux is the action of stomach acids reversing back into the esophagus (food pipe).

What is Acidity

The major reason responsible for acidity is stomach acids. Hydrochloric acid (produced inside the stomach) is an important component of our digestive system which helps in the breakdown of consumed food particles and also protects the body against harmful bacterias. However, the lining present in the stomach is tough and can resist the action of hydrochloric acid. But on the contrary, the lining inside the food pipe (esophagus) is comparatively gentler and it cannot resist the corrosive action of hydrochloric acid and that is why we feel the burning sensation and repeated episodes of acid reflux is known as GERD (Gastroesophageal Reflux Disease).

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Symptoms of Acidity

What to expect when you have acidity

  • Burning sensation in the chest- this is caused due to acid reflux inside the food pipe (esophagus) which worsens while lying or bending down. This can happen for a few hours continuously and may worsen after consuming meals.
  • You may experience pain in the neck and throat this is caused due to acid reflux.
  • You may burp a lot, often with a sour taste in the mouth
  • Often people experience nausea and possibly even vomiting
  • You could feel excessively full or bloated
  • You may develop a continuous dry cough
  • Some wheezing is quite common
  • Minor throat problems such as a sore throat or a hoarse voice
  • Pain in the throat for a long time
  • You could find it difficult to swallow, and even experience some pain along with it
  • Pain in the chest and upper abdomen
  • Acid reflux may damage your tooth enamel
  • Some people may develop a foul or unpleasant breath
  • You may notice some blood in your stool or that it is darker than usual (black)
  • Sometimes people get non-stop hiccups
  • You could experience weight loss without any apparent reason

When to see your doctor for Acidity

See a doctor if you are having the following symptoms along with acidity:

  • frequent episodes of heartburn.
  • difficulty in swallowing, especially solid foods.
  • significant and rapid weight loss due to unknown reasons.
  • suffocation, choking and cough since a long time
  • if you are already taking anti-acid medications for more than 15 days without any significant relief.
  • hoarse voice along with asthma and anxiety, must consult the doctor immediately
  • difficulty in performing daily routine activities due to acidity
  • chest pain along with pain in the jaws, neck and oral cavity (inside the mouth)
  • irregular pulse, difficulty in breathing, weakness and excessive sweating.
  • excessive abdominal pain.
  • passing blood in stool, black stool or loose motions.

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Acidity Causes & Risk Factors

Why does acidity happen?

  • Acidity is very common irrespective of age group and gender. Acidity has been experienced by each one of us at some point of time and is directly connected to the nature of the food we consume.
  • Research states that most women experience acidity during pregnancy because of the increase in pressure on the internal organs due to the growing fetus in the womb. Research also hints at overeating or can also cause acidity during pregnancy.
  • It has been observed that regular consumption of fried food items can increase the chances of acid reflux. Fried items take longer to digest because it enters the intestines at a very slow pace leading to acidic secretions which causes acidity.

Other reasons for acidity

You may develop acidity if you are

  • overweight or obese  
  • a regular or even passive smoker
  • consuming more than required salt intake.
  • taking less fiber-rich foods
  • not doing sufficient physical activity and exercise
  • taking certain medicines such as antidepressants, sedatives, painkillers, bronchodilators (medicines used for asthma).
  • a heavy drinker or drink a lot of beverages that contain caffeine.
  • a heavy eater or eating meals just before bedtime, it may disrupt normal digestion process and cause acidity.

Prevention of Acidity

How can you prevent acidity?

You can effectively prevent acidity by simply making changes in our diet patterns and by not consuming certain kind of food items which promotes acidity.

Here are the following ways

  • consume the maximum amount of fruits and vegetables which are not acidic in nature such as bananas, papayas, oatmeal. Read the section “what to eat” for more information.
  • eat small meals frequently, instead of 3 large meals.
  • keep a time gap of at least 1-2 hours while eating meals before bedtime.
  • maintain a healthy weight.
  • drink at least 3 liters of water daily
  • don't drink water 30 mins prior and 1 hour later after taking meals.
  • don't wear tight-fitting belts and items of clothing.
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Diagnosis of Acidity

How is acidity diagnosed?

Investigations and diagnosis for acidity must begin when no significant relief is felt after regular consumption of antacid medications and therapies. The detection and treatment of acidity is not a complex procedure at all, in fact, it is easily detectable and resolved. But many a time the symptoms of acidity mimic conditions such as pneumonia, heart attack and other chest-related disorders due to which people often get anxious and seek immediate medical attention. One of more of the following tests may be done to discern acidity from one of these conditions:

  • Endoscopy
    A process in which camera is used to check internal body parts such as buccal cavity (mouth, esophagus) gastrointestinal tract and stomach.
     
  • Biopsy
    A process in which tissue is collected aseptically and inspected under a microscope in the laboratory.
     
  • Barium X-ray
    An imaging technique used to capture images of the Gastrointestinal (GI) tract
     
  • Esophageal manometry
    A technique used to measure the pressure applied to the esophageal tract.
     
  • Impedance monitoring
    A technique used for monitoring the rate of acid produced in the stomach.
     
  • pH monitoring
    A process in which stomach acid entering the esophagus is measured.

Treatment of Acidity

Treatment of acidity is not complex process at all, infact in very a less number of cases requires any surgical intervention.The treatment mainly focuses on food habit changes, lifestyle changes and repair of esophageal damages(if any).

Medicines

  • Antacids: commonly available at any chemist shop near you. Antacids are very useful in suppressing excessive acid production in the stomach and preventing acidic reflux episodes.
  • Acid-suppressing medicines: To lower the acid production in the stomach mainly two kinds of medications are prescribed. a) Proton pump Inhibitors b) Histamine 2 receptor antagonist. These medicines help in repairing the esophagus lining and prevent excessive acid production.
  • Prokinetic agents: These medicines help in flushing down food particles and acids from the food pipe and stomach so that there are minimal or no chances of any acidic reflux.
  • Mucosal protective agents: These medicines help in protecting the mucous membrane in the esophagus by forming a protective layer which further prevents the esophagus from any burning sensation felt during acid-reflux episodes.

Surgery

When is surgery required?

  • When there is no relief in symptoms inspite of prolong medications. Sometimes prolong medications begin to induce unwanted side effects
  • When one does not want to take medicines for a long duration then surgery may be an option.

With the help of surgery the size and pressure of the sphincter (valve in the esophagus) are corrected which leads to lesser acid refluxes. Surgery can also be considered a useful option for people experiencing difficulty in swallowing food.

Lifestyle changes

Apart from changes in diet, one must also consider bringing in lifestyle changes for battling acidity effectively.

  • Consume medicines (anti-acids) on time (at least 30-60 mins prior meals) which suppress excessive acid production in the stomach before consuming meals.
  • Chewing of gum ( avoid peppermint flavor)
  • Do not lie down for least 2 hours after eating any meal.
  • Have dinner 2-3 hours prior to bedtime.
  • Do not indulge in binge eating (excessive eating).
  • Eat small frequent meals instead of large meals to reduce acid reflux episodes.
  • While sleeping keep your head elevated with a support (pillow) in line with your feet. This position helps in reducing acid reflux episodes.
  • Include minimum 30 mins of physical activity (any form) such as walking, jogging, yoga, aerobics, swimming etc to help reduce acidity problems.

What to avoid if you have Acidity

  • Do not consume on empty stomach dry fruit mixture and walnuts
  • Refined sugar and its products including honey
  • Certain spices green chilies, black pepper, cinnamon and vinegar
  • Alcohol
  • Tea and coffee (beverages rich in caffeine)
  • Acidic fruits such as lemon and oranges

What to eat if you have Acidity

  • Vegetables
    vegetables naturally contain very less sugar and acid hence certain vegetables can be safely consumed such as french beans, cabbage, and cucumbers. Researchers hint that consuming veggies can help in reducing acidity.
     
  • Ginger
    Ginger contains anti-inflammatory and anti-acid properties hence adding ginger to food items and having ginger will help reduce acidic conditions in the body.
     
  • Oatmeal
    Oatmeal is rich in fiber and helps in reducing weight and acidity hence consuming oatmeal is effective in helping people with acidity problems.
     
  • Fruits (non-acidic)
    Consumption of fruits which are less acidic in nature such as banana, papaya, apples, pears and muskmelon can be safely consumed.
     
  • Egg white
    The white portion in the egg which is also rich in protein should be consumed to help fight acidity. The yellow portion in the egg should be avoided because it does not help in battling acidity.
     
  • Oils & seeds
    essential oils and seeds are to be consumed and used as a cooking medium such as sunflower seed, chia seeds, olive oil, sunflower oil they help in reducing refluxes.


References

  1. National Health Service [Internet]. UK; Heartburn and acid reflux.
  2. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Acid Reflux (GER & GERD) in Adults.
  3. Frederik Hvid-Jensen, Rikke B Nielsen, Lars Pedersen, Peter Funch-Jensen, Asbjørn Mohr Drewes, Finn B Larsen, Reimar W Thomsen. Lifestyle factors among proton pump inhibitor users and nonusers: a cross-sectional study in a population-based setting. Clin Epidemiol. 2013; 5: 493–499.PMID: 24348070
  4. Lauren B. Gerson. Treatment of Gastroesophageal Reflux Disease During Pregnancy. Gastroenterol Hepatol (N Y). 2012 Nov; 8(11): 763–764.
  5. Health Harvard Publishing, Published: April, 2011. Harvard Medical School [Internet]. Proton-pump inhibitors. Harvard University, Cambridge, Massachusetts.

Medicines for Acidity

Medicines listed below are available for Acidity. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

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