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Acidity

Acidity

Also known as heartburn, acid reflux, hyperacidity

Overview

Acidity is one of the common ailments that almost everyone of us might have experienced once in our lifetime. In simple terms, it is a condition that causes excess acid production in the stomach. This not only causes discomfort in the stomach but also leads to other symptoms such as sour taste in the mouth, difficulty in swallowing and indigestion. 


There are numerous causes of acidity right from poor eating habits and excessive stress to use of certain medications. Moreover, lifestyle factors such as smoking and consuming foods loaded with oil, fats, and spices can also up your risk of acidity. 


If you experience acidity once in a while it may not indicate any health issues. However, if you suffer from frequent bouts of acidity, where the symptoms occur at least two or more days per week, there might be some underlying disorder associated with it. It is advised to consult your doctor in such cases.


You can fight acidity with simple lifestyle changes and effective home remedies such as consuming tulsi, mint, fennel etc. In most cases, over-the-counter medications to reduce/neutralise the acid are known to be of great help.

Key Facts

Usually seen in
  • Adults above 30 years of age
Gender affected
  • Both men and women
Body part(s) involved
  • Esophagus
  • Stomach
  • Intestine
Prevalence
  • Worldwide: 11.9% (2005)
  • India: 7.6–18.7% (2018)
Mimicking Conditions
  • GERD 
  • Peptic ulcer disease
  • Achalasia
  • Gastritis
  • Dyspepsia
  • Gastroparesis
Treatment
Antacids
     H2 receptor blockers
     Proton pump inhibitors
      Prokinetic drugs
     Coating drugs
  • Sucralfate
  • Carbenoxolone
  • Colloidal bismuth (CBS)
Specialists to consult
  • General Physician 
  • Gastroenterologist

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 which is caused when the excess stomach acid leaks out of the stomach 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, sour taste in the mouth, is also a symptom of acidity. It happens when food along with stomach acid and bile rise up to the back of your throat causing a bitter taste. This usually happens along with regurgitation.

4. Difficulty in swallowing

Also known as dysphagia, difficulty in swallowing happens when excess acids in the stomach cause a feeling of fullness. It also causes 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

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

Is it angina, heartburn or heart attack? Read the article to know the difference.

Causes Of Acidity

The stomach produces gastric acids that help in the digestion of the food. However, due to some causes, there are times when gastric acids are produced in excess thereby 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 spicy foods containing excessive amounts of chillies, pepper, vinegar,paprika etc.

  • Deep fried and oily foods

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

  • High intake of table salt

  • Diet low in dietary 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, worry, fear or depression

  • Stomach diseases like peptic ulcer, gastro-esophageal reflux disease, stomach cancer etc.

  • Medications like painkillers, antibiotics, chemotherapy medications, antidepressants etc.

Risk Factors Of Acidity

The following conditions are related to increased risk of acidity:

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

  • Hiatal hernia

  • Delayed stomach emptying

  • Obesity/overweight

  • Pregnancy

  • Women who are nearing menopause

  • Women on hormone replacement therapy

Avoid sleeping on your right side as it can worsen acidity
Sleeping on the left side can not only help you sleep better but also prevent heartburn. According to a study published in the American Journal of Gastroenterology, sleeping on the right side can worsen the symptoms of acid reflux. This is because when you lay on the right side, the chances of acid leaking through the LES is high, increasing the risk of heartburn. Heal your gut And heal yourself.

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:

 

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.

 

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

 

Barium swallow (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.

 

Esophageal manometry: It is a test which helps to 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 is able to move through the esophagus normally or not. 

 

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


To get the right diagnosis, it is important to consult the right doctor. Consult India’s best doctors online. 

Celebs affected

Illeana D’Cruz
Popular Bollywood actress, Illeana D-cruz, informed all her fans through Instagram that the reason why she was not able to share her workout posts is due to a really bad case of acid reflux.
Singer Ashlee Simpson
The famous singer is known to keep her acidity in check with dietary changes and not eating post 9 pm.
Former US President Bill Clinton
The former US President has adopted a vegan diet after he was diagnosed with acidity. He also avoids foods that increase the risk of acidity and GERD.
Former US President George W. Bush
George W. Bush, the 43rd president of the United States, avoids triggers of acidity such as coffee and peppermint to fight acid reflux.

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 oesophagus.

2. Eat a low-carb diet

A study has reported that a low-carb diet can improve symptoms of heartburn, 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 to beat indigestion, acidity, and heartburn.

4. Avoid eating late at night

Unhealthy eating habits are one of the leading causes of digestion-related problems. And eating late at night because of work pressure or snacking heavily in the evening can, in turn, make you more prone to heartburn. So 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 production of gastric acid. Similarly, deep fried foods are slow to digest and trigger more acid production. Hence these kinds of food should always be consumed in moderation.


6. Limit intake of caffeine and carbonated beverages

One of the key ways to prevent heartburn is to avoid foods that trigger acid reflux. Caffeine containing food and drinks like tea, coffee are highly acidic in nature and stimulate excessive production of gastric acid. Likewise, carbonated beverages increase acidity because the bubbles of carbonation 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, more so if you suffer from heartburn. Alcohol not only increases your risk of acid reflux but also worsens the condition. It irritates the lining of the stomach and impairs the ability of the LES to clear up acid. So avoiding alcohol can help to ease the symptoms of heartburn.


8. Quit smoking

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


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.


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.


 

Specialist To Visit

The symptoms of acidity are often easy to deal with the use of over the counter medications and 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 that can help to manage acidity include:

  • General physician

  • Gastroenterologist

Treatment Of Acidity

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

1. Antacids

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

Examples of this class of drugs include:

The side-effects of antacids are based on their ingredients. For example, antacids containing aluminium hydroxide might cause constipation as a side-effect whereas those containing magnesium hydroxide can lead to diarrhea as a side-effect. 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 present on the stomach cells that release gastric acids  thereby helping to fight acidity.These 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 this class include abdominal pain, and diarrhea. These are not advised to be taken by pregnant women as these can cause abortion and teratogenic (fetal defects) side-effects.

 Examples of this class of drugs include:


3. Proton Pump Inhibitor (PPI) inhibitors

They block and reduce the production of stomach acid to relieve acidity. These are available both over the counter and as prescription drugs. It is usually prescribed to people who do not show any improvement post diet and lifestyle changes or experience gastric symptoms on a regular basis. 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 of this class of drugs include:


4. Coating drugs

Also known as ulcer protective drugs, this class of drugs protect the esophagus and the stomach by forming a protective layer over the surface. It is mostly recommended for short-term action and is considered to be safe. These 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 which are known to act by promoting normal contraction of the esophagus and help 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 of the common side-effects of these drugs include diarrhea, drowsiness and agitation. Examples of drugs belonging to this class are:

Do not wear tight waist belts for long as they may cause heartburn
Wearing a tight-fitting waist belt, especially for a long time can cause heartburn. This is because wearing a tight waist belt can cause a change in anterior pelvic tilt (where your pelvis is rotated forward and the spine is curved). This mostly occurs when sitting or standing and causes an increased abdominal pressure by narrowing the waist circumference and a decreased space within the abdominal cavity. Read about other lifestyle factors.

Home Care For Acidity

Diet plays a key role in the management and treatment of acidity. Here are some do’s and don’ts you need to follow to keep your acid reflux under control and fight acidity.

Do’s 

  • Eating foods rich in fiber as a fiber rich diet aids 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 everyday.

  • Include foods such as oatmeal, ginger, salads, banana, melons and fennel in your daily diet.

  • Herbs such as cardamom and mint serve as 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 teas and coffee.

  • Say no to alcohol and carbonated beverages.

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

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 on a frequent basis and is left unattended, it can lead to various stomach problems such as


Gastro esophageal 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.

Erosive esophagitis: As the name suggests, it causes inflammation in the esophagus which may lead to ulcers as well as bleeding.


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

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.


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 on how to control and get relief from acidity.

1. Holy basil (Tulsi) leaves

Tulsi leaves have anti-ulcer properties of these leaves that help in lowering the acid level in the stomach. It also stimulates the stomach to produce more mucus thus, neutralizing the excess gastric acid in the stomach.  

Tip: Chew 4 - 5 leaves and swallow its juice to fight the burning sensation in the stomach and chest.


2. Cinnamon (Dalchini)

Cinnamon contains phytochemicals which helps in the process of digestion thus relieves acidity. 

Tip: Add a pinch of cinnamon powder to a teaspoonful of honey or water and consume it after meals to get rid of acidity.


3. Cumin seeds (Jeera)

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

Tip: Add 1/4-1/2 teaspoon of cumin seeds to a cup of water. Let it boil till the water becomes slightly dark in colour. 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 build up 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.

Tip: It is advised to drink cold (and not warm) milk to get rid of acidity. Remember to not add anything to it including sugar, honey and turmeric but drink it plain. 


5. Buttermilk (Chaas)

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

Tip: Drink a glass of buttermilk every day 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, which helps in secreting the gastric juices which in turn ease indigestion and gas.

Tip: Add a teaspoon of ajwain seeds or 3-4 fresh ajwain leaves to around 2-3 glasses of water and boil. Strain it and drink this water at regular intervals 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

Did you know?
Elevating the head of the bed can improve the clearing of stomach acid and reduce symptoms of acidity. This will ensure a good night's sleep.
Did you know?

Living With Acidity

If you experience acidity once in a while it can be managed with 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 acidity 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 acidity and prevent it from worsening. 

 

Additionally, here are a few changes that can help you to 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 the second attack of acidity.

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


Remember, chronic acidity can also indicate an underlying health problem such as Gastroesophageal reflux disease (GERD). So 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 level in the stomach. 

Heartburn is a symptom of acidity or acid reflux which is caused when the excess stomach acid leaks out of the stomach 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 neutralise or stop the production of the acid in the stomach to treat the condition. 


Heartburn in pregnancy

Heartburn is one of the most common gastrointestinal symptoms in pregnant women, with an incidence in pregnancy 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 relaxation of smooth muscle and decrease in lower esophageal sphincter pressure. Also, during pregnancy, food and gastric acid tend to pass from the stomach into the oesophagus, leading to inflammation and burning sensation in the esophagus. The pressure of the growing uterus on gastric contents as the pregnancy progresses may also worsen heartburn.


Most cases of heartburn improve 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 during pregnancy.

Frequently Asked Questions

References

  1. Vaishnav B, Bamanikar A, Maske P, Reddy A, Dasgupta S. Gastroesophageal Reflux Disease and its Association with Body Mass Index: Clinical and Endoscopic Study. J Clin Diagn Res. 2017 Apr;11(4):OC01-OC04. External Link
  2. Kahrilas PJ. Regurgitation in patients with gastroesophageal reflux disease. Gastroenterol Hepatol (N Y). 2013 Jan;9(1):37-9. External Link
  3. Wang HY, Leena KB, Plymoth A, et al. Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India. BMC Gastroenterol. 2016 Mar 15;16:36. External Link
  4. H.K. Bakhru. Indian Spices & Condiments as Natural Healers. Jaico Publishing House, 2001. 165 p. External Link
  5. Schachter H. Indigestion and Heartburn. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 83. External Link
  6. Eating, Diet, & Nutrition for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). External Link
  7. Do you need diagnostic tests for heartburn?. Diseases & Conditions. Harvard Health Publishing. Harvard Medical School. External Link
  8. Panda V, Shinde P, Deora J, Gupta P. A comparative study of the antacid effect of some commonly consumed foods for hyperacidity in an artificial stomach model. Complement Ther Med. 2017 Oct;34:111-115.External Link
  9. Definition & Facts for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). External Link
  10. Vazquez JC. Heartburn in pregnancy. BMJ Clin Evid. 2015;2015:1411. External Link
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