Acidity is more common than you think! About 7.6% of Indians report heartburn and/or regurgitation at least once a week.
When we eat food, it goes through the oesophagus and into the stomach. A circular muscle called the lower oesophageal sphincter (LES) exists between the oesophagus and the stomach that relaxes to allow food into the stomach and then closes (contracts) to prevent backflow into the oesophagus.
The stomach secretes acid to assist food breakdown during digestion. Excess production of acid by the stomach glands in some cases leads to a condition called acidity. For some people, the sphincter weakens or relaxes abnormally allowing the stomach acid to flow back into the oesophagus, causing acid reflux and heartburn.
Acid reflux can sometimes occur even in healthy people. It is usually for a shorter period without any significant symptoms.
Causes of Acidity and Heartburn
Acidity and heartburn are primarily caused by improper dietary habits and poor lifestyle choices. Major causes of acidity and heartburn include:
- Excessive intake of certain food items and drink such as chocolate, coffee, alcohol, and fatty or spicy food
- Improper dietary habits, irregular meal times, and long intervals between meals
- Being overweight or a sedentary lifestyle without much exercise
- Stress and anxiety
- Pregnancy or the onset of menopause
- Hernia – when part of your stomach moves up near your chest area
- Asthma, peptic ulcers and diabetes
- Certain medicines, such as anti-inflammatory painkillers
Frequent heartburn (several times a week) may be a symptom of a long-term condition known as gastroesophageal reflux disease (GERD). It is critical to treat frequent heartburn as untreated chronic acidity can lead to inflammation and narrowing of the oesophagus, precancerous changes, and cancer of the oesophagus.
Symptoms of Acid reflux and heartburn include-
- Chest pain
- Tooth erosion
- Painful burning sensation in throat or chest
- Trouble swallowing or eating normally
- Developing sour taste in the mouth
- Excessive salivating
- Breathlessness, asthma symptoms, chronic coughing and difficulty in breathing
Managing Heartburn and Acidity
The most important step in managing acidity and heartburn is to identify food items that trigger heartburn and reduce or stop the intake of those food items.
Certain home remedies can also help alleviate heartburn symptoms:
- Basil leaves Tea
Basil leaves have soothing and carminative properties that can provide instant relief from acidity.
Lactic acid present in buttermilk neutralises the stomach acid and alleviates acid reflux and heartburn.
- Cumin water
Cumin seeds are a great acid neutraliser, and they aid digestion and relieve stomach pain.
- Coconut Water
Coconut water stimulates the production of mucus in the stomach, thereby protecting the stomach lining from the harmful effects of excessive acid production. Being rich in fibre, it aids digestion and prevents the recurrence of acidity.
If heartburn symptoms continue despite diet and lifestyle modifications, consider taking over-the-counter or prescribed medication.
Medicines to manage heartburn and acidity
Medicines for managing heartburn include antacids, alginates, histamine-2 receptor antagonists (H2-receptor antagonists) and proton-pump inhibitors (PPIs).
Antacids neutralise the acid in the stomach, providing fast, short-term relief.
Alginates are extracted from algae and are used with antacids to prevent acid reflux. Alginates form a raft that sits on the surface of the stomach contents, preventing reflux.
- Histamine-2 receptor antagonists
The H2 receptor antagonists reduce stomach acid secretion.
- Proton-pump inhibitors
Proton-pump inhibitors (PPIs) block acid by reducing the production of gastric acid, allowing time for damaged oesophageal tissue to heal.
Amongst several PPIs available like Omeprazole (know more), Pantoprazole, Rabeprazole and Esomeprazole, Omeprazole is the one having highest published evidence and studies regarding its better safety. All the PPIs have similar efficacy; however, Omeprazole due to its better safety and highest affordability, is the most used PPI globally with more than 40% prescription share worldwide.
These medicines are most helpful for people who have heartburn often, i.e., more than two days of a week. In case of severe acidity, the patient may have to undergo surgery (vagotomy) to curb the acid production in the stomach.
When acidity and heartburn hits, many home remedies, over the counter treatments, and lifestyle changes may provide relief. If you experience heartburn or acidity more than twice or thrice a week, talk to your doctor. In some cases, they might suggest medication or other treatments.