Acidity

Causes of Acidity

Acidity occurs when there is an imbalance between the acid production in the stomach and the body’s ability to control or neutralize that acid. The lower esophageal sphincter (LES), a ring-like muscle at the junction of the esophagus and stomach, plays a critical role in keeping stomach acid where it belongs — in the stomach. When the LES is weakened or relaxes inappropriately, stomach acid can flow backward into the esophagus, leading to acid reflux and the sensation of heartburn.

Common Causes of Acidity:

1. Overeating or Eating Heavy Meals:
   • Large meals or heavy, fatty foods can put pressure on the LES, making it easier for acid to reflux into the esophagus.
2. Spicy Foods:
   • Spicy foods can irritate the stomach lining and increase the production of stomach acid, leading to acidity.
3. Caffeine and Carbonated Beverages:
   • Drinks like coffee, tea, soda, and energy drinks can relax the LES and increase acid production.
4. Alcohol:
   • Alcohol can relax the LES, contributing to acid reflux. It also irritates the stomach lining, exacerbating acidity.
5. Citrus Fruits and Tomatoes:
   • Foods like oranges, lemons, and tomatoes are acidic and can irritate the esophagus, leading to heartburn and discomfort.
6. Stress and Anxiety:
   • Stress and anxiety can increase stomach acid production and slow down digestion, contributing to acidity and acid reflux.
7. Smoking:
   • Smoking weakens the LES and can increase stomach acid production, which exacerbates acidity.
8. Obesity:
   • Excess weight, especially abdominal fat, can put pressure on the stomach, forcing acid into the esophagus.
9. Pregnancy:
   • Hormonal changes during pregnancy, along with the pressure from the growing fetus, can relax the LES, leading to acid reflux and acidity.
10. Certain Medications:
    • Some medications, such as painkillers (NSAIDs), calcium channel blockers, and certain antidepressants, can trigger acidity by relaxing the LES or irritating the stomach.
11. Hiatal Hernia:
    • A condition where part of the stomach pushes up into the chest cavity through the diaphragm. This can weaken the LES and cause acid reflux.
12. Delayed Stomach Emptying (Gastroparesis):
    • Conditions that slow the emptying of food from the stomach can increase the risk of acid reflux and acidity.

Symptoms of Acidity

The symptoms of acidity can range from mild to severe and typically include:

• Heartburn: A burning sensation in the chest or throat, especially after eating, which may worsen when lying down or bending over.
• Regurgitation: A sour or bitter taste in the mouth caused by stomach acid reaching the back of the throat or mouth.
• Bloating and Belching: A feeling of fullness or discomfort in the stomach, often accompanied by excessive burping or gas.
• Nausea: A feeling of unease or upset stomach, especially after eating.
• Chest Pain: A sharp or pressure-like pain in the chest, which can be mistaken for a heart attack but is typically related to the reflux of acid.
• Sour or Metallic Taste in the Mouth: The acidic contents of the stomach may travel up into the mouth, leading to an unpleasant taste.
• Difficulty Swallowing (Dysphagia): A sensation that food is stuck in the chest or throat.
• Chronic Cough or Hoarseness: Acid can irritate the throat and vocal cords, leading to a persistent cough or a sore throat.
• Worsening Symptoms at Night: Lying down can make acid reflux symptoms worse, especially at night.

Diagnosing Acidity

Acidity is typically diagnosed based on the patient’s symptoms, medical history, and lifestyle factors. In some cases, doctors may recommend further tests to rule out other conditions or if symptoms are severe or persistent.

1. Medical History and Symptom Assessment:
   • A doctor will ask about the frequency and severity of your symptoms, lifestyle habits, diet, and any medications you’re taking.
2. Endoscopy (Upper GI Endoscopy):
   • In some cases, a flexible tube with a camera (endoscope) is used to examine the esophagus and stomach for signs of irritation, ulcers, or other abnormalities.
3. 24-hour pH Monitoring:
   • This test measures the amount of acid in the esophagus over a 24-hour period to confirm the presence of acid reflux.
4. Esophageal Manometry:
   • This test measures the function of the esophagus and the LES to see if they are working properly.
5. Barium Swallow:
   • A type of X-ray used to check for any structural issues in the esophagus, such as a hiatal hernia.

Treatment for Acidity

The treatment for acidity typically involves a combination of lifestyle changes, dietary modifications, and medications. The goal is to reduce stomach acid production, improve digestion, and prevent reflux.

1. Lifestyle Changes

• Eat smaller, more frequent meals: Large meals can increase stomach pressure, so eating smaller meals helps reduce reflux.
• Avoid lying down immediately after eating: Wait at least 2-3 hours before lying down to prevent reflux.
• Elevate the head of the bed: Raising the head of the bed (using blocks or a wedge pillow) can help prevent acid from flowing back into the esophagus while sleeping.
• Wear loose clothing: Tight clothing, especially around the waist, can put pressure on the stomach and trigger acidity.
• Avoid smoking and limit alcohol: Smoking and alcohol weaken the LES and can exacerbate acidity.
• Manage stress: Practices like meditation, yoga, and deep breathing exercises can help reduce stress and lower acidity.

2. Dietary Modifications

• Avoid trigger foods: Certain foods, like spicy foods, fatty foods, citrus fruits, tomatoes, chocolate, caffeine, and peppermint, can worsen acidity. It’s important to identify and avoid your personal triggers.
• Eat bland, easily digestible foods: Foods like oats, rice, bananas, and boiled vegetables are gentler on the stomach.
• Drink plenty of water: Water helps dilute stomach acid and promotes digestion. Avoid sugary or carbonated drinks.
• Avoid eating late at night: Eating late at night or just before bed can worsen acidity as lying down allows acid to flow back into the esophagus.

3. Medications

• Antacids: Over-the-counter medications like Tums, Maalox, or Rolaids neutralize stomach acid and provide quick relief for occasional acidity.
• H2-receptor antagonists (H2 blockers): Medications like ranitidine (Zantac), famotidine (Pepcid), and cimetidine (Tagamet) reduce stomach acid production and provide longer-lasting relief than antacids.
• Proton Pump Inhibitors (PPIs): Medications like omeprazole (Prilosec), esomeprazole (Nexium), and lansoprazole (Prevacid) are highly effective at reducing stomach acid production and healing the esophagus. These are often prescribed for more persistent acidity or acid reflux.
• Alginates: Medications like Gaviscon create a foam barrier on top of the stomach contents, preventing acid from refluxing into the esophagus.
• Prokinetics: Medications such as metoclopramide (Reglan) help speed up stomach emptying and reduce reflux in some cases.

4. Surgery and Medical Procedures

• Surgery is typically reserved for people with chronic, severe acidity or acid reflux that does not respond to medications or lifestyle changes. Procedures include:
  • Fundoplication: This is a surgery where the top of the stomach is wrapped around the lower esophagus to strengthen the LES and prevent acid reflux.
  • LINX Device: A small magnetic device is implanted around the LES to help it stay closed and prevent reflux.
  • Endoscopic Procedures: Minimally invasive treatments to tighten the LES or improve its function may be used in some cases.

Complications of Acidity

While occasional acidity or acid reflux is common, chronic or untreated acidity can lead to several complications:

• Esophagitis: Inflammation and irritation of the esophagus, which can cause pain, bleeding, and difficulty swallowing.
• Esophageal Strictures: Scar tissue formation due to chronic acid exposure, which narrows the esophagus and makes swallowing difficult.
• Barrett’s Esophagus: A condition where the lining of the esophagus changes due to long-term acid exposure, increasing the risk of esophageal cancer.
• Respiratory Problems: Chronic acid reflux can worsen asthma, cause chronic cough, or lead to aspiration pneumonia.
• Tooth Erosion: Refluxed acid can reach the mouth, leading to enamel erosion on the teeth.

When to See a Doctor

You should see a doctor if you:

• Experience frequent or severe heartburn, acid reflux, or other symptoms of acidity.
• Have difficulty swallowing or feel like food is getting stuck in your chest or throat.
• Experience chest pain, especially if it is severe or accompanied by shortness of breath.
• Have persistent nausea or vomiting.
• Your symptoms do not improve with over-the-counter medications or lifestyle changes.

Conclusion

Acidity is a common condition caused by the reflux of stomach acid into the esophagus. It can lead to discomfort, such as heartburn, bloating, and chest pain. Managing acidity often involves lifestyle changes, dietary adjustments, and medications. If symptoms persist or worsen, it is important to consult a healthcare provider to prevent complications and explore treatment options.