By Apollo 24|7, Published on- 14 December 2022 & Updated on -
Acidity is a term commonly used to describe the signs and symptoms of acid reflux, also known as gastroesophageal reflux or GER. It is sometimes mistaken for gastroesophageal reflux disease or GERD.
Acidity or GER occurs when the stomach contents go in the reverse direction and reach the oesophagus. In contrast, GERD is more severe. The chronic condition lasts longer than GER and results from repeated acidity.
Generally, acidity can be categorised into a few categories such as:
While upright and supine acid reflux are the generic types of acidity, GERD is the chronic version. Upright acid reflux can occur throughout the day, especially while sitting up. Supine acid reflux, in contrast, happens during the night when the acid flows toward the oesophagus. Usually, lying down can provide temporary relief, but it is advisable to consult a gastroenterologist in case of supine acid reflux.
GERD, or gastroesophageal reflux disease, can occur every hour and involves more severe complications such as sphincter malfunction. Due to the improper functioning of the lower esophageal sphincter (LES), the stomach contents can move upwards back into the throat and mouth, giving a sour taste.
Common symptoms of acidity include chest pain and sore throat. However, long-term damage can cause complications in the respiratory system and stomach.
Patients suffering from the signs and symptoms of acidity need to seek medical assistance under the following conditions:
On Symptoms: Usually, an individual should consult a gastroenterologist if he/she experiences severe chest pain or shortness of breath. Any discomfort in the jaw or numbness in the arm must also be brought under immediate medical attention. Other than that, any recurring symptoms of acidity that last for more than two weeks need to be examined by a gastroenterologist. If a person suffers from heartburn despite taking over-the-counter medicines, he/she must also get checked by a doctor.
Difficulty Swallowing: If a patient suffers from Dysphagia or has difficulty swallowing, he/she must consult a doctor. Acute Dysphagia is usually followed by regurgitation and frequent heartburn. All of these can be a sign of acid reflux, and a gastroenterologist can provide the proper diagnosis and treatment for the same.
Difficulty Breathing: GERD is a chronic disorder often associated with asthma, aspiration, and bronchospasm. It can become fatal if not given immediate medical assistance. The most common problem that occurs due to acid reflux is Dyspnea, as the stomach acid enters the lungs. This can occur during sleep and swell the airways, causing bouts of asthma or aspiration pneumonia. The outcome is sudden wheezing or coughing during sleep.
Physical Examination: A gastroenterologist specialises in the digestive tract and can examine the signs and symptoms of acid reflux. The doctor will initially conduct a physical check-up to determine GER or GERD. This includes performing an oesophageal manometry for reflux testing and upper endoscopy. The oesophageal manometry confirms the proper functioning of the oesophagus, the long muscular tube connecting the throat to the stomach. For upper endoscopy, a flexible tube with a camera is inserted. It helps examine the oesophagus, stomach area, and small intestine. Patients are sedated while performing these tests.
Blood Tests: Anion gap blood tests are a way to check the pH balance in the blood. This test confirms whether the blood is too acidic and is performed along with the electrolyte panel test. This comprehensive examination confirms the presence of electrically charged minerals like sodium, potassium, and bicarbonate, which help regulate the acid-base balance in the blood.
Narrow-Band Imaging Test: Narrow-band imaging test helps better visualise the mucosal alteration due to GER or GERD. Doctors can inspect the mucosa minutely with the help of specific blue (410 nm) and green (540 nm) wavelengths from the standard white-light endoscope. The test also helps in examining blood vascular patterns and pit patterns.
Impedance-pH Testing: Since the changes in the mucosa is not visible in most patients of GERD, the endoscopic assessment may not always be accurate. So, a 24-hour oesophageal pH metry is conducted to check the oesophagus acidity levels in 24 hours. Doctors may even use impedance technology to measure the amount of liquid and air going up and down the oesophagus. The test helps determine both acidic and non-acidic GERD.
Home Care: In case the symptoms of acidity cause significant discomfort, an individual can temporarily subdue the symptoms with some home remedies. For instance, consuming one teaspoon of fennel powder with warm water can relieve symptoms like bloating. The mix is also seen to improve digestion. Another remedy is to chew a few cumin seeds and then drink a glass of water. An individual can boil a teaspoon of the seeds in water and then drink it as well. However, one must always consult a gastroenterologist before following these methods.
Prescription Medication: A doctor can prescribe some medicines to relieve the symptoms of GERD. These include:
While the prescription-strength H-2 blockers do not cause much side effects, proton pump inhibitors tend to cause nausea, headache, diarrhoea, and even low magnesium or B12 levels.
Non-prescription medication: A few non-prescription over-the-counter medications are available that patients can consume for temporary relief. Among these, antacids are the most common ones and help neutralise the acid in the stomach. However, over-consumption of antacids is never recommended as it can cause diarrhoea and kidney problems. Other non-prescription medications include histamine (H-2) blockers like Pepcid AC. However, these are less effective than antacids.
Surgical Treatment: Nissen Fundoplication is one of the most effective surgical procedures for treating GERD. During the surgery, a surgeon operates on the sphincter at the bottom of the oesophagus to control the acid reflux. Although the surgical method is shown to cure patients of the symptoms, it is often recommended as a last resort.
If left untreated, GER can turn into acute GERD in the long run and cause many problems, especially to the oesophagus.
1. Stage 1 – Mild GERD
2. Stage 2- Moderate GERD
3. Stage 3 – Severe GERD
4. Stage 4 – Precancer or cancer
1. LPR or Laryngopharyngeal reflux
Smoking harms not only the respiratory system but also the digestive system. It has been seen that smokers tend to suffer from frequent heartburn and peptic ulcer than non-smokers. Diseases like Crohn's disease, and gallstones, also occur more frequently in smokers.
Smoking can weaken the oesophageal sphincter, which prevents the backwards flow of stomach acid. So, it is highly recommended to avoid smoking to control and reduce the chances of acid reflux and GERD.
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How to reduce the risks of gastric or GERD quickly?
The easiest way to reduce the risks and complications of GERD is to avoid common triggers. This includes avoiding eating large meals or eating too fast. Fasting can increase gastric acidity levels, so that needs to be avoided. An individual must drink plenty of water throughout the day to help in motility and digestion, reducing the symptoms of acid reflux. Also, consultation with a doctor regarding the ongoing medications to know which ones to avoid, is essential.
Is there a permanent cure for acidity?
Although there is no medication for permanently curing acidity, surgical procedures like the Nissen Fundoplication method can reduce the symptoms. However, the best remedy for getting rid of acidity is to lead a healthy lifestyle. It is possible to permanently cure acidity internally by controlling digestion and gastric problems. However, if an individual is suffering from GERD, he/she needs medical attention as it will not go away on its own.
Can stress cause acid reflux?
Yes, stress can trigger acidity as emotional conditions impact the acid production in the stomach. Patients with GERD and a weaker oesophageal sphincter may need to practice meditation and other methods to reduce stress, to reduce the frequency of acid reflux.
Why do some patients suffer from frequent acidity?
Acidity or acid reflux is caused by the malfunctioning of the lower sphincter muscle of the oesophagus. When the sphincter relaxes at the wrong time, stomach acid gets released into the oesophagus, causing heartburn and other symptoms of acidity. This backwash of stomach acid is caused due to poor lifestyle choices like eating fried food, fasting for longer, and smoking. To avoid the frequency of acidity, one must avoid these bad habits and adopt a healthy lifestyle. However, in severe conditions, only a gastroenterologist can provide proper treatment.