‘Acidity’: Expert Speaks on The Misinterpreted Condition

There is a common misconception that people who have these symptoms produce more acid which isn't true, says the expert.

To start with it might be interesting to know that 'acidity' is not a medical term. Though popular in usage, the word 'acidity' is often casually used for symptoms of ingestion, heartburn or a burning sensation in the chest. The term is casually used as a replacement for conditions like ulcer disease and acid reflux.

Ulcers occur when digestive acids damage the gastrointestinal walls. They are painful sores that might appear in the gastric tract. Sometimes, some of the acid content of the stomach might flow up into the oesophagus. This is called acid reflux, if it occurs frequently, then, it might be a sign of gastroesophageal reflux disorder (GERD). There is a common conception among people that people who have these symptoms might produce more acid in their body and this might not be true.

'Acidity' is not a medical term

According to Dr Poorna Chandra K S, Consultant and Head of Medical Gastroenterology (SPARSH Hospital), the term 'acidity' is often misinterpreted and used interchangeably for symptoms such as burning sensation in the chest, burping, sour burping, bloating, sounds in the abdomen, farting, and aches & pains. From a medical perspective, acidity can be characterized by sour burps with burning in the chest (known as heartburn), reflux, and pain in the upper abdomen that may increase or decrease with meal intake.

The expert said: "When we look at the true medical literature, there is no specific term such as 'acidity'. Everyone has acid in their stomach. There is a common misconception that people who have these symptoms produce more acid which isn't true."

The stomach contains hydrochloric acid (HCL) that helps break down food and provides protection against pathogens. The lining of the stomach is usually well-adapted and protected from the powerful acid. Even the oesophagus has a valve (gastroesophageal sphincter) that prevents the content from the stomach to go into the oesophagus. When this valve fails to act or the lining of the stomach becomes susceptible to the attack of the acid, then we might experience conditions like acid reflux or ulcer formation.

The expert while explaining acid-related conditions said: "Stomach mucosa is usually protected by the gastric acid by various protective mechanisms like mucus, bicarbonate in the secretions and these are maintained by a well-controlled reflex mechanism and gastric blood supply. Ulcer disease occurs when the stomach lining becomes susceptible to normally present acid in the stomach. Ulcer disease is usually caused by infections such as H pylori or the consumption of painkillers, which can alter the stomach's protective mechanisms. It can also arise due to bile reflux into the stomach, certain chemicals, a drop in blood pressure and some immune conditions. Additionally, reflux/ GERD occurs when acid enters places where it should not be, such as the oesophagus."

Food and acid: Understanding the connection

Conditions like ulcer disease and acid reflux can happen to people of all ages. Lifestyle can be a cause but there might be other reasons. Heartburn is the most prominent symptom of the condition that a person might feel right behind the breastbone area. It tends to get worsen as one lies down. While the condition is not always preventable, there are dietary habits that can make us more vulnerable to it.

Dr Chandra shared some dietary habits that could increase our risk of suffering from acid reflux-

All food stimulates acid production in the stomach. Hence these notions may not be accurate. However, consuming non-vegetarian or fried food/protein-rich food can delay the emptying of the stomach, which means that the food stays in the stomach for a longer period of time. Hence when eaten in large quantities (Gastric distension), this longer persistence of food in the stomach increases the probability of GERD.

1. Some foods like citrus foods and chilli/ masala irritate the mucosa (inner skin of the stomach) and increase the symptoms of GERD and don't cause GERD as such. Hence avoiding such foods for GERD helps avoid symptoms.
2. Similarly wearing tight clothes increases the pressure on the abdomen and may aid reflux and hence GERD
3. Drinking water dilutes the acid and also flushes out the acid refluxing into the oesophagus. Hence drinking more water helps but overdoing it may not give incremental benefit.
4. Smoking and alcohol directly injure the stomach mucosa, and relax the valve thereby causing symptoms of GERD and gastritis.
5. H pylori is a bacterium which is most strongly associated with ulcer disease. It is mostly acquired by eating contaminated food and water. Hence taking care to have good hygienic food and water as well as general sanitation goes a long way in reducing ulcer disease.
6. Painkillers and NSAIDs are a major cause of ulcer disease and act by disrupting the protective mechanisms of the stomach. In our country, these drugs are available as over-the-counter drugs and are frequently abused. Use of the drugs should be restricted to on prescription by a doctor and used only when absolutely needed.
7. Certain juices and concoctions when used in a concentrated form can irritate and injure the mucosa. This effect may be more when taken on an empty stomach as food generally dilutes them.