Acidity, Reflux or GERD? Knowing When Heartburn Needs Medical AttentionBy Dr. Pinakee Sunder Kar, Consultant - Gastroenterologist and Hepatologist, Manipal Hospital Siliguri




Understanding Acidity 
Acidity is a common digestive complaint caused by excessive production of stomach acid, often triggered by lifestyle and dietary factors such as spicy or oily food, irregular meal timings, stress, lack of sleep, and excessive consumption of tea or coffee. It usually presents as a mild burning sensation in the chest or upper abdomen, accompanied by bloating or discomfort. These symptoms are typically occasional and can be managed with simple lifestyle changes or over-the-counter antacids.

What Causes Acid Reflux 
Acid reflux occurs when stomach acid flows back into the oesophagus due to a weakened or improperly functioning lower oesophageal sphincter, the muscle that prevents backflow of food and acid. This backward movement of acid irritates the lining of the food pipe, leading to symptoms such as heartburn, sour or bitter taste in the mouth, regurgitation of food, and discomfort that often worsens after meals or while lying down. While occasional reflux is common, frequent episodes may indicate an underlying problem.

When Reflux Becomes GERD 
Gastroesophageal Reflux Disease (GERD) is a chronic condition characterised by frequent and persistent acid reflux that interferes with daily activities and sleep. Individuals with GERD often experience recurring heartburn, difficulty in swallowing, chest pain, chronic cough, hoarseness of voice, and a constant sensation of acidity. These symptoms may be mistaken for other conditions, including heart-related problems, leading to delays in diagnosis.

Why GERD Should Not Be Ignored 
Untreated GERD can lead to serious complications over time. Continuous exposure of the oesophagus to stomach acid may cause inflammation, ulcers, and narrowing of the food pipe, making swallowing painful. In some cases, long-standing GERD can result in Barrett’s oesophagus, a condition that increases the risk of oesophageal cancer. Early diagnosis and proper treatment are therefore essential to prevent long-term damage.

When to Seek Medical Attention 
Medical consultation is necessary if heartburn occurs more than twice a week, persists despite medication, or is accompanied by symptoms such as pain while swallowing, unexplained weight loss, chronic cough, wheezing, or chest pain. These signs may indicate GERD or other gastrointestinal disorders that require further evaluation and treatment.

Diagnosis and Treatment Options 
Diagnosis is usually based on symptoms, but in certain cases, doctors may recommend investigations such as endoscopy or specialised tests to measure acid levels in the oesophagus. Treatment generally includes medications that reduce acid production along with lifestyle and dietary modifications to control symptoms and prevent recurrence.
Lifestyle Changes That Help Control Symptoms 
Simple lifestyle adjustments can significantly reduce acidity and reflux. Eating smaller, frequent meals, avoiding late-night eating, limiting spicy and fried foods, maintaining a healthy body weight, and quitting smoking are highly effective. Elevating the head while sleeping and avoiding lying down immediately after meals can also help prevent acid reflux.

The Bottom Line
While occasional acidity is common and usually harmless, frequent heartburn should not be ignored. Persistent symptoms may point to acid reflux or GERD, conditions that require medical attention. Early intervention can prevent complications and help individuals maintain a better quality of life.

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