Acidity or Acid Peptic Disease (APD)

Secretion of acid essential in the digestive process is normally done by stomach. This acid helps breaking down the food during digestion. But if there is an excess production of acid in the stomach, it causes acidity or APD.

There are some types of ulcers where acid secretion is either normal or even reduced. Acidity is responsible for dyspepsia, heartburn and the formation of ulcers (erosion of the lining of the stomach or intestines). Acidity may result in a much higher incidence in highly emotional and nervous individuals. It is also more frequent in the developed and industrialized nations, though a recent hike in this ailment has also been noticed in the developing countries.

Causes

Lifestyle – Use of alcohol or cigarettes, obesity, poor posture (slouching) Medications – Blood pressure drugs called calcium channel blockers, theophylline (Tedral, Hydrophed, Marax, Bronchial, and Quibron), nitrates, and antihistamines.

Diet – Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acidic foods such as citrus fruits and tomatoes, spicy foods, mint flavorings. Eating habits – Eating large meals, eating before bedtime Other medical conditions – Hiatal hernia, pregnancy, diabetes

Gastro-oesophageal reflux

The weakness of the valve situated between the stomach and oesophagus (food pipe) can result in a reflux of the acid from the stomach to the lower section of the oesophagus which can cause heart-burn.

At times, a heavy meal or rise in intra-abdominal pressure while straining or lifting weights, can bring about this reflux.

Excess acid secretion can also cause acidity and ulcers bringing about the damage to the normal protective lining of the stomach and duodenum (the part of the intestine that joins the stomach). This ulcer is termed as gastric ulcer if it occurs in the stomach and duodenal ulcer if it forms in the duodenum.

In a condition known as Zollinger-Ellison Syndrome, a large amount of acid is secreted being stimulated by tumors situated in the pancreas or duodenum.

Any kind of obstruction in the defense mechanisms that defend the stomach and intestine from damage by acid can result in acidity.

Human body secretes bicarbonate into the mucous layer to deactivate the acidic property. Hormone-like substances known as prostaglandins help to maintain the blood vessels in the stomach dilated to maintain sufficient blood flow. Lack of adequate blood flow to the stomach may cause ulcers. Prostaglandins are also useful in stimulating bicarbonate and mucous production and thus protect the stomach.

Symptoms

Acidity generally occurs after you have your meals and is caused by excess intra-abdominal pressure during lifting weights or straining. It can also be experienced at night on lying down and is relieved when the individual sits up. The pain is directly related to posture. Regurgitation of the gastric contents may also take place. The symptom of ulcers is mainly pain that can be either confined to a small area or diffused. Sometimes it spread to the back or to the chest.

Dyspepsia and heartburn are often the chief symptoms of acidity. Heartburn takes place when food and stomach juices are refluxed into the esophagus (the tube leading from the throat to the stomach). This process is known as gastroesophageal reflux.

The most common symptom of acidity is dyspepsia- a burning or aching pain in the upper abdomen which is sometimes described as a \”stabbing feeling penetrating through the width of the gut\”. Rarely, there happens to be any pain at all, but only a feeling of indigestion or nausea is experienced.

Eating a meal usually reduces the pain in case of duodenal ulcer, but in case of gastric ulcer there may be no noticeable change rather the condition may become worse. Peptic ulcer disease may have no symptoms at all. Symptoms may also be seen when there is no ulcer present. This is known as non-ulcer dyspepsia.

Diagnosis

While a doctor may be able to diagnose a simple case of acidity studying the medical history, more detailed study may be required to diagnose the presence of ulcers in the stomach and the duodenum.

The doctor will take a thorough history of use of drugs such as NSAIDs including a history of family members with ulcers, alcohol consumption and smoking to find out the causes of acidity.

An evaluation of a person\’s stress level is also essential to determine diagnosis. A doctor may recommend an Upper Gastrointestinal Endoscopy to discover the presence of ulcers.

If Zollinger-Ellison Syndrome is suspected, blood levels of gastrin may be considered. Barium Meal studies are helpful in revealing an inflammation, active ulcer craters, or deformities and scarring because of ulcers. Sometimes, a doctor may also suggest a biopsy of an ulcer, to negate a cancer.

Treatment

The treatment of acidity includes identifying and avoiding causative factors. A suitable diet is essential to follow. Avoid spicy, salty and acidic foods and stop smoking and alcohol consumption. People with highly nervous and emotional temperament and those who are busy in high-stress jobs must receive lifestyle modifying measures.

Antacids provide instant relief of symptoms by neutralizing the excess acid secretion. A group of drugs known as H2 Receptor Blockers cause the stomach to decrease the production of acid by blocking histamine receptors such as, drugs like Cimetidine, Ranitidine, Famotidine or Nizatidine.

Another group of drugs known as Proton Pump Inhibitors selectively hinder in production of acid in acid-producing cells thus restricting acid production are more effective and include Omeprazole and Lansoprazole.

In case of the occurrence of ulcers, they must be diagnosed quickly and treated to prevent complications such as perforations. Long term therapy for weeks may be suggested to produce complete remedial. Surgical methods of reducing the acid secretion like Vagotomy are hardly used.

Prevention

Acidity can be prohibited by avoiding alcohol consumption, spicy foods, drugs like NSAID\’s, steroidsetc. Regular eating habits and following a healthy diet can prevent acidity. People with a highly nervous and emotional temperament and those involved in high-stress jobs could decide to have a change in their lifestyle and reduce the stress to avoid such state.

Some home remedies to cure acidity

Skip the aerated drinks and the caffeine and have herbal tea instead.
Have a glass of lukewarm water everyday.
Avoid drinking water soon before and after meals. Include banana, watermelon and cucumber in your daily diet; remember watermelon juice is excellent for curing acidity.
Coconut water is known to soothe the digestive system if you suffer from acidity.
Drink a glass of cold milk everyday.
Have your last meal at least two to three hours before you go to bed.
Keeping long intervals between meals is another reason for acidity. So try to have small but regular meals.
Avoid pickles, spicy chutneys, vinegar etc.
Boil some mint leaves in water and have a glass of this after meals.
Chewing a piece of clove is another effective remedy.
Jaggery, lemon, banana, almonds and yogurt are all known to provide you immediate relief from acidity.
Excessive smoking and drinking increase acidity, so quit these harmful habits.
Chewing gum generates saliva that helps move food through the esophagus, easing symptoms of heartburn.
Ginger helps digestion. You can either buy powdered ginger in capsule forms or add the herb to your recipes.
A simple mixture of lemon water with sugar can be sipped on an hour before lunch to reduce discomfort.
As the acid is neutralized by base hence intake of calcium bi-carbonate commonly known as sweet soda is a world famous remedy in treating acidity.
Consume vegetables like drumsticks, beans, pumpkin, cabbage, carrot and spring onions.
Cumin seed boiled in water should be consumed with meals.
Usage of medicines like aspirin, diclofenac sodium and antibiotics should be avoided.