Dr Ajay Kumar BhaIIa answers readers’ queries on heartburn
I think I have acidity. I feel a burning sensation in my throat after meals. Or could it be some other problem?
Normally, a protective valve called the lower oesophageal sphincter keeps stomach contents from going back into oesophagus (the food pipe). If the valve relaxes and acid rises up into the oesophagus, there’s a burning sensation in the throat and food pipe. It’s also called heartburn. Medically, it’s called reflux oesophagitis or GERD (gastrooesophageal reflux disease). In such a case, you usually experience a burning sensation. Though unrelated to the heart, it can even cause chest pain similar to angina (pain radiating to arm or jaw). In severe cases, you may experience difficulty in swallowing, food sticking in throat, loss of appetite, and even weight loss.
Everyone in my family suffers from acidity. How common is the problem? Seven per cent of Indians experience heartburn every day; 14 per cent once a week; and 15 per cent once a month. It’s a common problem, certainly the most common gastrointestinal complaint. And there’s evidence that GERD is on a rise in tandem with increasing cases of obesity—excessive weight adds pressure on the oesophageal valve.
My doctor has asked me to stay away from junk food to prevent acidity. Are certain foods more likely to cause heartburn? There’s a long list of possible culprits, including spicy foods, chocolate, wine, coffee and fatty foods. But in my own clinical practice, I don’t like to dictate dietary dos and don’ts. If someone says he gets heartburn after drinking alcohol or eating chocolates, I tell him to go easy on alcohol or chocolates. The triggers for heartburn are so different for different people that it’s best to individualise lifestyle advice.
What are the common lifestyle modifications that can prevent heartburn? If you’re overweight or obese, losing weight can help, especially if you begin to experience heartburn soon after gaining weight. Dieting isn’t easy. But sometimes the discomfort of heartburn and the prospect of having to go on with medications is enough to motivate people. Most people get heartburn in the evening, especially if they eat a big meal and then immediately go to bed. I tell patients to avoid eating anything three hours before bedtime. By that time, food and liquid have passed through the stomach and the possibility of acid reflux diminishes. I give similar advice to those who experience reflux when they exercise. Avoid eating anything two hours before you work out and you are less likely to have a problem. For people who are awakened by heartburn at night, elevating the head of the bed by four to six inches can help.
What are the complications arising from heartburn?
Alt can lead to sore throat, asthmatic bronchitis, hoarse voice and dental decay. I recommend an upper gastrointestinal endoscopy to diagnose GERD and assess its severity. Other investigations include barium X-ray and pH monitoring.
I often take Digene syrup for immediate relief from acidity. How effective are over- the-counter antacids? If you have occasional heartburn, antacids like Digene or Gelusil and PPI (proton pump inhibitors) like Omeprazole and Rabeprazole and coating agents like Sucralfate can offer quick relief. Those who respond poorly to medicines may require surgery to tighten the lower oesophagus.
Dr Ajay Bhalla is senior consultant and coordinator, department of gastroenterology, Fortis Hospital (NOIDA); he is a visiting consultant at Sir Ganga Ram Hospital and Max Hospital, Delhi
I think I have acidity. I feel a burning sensation in my throat after meals. Or could it be some other problem?
