I see a lot of patients who come to me complaining of self-diagnosed acidity. This mean almost everybody has a self-diagnosis of acidity, which obviously can not be true.
Everyone who has the self-diagnosis has tried different homemade remedies. If there are so many cures for one condition, surely one solution does not work for all.
Most people self-medicate with acidity tablets. If a study is conducted, the actual number of acidity medications sold in India might be more than lollypops!
Different people list different foods that cause acidity. You don’t have to follow restrictions on all these foods. If you do, then you will not be left with nothing to eat. So, it is plain obvious that foods do not cause acidity. It also means that you do not have to avoid any food on the advice of others.
One thing that is sure to cause acidity is food habits. As long as the spice is within normal limit and food is consumed on time, there is no need to avoid any food. So, as much as possible, food needs to be consumed on time.
The most important thing that we need to understand is that acid is produced by everyone in the stomach, so it is absolutely necessary to digest food completely. Without acid, you will not be able to digest food properly and hence, taking acid suppression tablets for long term might lead to deficiencies.
Acid produced in the stomach can give burning sensation if the stomach is empty for long time. This is because acid that is meant to digest food will start to very slowly digest the inner lining of stomach, which is mucosa (toughest and most acid-resistant layer of the stomach). If this goes on for a long time, then it will lead to ulcer. Hence, it is important to eat regularly so that acid digests the food that it is meant to be digested and not the stomach.
Acid is not meant to come into the oesophagus at all. There are different mechanisms to prevent acid from coming into the oesophagus. When one or all these mechanisms are disrupted, then acid comes into the oesophagus. This will cause a burning sensation in the chest and at times, can mimic a heart attack. Treatment for this can be to reduce acid production with Proton Pump Inhibitors (PPIs) or correction of disrupted mechanism and recreation of natural mechanisms to prevent acid from coming into the chest. (hiatus hernia / LAX LES—see separate blog).
As discussed previously, prolonged acid suppression might lead to nutritional deficiencies. In these scenarios, one might have to consider surgery as the permanent cure for acid reflux. Surgery does not reduce the acid production, but it is effective in preventing acid from reaching the chest by recreating the lost natural defense mechanisms.