Knowing Acidity from Indigestion

Published in "Panorama", the Friday Magazine of "The Gulf Today"



Knowing Acidity from Indigestion


David often complains of a bloated belly and excessive burping, particularly after consuming potatoes and gram flour preparations. He insists he is suffering from hyperacidity and that the potatoes and gram flour are the causative agents. He further claims that by avoiding these two food items, his symptoms are relieved.

Is it true then that David’s is a problem of hyperacidity brought on by eating potatoes and gram flour dishes? “Not so,” assures Dr.Abuthina, Consultant and Laparoscopic Surgeon, International Specialist Medical Centre, Dubai. “This only indicates that his body has reacted to that particular food in that specific manner. It does not in any way mean that potato or the lentil produces acidity in the body. It’s similar to an allergy – some people may break into a rash; in this particular individual, it’s caused the bloating and burping. His problem may be one of indigestion, and not acidity.”

Is there a correlation between the type of food eaten and acidity? Dr.Abuthina clarifies, “I wouldn’t say that there is a definite correlation between the type of food eaten and acidity. But as individuals we may all to react to different foods in different ways. For instance if two people are having hyperacidity and one of them is comfortable eating rice, we cannot expect the other person too to feel comfortable eating rice! His reaction to rice may be different where he shows up symptoms of indigestion.

So identifying the food causing indigestion and eliminating it from the diet does not really solve the problem of acidity because acidity is not food related in that sense. True, that indigestion may be aggravated by foods but foods do not cause hyper acidity.”

Dr. Abuthina also dispels the myth that fried foods cause acidity. “I would rather relate fried foods to gall bladder problems rather than acidity. Fatty foods may cause bloated abdomen, when they don’t get digested properly or when the gall bladder is not functioning properly.”

Elaborating on this issue, Dr.Abuthina clarifies, “Bloated abdomen and constant burping would first and foremost indicate gall bladder problem. Once that’s ruled out by ultrasound, one could attribute this to acidity, as an Atypical symptom of acidity.”

Which brings us to the point that indigestion is not to be made synonymous with acidity. Dr.Abuthina explains, “Indigestion is a loose term that covers gall bladder problem, colon problem, hyperacidity, pancreatic problems.”

What then is acidity and what factors cause it? Either hyper secretion of gastric juice or increase in the acidic component of the gastric juice results in acidity, explains Dr.Abuthina. The gastric juice contains hydrochloric acid which aids digestion. However, when there is excess production of this acid and the protective mechanism against the acid in the body is unable to tackle this, the result is acidity. Dr.Abuthina explains, “There are some people who have hyper secretion of gastric juice without hyperacidity, some with hyper acidity of the gastric juice and yet they have no complaints at all. This is because their stomach can tolerate the high acidity without manifesting with symptoms like heartburn and abdominal pain, generally associated with hyperacidity.

Apart from the excess secretion of gastric acid, other causative factors for acidity are still not very well defined according to Dr.Abuthina, “The only stimulant factor which can cause hyperactivity are smoking and alcohol. The other proven factor in initiating peptic ulcers and gastric problems is a kind of bacteria known as Helicobacter pylori which apparently survives in the forbidding acid environment of the stomach and duodenum by hiding in the mucus and neutralizing stomach acid in its local environment. These bacteria which are in the stomach should be detected because these people who carry these bacteria even face a high risk of gastric cancer. Non Steroidal Anti-Inflammatory Drugs also cause gastric acidity. There is a higher incidence of acidity in highly emotional and nervous individuals. Of course, Stress aggravates acidity as it does various other maladies.”

Excess acid secretion which causes acidity may lead to gastric, duodenal or oesophagal ulcers, when the normal protective lining of the stomach and duodenum, which is a part of the intestine, is damaged, says Dr.Abuthina. “Of course duodenal ulcer is not purely related to hyperacidity; diet, smoking and alcohol are all contributory factors. But usually, approximately 90% of people with duodenal ulcer have hyper acidity.”

A weakness of the valve between the stomach and oesophagus or food pipe can cause a reflux of the acid from the stomach to the lower part of the oesophagus. This gastro-oesophageal reflux can cause heart-burn, a typical symptom of acidity.

Sometimes, a heavy meal or increase in intra-abdominal pressure such as while straining or lifting weights, can bring about this reflux. The typical presentation of acidity is abdominal pain, especially hunger pain or immediately after a meal, and heartburn. Heartburn is characterized by a deeply placed, burning pain in the chest behind the breast-bone. It occurs before meals as hunger pains or after meals and is precipitated by increase in intra-abdominal pressure like straining or lifting weights. It is more common at night when a person is lying down.

Sometimes, people could present with Atypical presentation in rare cases where there may be no pain, but only a feeling of indigestion, fullness, bloating, flatulence or nausea, says Dr.Abuthina.

Very often people panic over the pain from heartburn, mistaking it to be angina, related to the heart. Dr.Abuthina is reassuring, “Heartburn from acidity comes on normally when the victim is lying down, not while he or she is doing some exercise or work involving effort. Angina pains usually come on with exertion and exercise. Heartburn is not sudden in onset; it comes gradually and people know when it’s coming and it is usually relieved by taking food because oftentimes it comes with hunger. Angina pain is sudden in onset and pain may radiate to the left shoulder and arm. Angina pain is relieved by taking certain medication under the tongue. Heartburn due to hyperacidity is usually dealt with by taking antiacid medications.

Are there specific tests for the diagnosis of acidity? Usually, a thorough questioning of the patient, according to Dr.Abuthina, may be all that is required to diagnose acidity. However, to detect ulcers, more detailed investigations may be necessary.

Drugs called H2 Receptor Blockers cause the stomach to produce less acid by blocking histamine receptors. Similarly Proton Pump Inhibitors, another group of drugs selectively disables a mechanism in acid-making cells thus stopping acid production.

On a highly positive note Dr.Abuthina concludes that whatever the cause, there is improved medication to tackle the problem of acidity and ulcer today, including that of bad ulcers. “Surgery for ulcer is no more an option because we have very good medication that can heal the ulcers. 99% of people with respond to these.”


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