Acidity and Heartburn That Keeps Coming Back: What Helps, What to Test, and When It Is Not Your Stomach

A burning feeling behind the breastbone after a heavy dinner. A sour taste rising into the throat when you lie down. A dry cough that only seems to start at night. Most people in Delhi call this acidity, and treat it with something from the chemist and the hope that it does not come back.

Occasional heartburn after a large or late meal is common and not dangerous. But if you have been buying antacids for months rather than weeks, or the burning wakes you up, it is worth having it looked at — and in a few situations, it is not your stomach at all.

What "acidity" actually is

Your stomach makes acid to digest food. A ring of muscle at the bottom of the food pipe (the oesophagus) normally stops that acid flowing back up. When the ring relaxes at the wrong time, or the stomach is very full, acid and stomach contents rise into the food pipe. That is reflux, and the burning it causes is heartburn.

When reflux happens often enough to cause regular symptoms or irritate the lining of the food pipe, doctors call it gastro-oesophageal reflux disease, usually shortened to GERD or GORD. Studies in India put it at between 7.6% and 30% of adults, depending on how it is measured.

"Acidity" is also used for a related but different problem: a burning or gnawing pain in the upper stomach, below the ribs, with bloating or feeling full quickly. That is dyspepsia (indigestion). It can come from an irritated stomach lining, an ulcer, or a common stomach infection called H. pylori. Telling the doctor exactly where the burning is — chest or upper stomach — is one of the most useful things you can do.

Symptoms, in the words people actually use

- "Burning in my chest after I eat," often worse when you bend over or lie down

- "Khatta pani" — a sour or bitter taste coming up into the mouth

- Burping a lot, or food coming back up without being sick

- "Gas" and bloating, or feeling full after a few bites

- A dry cough, a hoarse voice or a sore throat in the morning, with no cold

- Waking at night with burning or coughing

Symptoms are usually worse after large, rich or late meals — which is why the festive season brings more of these calls.

🔴 When to go to a hospital, not a clinic

Chest pain is the one to take seriously. A heart attack can feel like bad indigestion, and the time spent waiting for an antacid to work is time that matters. Call 112 or go straight to a hospital emergency department if:

- The chest feels tight, heavy or squeezed, rather than burning

- The pain spreads to your arm, shoulder, neck, jaw or back

- It comes with breathlessness, sweating, nausea, faintness or unusual weakness

- It lasts more than 15 minutes and does not ease with rest

- It comes on with exertion — climbing stairs, walking fast — and settles when you stop

- You have diabetes, high blood pressure, high cholesterol, smoke, or have had heart trouble before, and this feels new

Also go to a hospital, not a clinic, if you:

- Vomit blood, or vomit something that looks like coffee grounds

- Pass black, sticky, tar-like stools

- Have food stuck in your chest and cannot swallow even your own saliva

- Have sudden, severe stomach pain, especially if the belly is hard to the touch

Do not drive yourself. If you are not sure whether it is your heart, treat it as your heart.

When to book a doctor's appointment soon

These are not emergencies, but they are reasons not to keep treating it yourself:

- Heartburn on most days for more than three or four weeks

- Chemist remedies are not helping, or you need them every day

- Difficulty swallowing, or food feeling as if it sticks on the way down

- Losing weight without trying

- Repeated vomiting

- Feeling unusually tired or breathless, which can mean a low blood count

- New, persistent indigestion if you are over about 55

- A family history of serious stomach or food-pipe disease

What actually helps

The advice most people hear is "avoid spicy food." The evidence is more specific, and kinder. A systematic review of the trials found that two lifestyle changes have the clearest evidence: losing weight if you are overweight, and raising the head of your bed.

- Raise the head of the bed by about 10 to 20 cm. Put blocks or bricks under the legs at the head end, or use a wedge under the mattress. Extra pillows do not work as well — they bend you at the waist and can push more acid up.

- Leave two to three hours between dinner and bed. In Delhi households where dinner is at ten, this is the single change that helps most people.

- Eat smaller meals. A very full stomach pushes acid upwards.

- Lose some weight if you are carrying extra around the middle. Even modest weight loss helps many people.

- Loosen tight waistbands and belts, especially after eating.

- Notice your own triggers. Fried food, rich gravies, coffee, alcohol and fizzy drinks set some people off and not others. Cut out what bothers you, not a whole list.

- Stop smoking. Guidelines recommend it for reflux, and it helps your heart as much as your stomach.

Acid-reducing medicine works well for most people with reflux, and a doctor may suggest a course of four to eight weeks. Read the box of anything you already take, and if you are not sure what a tablet is, bring the strip with you to the appointment. Do not stop a medicine a doctor has prescribed without speaking to them first.

What we will not do

- We will not hand you months of acid-reducing tablets and leave it there. Guidelines advise a defined course, then a review, then stepping down to the lowest dose that keeps you comfortable — or stopping if you can. Long-term use without a reason is not good care.

- We will not send everyone with heartburn for an endoscopy. If you are younger, your symptoms are typical and there are no warning signs, a trial of treatment and lifestyle changes usually comes first. An endoscopy is for warning signs, for symptoms that do not respond, or when the diagnosis is unclear.

- We will not treat chest pain as acidity without thinking about your heart first. If there is any doubt, the doctor will say so and send you for a heart check rather than prescribe for your stomach.

- We will not tell you to give up all spicy food for life. The evidence does not support blanket food bans, and an unnecessary restriction is one more thing to feel bad about.

Tests, and when they are worth doing

Most people do not need a test to start treatment. A careful history and examination usually tells the doctor what this is. Depending on what they find, they may suggest:

- A blood count (CBC) — to check for anaemia, which can be a sign of slow bleeding from the stomach.

- A test for H. pylori — for upper-stomach burning or indigestion. Guidelines recommend "test and treat" for this infection, because clearing it can settle the symptoms and lower the risk of ulcers.

- Upper GI endoscopy — a thin, flexible camera passed through the mouth to look at the food pipe, stomach and the first part of the small intestine. It is recommended when there are warning signs such as difficulty swallowing, bleeding or weight loss, or when symptoms have not settled with treatment. At All Is Well, endoscopy is done at the clinic by our gastroenterologist.

What it costs

| | Fee |

|---|---|

| General physician consultation | from ₹800 |

| Gastroenterology consultation — Dr. Anuj Pahuja | ₹1,500 when you book directly with us |

| CBC (blood count) | ₹319 |

| Upper GI endoscopy, at the clinic | ₹5,000 |

Blood samples can be collected at home free of charge, with no minimum order. We tell you the price before anything is booked. Fees for appointments booked through third-party platforms are set on those platforms and may differ. If the doctor recommends anything beyond what is listed here, you will be told what it is and what it costs before it is done.

Who you will see

For ordinary heartburn, start with a general physician. A general physician is in the clinic throughout our opening hours, Monday to Saturday, and treats most acidity and reflux well. If your symptoms need a specialist or a test, they will tell you.

For acidity that has not settled, or any warning sign, see a gastroenterologist. Dr. Anuj Pahuja is the gastroenterologist on our panel — MBBS, MD (General Medicine) and DNB (Medical Gastroenterology), with 9 years' experience. He is an Associate Consultant at the Fortis Escorts Liver & Digestive Institute, Okhla, and performs upper GI endoscopy and colonoscopy at our clinic. He consults Monday to Saturday from 8:00 to 9:00 AM and from 8:00 to 9:00 PM, so you can be seen before or after work.

Bring previous reports and the strips of any medicines you take.

Frequently asked questions

Is acidity the same as an ulcer?

No. Reflux is acid rising into the food pipe and usually causes burning in the chest. An ulcer is a sore in the lining of the stomach or the first part of the small intestine and more often causes pain in the upper stomach. They can feel similar, which is why the doctor asks exactly where it hurts and may test for H. pylori.

Can acidity cause chest pain?

Yes, but so can the heart. Pain that is tight or heavy, spreads to the arm or jaw, or comes with breathlessness or sweating needs a hospital, not an antacid.

Do I need an endoscopy for acidity?

Not usually at first. With typical symptoms and no warning signs, a short course of treatment comes first. Endoscopy is for difficulty swallowing, bleeding, weight loss, anaemia, or symptoms that do not respond.

Is it safe to take acid-reducing tablets every day?

For a defined course, yes, for most people. Taken for years without review, they can bring side effects of their own, which is why the usual approach is a course, then a review and the lowest dose that keeps you comfortable.

Which home remedies actually work?

Raising the head of the bed, eating dinner two to three hours before sleep, smaller meals and losing weight if you are overweight have the strongest evidence. Cold milk and other quick fixes may feel soothing for a while, but they do not change how often reflux happens.

Can I come without an appointment?

Please call first and we will give you a time. If it is urgent, say so and we will find you the earliest slot. With chest pain or any of the hospital signs above, go to a hospital emergency department instead.

All Is Well Medical Centre

Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

Clinic hours: Monday to Saturday, 8:00 AM – 9:00 PM. Closed Sunday.

Phone: 8800844793 · WhatsApp: https://wa.me/918800844793

Rated 4.9★ by patients on Google.

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Medically reviewed by Dr. Anuj Pahuja, MBBS, MD (General Medicine), DNB (Medical Gastroenterology) — gastroenterologist, All Is Well Medical Centre.

This article is general information and is not a substitute for a consultation with a doctor. If you are worried about your symptoms, please see a doctor. In an emergency, call 112 or go to the nearest hospital.

Contact

Call 8800844793. Home nursing 6 am to midnight

Phone

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