ICD-10 · K21
Acidity and Acid Reflux (GERD)
Acid reflux happens when stomach acid flows back into the food pipe, causing burning behind the breastbone. Occasional acidity is common; when it occurs more than twice a week it is called GERD and needs proper treatment rather than daily antacids.
Symptoms
Burning in the chest after meals or on lying down, sour or bitter regurgitation, bloating, belching, nausea, a persistent dry cough, hoarseness, and disturbed sleep.
Causes & risk factors
Weak lower oesophageal sphincter, obesity, late heavy dinners, spicy and fried food, tea and coffee on an empty stomach, smoking, alcohol, pregnancy, hiatus hernia, and long-term NSAID use.
Diagnosis
Diagnosis is usually clinical. Endoscopy is advised for alarm features or symptoms persisting beyond 4–8 weeks of treatment. Testing for Helicobacter pylori is common in India given its high prevalence.
Treatment options
Proton pump inhibitors such as pantoprazole, omeprazole or rabeprazole 20–40 mg once daily before breakfast are the mainstay, typically for 4–8 weeks rather than indefinitely. Antacid gels and H2 blockers such as famotidine give quick relief. Eating dinner three hours before bed, raising the head of the bed, and losing weight are as important as the tablets.
When to see a doctor
Difficulty or pain on swallowing, vomiting blood, black stools, unintentional weight loss, anaemia, or symptoms that persist despite eight weeks of treatment.