Acid Reflux and GERD: Symptoms, Triggers and How to Get Relief

A rich biryani, a few samosas at iftar, a cup of strong chai on an empty stomach, and suddenly there is a burning feeling climbing up behind your chest. If that sounds familiar, you are in very large company. Acid reflux is one of the most common digestive complaints in Pakistan, and most people can control it with a few practical changes and the right medicine used the right way.

What is acid reflux?

At the bottom of your food pipe there is a small muscular valve that works like a one-way door. It lets food into the stomach and keeps stomach acid from coming back up. When this valve relaxes at the wrong time or is weak, acid flows upward and irritates the lining of the food pipe. That is acid reflux. When it happens more than twice a week, or keeps coming back over weeks, doctors call it GERD (gastro-oesophageal reflux disease).

Acid reflux symptoms

• Heartburn: a burning feeling behind the breastbone, often after meals or when lying down
• A sour or bitter taste in the mouth, or food and liquid coming back up
• Burping, bloating and feeling full quickly
• A lump-in-the-throat feeling
• A dry cough that gets worse at night, a hoarse voice or a sore throat that never quite goes away
• Nausea, especially after heavy meals

Some people have no heartburn at all and only notice the throat and cough symptoms, which is sometimes called silent reflux.

What triggers reflux?

• Large, heavy meals, and lying down or sleeping within 2 to 3 hours of eating
• Fried and very spicy food, such as pakoras, parathas, nihari and rich curries
• Tea or coffee on an empty stomach, and fizzy soft drinks
• Chocolate, mint and citrus for some people
• Smoking, including shisha
• Extra weight around the belly, and tight belts or clothing
• Pregnancy
• Painkillers such as ibuprofen, diclofenac and aspirin
• Stress and irregular meal times

Simple changes that make a real difference

• Eat smaller meals and finish dinner at least 3 hours before bed.
• Raise the head of your bed by 15 to 20 cm with blocks under the legs. Extra pillows are less effective.
• Sleeping on your left side can reduce night-time reflux.
• Take your tea after meals rather than first thing in the morning.
• Cut back on fried foods, fizzy drinks and smoking.
• If you are overweight, losing even 3 to 5 kg often brings clear relief.
• During Ramadan, break your fast with dates and water, wait a little, then eat a normal-sized meal rather than heavy fried food.

Medicines for acid reflux

Different medicines suit different situations:

• Antacids (aluminium, magnesium or calcium based) neutralise acid within minutes and are good for occasional heartburn. Take them after meals and at bedtime.
• Alginate liquids form a protective layer on top of stomach contents and can help after meals and at night.
• H2 blockers such as famotidine reduce acid for several hours and work well for night symptoms.
• Proton pump inhibitors (PPIs) such as omeprazole, esomeprazole, pantoprazole and rabeprazole are the strongest option. They are best taken 30 to 60 minutes before breakfast.

PPIs deserve a special mention. They are very effective, but many people stay on them for years just because they “feel better”. Longer-term use has been linked to low magnesium, low vitamin B12 and a higher chance of some infections and fractures. A typical course is 4 to 8 weeks. Ask your doctor to review the dose and the plan instead of continuing indefinitely.

Heartburn or heart attack?

The two can feel similar. Call for emergency help if chest discomfort comes with sweating, shortness of breath, pain spreading to the arm, jaw or back, or a sense of dread. Do not assume it is gas, especially if you are over 40 or have diabetes, high blood pressure or high cholesterol.

Warning signs that need a doctor

• Difficulty or pain when swallowing
• Weight loss without trying
• Repeated vomiting, or vomiting blood
• Black, tarry stools
• Anaemia that has no clear cause
• Symptoms that continue after 3 weeks of treatment
• New reflux symptoms after the age of 50

Long-standing, untreated reflux can inflame and scar the food pipe, and in a small number of people it leads to changes in the lining that need monitoring. A stomach infection with H. pylori can also cause similar symptoms and may need its own treatment, so persistent complaints are worth checking. If you also have burning pain between meals, see our range for stomach ulcer care.

Key takeaways

• Heartburn, a sour taste and a night-time cough are the most common signs of acid reflux.
• Meal size, meal timing, fried food, smoking and extra weight are the biggest triggers.
• Antacids are for quick relief; PPIs are for a defined course, not for years.
• Trouble swallowing, weight loss, vomiting blood or black stools need prompt medical review.

Related medicines on Medimart

These are the common medicine groups used for acid reflux and heartburn:

• Antacids: quick relief for occasional heartburn
• Famotidine: reduces acid for several hours, useful at night
• Omeprazole: a proton pump inhibitor for a defined course
• Esomeprazole: a proton pump inhibitor
• Pantoprazole: a proton pump inhibitor
• Rabeprazole: a proton pump inhibitor
• Lansoprazole: a proton pump inhibitor
• Domperidone: helps with nausea and a slow-emptying stomach

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Find acid reflux and ulcer medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If symptoms persist or worsen, please see a doctor.