Download 1 - ClubRunner

OPK’s Health Corner – Digestive system
issue-
Acidity or Acid Peptic Disease (APD)
What is Acidity or APD?
The stomach normally secretes acid that is essential in the digestive
process. This acid helps in breaking down the food during digestion. When
there is excess production of acid in the stomach, it results in the condition
known as acidity or APD.
Normally, there are some protective mechanisms against the acid, in the
stomach and proximal intestine. But an imbalance between the protective
mechanisms and the level of acid secretion can cause acidity.
What are the causes of acidity?
A weakness of the valve between the stomach and oesophagus (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.
Sometimes, a heavy meal or increase in intra-abdominal pressure such as
while straining or lifting weights, can bring about this reflux.
Excess acid secretion can also cause acidity and ulcers, when the normal
protective lining of the stomach and duodenum (the part of the intestine
that joins the stomach), is damaged. The resulting ulcer is called gastric
ulcer if it is in the stomach and duodenal ulcer if it is in the duodenum.
O P Khanna
Page 1
6/30/2017
OPK’s Health Corner – Digestive system
issue-
In a condition known as Zollinger-Ellison Syndrome, a large amount of acid
is secreted because of stimulation by tumours located in the pancreas or
duodenum.
Any kind of break down in the defense mechanisms that protect the
stomach and intestine from damage by acid can cause acidity.
The body secretes bicarbonate into the mucous layer, which neutralises the
acid. Hormone-like substances known as prostaglandins, help to keep the
blood vessels in the stomach dilated, ensuring adequate blood flow.
Lack of adequate blood flow to the stomach may contribute to ulcers.
Prostaglandins are also believed to stimulate bicarbonate and mucous
production, which help protect the stomach.
Consumption of alcohol, highly spicy foodstuffs, irregular food habits, and
Non Steroidal Anti-Inflammatory Drugs (NSAIDs) also predispose to gastric
acidity.
There is a higher incidence of acidity in highly emotional and nervous
individuals. It is also more common in the developed and industrialized
nations, though a recent increase in incidence has also occurred in the
developing countries
What are the symptoms of acidity?
The main symptoms of acidity are Heartburn and Dyspepsia.
Heartburn is characterized by a deeply placed, burning pain in the chest
behind the sternum (breast-bone). It occurs 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. Heartburn is usually
relieved when the person sits up. Regurgitation of the gastric contents may
also occur. The symptoms of ulcers are mainly pain that can be either
localized or diffuse. Sometimes it radiates to the back or to the chest.
Dyspepsia is a burning or an aching pain in the upper abdomen, sometimes
described as a stabbing sensation penetrating through the gut. In rare cases
there may be no pain, but only a feeling of indigestion, fullness, bloating,
O P Khanna
Page 2
6/30/2017
OPK’s Health Corner – Digestive system
issue-
flatulence or nausea. When the cause is a duodenal ulcer, having a meal
usually relieves the pain. But in the case of a gastric ulcer there may be no
change, or the pain may become worse after eating. Peptic ulcer disease
can sometimes occur without symptoms. Symptoms may also arise when
there is no ulcer present, which is known as non-ulcer dyspepsia.
Are there specific tests for the diagnosis of acidity?
While a doctor may be able to diagnose a simple case of acidity from the
medical history, more detailed investigations may be necessary to detect
the presence of ulcers in the stomach and the duodenum.
The doctor will take a detailed history of use of drugs such as NSAIDs, a
history of family members with ulcers, alcohol consumption and smoking to
determine the causes of acidity.
An assessment of a person's stress level is also important to reach a
diagnosis.
A doctor may request an Upper Gastrointestinal Endoscopy to detect the
presence of ulcers.
If Zollinger-Ellison Syndrome is suspected, blood levels of gastrin may be
measured.
Barium Meal studies are useful as these may reveal an inflammation, active
ulcer craters, or deformities and scarring due to ulcers. In some cases, a
doctor may also request a biopsy of an ulcer, to rule out a cancer.
What is the treatment for acidity or ulcer?
The most important part of treatment of acidity, is to identify and avoid the
causative factors. Foods that are spicy, salty and acidic should be avoided.
Smoking and alcohol consumption must be stopped.
Avoiding stress and modification of lifestyle may prove very helpful in
treatment of acidity and ulcers, particularly in those with a nervous and
emotional disposition and people involved in high-stress jobs.
Antacids can provide immediate relief of symptoms by neutralizing the
excess acid secreted.
O P Khanna
Page 3
6/30/2017
OPK’s Health Corner – Digestive system
issue-
A group of drugs called H2 Receptor Blockers cause the stomach to produce
less acid by blocking histamine receptors (example: Cimetidine and
Ranitidine).
Another group of drugs called the Proton Pump Inhibitors selectively
disables a mechanism in acid-making cells thus stopping acid production.
These are more powerful and include Omeprazole and Lansoprazole.
Early detection of and treatment of ulcers can prevent complications like
perforations. Long term therapy may be necessary to produce complete
healing.
Surgical methods like Vagotomy are sometimes used to control acid
secretion.
How can acidity be prevented?
Acidity can be prevented by avoiding the known causative factors like
alcohol consumption, spicy foods, drugs like NSAID's, steroids etc. Regular
eating habits and a healthy diet can prevent acidity. People with a highly
nervous and emotional disposition and those involved in high-stress jobs
could opt for a change in their lifestyle and reduce the stress.
Contributed by Dr. Shiva Prasad
O P Khanna
Page 4
6/30/2017