Acidity Is a Symptom, Not a Diagnosis: Why Self-Medicating Can Backfire

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A heavy meal, then a familiar burn in the chest. Sour belches after a late-night dinner. That fiery aftermath of one hot sauce too many.

For many Indians, these symptoms are so routine that reaching for an antacid has become second nature. Walk into any pharmacy and acid-reducing medicines are freely available over the counter. Many people keep them in handbags, office drawers and bedside tables, popping one whenever discomfort strikes.

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Acidity is common, and over-the-counter medicines can offer temporary relief. But what worries gastroenterologists is the growing trend of treating recurrent symptoms without ever finding out what is causing them.

We spoke to Dr Sushrutha CS, Surgical Gastroenterology, Hepato-biliary-pancreatic Surgery and Liver Transplant Surgeon, HOSMAT Hospitals, Bengaluru, to understand why this habit deserves a closer look.

Acidity Is a Symptom, Not a Diagnosis

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"The problem with self-medication is that it often hides the underlying cause. Frequent heartburn may be a sign of gastro-oesophageal reflux disease (GERD), but it can also mean stomach ulcers, Helicobacter pylori infection, gallbladder disease or, in rare cases, stomach or oesophageal cancers," said Dr Sushrutha.

Resolving these issues is about more than just stopping acid; if you wait too long to see a doctor, the disease can advance.

Acid reflux is also becoming more common worldwide. Gastro-oesophageal reflux disease is one of the most common digestive disorders, affecting more than one billion people worldwide, according to the 2023 Global Burden of Disease Study. In India, gastroenterologists are seeing younger adults with persistent reflux, often linked to obesity, irregular eating habits, stress and increasingly sedentary lifestyles.

The PPI Problem: When Relief Becomes a Habit

"One of the most commonly misused medications is the proton pump inhibitor (PPI) which includes drugs like pantoprazole, omeprazole and rabeprazole. These drugs work well if taken correctly but many people continue to take them for months and years without any medical supervision," added Dr Sushrutha.

A 2024 review in The BMJ said long-term use of PPIs should always be reviewed periodically, because unnecessarily continuing to use them may expose patients to avoidable risks. While these drugs are generally safe, long-term and inappropriate use has been associated with vitamin B12 deficiency, low magnesium levels, decreased calcium absorption, some intestinal infections and, in some patients, an increased risk of kidney disease.

The key issue is not that PPIs are unsafe, but that they must be used for the right indication and duration.

The Lifestyle Factor Nobody Wants to Fix

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"Acid reflux can be worsened by large meals, late dinners, too much tea or coffee, alcohol, smoking, poor sleep and chronic stress. Lots of hope that medicines will fix the problem and they will be able to keep doing the same things that triggered each day," added Dr Sushrutha.

For many patients, simple changes can dramatically reduce symptoms. These include eating smaller meals, not lying down right after eating, maintaining a healthy weight, limiting foods that trigger symptoms, and improving sleep.

The Warning Signs You Should Never Ignore

There are times when acidity should never be brushed aside. A doctor should promptly evaluate:

• Difficulty swallowing
• Persistent vomiting
• Unexpected weight loss
• Black stools
• Vomiting blood
• Severe chest pain, or heartburn that recurs several times a week despite medication

These are warning signs - and they should not be treated with repeated over-the-counter remedies.

Message From The Expert

Dr Sushrutha concluded, "This isn't a call to abandon antacids altogether. Used sparingly and correctly, they can be quite effective. The concern is when medicines become a replacement for diagnosis. If you are taking acidity tablets several times a week, or for months at a stretch, your body may be signalling something more important. Symptom relief is only half the treatment. The real protection for your long-term digestive health lies in identifying and addressing the root cause."

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.