In short
- Acidity vs GERD
- Alarm symptoms
- Why PPIs stop working
- What actually reduces reflux
- Long-term risk
Acidity vs GERD
Occasional burning after a heavy meal is acidity. Heartburn or regurgitation twice a week or more, for weeks, is GERD — reflux disease — and needs a diagnosis, not another sachet.
Alarm symptoms
Difficulty swallowing, vomiting, black stool, weight loss, anaemia, chest pain, or onset after 50: get an endoscopy soon.
Why PPIs stop working
In up to a third of people on long-term PPIs, the problem is not acid at all — it is non-acid reflux, an oversensitive oesophagus, or a motility disorder. A 24-hour pH-impedance study identifies which, and each is treated differently.
What actually reduces reflux
Eating dinner 3 hours before bed, losing central fat, raising the head of the bed, and stopping smoking reduce reflux episodes more than any food list.
Long-term risk
Years of untreated reflux can cause Barrett's oesophagus. Endoscopic surveillance with narrow-band imaging catches change early — and early lesions can be removed endoscopically.
Dr Maneesh Paliwal
MBBS, MD, DM Gastroenterology & Hepatology (SGPGI), SCE (UK). Senior Consultant, PSRI Hospital; founder, Gut Liver Obesity Clinic, Chittaranjan Park. 22+ years; founded Delhi's first luminal GI lab.