Acid reflux, often labelled heartburn, is one of the most common causes of acid reflux symptoms in India and occurs when acidic stomach contents flow back into the oesophagus. Nearly one in five Indian adults reports weekly reflux symptoms, thanks to spicy diets, erratic mealtimes, sedentary jobs, and rising obesity rates. Left unchecked, repeated reflux can injure the oesophagus and evolve into gastro-oesophageal reflux disease (GERD). Understanding cause of acid reflux and what is the first step to lasting relief.
How Acid Reflux Happens
At the junction of the oesophagus and stomach sits the lower oesophageal sphincter (LES). This band of muscle normally shuts tightly after food enters the stomach. When it relaxes at the wrong time or when abdominal pressure pushes hard against it acid splashes upward and irritates the sensitive oesophageal lining. Reflux becomes GERD when this back-flow occurs more than twice a week for several weeks.
1. Dietary Triggers You May Be Ignoring
Certain foods either relax the LES or increase stomach acidity, making reflux much more likely. The worst offenders are:
| Food Category | Why It Triggers Reflux | Indian Examples |
| Spicy dishes | Capsaicin delays gastric emptying | Mirchi pickle, Andhra curries |
| Acidic produce | High citric/malic acids irritate LES | Oranges, sweet lime, tomatoes |
| High-fat meals | Fat slows stomach emptying & lowers LES tone | Fried pakoras, samosas, creamy gravies |
| Chocolate & caffeine | Contain methylxanthines that loosen LES | Chocolate barfi, strong filter coffee |
| Carbonated & fizzy drinks | Gas expands the stomach, increasing pressure on LES | Colas, soda lime |
Action plan: Start a seven-day food diary noting what you eat, when symptoms flare, and portion sizes. Patterns usually emerge within a week, allowing targeted eliminations rather than blanket restrictions.
2. Lifestyle & Behavioural Factors
- Large or late-night meals – A full stomach puts upward pressure on the LES, especially if you lie down within three hours of eating.
- Obesity & belly fat – Extra abdominal weight mechanically forces acid northward.
- Smoking & alcohol – Both reduce LES pressure and impair oesophageal clearance.
- Tight waistbands & belts – Compress the stomach after meals, mimicking the effect of obesity.
- Slumped posture at desks – Hunching increases intra-abdominal pressure; use an ergonomic chair and stretch hourly.
3. Medical & Physiological Causes
- Hiatal hernia: Part of the stomach slides through the diaphragm, weakening the LES seal.
- Pregnancy: Hormonal changes plus foetal pressure make reflux common, especially in the 3rd trimester.
- Medications: NSAIDs, certain blood-pressure drugs, muscle relaxants, and some asthma inhalers can aggravate reflux.
- Gastroparesis & diabetes: Delayed stomach emptying means acid lingers longer, raising reflux risk.
- Connective-tissue disorders: Scleroderma can stiffen the LES and oesophagus, leading to chronic reflux.
Consult your physician before stopping or switching any prescription medicine.
4. Cultural Habits That Worsen Reflux in India
- Repeated cups of strong masala chai or filter coffee throughout the workday add caffeine and fat-rich milk.
- Festival feasts loaded with ghee-based sweets, fried snacks, and sugary sodas create the perfect reflux storm.
- Chewing paan with tobacco relaxes the LES much like cigarette smoking.
Embrace traditional buttermilk, coconut water, and lightly spiced vegetable dishes as gut-friendly swaps.
5. Prevention Strategies Backed by Science
- Smaller, frequent meals: Five fist-sized meals curb pressure on the LES.
- Early dinners: Finish eating three hours before bedtime; aim for 7:00 p.m. if possible.
- Left-side sleeping: This position keeps the stomach lower than the oesophagus, reducing nocturnal reflux.
- Elevate the head of your bed: Raise by 6-9 inches using wooden blocks or a wedge pillow.
- Weight management: A 5-10% drop in body weight markedly reduces heartburn episodes.
- Quit tobacco & limit alcohol: Both actions restore LES strength within weeks.
- Chew food slowly & mindfully: Proper mastication signals fullness sooner and limits overeating.
6. When to Seek Medical Care
See a gastroenterologist if you experience any of the following:
- Reflux symptoms more than twice a week for six weeks
- Difficulty or pain while swallowing
- Unintended weight loss, persistent nausea, or vomiting blood
- Pain that radiates to jaw or arm (to rule out cardiac issues)
Prolonged, untreated GERD can lead to oesophagitis, strictures, or Barrett’s oesophagus, a pre-cancerous change in cells.
Frequently Asked Questions
Q1. Can stress cause acid reflux?
Yes. Stress heightens visceral sensitivity and delays digestion, making the oesophagus more reactive to minimal acid exposure. Yoga, diaphragmatic breathing, and short walking breaks reduce episodes.
Q2. Is acid reflux the same as GERD?
Occasional reflux is normal. GERD is diagnosed when reflux occurs at least twice weekly or causes complications such as oesophageal inflammation.
Q3. Do milk and curd relieve heartburn?
Cold, low-fat milk or plain curd can provide temporary relief by buffering stomach acid, but high-fat dairy can worsen symptoms. Choose skim milk or thin buttermilk over full-cream options.
Q4. Which Indian foods actually soothe reflux?
Bananas, watermelon, oats, boiled rice, tender coconut water, and ginger-infused teas are gentle on the stomach lining.
Q5. Are proton-pump inhibitors (PPIs) safe for long-term use?
PPIs are effective but may cause nutrient malabsorption and gut-microbe shifts with extended use. Physicians now recommend the lowest effective dose for the shortest duration alongside lifestyle changes.
Q6. Can children get acid reflux?
Yes. Childhood obesity, carbonated drinks, and frequent junk food increase paediatric reflux. Consult a paediatric gastroenterologist for persistent symptoms.
Key Takeaways
- Acid reflux stems from a weakened LES combined with dietary, lifestyle, or medical triggers.
- Spicy, acidic, high-fat foods and late-night meals are top culprits in Indian households.
- Simple habits, smaller meals, early dinners, left-side sleeping, weight loss, and quitting tobacco offer powerful, research-backed relief.
- Persistent or complicated reflux warrants professional evaluation to prevent long-term damage.
Prioritise mindful eating, active living, and culturally compatible swaps to keep heartburn from hijacking your day or night.