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acidity
Acidity trends in India

Heartburn in India

Acidity most commonly manifests as a burning sensation in the middle of the chest. The common cause of heartburn is gastroesopheal reflux or the reflux of stomach acid into the food pipe or(also known as the esophagus).

What factors are responsible for heartburn?

Lifestyle, food habits, and stress are the major factors that determine the prevalence of heartburn in a person. In a population-based study conducted on all the employees of All Indian Institute of Medical Sciences (AIIMS) in 2011, 16.2% of urban Indian population in northern India suffers from heartburn. This study is based on the factors like age, sex, BMI, social class index, smoking, alcohol, NSAIDS, and comorbid illness.1

Age: Earlier, it was believed that heartburn affects the people above 30 years. However, even an 18-year-old is reporting the symptoms of heartburn due to the changing trends in lifestyle. Decreased metabolism in elderly above 55 years is also a contributing factor for heartburn.2

Gender: Females are found to be more affected with acidity when compared to males. The same is applicable to all developing countries.2, 3

Body mass index: Body mass index seems to be directly proportional to acidity. Obesity drastically increases the risk of heartburn. Higher BMI is associated with more frequent and more severe heartburn and regurgitation. 2, 4, 5, 6

A population-based study found that a younger age group, sedentary lifestyle, serum LDL >150 mg/dL, high consumption of meat, low consumption of salted tea and low consumption of fresh fruits were significant risk factors for heartburn.7

Heartburn is also common in pregnancy, often in second and third trimester. Non-vegetarianism and aerated beverages increased the risk of reflux in pregnancy.8

Heartburn during sleep is very common in the general population. It is strongly associated with increased BMI, carbonated soft drink consumption, insomnia, hypertension, asthma, and usage of benzodiazepines. 9

Trends abroad

The statistics of heartburn changes with changing geographical diversity, nutritional pattern, and ethnicity. Let us have a look at the prevalence of heartburn at various geographical locations. 10

Europe: Heartburn is a common symptom in Europe. According to an article published in the Alimentary Pharmacology and Therapeutics, 32% of northern Europe population shows the symptoms of heartburn. This count comes down to 7% in Italy.

USA: The prevalence of heartburn in USA is more than any other westernized world. It was believed that 15 million Americans suffer heartburn daily. It accounts for approximate 1 in 18 people of America suffer heartburn. Eating spicy and fatty foods, alcohol and coffee consumption are the main causes for heartburn.

Australia: According to statistics, 11.6% of the Australian population suffers from heartburn. Just over one in ten Australians experiences heartburn at least once a week.

East Asia: The prevalence of heartburn in East Asian countries is below 10% ranging from 2.5 – 7.8%.

Africa: The prevalence of heartburn in black African population is 9.2% who suffer heartburn once in a week. In Africa, the incidence of heartburn in male population is considerably less when compared to their female counterpart.

With heartburn so rampant, it is important that we find an effective remedy, which is safe, easily accessible, and inexpensive.

References

  1. Sharma PK, Ahuja V, Madan K, Gupta S, Raizada A, Sharma MP. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India. Indian J Gastroenterol. 2011 May;30(3):128-34.
  2. Wong BC, Kinoshita Y. Systematic review on epidemiology of gastroesophageal reflux disease in Asia. Clin Gastroenterol Hepatol. 2006 Apr;4(4):398-407.
  3. Dore MP, Maragkoudakis E, Fraley K, Pedroni A, Tadeu V, Realdi G, Graham DY, Delitala G, Malaty HM. Diet, lifestyle and gender in gastro-esophageal reflux disease. Dig Dis Sci. 2008 Aug;53(8):2027-32.
  4. Dore MP, Maragkoudakis E, Fraley K, Pedroni A, Tadeu V, Realdi G, Graham DY, Delitala G, Malaty HM. Diet, lifestyle and gender in gastro-esophageal reflux disease. Dig Dis Sci. 2008 Aug;53(8):2027-32.
  5. Nocon M, Labenz J, Jaspersen D, Meyer-Sabellek W, Stolte M, Lind T, Malfertheiner P, Willich SN. Association of body mass index with heartburn, regurgitation and esophagitis: results of the Progression of Gastroesophageal Reflux Disease study. J Gastroenterol Hepatol. 2007 Nov;22(11):1728-31.
  6. Sharma PK, Ahuja V, Madan K, Gupta S, Raizada A, Sharma MP. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India. Indian J Gastroenterol. 2011 May;30(3):128-34.
  7. Kumar S, Sharma S, Norboo T, Dolma D, Norboo A, Stobdan T, Rohatgi S, Munot K, Ahuja V, Saraya A. Population based study to assess prevalence and risk factors of gastroesophageal reflux disease in a high altitude area. Indian J Gastroenterol. 2011 May;30(3):135-43.
  8. Ramu B, Mohan P, Rajasekaran MS, Jayanthi V.Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol. 2011 May;30(3):144-7.
  9. Fass R, Quan SF, O'Connor GT, Ervin A, Iber C. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005 May;127(5):1658-66.
  10. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review. Gut. 2014 Jun;63(6):871-80.