Why do I get acidity every day Causes, Triggers & Fixes

Daily acidity, referred to as gastric by most Singaporeans, is often caused by a weakened Lower Esophageal Sphincter (LES) that allows stomach acid to flow back into the esophagus. In Singapore and across Asia, the most common drivers are dietary habits (late hawker meals, spicy and fatty foods), H. pylori infection, obesity and hiatal hernia. If it happens every day, it is likely GERD or H. pylori gastritis and warrants a medical review by a gastroenterologist.

Key Takeaways 

1. Acidity becomes GERD when it occurs at least twice a week with significant discomfort.
2. In many people with GERD, the lower esophageal sphincter does not prevent reflux effectively, allowing stomach contents to move upward into the esophagus
3. In Singapore, H. pylori affects 31% of the population. This bacteria causes gastritis that is frequently mistaken for GERD and requires different treatment entirely.
4. Common local triggers include kopi, teh tarik, laksa, curry, char kway teow, roti prata and late-night hawker meals.
5. Asians more often present with throat symptoms (hoarseness, throat clearing, cough) rather than classic heartburn. This is called silent reflux (LPR) and is frequently missed.
6. GERD in Asia often shows no visible damage on endoscopy but the symptoms are still real and need treatment.
7. Untreated daily GERD can progress to Barrett's esophagus (precancerous) in 10-15% of cases.

Key Terminologies Defined

Gastric (common Singapore term for acidity): The local term Singaporeans use for stomach pain, acidity and reflux. Medically, gastric refers to the stomach. What most people mean is either gastritis (stomach lining inflammation), GERD (acid reflux) or H. pylori infection; three different conditions that overlap in symptoms but require different treatments.

Acid reflux: When stomach acid flows backward into the esophagus, causing a burning sensation. Occasional and normal. Daily occurrence is not.

Gastroesophageal Reflux Disease (GERD): Chronic acid reflux occurring at least twice a week. A diagnosable medical condition, not just a sensitive stomach.

LES (lower esophageal sphincter): The muscle valve between your stomach and esophagus. When it weakens or relaxes at the wrong time, acid escapes upward. This is the primary mechanism behind most reflux episodes.

H. pylori (Helicobacter pylori): A bacterium that lives in the stomach lining, present in 31% of Singaporeans. It causes chronic gastritis and ulcers that feel identical to GERD but are treated with antibiotics, not antacids. Going undetected is extremely common.

NERD (non-erosive reflux disease): GERD where the symptoms are real and severe but an endoscopy shows no visible damage to the esophagus. More common in Asian patients. Often dismissed with "your scope is normal" when it isn't.

LPR (laryngopharyngeal reflux) or silent reflux: Acid that travels all the way up past the esophagus into the throat and voice box. Causes chronic throat clearing, hoarseness, cough and a lump-in-throat feeling with no heartburn. Very commonly missed in Asian patients.

Barrett's esophagus: A precancerous condition where chronic acid exposure changes the esophageal lining. Develops in 10-15% of chronic GERD cases over 5-10 years.

How common is daily acidity in Singapore and Asia?

1. GERD prevalence in Asia ranges between 2.5 to 7.1% in population-based studies but it is rising rapidly. GERD and its complications are increasing across Asia, coinciding with more Westernised diets, rising obesity rates and declining H. pylori prevalence.
2. H. pylori affects 31% of Singaporeans overall, rising to 71% in adults above age 65
3. A survey of Asian otolaryngologists estimated the prevalence of LPR at approximately 25.5%
4. Asians are significantly more likely to have NERD, which is GERD with normal-looking endoscopy results

What causes daily acidity?

In most cases of GERD, reflux occurs because LES fails to stay closed, letting acid escape upward. Some common conditions that are often related to acidity are:

1. Hiatal hernia

Research confirms that 50-94% of GERD patients have a sliding hiatal hernia, where the upper stomach pushes through the diaphragm, physically displacing the LES and eliminating the pressure barrier that keeps acid down. The hernia also creates a pocket where gastric contents pool and reflux back with each LES relaxation.

2. H. pylori infection

According to NUH Singapore, H. pylori is present in up to 31% of Singaporeans, rising to 71% in adults above 65. H. pylori causes chronic gastritis and peptic ulcers that produce symptoms including epigastric pain, bloating, nausea, burning, nearly identical to GERD. The key difference, however , is that H. pylori requires targeted treatment, not lifelong antacids. Many Singaporeans self-treat with antacids for years without realising they have a bacterial infection. A simple urea breath test or stool antigen test confirms or rules it out. If you haven't been tested, this is step one. 

3. Obesity (BMI > 23-27.5 for Asians)

Excess abdominal fat raises intra-abdominal pressure, compressing the LES. A BMI above 30 is a documented independent risk factor for GERD. Asian populations carry metabolic and abdominal fat risk at lower BMI thresholds. The WHO recommends using BMI > 23 as overweight and BMI > 27.5 as obese for Asian adults. Even moderate weight gain worsens reflux.

4. Weakened LES from medications

Nitrates, calcium channel blockers and anticholinergics directly lower LES pressure. If you take any of these for blood pressure or heart conditions and have daily reflux, a medication review with your doctor is warranted.

5. Smoking

Nicotine weakens the LES and stimulates acid production simultaneously. Cessation is a standard first-line recommendation in all GERD guidelines. 

6. Late-night eating

Hawker centres and supper spots operate until midnight and beyond. Eating within 2-3 hours of lying down is one of the most direct lifestyle causes of nocturnal reflux and it is normalised in Singapore eating culture. Char kway teow at 10:30pm followed by bed at midnight is a near-perfect recipe for acid reflux.

7. Delayed gastric emptying (gastroparesis)

When the stomach empties too slowly, pressure builds and increases the chance of acid backflow. Common in people with diabetes and connective tissue disorders.

8. Pregnancy

Rising progesterone relaxes smooth muscle including the LES. Combined with increasing abdominal pressure from the growing uterus, reflux is very common in the second and third trimesters.

What foods and habits trigger daily acidity in Asians?

Triggers do not cause GERD; they aggravate an already compromised LES. Northwestern Medicine notes there are no universal food triggers; what causes reflux is individual.

Standard triggers that are relevant globally

Fatty foods, spicy foods, citrus, tomatoes, chocolate, coffee, alcohol, mint, onions, garlic and large meals also apply. Keep a 2-week food and symptom diary before eliminating anything. Mass General Brigham dietitians warn that blanket elimination removes beneficial nutrients unnecessarily.

Evidence-based fixes for Singapore

Harvard Medical School states that dietary change alone may be sufficient for mild GERD. For persistent cases, medication or targeted supplementation is added. Surgery is reserved for refractory disease.

Lifestyle changes 

1. Stop eating 2-3 hours before lying down
2. Eat smaller, more frequent meals
3. Large hawker portions distend the stomach and push against the LES
4. 4-5 smaller portions daily consistently reduces reflux pressure
5. Sleep on your left side
6. Elevate the head of your bed 6-8 inches
7. Take PPIs correctly, i.e., 30 to 60 minutes before your first meal
8. Lose weight if BMI is above 23 (Asian threshold)
9. Quit smoking
10. Eat slowly and sit upright during and after meals
11. Don't drink large volumes of water with meals
12. Avoid exercise that compresses the abdomen after meals
13. Gentle walking after meals actively aids gastric emptying and reduces reflux
14. Avoid tight waistbands and shapewear after meals

Why you should consider Vicopyl® by iAM Health 

Given that H. pylori affects 31% of Singaporeans and is a leading cause of the acidity or gastric symptoms most people self-treat with antacids indefinitely, here's a more scientific and targeted probiotic supplement to address this. A natural, science-based approach to gastric and digestive health, Vicopyl® is a safe and effective option to help nurture and maintain a healthy digestive system. 

Carefully crafted with clinically researched ingredients, this probiotic health supplement supports your body in reducing harmful bacteria in the stomach while promoting a healthy gut environment, so you can feel better in your body, every day.

Vicopyl® by iAM Health is a natural health supplement designed to promote better gastric health by helping to:

• Restore beneficial gut bacteria
• Suppress harmful bacteria in the digestive system
• Support gastrointestinal system health
• Easing symptoms of abdominal discomfort and stomach-related issues

Vicopy®l is most appropriately used as a support tool, not a replacement for medical diagnosis and treatment.

Reviewed by: Dr. Cheryl Yeo, Founder, iAM Health 

References Used:

1. https://my.clevelandclinic.org/health/diseases/14432-barretts-esophagus
2. https://www.nuhs.edu.sg/patient-care/find-a-condition/helicobactor-pylori
3. https://pubmed.ncbi.nlm.nih.gov/19120871/
4. https://www.ncbi.nlm.nih.gov/books/NBK562200/
5. https://www.nuh.com.sg/health-resources/diseases-and-conditions/helicobactor-pylori
6. https://www.mayoclinic.org/diseases-conditions/h-pylori/symptoms-causes/syc-20356171
7. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2017&volume=11&issue=4&page=OC01&issn=0973-709x&id=9562
8. https://www.japscjournal.com/articles/obesity-asia-pacific-region-current-perspectives
9. https://www.emc.id/en/care-plus/smoking-and-gerd-how-nicotine-weakens-the-gastric-valve-triggering-acid-reflux
10. https://www.nm.org/conditions-and-care-areas/gastroenterology/gastroesophageal-reflux-disease/causes-and-diagnoses
11. https://www.brighamandwomens.org/patients-and-families/meals-and-nutrition/bwh-nutrition-and-wellness-hub/guidelines-for-healthy-eating
12. https://www.iamhealth.live/blogs/news/which-probiotic-is-right-for-you-a-practical-guide-to-gut-health-immunity-and-daily-balance?_pos=6&_sid=e8b29d1aa&_ss=r
13. https://www.iamhealth.live/blogs/clinical-studies/vicopyl-clinical-study-a-proven-solution-for-stomach-health
14. https://www.iamhealth.live/pages/our-story?srsltid=AfmBOopNjFJaxjxVoOpLxR7Zc7SzwLAXmcKhW02JJN23Kh5zmnroLwqh