Heartburn after a heavy meal, a burning sensation that wakes you up at night, a dull ache that won't quite go away — these are familiar complaints, and the words we use to describe them often blur together. Acidity. Gastritis. Ulcer. They sound related, and they are. But they're not the same thing, and the difference matters for treatment.
Acidity (acid reflux / GERD)
This is the most common of the three. Stomach acid flows back up into the food pipe, causing a burning sensation in the chest, often after eating or when lying down. It's typically triggered by certain foods, large meals, or weight pressing on the abdomen. Occasional acidity is normal; persistent acidity that needs daily medication is not.
Gastritis
This is inflammation of the stomach lining itself. It can come from a bacterial infection (most often H. pylori), long-term use of painkillers like ibuprofen, excessive alcohol, or stress. Symptoms include a gnawing or burning pain in the upper abdomen, often worse on an empty stomach, sometimes with nausea or bloating.
Peptic ulcer
This is a step further — an actual sore in the stomach lining or the upper part of the small intestine. Symptoms overlap with gastritis: burning pain, often when hungry, relieved temporarily by food or antacids. The danger signs are different though — black tarry stools, vomiting blood, or sudden severe pain warrant immediate attention.
When to see a specialist
For all three, the same rule applies: if it's been more than two weeks and over-the-counter antacids aren't doing the job, get evaluated. An endoscopy can usually tell the three apart quickly and check for H. pylori, which is treatable with antibiotics.
Self-medicating long-term with antacids masks the underlying problem and can let ulcers progress to bleeding. Worth a one-time consultation to know what you're actually dealing with.