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PHARMACIST-REVIEWED GUIDE · PAKISTAN
Heartburn, sour burps, burning stomach pain: what causes them, which medicine to use, and when it needs tests.
✓ Reviewed by Arhum Nadeem, Pharm-D · ✓ Based on NHS guidance · ✓ 3–4 hr delivery in Lahore
Medically reviewed by Arhum Nadeem, Pharm-D (8 years’ experience as a pharmacist) · Last reviewed: 17 October 2026
The main symptoms of acid reflux are heartburn (a burning feeling rising from the stomach into the chest), a sour or bitter taste at the back of the mouth, burping, bloating and nausea, often worse after meals or when lying down. A stomach ulcer typically causes a burning or gnawing pain in the upper middle of the tummy, sometimes eased or worsened by eating. Antacids and alginates (such as Gaviscon or Mucaine) relieve occasional symptoms quickly, while omeprazole-type medicines reduce acid for longer. Ulcers are usually caused by H. pylori infection or painkillers like ibuprofen, so they need proper diagnosis and treatment.
Key points
| Acid reflux (GERD) | Stomach ulcer | |
|---|---|---|
| Main feeling | Burning in the chest (heartburn), sour taste | Burning or gnawing pain in the upper tummy |
| Timing | After meals, bending or lying down, at night | Often between meals or at night; food may ease or worsen it |
| Other signs | Burping, hoarse voice, cough, bad breath, bloating | Indigestion, nausea, feeling full quickly |
| Common causes | Large or late meals, oily or spicy food, weight, smoking, pregnancy | H. pylori infection, NSAID painkillers, smoking |
| Type | How it works | Examples (Oct 2026 price) |
|---|---|---|
| Alginate | Forms a raft on top of the stomach contents to block reflux | Gaviscon liquid (about Rs 266), Gaviscon Advance (about Rs 361) |
| Antacid | Neutralises acid within minutes; short-lived | Mucaine (about Rs 186), Digas sachets, Eno |
| Proton pump inhibitor (PPI) | Reduces acid production for 24 hours; takes 1–4 days for full effect | Risek 20 mg (omeprazole), Nexum 20 mg (esomeprazole) |
How to use them: take antacids or alginates after meals and at bedtime, or when symptoms start. Take a PPI 30 to 60 minutes before breakfast. If you need a PPI for more than 2 to 4 weeks, see a doctor rather than continuing on your own. Long-term use needs review because it can lower B12 and magnesium and raise infection risk.
Timing with other medicines: antacids reduce absorption of some antibiotics, iron and thyroid tablets. Separate them by 2 to 4 hours. See Can You Take Antibiotics With Antacids?.
Helicobacter pylori is a stomach infection that is very common in Pakistan. It causes most stomach and duodenal ulcers and can lead to stomach cancer over many years. A breath test, stool antigen test or endoscopy confirms it. Treatment is a 1 to 2 week combination of a PPI and two antibiotics, prescribed by a doctor. Stop omeprazole-type medicines 2 weeks before testing if your doctor asks, as they can give a false negative result.
Ibuprofen (Brufen), diclofenac (Voltral), naproxen (Synflex), mefenamic acid (Ponstan) and aspirin can cause ulcers and stomach bleeding, especially in older people or with long-term use. If you have reflux or an ulcer, use paracetamol for pain unless your doctor advises otherwise.
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Also see a doctor if heartburn happens most days for 3 weeks or more despite treatment.
Acid reflux mein seene mein jalan, munh mein khatta pani, dakaar aur pait phoolna aam hai, khaas tor par khane ke baad ya letne par. Stomach ulcer mein pait ke beech mein jalan ya kaatne wala dard hota hai. Kabhi kabhar ki jalan ke liye Gaviscon ya Mucaine khane ke baad lein. Baar baar ho to omeprazole (Risek) nashte se pehle, lekin 2 se 4 hafte se zyada doctor ke baghair na lein. Ulcer ki aam wajah H. pylori aur Brufen jaisi dard ki goliyan hain. Khoon ki ulti ya kala pakhana ho to foran hospital jayen.
Heartburn after meals or when lying down, a sour taste in the mouth, and frequent burping are usually the first signs.
For occasional symptoms, an alginate (Gaviscon) or antacid (Mucaine) works fast. For frequent heartburn, a short course of omeprazole or esomeprazole works better. A doctor should review long-term use.
Short courses are generally safe. Daily use for months should be reviewed by a doctor, who may lower the dose or stop it.
A burning or gnawing upper tummy pain, especially between meals or at night, suggests an ulcer. A doctor confirms it with an H. pylori test or endoscopy.
Some heal, but they often return unless the cause, H. pylori or NSAID use, is treated. Untreated ulcers can bleed or perforate.
Milk may soothe briefly, but it can trigger more acid afterwards. It’s not a reliable treatment.
This article is for general information and does not replace advice from your doctor or pharmacist. Always read the pack leaflet and follow the dose on the label or prescription.
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