Special to CSMS Magazine
Another common complaint
Nonulcer dyspepsia (NUD) is another common stomach complaint.
Symptoms: Gnawing stomach pain, nausea and vague acidity. These symptoms often mimic those of a peptic ulcer, although the stomach is otherwise normal. Sometimes NUD is marked more by a feeling that the stomach is not emptying quickly enough. Food seems to linger too long, leading to fullness, swelling and gassiness. These symptoms can begin well before a meal is over…or up to two hours later. No one knows exactly what causes NUD, but studies point to disturbances in the muscular action o the stomach, duodenum or esophagus.
RX For troubled stomachs
While Maalox, Mylanta, Tums, Rolaids and other over-the-counter antacids are often helpful, it’s better to prevent indigestion in the first place. Prevention strategies…
Eat three square meals a day. Or, if you prefer, eat several small, light meals. Never skip breakfast or lunch with the intention of “making up for it” at the end of the day. Stuffing yourself at one sitting only increases pressure inside the stomach and with it, the possibility of reflux.
Don’t lie down too soon after eating. Reflux is more likely to occur when you’re lying down. So avoid late-night snacks and “siestas” during the day. If you must sleep immediately after eating, be sure to keep your chest elevated. Put several pillows under your mattress or put the head of the bed on blocks. If you crave a late-night snack, try drinking a cup of herbal or decaffeinated tea fluids leave the stomach faster than solids.
Take steps to avoid constipation. It raises abdominal pressure, making reflux more likely. Eat fiber-rich foods…drinks plenty of fluids…exercise regularly…avoid tight belts or girdles…and keep excess weight off.
Avoid greasy or highly seasoned foods. Examples: curries, Szechuan dishes and dishes made with chili powder. If you’ve experienced indigestion after eating such foods in the past, be especially careful to avoid them.
If your discomfort persists, seek professional help. To help the doctor make an accurate diagnosis, prepare a detailed account of symptoms how long you have them and under what circumstances.
Examples: A gnawing or burning pain above the navel within one to three hours after eating can signal an ulcer. A thorough checkup should consist of a general physical exam, a blood and stool test and an upper GI with barium in the stomach and esophagus. In order to clearly see the esophageal lining, the doctor may perform an upper GI endoscopy in which he will use a viewing probe called an endoscope. Some prescription remedies are designed the irritating effects of reflux by suppressing stomach acidity or neutralizing the acid already secreted. Others clear the esophagus, strengthen its sphincter muscle and help empty the stomach in the proper direction.
A class of drugs called histamine 2 blockers, along with medications such as Prilosec, stop production of hydrochloric acid in the stomach especially overnight when it is most likely to accumulate and back up. The histamine 2 blockers Pepcid, Tagamet and Zantac are available over-the-counter, and help the pain of heartburn. If tests confirm full-blown esophagitis, caffeine, tobacco and alcohol must be strictly forbidden, along with aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). The suggestion on diet and sleep must also be followed rigorously, and prescription medications must be continued for months even after all symptoms have disappeared. The most striking new information about stomach ulcers is the discovery that the bacterium H. pylori, if present, must be eliminated by antibiotics to ensure that there will be lasting healing off the problem.