Do not ignore heartburn

Apr 17, 2007

YOUR great day may be disorganised by a nagging heartburn. It can also be a symptom of a bigger problem like peptic ulcers or hiatus hernia, if it persists. Medics say it is a symptom of indigestion.

By Louis Mwijuka

YOUR great day may be disorganised by a nagging heartburn. It can also be a symptom of a bigger problem like peptic ulcers or hiatus hernia, if it persists.

Dr Lawrence Turyomunsi, a gastroenterologist in Kamwokya, says it is a symptom of indigestion.

Turyomunsi says indigestion usually happens when people eat too much, too fast or when they consume foods that do not ‘agree’ with them.

“Heartburn is a burning feeling that travels from your stomach up to the throat. It is caused by stomach acid, which isn’t a problem unless it gets out of your stomach.”

He says when the stomach acid splashes up, it irritates the oesophagus (the tube that carries food from the mouth to the stomach). Other forms of indigestion include nausea, which is the sensation that precedes vomiting, and constipation.

Causes

The main symptoms of indigestion are heartburn, feeling bloated, uncomfortably full or having a lot of wind (burping).

Turyomunsi explains that the sphincter (muscle at the joint between the stomach and the oesophagus) relaxes to let food into your stomach and tightens to stop stomach acid from coming out and back up into the oesophagus. Sometimes it fails, which allows acid back up to cause the uncomfortable symptoms of indigestion.

“This may be caused by large amounts of pressure on the stomach, say after a big meal or because the sphincter isn’t working very well. Triggers include the following:
  • Eating a particularly large, spicy or fatty meal.

  • Eating foods which relax the sphincter such as chocolate or oranges.

  • Eating foods that directly irritate the lining of the oesophagus, such as coffee and tomatoes.

  • Smoking, which relaxes the sphincter and make acid reflux more likely.
  • Leaving a lot of time between meals.

  • Pregnancy; when the developing baby pushes the stomach upwards towards the oesophagus.

  • Peptic ulcers, which develop when the lining of your stomach or duodenum (first part of the small intestine) is damaged, exposing the sensitive tissue to irritating acidic juices, causing pain and discomfort.

  • Hiatus hernia where part of the stomach pokes through the diaphragm, stretching its muscles to stop the sphincter from closing properly.

  • Side effects from medicines, especially anti-inflammatory medicines, such as ibuprofen, diclofenac or aspirin and some antibiotics, such as erythromycin, metronidazole and corticosteroids.

  • Psychological factors like stress.


  • Solutions
    Turyomunsi says you don’t have to see a doctor unless it persists or occurs after eating healthy foods, exercising, and getting enough sleep.
    It could mean an indication of another problem in your digestive tract like peptic ulcers.
  • Find out which foods irritate your stomach and avoid them.

  • Eat small, regular meals with low fat content.

  • Avoid too much chocolate or many citrus fruits.

  • Give your body a chance to digest food. “Don’t eat a heavy meal and immediately go to do sports. Eat at least an hour beforehand or afterwards,” Turyomunsi says.

  • Cut down on the amount of alcohol you drink.

  • Lose weight. Being overweight can exert more pressure on the stomach, making it easier for stomach acid to be pushed into the oesophagus.

  • Stop smoking because it can reduce the strength of the sphincter.

  • Work on your stress, anxiety or depression with the help of counselling, anti-depressant drugs and removal of the stressing factor.

  • You need a comfortable posture when your body is trying to digest food. Sitting hunched forward in your seat, wearing tight belts or waistbands and lying down soon after a meal, may put more pressure on the stomach and trigger indigestion.

  • If you get indigestion symptoms at night, avoid eating or drinking for about three hours before you go to bed.
    Use a couple of pillows to prop your head and shoulders up and discourage stomach acid from moving up into the oesophagus.

  • Inform your doctor to change your medication if you think it is causing the problem.

  • You can use anti-acids for occasional bouts of indigestion, best taken when symptoms occur. They relieve symptoms by neutralising the acid in the stomach.
    However, they shouldn’t be taken at the same time as other medicines, because they can stop other drugs from being properly absorbed by your body and may damage the special coating on some tablets.

  • If symptoms persist, see a doctor to rule out more serious abdominal conditions for example cancer of the stomach or gall stone survey.
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