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What does your gut tell you?
A TUMMY ACHE MAY SEEM COMMONPLACE AND MINOR – UNTIL YOU YOURSELF GET ONE. IT CAN DOWN YOU LIKE A HORSE’S KICK. DON’T LET A BELLY ACHE CRAMP YOUR STYLE, BY SWALLOWING A GOOD DOSE OF KNOWLEDGE.
Distressing dyspepsia Everyone experiences aches and pains every once in a while. But no pain debilitates more than abdominal pain. And for me, personally, nothing evokes such an overwhelming reaction as dyspepsia. Aside from the pain, I experience retching, palpitations, lightheadedness, and sweating. Dyspepsia is not really a disease, but a symptom. It is repeated pain in the upper abdominal area (the area from under the ribs to just above the navel), and is usually described as a feeling of fullness. It can also be felt together with belching, nausea, and heartburn. Heartburn is a symptom, like dyspepsia. The difference is that the sensation is that of burning instead of fullness. Dyspepsia is usually caused by stomach acid-related diseases. These include gastroesophageal reflux disease (GERD), gastritis, or early peptic ulcer disease. Once these diseases have been treated, dyspepsia usually goes away. However, over-thecounter antacids, especially those with simethicone, or domperidone, may work for mild dyspepsia. Antacids containing calcium carbonate may sometimes worsen dyspepsia.
A Slice of Orange is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes-Delfin Ivan Olegario, MD
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SEEK MEDICAL ATTENTION IMMEDIATELY IF YOUR DYSPEPSIA IS ASSOCIATED WITH THE FOLLOWING ALARM SYMPTOMS: • • • • • • •
• • • First episode at age 55 years old • or older Blood in vomit or stool (blood in stools may sometimes be indicated by black flecks, not fresh red blood) Pain or difficulty in swallowing • Loss of appetite Unintentional weight loss Abdominal swelling Repeated vomiting
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Relax (see Is it all in your head?) Avoid caffeine-containing drinks (see Cramps in a cup), alcohol and smoking. Avoid foods high in fats, which increase the bloated sensation. Avoid chocolates, peppermint, cabbage, cauliflower, broccoli, and acidic foods, such as citrus fruits and tomatoes/tomatobased foods. Avoid milk and milk-based foods. It is a myth that milk can neutralize acid. In fact, the calcium in milk may increase acid.
IF YOU EXPERIENCE DYSPEPSIA, YOU MAY PREVENT MOST EPISODES WITH THE FOLLOWING MEASURES: •
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Some people get dyspepsia after eating spicy food, but this is not true for all patients with dyspepsia. GETTING TO THE GUT OF THINGS As mentioned, dyspepsia is commonly caused by GERD, gastritis, or peptic ulcer disease.
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Is it all in your head?
Abdominal pain is one of the most common psychosomatic symptoms— symptoms that are, well, all in your head. Mere stress or intense emotions can get your gut grumbling and grinding. This is because psychological stress can: • • • •
Avoid eating to fullness. Eat small, frequent meals instead. Do not eat 3 hours before sleeping. Do not skip meals.
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Increase acid secretion Paralyze the muscles of the gut Weaken the acid defenses of the gut Trigger the brain’s vomit reflex
If you feel that your abdominal pain is caused by stress, the best treatment is relaxation. Learn time-management. Prioritize. Don’t sweat the small stuff (nobody’s perfect). Learn to focus on solutions and not problems. Give yourself a treat. If all else fails, see a psychiatrist or a therapist. Stress and anxiety are legitimate medical concerns, and there are several treatment strategies and medications that can help you cope.
GERD is damage to the lining of the esophagus, which happens when acid from the stomach refluxes back to the esophagus. If untreated, GERD can lead to permanent damage to the esophagus, as well as laryngitis, asthma, tooth erosion, and sinusitis.
Peptic ulcer is an erosion of the lining of the stomach and intestines. Like gastritis, it may be caused by steroids and painkillers. But 80% of peptic ulcers is caused by the bacterium, Helicobacter pylori. A simple urea breath test, available in most big hospitals, can tell if this infection is present.
Gastritis is inflammation of the lining of the stomach. It is caused by excessive intake of alcohol, steroid medications, or painkillers such as aspirin, ibuprofen, mefenamic acid, or naproxen.
About 4% of stomach ulcers are caused by gastric cancer. Untreated peptic ulcers can lead to life threatening conditions, such as massive bleeding or perforation of the stomach or intestines.
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The best way to diagnose GERD, gastritis, and peptic ulcers, is through a procedure called endoscopy. This is most appropriate for frequent, moderate to severe cases, or those with alarm symptoms as described above. In this procedure, a thin, flexible tube with a video camera at the end is swallowed and threaded down into the esophagus, stomach, then intestines. The endoscopist can then see the lining of these organs through the camera. It can be performed on an out-patient basis, under mild sedation.
If these simple measures don’t work, these can be treated with acid-suppresants, prokinetics, and if H pylori is a culprit, a combination of antibiotics and mucosal protectants. All these medications require medical supervision and may only be taken under prescription.
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In rural areas, diluted warm coffee is used to treat tummy aches: a big no-no. Caffeine from coffee, tea, energy drinks, and soft drinks are potent stimulators of gastric acid secretion. Avoid these if you have a history of dyspepsia, heartburn, or peptic ulcers.
For severe cases, surgery may be required. But acid-reflux diseases display symptoms early. Severe disease means only one thing: you ignored your symptoms before seeking medical attention. Don’t let these seemingly simple gut problems get in the way. If you have alarm symptoms, or the simple steps we recommended here do not seem to work in the span of 2 weeks, visit your doctor.
Looking to enhance your corporate healthcare benefits? E-mail us at benefits@activelink-consult.com. The information in this newsletter is not intended as a substitute for professional medical care. Consult a doctor for all matters relating to your health, particularly for symptoms that may require diagnosis or medical attention. © 2010 ActiveLink
Benefits Made Better
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Cramps in a cup
GOOD GUT FEELING The best treatment for these acid-related diseases is the avoidance of its triggers, as described above (see Distressing Dyspepsia).
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ActiveLink 7/F Electra House Building 115-117 Esteban St., Legaspi Village, Makati City www.activelink-consult.com
So what do you do instead to keep yourself awake and alert? Give your body a mild dose of adrenaline instead, by doing exercises in your work station. Stand up, stretch, touch your toes. Mental exercises can also do wonders. Here’s a suggestion. Assign a number to each letter of the alphabet (a=1, b=2, c=3...). Choose any word, and first, guess the sum of the numbers corresponding to the letters. Next, do the math, and see how far your guess was to the actual sum. Practice makes perfect.
The Orange wants to he ar from you! Dying to ask us your health related questio ns? Itching to share your pe rsonal health tips? Want to sugg est topics for future issues? Feel free to contac t us. You can e-m ail our team at orange@activ elink-consult.c om.