Ask the doctor: I suffer from indigestion. Do you have any tips on how to enjoy festive food without getting heartburn?

Question: I have general indigestion and want to enjoy my food over the holiday season without making my symptoms too bad. I generally stay away from foods that trigger it — coffee, rich foods, alcohol — but I really want to let go for a while. Do you have any tips? Foods I should avoid, products I could buy?

Answers: Indigestion (or heartburn) is typically described as a burning sensation in the central chest area, most commonly occurring after eating a large meal. It may be accompanied by regurgitation, which is the flow of refluxed stomach contents into the mouth/pharynx. Often the excesses associated with western life tend to produce indigestion, especially at this time of year. However, in some people there may be an element of disease that makes it worse.

The most common condition that causes frequent and regular (chronic) heartburn is gastroesophageal reflux disease (GERD). Diagnosing GERD can be difficult because there is no direct relationship between symptoms and the severity of the condition. Therefore, patients with evidence of GERD during a camera test in the stomach — known as a gastroscopy — do not always complain of heartburn. Conversely, heartburn is not always severe enough to suggest the presence of GERD

Generally, severe GERD is accompanied by other associated symptoms, including difficulty swallowing, chest pain, flushing, globus sensation, pain on swallowing, chronic cough, hoarseness, wheezing, and occasionally nausea. Difficulty swallowing can be caused by chronic heartburn, when the esophagus becomes inflamed, known as esophagitis. Chronic esophagitis can cause the formation of a narrowing, ulcer, or even precancerous changes in the lower esophagus known as Barrett’s esophagus. The presence of vomiting, abdominal pain, difficulty in swallowing or pain on swallowing, particularly if these symptoms are progressively worsening, and/or associated fatigue (due to anaemia) or unexplained weight loss (due to loss of appetite due to abdominal pain). ) urgently need to be evaluated.

Another condition that can cause heartburn is a stomach infection caused by the bacterium Helicobacter pylori (H. pylori). It is the most common chronic bacterial infection in humans, with the prevalence of infection increasing with age. In mild cases of persistent heartburn, noninvasive tests, such as a urea breath test, can be done to check for the presence of H. pylori. In more severe cases with multiple symptoms, it is best to have a camera test in the stomach (gastroscopy).

To put things in perspective, heartburn alone is a very common symptom and is usually benign unless accompanied by other symptoms. Most episodes of heartburn are brief and may not cause symptoms, esophageal injury, or other complications. Gastroesophageal reflux becomes a disease when it either causes macroscopic damage to the esophagus or causes frequent and regular symptoms. Initial treatment for simple digestive disorders includes lifestyle intervention and medication. Losing weight in patients who are overweight or who have recently gained weight may help improve symptoms. For patients who have heartburn at night or have symptoms such as coughing, hoarseness, and clearing their throat, elevating their head (proper support), avoiding lying down after meals, and fasting for at least 2-3 hours before bedtime help to relieve symptoms.

You’ve already mentioned some dietary triggers, but surely cutting out caffeine, chocolate, spicy foods, high-fat foods, carbonated drinks, and peppermint can improve symptoms. In terms of medications, proton pump inhibitors (PPIs) are the most effective inhibitors of gastric acid secretion and are most effective when taken 30-60 minutes before the first meal of the day. PPIs should be administered daily rather than as needed because continuous therapy provides better symptom control. When taken in standard doses for eight weeks, they’ve been shown to relieve symptoms of GERD and cure esophagitis in over 85 percent of patients.

dr Jennifer Grant is a GP at Beacon HealthCheck Ask the doctor: I suffer from indigestion. Do you have any tips on how to enjoy festive food without getting heartburn?

Fry Electronics Team

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