We are society that is constantly obsessing about what we are or are not putting in our mouths. Obesity and other eating disorders are at an all-time high in Western culture, mostly because we live in a society that is wealthy in terms of the availability, diversity and affordability of food. This gives us choices. Aide from poverty, the only thing that restricts our consumption of food is our own health.
For millions of North Americans, and the number is growing every year, concerns about eating are not restricted to what we feel like or dinner or caloric intake. For millions of people suffering form gastrointestinal disorders, eating can be one of the most painful parts of the day. While there are a number of factors (what we are eating, how much we are—or are not—eating, for example), for many, the issue is a chronic gastrointestinal condition, the most common being Gastroesophageal Reflux Disease (GERD) and peptic ulcers.
In order to recognize if the stomach problems that `are interrupting your eating, and probably even your sleeping patterns, are chronic and treatable, you must be able to recognize the symptoms and know when to go for help.
When the Lower Esophageal Sphincter (LES: the plug between your stomach and your esophagus) does not close properly, stomach contents, including painful and damaging acid, can leak back up into the esophagus, causing a condition called Gastroesophageal Reflux Disease. While your stomach lining has a mucus membrane that protects it from the powerful acids required to break down food, your esophagus is not as well equipped. Persistent acid reflux (the term for the acid squeezing back up into your esophagus) causes daily discomfort and pain in the from of heartburn and acid indigestion, and it can also cause long-term damage to the cells in the throat. This can lead to several dangerous conditions in the future, including esophageal cancer.
The common symptoms to look out for when assessing whether you have GERD, as opposed to simply occasional indigestion, are any combination of the following:
- Persistent heartburn (more than twice a week). Heartburn is characterized by a burning or discomfort in the chest, behind the sternum, or in the base of the throat;
- Acid indigestion, which is characterized by a persistent acidic taste in the throat;
- Hoarse voice in the morning;
- Trouble swallowing, or a choking feeling as though something is stuck in your throat (like a large pill);
- Persistent bad breath.
Other, less common symptoms include a change in your voice, chronic ear aches or sinusitis. If you are experiencing any of these symptoms more frequently than once a week, you should go to your doctor and have him or her check you out. Most doctors will be well familiar with the symptoms of GERD (due to its increasing diagnosis), and will probably diagnose you based on your anecdotal symptoms. Treatment is fairly successful, as long as your doctor hits the right combination for you.
You doctor will likely ask you to make some lifestyle changes. The most common, and most influential changes will be to lose weight if you are overweight, the quit drinking and smoking, to refrain from eating 2 hours before you go to bed, and to make some diet adjustments. The following foods can exacerbate GERD: acidic or acid-stimulating foods (citrus fruit, tomatoes, garlic and onion), caffeine (in chocolate, coffee, tea), fatty or fried foods (which slows digestion), spicy foods, and mint flavourings.
One of the best ways to combat acid reflux at night is to elevate the head of your bed 6-8 inches. Exploit gravity to keep those acids flowing downwards instead of back up!
Aside form lifestyle changes, you might need to get on some medication in order to neutralize stomach acid and allow the esophagus to heal. This could be any combination of over-the-counter antacids, which raise the pH of the acid to make it less harmful; foaming agents, which lay a layer of foam over the stomach contents to keep it at bay; H2 blockers or proton pump inhibitors, which impede acid production at the source; and prokinetics, which work to strengthen the sphincter and get the stomach moving to process food and get it out.
In extreme cases of GERD, or cases that have gone untreated for a long time, these basic treatments might not help, and further testing, such as a barium x-ray or an endoscope may be employed to see if there are other factors going on. You may be suffering from another of the more common stoach problems: peptic ulcers.
For the vast majority of the past century, it was believed that peptic ulcers were caused by stress or spicy foods. While these two factors can certainly exacerbate the symptoms you are experiencing, it is now commonly known that the two primary causes of peptic ulcers are: a bacteria called Helicobacter pylori (or H. pylori for short), which is believed to be the culprit in almost 80% of cases, and nonsteroidal anti-inflammatory drugs like aspirin or ibuprofin. Both of these culprits weaken the stomach lining, allowing powerful stomach acids to bore into the walls of the stomach or duodenum (the first part of your small intestine, directly under the stomach).
If you have an ulcer, you will most likely be experiencing the following symptoms:
- Abdominal pain, with increased severity around mealtimes or at night (if your ulcer is in your stomach, it will be exacerbated by eating, while if it is the duodenum, pain will be relieved by eating);
- Weight loss or loss of appetite;
- Vomiting (watch especially for blood in your vomit or in your feces).
If you have blood in your vomit or in your feces, see a doctor immediately. This could be a sign that the ulcer has perforated the lining of the stomach, that it has broken a blood vessel, or that your food is not moving through your stomach or duodenum.
Now that the we know why an ulcer forms, treatment is much more successful. Doctors will usually give you a cocktail of two antibiotics (to fight the H. pylori) and a proton pump inhibitor to prevent the production of stomach acid. By neutralizing your stomach acid and clearing up the bacteria, the sore on your stomach or duodenum lining should be able to heal and you should have no more problems, barring a recurrence of the bacteria. As with any bacteria, take your full dosage of antibiotics, or the entire treatment may be pointless. Bacteria must be completely killed to prevent a recurrence.
The good thing that might come out of suffering any type of gastrointestinal condition is an examination of your eating habits. Whether or not you suffer from any of the life-altering symptoms of GERD or ulcers, there are several things you can incorporate to prevent future stomach problems: eat healthy; exercise to promote good digestion; cut back on the booze, smokes and caffeine; and eat smaller meals several times a day to give your digestive system less of a workout all at once. Once you have suffered the symptoms of gastrointestinal pain, you will never want to go back.