Indigestion

Indigestion, medically known as dyspepsia, is a condition that includes symptoms like a feeling of fullness while eating, an uncomfortable feeling of fullness after a meal (as if you have overeaten) and a pain or burning sensation in the upper abdomen. You get indigestion from a disorder in the digestive tract, when the stomach acid flows back up the oesophagus. This makes the stomach lining sore and irritated and hence the pain and heartburn. In this condition, the valve or the sphincter at the top of the stomach does not function efficiently. It is called the gastro-oesophageal reflux disease (GORD). Sometimes you cannot trace the causes of indigestion in people and this is known as functional dyspepsia. Underlying medical conditions like peptic ulcers, abnormalities in the bile ducts or pancreas, and in rare cases stomach cancer can lead to dyspepsia. To find the exact causes of indigestion, doctors may require blood and stool samples for testing, X rays and an endoscopy with biopsies to analyze the causes. Decreasing stress levels and making certain lifestyle changes can bring you relief from the condition.

Symptoms of Indigestion

Indigestion is something that almost all of us have experienced at some point, yet it's never easy to describe or summarize the experience.

• The most characteristic indigestion symptom would be the feeling of uneasiness and a fullness in your chest and stomach soon after your meals, although sometimes there can be a delay between indigestion and eating or drinking.
• Heartburn is the next indicator of indigestion and involves a strong pain behind the breastbone (sternum) when digestive acids escape from stomach, travelling up the esophagus or gullet. Heartburn isn't necessarily accompanied by vomiting, but at times it may be.
• The other indicators are bloating and belching, and burping.

Indigestion in the elderly can be accompanied by more serious health problems. You should seek medical advice if you are over 55 years and have recurring indigestion. The following are some of the additional health disorders that should be treated immediately if they occur with chronic indigestion in old age:

• You unintentionally lose a lot of weight, find it difficult to swallow (dysphagia) and have persistent vomiting.
• If you have vomited blood or have passed stools with blood, you have gastrointestinal bleeding (bleeding in the stomach and intestines) that needs immediate medical attention. This condition will make you feel dizzy and tired.
• If you suffer from iron deficiency anemia (where the red blood cell count decreases because the body lacks the iron needed to produce them) and suffer from fatigue, irregular heartbeat and breathlessness, you should get yourself checked.
• Chronic or recurring indigestion should be checked through an endoscopy procedure for any lumps that may have formed inside the stomach.

Chronic and recurring indigestion in elderly people along with the above stated conditions can be a cause of concern because in some cases these are indications of a stomach cancer.

Causes of Indigestion

There are various possible causes for indigestion and dyspepsia.

• Indigestion causes are from digestive tract disorders like gastroesophageal reflux disease (GERD) and other abnormal conditions in the stomach.
• Indigestion can be triggered by conditions in the stomach such as irregularities in the pancreas or bile ducts, peptic ulcers in your duodenum and in worst cases, stomach cancer. However, since the conditions are inter related, the symptoms of indigestion improves if these conditions are treated and resolved.

There are certain underlying medical conditions that cause indigestion.

• Peptic ulcers occur when the lining of either the stomach or the first part of your small bowel, called the duodenum is damaged and becomes inflamed. There is a mucus layer in your stomach, esophagus and bowel walls that act as a protection against the strong stomach acids that acts on the food, helps digest it and protect it from infection. When this mucus layer gets disturbed, or is damaged; the strong stomach acids irritate the tissues underneath. Peptic ulcers are caused by a bacterium that lives in the mucus layer of the stomach, called Helicobacter pylori (H. pylori).
• Hiatus hernia can trigger heartburns. A part of the stomach or sphincter slides up to your chest cavity when you have hiatus hernia, and this causes reflux.
• Pregnancy increases the levels of female hormones progesterone and estrogen in the body. These hormones relax the sphincter muscles causing indigestion and heartburns in pregnant women.
• There is a category of indigestion, called functional dyspepsia where the indigestion occurs in the body without any cause. It is thought to affect the area where the small intestine meets the stomach. The indigestion may be because of abnormalities or a disorder in motility. Motility is the squeezing and relaxing action of the muscles in the stomach when it receives, digests and pushes the food into the small intestine.
• Indigestion is a side effect of certain medications like aspirin and anti-inflammatory medicines needed to treat arthritis.
• Indigestion causes can be linked with its remedies if you can make certain lifestyle changes. Some of the trigger symptoms of indigestion are too much smoking, intake of excessive alcohol and anxiety and stress. You can control indigestion by avoiding these.
• Certain pleasure foods like chocolates and caffeine relax the sphincter at the joint of the oessophagus and stomach and directly irritate the lining of the oesophagus.
• Obesity or being overweight increases the pressure on your stomach and make you feel like you are suffering from indigestion. Regular exercises and a walk after your meals help in settling the food down and reduce reflux.

Remedies for Indigestion

Indigestion remedies are linked with several factors, so you will have to consciously make some lifestyle changes along with the use of appropriate medications to get rid of your indigestion. There are several home remedies for indigestion that can help relieve the condition, some of which have been backed by scientific studies.

• Refrain from smoking or from consuming aerated drinks, coffee and alcohol.
• Eat in small quantities throughout the day and avoid fatty foods that are hard to digest.
• Stop using medications that aggravate the condition by irritating the stomach lining; like aspirin and anti-inflammatory drugs. If any such medications are being used to treat an existing condition, consult with your doctor for alternatives.
• Avoid emotional and physical stress. You can take up physical or meditative practices to combat stress, such as yoga or even swimming.
• Get enough sleep at night and try to rest as much as possible during the day.

According to many natural health enthusiasts some of these home remedies for indigestion could help. Like many other claims from natural health enthusiasts however, many of these are not subjected to rigorous testing and may prove ineffective.

• Drink half a glass of pineapple juice after eating.
• Apply an ice bag over your stomach, half an hour after eating.
• Add two spoons of coriander juice to a glass of buttermilk and drink when dealing with indigestion.
• Mix a spoon of lemon and ginger juice and two spoons of honey with lukewarm water and drink the concoction.
• Drink a cup of ginger tea after meals to avoid heartburn and nausea.
• Chewing a fresh garlic clove with some salt five to ten minutes before eating stimulates digestion

You may be prescribed over the counter medicines and antacids as acid indigestion treatment. These medications will provide you with acid indigestion relief by helping the stomach move food rapidly into the small intestine. You should not use these nonprescription medications over a length of time without consulting your doctor.

• Antacids like Maalox, Alka-Seltzer, Rolaids and Riopan are usually the first prescribed drugs for acid indigestion relief. The concept of the antacids is to combine three different salts, calcium, aluminum and magnesium with hydroxide and bicarbonate ions to neutralize the acid in the stomach. Antacids have side effects and can cause diarrhea or constipation.
• H2 receptor antagonists, known as H2RAs are famotidine (Pepcid), nizatidine (Axid), ranitidine (Zantac) and cimetidine (Tagamet). H2RAs reduce stomach acids and work slowly in improving digestion. The side effects include constipation, diarrhea, unusual bleeding or bruising and, vomiting, headache or nausea
• Proton pump inhibitors (PPIs) are rabeprazole (Aciphex), omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), esomeprazole (Nexium) and pantoprazole (Protonix). PPIs are stronger than H2RAs and treat indigestion by reducing stomach acid. PPIs are most effective in treating people suffering from GERD. Side effects of PPIs are abdominal pain, back pain, cough, dizziness, gas, nausea, vomiting, headache, constipation, and diarrhea.
• Prokinetics like metoclopramide (Reglan) is used to treat people who have problems with the stomach emptying too slowly. This medicine also improves the muscle action in the digestive tract. Prokinetics however have several side effects that limit its usefulness. Sleepiness, fatigue, anxiety, involuntary muscle spasms or movements and depression.

Diet for Indigestion

Dietary considerations are particularly relevant in the treatment of indigestions, as this directly influences the condition. You need follow a strict diet and incorporate some eating habits if you want to get rid of indigestion.

• Eat lots of fruits. Fruits should be included in your diet in the whole form and processed juices avoided since they are more acidic. However, avoid acidic foods like citrus fruits, onions, tomatoes if these trigger off heartburns.
• You should avoid all junk foods, fatty, fried foods, spicy foods like pickles, curries and so on. Avoid drinks with caffeine like carbonated drinks, coffee, peppermint, chocolate, alcohol and quit smoking.
• Eat regularly and do not miss meals.
• Eat small meals at regular intervals as they are better tolerated and easier to digest.
• Avoid eating large meals, especially at night.

Suggestions for Indigestion

Maintaining a regular exercise routine is good for digestion. You should walk at least thirty minutes in a day. However, you should not indulge in any rigorous physical activity immediately after your meal. A brisk walk at night after your meal will help with digestion. Try and maintain regularity with your meal times, and serve yourself smaller portions. Heavy meals are typically a lot harder to digest. Kids are always told to chew their food thoroughly and this bit of advice is just as important to all of us. Digestion begins the minute you begin chewing, because the food is being broken up and your saliva begins to work on it.

References

1. van Nieuw Amerongen A, Veerman EC. [Role of saliva during mastication]. Ned Tijdschr Tandheelkd. 1995 Nov;102(11):441-2. Dutch. PubMed PMID: 11837086.