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Festivities are well under way, but don’t let indigestion or heartburn stop the fun. You can still enjoy the fizz, rich food and a Christmas chocolate or two (hundred) without the uncomfortable symptoms.
Dr Mark Cox, a Consultant Gastroenterologist at Spire Parkway Hospital, looks at the causes of indigestion, heartburn or acid reflux how we treat it and what we have to do to avoid it altogether this Christmas.
Firstly, how do you know if you have indigestion? There are several common indigestion symptoms:
- heartburn – a painful burning feeling in the chest, often after eating
- feeling full and bloated
- feeling sick
- belching and or passing wind
- bringing up food or bitter tasting fluids
What is indigestion?
Indigestion describe symptoms that are attributable to the oesophagus, stomach and small intestine. ‘The symptoms are often pain or discomfort aggravated by eating or drinking – the feeling of nausea after food or the sensation of being over full. Also heartburn and reflux can also be described as indigestion,’ says Dr Cox.
What causes indigestion?
It is classically caused by acid reflux disease, gastritis (inflammation of the stomach) or ulcers in the stomach or small intestine. ‘The stomach has natural defence against stomach acid but if this is damaged then problems can arise from naturally occurring acid,’ he explains.
‘The oesophagus on the other hand has no natural protection so acid refluxing out of the stomach into the oesophagus will cause symptoms. Helicobacter pylori – a bacteria frequently found in peoples stomach – can tip the balance towards damage from stomach acid.
‘Other things that increase stomach acid production can promote symptoms,’ he says. ‘These include smoking, acidic drinks such as wine, fruit juices and spicy food. Stress is another possible trigger.’
Are there any causes of indigestion that people aren’t so aware of?
‘The bottom of the oesophagus (gullet) has a muscle that tries to prevent reflux. However, this muscle can be relaxed by alcohol and, perhaps more surprisingly, by chocolate,’ he says. ‘Late night chocolate treats can classically results in nocturnal heartburn.’ With that in mind, it might be best to pass on the Christmas chocolate tin just before bedtime.
What about alcohol – are spirits more likely to bring on a bout of indigestion than beers or lagers?
All alcohol will relax the lower oesophagus and promote reflux, explains Dr Cox, however, fizzy, carbonated drinks, such as lager, are more likely to cause reflux, especially when drunk in larger volumes. ‘However all alcohol will cause some damage to the stomach so don’t believe the medical myth that you can use brandy to settle your stomach,’ he says.
Besides abstaining for alcohols and saying ‘no’ to tasty treats, what measures can people take to avoid indigestion?
Avoiding alcohol and tempting treats around Christmas time can prove difficult, but there are ways around it. ‘Eating and drinking a number of hours before going to bed is a good option, while smaller and frequent meals tend to help too,’ says Dr Cox. If reflux is the major issue at night time, he advises propping the head of the mattress on a couple of bricks helps increase the effect of gravity to reduce reflux.
Does a pint of milk at the start of the evening help or is that an ‘old wives tale’?
‘Funnily enough, while the pint of milk theory is another “medical myth” it is a fact that before the advent of modern anti-acid drugs, patients with ulcers were often treated with milk drips direct to the stomach,’ says Dr Cox.
If you do get indigestion what is the best way of treating it?
‘Modern drugs such as the PPIs (Proton-pump inhibitors, such a omeprazole) have transformed the management of indigestion by reducing acid production very dramatically,’ he says.
‘H2 blockers such as (ranitidine) reduce acid production. However, many of the over-the-counter remedies are only antacids that will neutralise the stomach acid for a relatively short period.’
When should you see a GP about indigestion and heartburn?
If you’re suffering with heartburn regularly, it’s important to book in with your GP for a check up. ‘If lifestyle issues and a short course or medicine (maybe two weeks of treatment) does not resolve the issue, then seeking medical advice is sensible,’ advises Dr Cox.