The Ins and Outs of Indigestion

I remember succinctly during my Intern year training, developing a severe burning epigastric pain that radiated up my chest.  I doubt it had anything to do with stress, but rather the awesome breakfast Carne Asada burritos.  For all those great breakfasts, I paid dearly by taking Nexium for the next 2 years.

Indigestion, or dyspepsia (our medical term) can be caused by several reasons.  Improper stomach emptying may increase acid buildup.  Sometimes OTC pain meds such as Advil or Motrin, and Tylenol can cause it. 

Some people get ulcers in their stomach or intestines from H. Pylori (Helicobacter Pylori).  An infection from this bacteria can cause indigestion.  This is one of the bacteria that can actually cause gastric carcinoma.

Sometimes indigestion can be a sign of something serious like gallstones, or rarely, cancer.  Be on the look out for other signs of serious illness like: weight loss, anemia, loss of appetite, trouble swallowing, frequent vomiting, and indigestion symptoms that begin after age of 55.  Schedule an appointment asap if any of these symptoms appear.

We know what causes indigestion, now what do we do about it?  First off, you should stop taking OTC pain meds.  Drink less alcohol, quit smoking, and changing diet may help.  Fatty fried foods relax the lower esophageal sphincter which is the muscle that closes off the stomach acid from irritating your esophagus.   Try to avoid foods that make symptoms worse, like the wonderful Carne asada burritos I devoured, or spicy foods.  Indigestion can be worse if you are stressed or depressed.  Doctors can help you find healthy ways to cope with stress or talk to you about treating depression.

If you have pain or burning, doctors may recommend medicine such as ranitidine, or omeprazole.  Omeprazole is a proton pump inhibitor (PPI) which is really too strong to be treating acid reflux.  I tell patients, it’s like killing a fly with a shotgun.  Recently a new disease has emerged secondary to chronic use of PPIs.  It is called Gastric Rebound disease. 

A little acid is good, to kill all the bacteria, viruses, and parasites we swallow with our food.  But when our stomach is not making acid, it produces more and more acid producing cells.  So when you take away your meds, the acid overflows and worsens any reflux symptoms.  A proper weaning protocol is essential to getting completely off PPIs and using them only as needed. 

There are other meds that may help if you feel bloated or full.  If you have a bacterial infection you may need antibiotics.  Schedule an appointment if you feel any symptoms that are not going away.  Thanks again for all the questions!  Be safe and healthy!