Tips for stomach upset, dyspepsia and ulcer

Some time ago, I was fortunate to interview two outstanding doctors in our program, Dr. Venancio Gloria, past president of the Philippine College of Physicians, and Dr. Ramon Estrada, past president of the Philippine Society of Colon and Rectal Surgery. We discussed stomach problems and answered dozens of phone-in questions. Here are some of the tips:

Three causes of ulcer

Gloria said that stomach ulcers can be due to: 1) too much acid produced by the stomach, 2) a bacteria called Helicobacter pylori and 3) intake of non-steroidal anti-inflammatory drugs for pain such as mefenamic acid and the like.  Estrada said that the bacteria Helicobacter pylori has been found to cause ulcers. A recent strategy used for young patients with dyspeptic symptoms is to do a breath or blood test to detect the presence of the bacteria. Anti-acid treatment is given for patients with dyspepsia symptoms. If the patient is positive for the bacteria, then a course of antibiotics is given to eradicate Helicobacter pylori.

Two secrets to a healthy stomach

Recently, doctors questioned the belief that certain foods cause ulcers. Drinking calamansi juice, eating spicy food or taking in too much food does not necessarily aggravate ulcers.  As an expert gastroenterologist, Gloria’s practical advice to the public is “moderation in everything,” which means not to take too much of anything, like alcohol and fatty food. Second is “as tolerated.” If you can take it in and feel no pain, then that’s alright. There’s no need to limit certain types of food. Only two things are sure to aggravate ulcers: smoking and NSAID intake.

Dyspepsia does not mean you have an ulcer

One thing Gloria emphasized is that dyspeptic symptoms, such as heartburn and any discomfort in the epigastric area, does not mean one has ulcer. Ulcers can have no symptoms whatsoever. People with Type O blood are prone to have ulcers while those with Type A blood are prone to develop stomach cancer.

Watch out for alarm symptoms

Gloria emphasized the need to watch out for alarm symptoms. Patients with weight loss, loss of appetite, bleeding or vomiting should be immediately checked with a gastroscopy. Patients over 50 years of age should ideally also undergo gastroscopy to rule out stomach cancer, which is treatable if caught early.Estrada said that most Japanese have a gastroscopy yearly starting from their 40th birthday. This is because of the high incidence of stomach cancer there.

Because of the difficulty in differentiating the milder problem of dyspepsia as compared to an ulcer, Gloria believes most patients with dyspepsia will at one time or another need a definitive diagnosis. Because of the recurrence of dyspeptic symptoms, patients may be better off finding out once and for all if they have an ulcer through a gastroscopy. Estrada commented that gastroscopy is a safe and simple procedure. The doctors also advocated the use of both an ultrasound of the upper abdomen and a gastroscopy to diagnose most cases of epigastric pain.

10 tips for a healthy digestion
1. Eat more slowly. Take your time and don’t rush.
2. Chew your food. For the elderly, you can cut your food into little pieces.
3. Eat more fiber, like vegetables, fruits and cereals. Vegetables and fruits contain healthy fiber which are good for the digestion. Fiber promotes bowel movement and helps prevent bowel cancer. A common bowel disease called diverticulosis results from eating too little fiber. Vegetables like okra, kangkong and cabbage are rich in fiber. Fruits rich in fiber are apples with the skin, and oranges with the membrane in-between.
4. Eat five or six small meals a day. Eat regularly and on time.
5. Sit down when eating. Eat in a relaxed and peaceful environment.
6. Don’t believe in fad diets and avoid binge eating. Choose healthy foods over junk foods.
7. Drink eight to 10 glasses of water a day. The correct way to drink water is to sip it little by little throughout the day. Don’t gulp down two glasses at once.
8. Take a stroll after eating. It’s good for your digestion. After a full meal, take a 15-minute leisurely walk. By staying upright and helping gravity push the food down, you are helping in your digestion. You’ll also avoid becoming a victim of “bangungot syndrome,” which is probably due to acute pancreatitis. So take our advice: Don’t go to sleep right after eating a heavy meal. Take a stroll.
9. Doing regular exercise helps promote the movement of food in the digestive system.
10. Finally, be careful with what you eat. Know who prepared your food and check whether it’s clean or not.