Got upset stomach, dyspepsia or ulcers?

Some time ago, I was fortunate enough to have interviewed two outstanding doctors on our program. They were 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 things we tackled.

Three causes of ulcers

Dr. 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 (NSAID) for pain such as mefenamic acid and the like.

Dr. Ramon Estrada said that a certain bacteria, called 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 Helicobacter pylori) and to give anti-acid treatment 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 foods or taking in too much food do not necessarily aggravate ulcers. As an expert gastroenterologist, Dr. Gloria’s practical advice to the public is “moderation in everything,” which means not to take too much of anything, like alcohol and fatty foods. The second advice is “as tolerated.” If you can take it in, and feel no pain, then that’s all right. 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 ulcers

One thing emphasized by Dr. Gloria is that dyspeptic symptoms, such as heartburn and any discomfort in the epigastric area, do not mean one has an 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

Dr. Gloria stressed the need to watch out for alarm symptoms. Patients experiencing weight loss, loss of appetite, bleeding or vomiting should be immediately checked with a gastroscopy. Patients over 50 years old should ideally also undergo gastroscopy to rule out stomach cancer, which is treatable if caught early.

Dr. Estrada said that most Japanese have a gastroscopy yearly, starting from their 40th birthday. This is because of the high incidence of stomach cancer in Japan.

Because of the difficulty in differentiating the milder problem of dyspepsia from an ulcer, Dr. 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.

Dr. 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 is good for 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 the bangungot syndrome, which is probably due to acute pancreatitis.

9) Do regular exercise to help 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.