HEARTBURN OR MORE?
By "DocNurse" Norma Stephens Hannigan
Everyone gets a little indigestion (heartburn) from time to time. It’s such a common problem that we even see commercials for Pepcid AC on television and can buy similar drugs like Prilosec and Prevacid (these medicines as a group are called PPIs) over the counter. Unfortunately, sometimes it is more than just a little indigestion – in fact, one of the causes of indigestion can lead to stomach cancer and should be treated with medicines other than those sold over the counter. A heart attack can also sometimes be confused with indigestion.
Some of the possible causes of feeling bloated, burping a lot and having a burning sensation in the upper abdomen/stomach area can include dyspepsia, gastroesophageal reflux disorder (GERD), peptic ulcer and/or Helicobacter Pylori (H. Pylori) infection. Some of these conditions can be serious, so it is important to know what is causing your problems.
Indigestion can be caused by a variety of things. According to the National Digestive Diseases Information Clearinghouse, “It results from eating too much, eating too quickly, eating high-fat foods, or eating during stressful situations. Smoking, drinking too much alcohol, using medications that irritate the stomach, being tired, and having ongoing stress can also cause indigestion or make it worse.” Interestingly, one of the commercials advises you to take their product before overeating, rather than advising you not to overeat. If any of these things are the cause, stopping them can usually make the indigestion go away. The common medicines that irritate the stomach are pain killers like Motrin or Advil (ibuprofen).
Sometimes people have a bacterium in their stomach that can cause a peptic ulcer which makes them have the same symptoms as indigestion. Often, the person takes a medicine like the ones mentioned and, for the time they are taking it, their discomfort is eased. However, as soon as they stop taking the medicine, the burning, gnawing feeling and bloating return and they feel miserable again. In this case, there is a possibility that the person has Helicobacter Pylori infection. This is a common infection; many people carry the bacteria, but not everyone gets sick from it.
It is not known why some people get sick and others don’t. Although it is not well understood, scientists believe that the bacteria spread through fecal contamination from one person to another. That is to say, when you don’t wash your hands after using the bathroom, you can share your unhappy bacteria with others. The bacteria can cause an ulcer in the stomach or beginning of the intestine. An ulcer is a little crater, like a sore you might see on your skin. Since it is an infection, taking medicines for acid indigestion only helps with the symptoms but does not get rid of the root cause of the discomfort.
To completely get rid of the H. Pylori, a person must take either three or four different medications, including antibiotics. The only way to find out if you have this infection is to see your health care provider and discuss a special test to check for the bacteria. The best tests are the Urea Breath test and the Stool Antigen test. Your health care provider will either do it in the office or give you a prescription to go to a laboratory to have it done. There is a blood test, but this is not the most accurate way to test and, unlike the other two tests mentioned, cannot determine if you have been cured from the infection in the future.
An important reason to be checked if you have symptoms of indigestion is because the H. Pylori bacteria, if left untreated, can cause stomach cancer. Most of the symptoms of stomach cancer are the same as those of indigestion or ulcer and can be very subtle. Red flag signs and symptoms of stomach cancer include weight loss (without trying to lose weight), a feeling of fullness before you have eaten very much, and nausea and/or vomiting.
But let’s say you have the test for H. Pylori and it is negative – you don’t have the bacteria. Another possible cause for your discomfort is gastroesophageal reflux disorder (GERD). This condition occurs when the muscle at the top of the stomach that acts like a valve is not preventing the acid in your stomach from heading north into the esophagus (the tube where the food slides down and drops into your stomach). In the case of GERD, some very simple steps can be taken to prevent your indigestion: 1) Eat small meals more frequently instead of three large meals a day; 2) Don’t lie down after you eat until a few hours have gone by; 3) Avoid any foods that you know give you these symptoms – for some people it’s spicy food, for others it’s fatty food; 4) If you are overweight, lose weight – your belly may be pushing up against your stomach forcing the acid up and out; and 5) Avoid tight clothing around the abdomen. If you still need medicine, taking an over the counter PPI should do the trick.
Sometimes a person who is having a heart attack will complain of symptoms like indigestion – especially women. If you are a person who generally does not suffer from stomach upset and indigestion but suddenly develop it, you should be thinking about the possibility of a heart attack. This is especially true if you have risk factors for heart disease like being overweight, a family history of heart problems, you are a smoker, or you have already had a heart attack.
Another ailment that is often thought to be merely indigestion is a bleeding ulcer. Some signs that this might be happening include black stools, severe stomach pain that doesn’t go away, and vomiting fluid that looks like coffee grounds. If one or both of these last two symptoms occur, this is an emergency – call 911 (or whatever your local emergency number is)! Many times people say they would feel foolish calling an ambulance and going to the emergency room only to find out they had heartburn. Better to live long enough to feel foolish, don’t you think?
So, get on the road to better stomach health by doing all those things we’re supposed to be doing anyway – eat right, exercise and lose weight! And if you continue to have recurring heartburn, even after addressing the points I have made in this article, get checked out by your health care provider. It is always better to be safe than sorry!
~ Dr. Norma Stephens Hannigan, who recently graduated with a Doctor of Nursing Practice degree, teaches at Columbia University in New York and has treated many truck drivers at the various clinics she has worked over the years. She currently writes from her home in Newburgh, New York.