Stomach Issues

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GASTRITIS / DYSPEPSIA

‘Gastritis’ is a term often used by general public to describe indigestion and refers to symptoms of chronic or recurrent pain or discomfort centered in the upper part of the abdomen. The medical term for these symptoms is dyspepsia. The medical definition of gastritis however refers more specifically to inflammation of the lining of the stomach.

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REFLUX

Reflux is an irritation of the swallowing tube, called the esophagus by acid that comes up from the stomach which causes troublesome symptoms and/or complications. It happens because the junction between the gullet and the stomach does not function normally, resulting in reflux.

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GASTRITIS / DYSPEPSIA

‘Gastritis’ is a term often used by general public to describe indigestion and refers to symptoms of chronic or recurrent pain or discomfort centered in the upper part of the abdomen. The medical term for these symptoms is dyspepsia. The medical definition of gastritis however refers more specifically to inflammation of the lining of the stomach.

What are the common symptoms?

Most people do not suffer of pain in the upper abdomen all the time and the pain tends to come and go. For some, the pain often occurs when they are hungry and seems to be relieved by food, although for others the pain or discomfort tends to occur after eating.

In some people the stomach may feel full soon after starting to eat, so that it is difficult to finish a meal, or there may be an uncomfortable sense of fullness or bloating after a meal. The word ‘indigestion’ may also be used to describe nausea, retching or even vomiting after food.

However it is important to realize that these symptoms may not always be due to the gastritis, and very often no obvious cause can be found.

What are the possible causes of dyspepsia?

Most indigestion symptoms are harmless but may affect your quality of life. Very often tests are not needed. When tests are performed and no specific cause is found you may suffer of ‘non-ulcer dyspepsia’ or ‘functional dyspepsia’. Some of the causes in these cases include irregular meal times and certain types of food.

In about 10% of cases, indigestion may be caused by an ulcer. An ulcer is a break in the lining of the stomach or duodenum (the first part of the small intestine).

Some of the causes of ulcers or gastritis are as a result of smoking, over-indulgence in alcohol, the use of aspirin or painkillers containing aspirin like drugs, or due to a specific type of bacterial infection known as Helicobacter Pylori.

Other causes of indigestion besides gastritis or ulcers may include disorders of the intestine, gallbladder or pancreas.

What can I do to avoid dyspepsia?

Although dyspepsia or indigestion is still incompletely understood, these are a few simple measures which should help.

• Avoid skipping meals
• Eat meals at regular times and do not rush meals
• Avoid those foods you associate with your symptoms
• Learn to manage stress in your life

When should I seek help?

Many people who suffer occasional indigestion can obtain relief from simple antacid tablets which are available from the pharmacy.

You should consult your doctor if:

• your indigestion symptoms persist for more than two weeks, especially if this is a new symptom, do not respond to antacids, interfere with work, leisure and/or sleep
• over 40 years old
• have a family history of gastric problems
• drink or smoke heavily
• take aspirin or pain killers containing non-steroidal anti-inflammatory medication regularly

You should consult your doctor urgently if you experience:

• prolonged or severe pain
• red or altered blood (like coffee grounds) in vomit
• black ‘tarry’ stools
• loss of appetite or weight loss
• recurrent vomiting
• difficulty in swallowing
• low hemoglobin (low blood count/anemia)
• yellowing of the skin (jaundice)

What investigations may be necessary?

Many people with mild symptoms do not require investigation, but as persistent indigestion may suggest a more serious underlying complaint, the doctor may arrange any of these tests:

gastroscopy - which involves swallowing a slim flexible tube with a light and a camera at the end (gastroscope) that enables the doctor to look into the stomach, check for gastritis, ulcers or any other findings and test for bacteria Helicobacter pylori
barium meal - which involves swallowing a liquid which enables the outline of the stomach to show up on X-ray
ultrasound scan - a technique using reflected sound-waves to show the structure of abdominal organs, may detect stones in gallbladder and kidneys.
blood test to detect anemia or other abnormality

What treatment is available?

The appropriate treatment will be discussed after the doctor examine you and complete the necessary tests.

If the results of the test are normal, general advice, an explanation of the symptoms and reassurance will be offered. Advice will be given if there are factors in your lifestyle which may be contributing to the difficulties.

Medicine may be prescribed, ranging from antacids to more powerful medication which reduces gastric acid secretion, or a course of antibiotics to treat bacteria if it was found in your stomach.

However, it is important to understand that in some people, especially those where no obvious cause is found (functional dyspepsia), symptoms may recur intermittently over the course of time and they may require medication during these episodes of exacerabation.