Dyspepsia (Heartburn)

Dyspepsia, defined as painful and difficult digestion, is better known as heartburn. Despite the abdominal discomfort, there are no lesions in the gastrointestinal tract. Dyspepsia represents 15 to 20% of all gastroenterological disorders and mainly affects adults.

Causes

The most common causes of heartburn are inflammation of the stomach lining, excessive stomach acid (gastric hyperacidity) and air in the gastrointestinal tract. Certain aggravating factors such as stress, poor diet and lack of exercise worsen the situation.

Symptoms

The most common symptoms are:

• Abdominal and stomach pain (burning)
• Burping, flatulence and hiccups
• Gurgling
• Bloating
• Nausea and vomiting

Persons most at risk

Those most likely to suffer from dyspepsia are anxious persons and those with a family history of heartburn. Pregnant women are also more at risk. Other than hormonal changes, another reason why dyspepsia affects pregnant women is because of the added pressure on the stomach.

Diagnosis

Should you experience more severe signs such as unexplained weight loss, blood in stool or vomit, persistent vomiting, difficulty swallowing or chest pain, we recommend that you seek medical treatment. A family physician can usually determine whether the pain you are experiencing is truly dyspepsia or if it is associated with another disorder (angina, gastrointestinal reflux or ulcer, for example), simply by palpating your abdomen. Your family physician will also be able to refer you to a specialist (gastroenterologist) who will, if necessary, perform a gastroscopy (insertion of a camera into the gastrointestinal tract).

Treatment

The first treatment approach involves making certain lifestyle changes by doing away with anything that may predispose sufferers to heartburn.

Foods to avoid

• Alcohol and soft drinks
• Fatty and/or spicy foods
• Acidic foods (citrus-based juices, for example)
• Very cold or very hot foods
• Caffeine (tea, coffee and cola)
• Mint and chocolate

Lifestyle changes

• Stop smoking
• Reduce stress and focus on relaxation
• Lose weight
• Avoid wearing clothes that are too tight
• Avoid lying down after a meal
• Eat slowly and drink only between meals

The second treatment approach involves the use of medications to prevent or relieve the symptoms of dyspepsia. There are four different classes of medications designed to treat heartburn:

• Antacids which temporarily neutralize gastric acid
• Medications that accelerate digestion
• Medications that reduce the quantity of acid produced by the stomach
• Antispasmodics that reduce contractions of the gastrointestinal tract and painful spasms

Antacids and certain medications that reduce acid production are available without a prescription. More powerful medications however, require medical monitoring. Given that the underlying causes of dyspepsia vary greatly from one person to another and that people react differently to medication, treatment must be tailored. To truly benefit from these medications, regardless of whether they are prescription or over-the-counter, it is important that they be taken as indicated and according to a set schedule. Pharmacists will be able to provide you with the most comprehensive advice. Don't hesitate to ask them for their opinion. If you have made lifestyle changes and your symptoms still persist or if your over-the-counter medication does not relieve your symptoms after 2 to 4 weeks, it is recommended that you consult a physician.