Indigestion is More than a Nuisance

There’s this idea that as we age we should be able to eat just as we did when we were teenagers. I went to South End Pizza with my friend Sandy when I was 18. I remember it so well, because we ordered the largest pizza they had and ate the whole thing. I also remember how I felt the rest of the night. That was the day that I understood that I can’t eat everything.

So how about you? Do you try to eat everything? Well, listen, the older we are, the less leeway there is for our digestive tract to handle the foods that we eat. The result of that is “indigestion” and a specialized form of indigestion is called GERD, Gastro Esophageal Reflux Disease. Food hits your stomach. Rather than making the traditional path through the digestive system, it comes back up carrying stomach acids along with it. The constant bathing of your esophagus with acid creates damage to the esophagus, called Barrett’s Esophagus and can dissolve the enamel of your teeth. If you’re dependent on drugs to allow you to eat the way you want, that may produce a bigger problem down the road.

The offenders that I’ll talk about today are the proton pump inhibitors (PPI), widely prescribed, probably too much so according to some pretty scholarly articles in the Annals of Internal Medicine, a widely read medical journal. What’s a proton pump inhibitor? Without going into brand names, if the generic name ends in –prazole, it is a PPI. It works by binding stomach acid at the source of its production. Sounds good, doesn’t it. But we need stomach acid to digest our food. When that acid level is reduced too much, other problems occur. The big problem that may occur, particularly among the elderly and hospitalized patients, is an intestinal bacterial infection called Clostridium difficile, better known as C diff. The C diff infection is difficult to treat and can be fatal.

Opinions vary on the relationship between PPI’s and C diff. A prevalent thought is that we have C diff in our intestines anyway, but it is kept in check by the acids in our stomach. Once we change that acid/base balance, C diff can then proliferate. C diff can be transmitted from person to person. It can also result from the overuse of antibiotics.

But let’s go back and look at how we are eating and what we can do to reduce the use of these PPI’s. First is to get to the cause of the problem. If you’re eating acidic fruits, such as citrus, just substituting a less acidic fruit such as an apple, may solve the problem. If you’re eating big, heavy meals, you can reduce the problem by eating several small meals a day. There are digestive aids that can be purchased in the health food store that increase your ability to digest your foods, reducing your tendency to develop too much stomach acid. And if you’re eating a lot of junk, just stop it. And remember, if it’s in a can or a box, it’s generally highly processed food that your stomach may not know how to handle.

While the diagnosis of GERD (Gastro Esophageal Reflux Disease) or other digestive problems is important, your ability to change your lifestyle to stop the GERD is the real key. Visit a nutritionist. Look on line and read some books on GERD. You’ll find out some simple things that you can do to stop the reflux. The more you do, the less reliant you will be on medications, and that’s how you can improve your overall health.

Lee N. Sheldon, DMD