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Treating Indigestion
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What is Indigestion and its Symptoms?
Indigestion is a general term used to describe discomfort or pain in the upper abdomen or chest, usually after meals. An alternative term is dyspepsia. When a burning discomfort is felt behind the breast bone, it is known as heartburn.
Heartburn is a burning pain caused by the stomach acid flowing back up your food tube (oesophagus). This is called reflux, the valve (sphincter) at the join between the oesophagus and stomach does not work properly, allowing reflux of the stomach acid. You will normally feel this pain in the centre of your chest or behind your breastbone (sternum). If this is severe, it might feel similar to a heart attack.
Your stomach produces a strong acid that helps digest food and protects you against infection. A layer of mucus lines the stomach, oesophagus and intestines to act as a barrier against this acid. If the mucus layer is damaged, the acid can irritate the tissues underneath and this is known as a peptic ulcer.
Some of the following things can make the symptoms worse: eating a heavy meal, drinking excess alcohol, smoking, stress and anxiety, drugs such as aspirin and ibuprofen, pregnancy, a peptic ulcer (stomach or duodenal ulcer).
You should seek advice from your GP if you have any of the following symptoms: unintended weight loss, indigestion symptoms for the first time if you are 45 or older, if you experience severe pain, or if the pain gets worse or changes.
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Treatments for Indigestion
The more common over-the-counter indigestion products are antacids, usually a mixture of magnesium ((Philip's Milk of Magnesia) and aluminium salts; calcium carbonate (Setlers); or sodium bicarbonate (Bisodol).
Dimeticone and/or peppermint oil-containing products act as deflatulents. They have an anti-foaming action and release trapped gas to assist belching. Alginate products (Gaviscon) act by forming a raft that floats on the stomach contents and forms a physical barrier between the acidic contents of the stomach and the oesophagus lining. They are particularly appropriate when symptoms are caused by reflux of the stomach content into the oesophagus.
The choice between tablet or liquid is often down to personal preference. But there is some evidence that liquids work quicker, while tablets have a longer lasting effect. Some tablets have a high sugar content.
H2 blockers work by reducing the amount of acid that the stomach produces. Examples of H2 blockers are famotidine (Pepcid) and ranitidine (Zantac) cimetidine. The maximum treatment period is two weeks.
Omeprazole (Zanprol), a proton pump inhibitor (PPI), PPI work by blocking the release of acid and are indicated in gastric reflux.
Domperidone (Motilium ), stimulates gastric empting and small intestinal transit, as well as enhancing the strength of oesophageal sphincter contraction. Motilium can be given when 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. Buccastem can be used for the treatment of nausea, or even vomiting after food.
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