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VOICES

Indigestion at Christmas time - that is your stomach crying out for a break

Use of indigestion medication can lead to deficiencies in minerals and vitamins and could start a vicious cycle. Heed the warning signs and try improving your diet instead, writes Ciara Wright.

CHRISTMAS IS A time of excess. On average we pack away an extra 60 units of alcohol over the extended festive season.

Now that this season seems to begin as soon as Hallowe’en ends, it can be difficult to make it to 25 December without attrition. For many, we will find that our digestive system just can’t put up with the endless onslaught of mince pies and sparkling wine.

Going heavy on the nibbles can lead to many symptoms of indigestion. These can vary from heartburn, nausea and belching to a feeling of food coming up or feeling of dinner not going down. Some people simply feel a constant need to clear their throat like a tickly cough.

These symptoms bear all the hallmarks of a stomach being overworked by being asked to digest richer food than normal.

One of the most prescribed medicines in Ireland is for indigestion. It’s tempting to reach for the over-the-counter remedy, a simple chewy or a slug from a bottle to quell the sensation.

The relief can be short-lived though, so you may find yourself looking for stronger stuff.

Proton pump inhibitors, or PPIs, are among the most common medications prescribed in Ireland. A proton pump may sound like something out of a Formula One engine, but in our stomach, a proton pump inhibitor works by reducing the flow of acid into our stomach.

A 2018 study in a reputable medical journal the BMJ Open, identified that these proton pump inhibitors were the second most prescribed medication in Ireland, only coming marginally after statins and miles above anything else. 

But there is a serious downside to relying on this medication. 

Downsides

Our digestive system was designed so that the stomach would do the heavy lifting when it comes to breaking down our food. Strong acid helps to break down all the stuff we are tipping down our gullet.

Your food will churn and churn in there for about an hour while the acid does its job. Food isn’t meant to progress through to the rest of the intestines until the acid has had a good go at it.

So what happens if you are inhibiting this process?

Firstly, the pH of the stomach goes up. Your food is meant to be quite acidic when it leaves the stomach and your good bacteria don’t like it when you mess with their food. Studies show that PPI use alters the bacteria in your gut.

Secondly, you may not digest your food as well as you should. This can lead to malabsorption and even deficiencies in minerals and vitamins.

Most studies have identified reduced absorption of vitamin B12, zinc, iron and possibly calcium as a risk. It goes without saying that the longer you are on this medication the bigger the problem.

Strictly Necessary?
Much advice has been issued to only take PPIs when necessary and only when correctly indicated. They have one last trick up their sleeve too, and it’s call rebound acid hypersecretion – a catchy name.

It means that when you stop taking them, you might actually feel a surge of acid that may be worse than your initial symptoms. It would be a normal reaction to think that you need to go back on the medication. And there begins a vicious cycle which can lead to prolonged use.

So when you’re saying yes to just one more cocktail sausage, or one more cocktail, give a second thought to what your poor stomach has to go through.

If you find yourself consistently reaching for the over-the-counter remedies, maybe it’s time to give your stomach a break.

Although there are many causes for reflux and stomach upset, start with a high-fibre diet containing 5-7 portions of fruits and vegetables to help to keep the food moving in a one-way system, down instead of up.  

If the problem persists after improving your diet, it could be a sign of something more serious. Speak to your GP instead of reaching for the old reliable remedies over and over again, or you may be causing other problems in the long run.

Ciara Wright PhD DipNT, Senior Nutritional Therapist and Director of Glenville Nutrition and The Wellness Crew: www.glenvillenutrition.ie www.thewellnesscrew.ie

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