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October 1, 2008 > Are You Suffering from Stomach Problems?

Are You Suffering from Stomach Problems?

Learn About Treatment Options at Upcoming Health and Wellness Seminar

Do you ever have heartburn? Stomach pain? Abdominal gas and bloating? Nearly everyone suffers from some sort of digestive problem at one time or another. Such discomforts generally subside fairly quickly. Recurring symptoms, however, may indicate a more serious condition.

"It's normal to have stomach upsets from time to time," says Washington Township Medical Group gastroenterologist Dr. Annamalai Veerappan. "If you have frequent indigestion, though, it helps to understand what is causing your problems and what your treatment options are."

To promote greater awareness of digestive disorders, Washington Hospital will conduct a Health & Wellness seminar on Tuesday, October 7 from 1 to 2:30 p.m. The seminar, featuring Dr. Veerappan, will be held at the Conference Center adjacent to the Nakamura Clinic at 33077 Alvarado-Niles Road in Union City. For more information about the Health & Wellness seminar, or to register to attend, please call (800) 963-7070.

Among the topics Dr. Veerappan will discuss are gastroesophageal reflux disease (GERD), peptic ulcers and abdominal gas.


"Gastroesophageal reflux disease, commonly known as heartburn, is one of the most common digestive problems," Dr. Veerappan says. "Sometimes the sphincter muscles between the esophagus (or food pipe) and the stomach relax inappropriately. Then acid from the stomach moves up into the esophagus and produces a burning sensation in the chest, which is why they call it heartburn. It's normal to have some brief episodes of heartburn after a full meal. In some people, though, the sphincter muscles are weakened and allow acid up into the esophagus frequently. That's when we would consider it to be reflux disease. "

Dr. Veerappan notes that the problem generally can be treated by making a variety of lifestyle changes such as avoiding spicy and fatty foods, caffeine, chocolate, mints and alcohol. He also advises avoiding both large meals and eating late at night, smoking and tight-fitting clothes. Patients who are overweight may benefit from losing weight. In most cases, raising the head of the bed four to six inches can help. Medications also can be useful.

"Some people can alleviate their heartburn with the use of over-the-counter antacids such as Mylanta or Maalox," he says. "If those don't suffice, the patient can progress to medications called H2 blockers. These drugs, such as famotidine (Pepcid) or ranitidine (Zantac), block the histamine receptors in the stomach that produce gastric acid. For frequent, persistent heartburn, people might use more potent medications called proton pump inhibitors, such as over-the-counter Prilosec or prescription drugs such as Nexium. These medications are all very effective, but in rare cases when a patient doesn't respond to medications, it may require surgery to correct the problem. Fortunately, this surgery can now be done laparoscopically, so it is less invasive."

Peptic Ulcers

Another fairly common digestive ailment is that of peptic ulcers, which can occur in either the stomach or the duodenum, the first portion of the small intestine. The most common symptom of an ulcer is a burning pain in the stomach, between the breastbone and navel. The pain is most common when the stomach is empty, but it can occur at any time. Other symptoms may include nausea, vomiting or blood in the stool.

"More than 90 percent of ulcers are caused by overuse of medicines such as nonsteroidal anti-inflammatories including aspirin and ibuprophen or by an infection of H. pylori bacteria," Dr. Veerappan says. "These ulcers can be treated with medications such as H2 blockers and proton pump inhibitors and, in cases where H. pylori bacteria is present, antibiotics. We also advise patients with ulcers to use alternatives to aspirin and ibuprophen - medications such as Tylenol or Celebrex do not irritate the stomach as much."

Dr. Veerappan notes that untreated peptic ulcers can result in complications such as internal bleeding, dramatic weight loss, perforation of the duodenum or stomach, and obstructions from scarring that prevent food from continuing down the gastrointestinal tract.

Abdominal Gas

"Forming and passing gas is absolutely normal - everyone does it," Dr. Veerappan remarks, "but some people produce more gas than others. For example, people with a disorder such as irritable bowel syndrome or lactose intolerance would produce more gas. Another cause of excess gas production is swallowing too much air, which can happen when you eat too fast, chew gum (especially with your mouth open), drink carbonated beverages or hyperventilate when you are overly anxious."

Excess gas also can result when the normally harmless bacteria in the large and small bowel act on incompletely digested carbohydrates to produce gas. Cruciferous vegetables such as broccoli, cauliflower, cabbage, Brussels sprouts and asparagus are common culprits. People with lactose intolerance are unable to break down the carbohydrate component of milk.

"Obviously, the first line of treatment would be to avoid those foods that are causing the problem," Dr. Veerappan advises. "Also, there are various over-the-counter drugs containing simethicone - an ingredient that breaks up gas bubbles in the stomach or intestine. Some examples would include Gas-X, Mylanta, Maalox and Pepto-Bismol. Another product, Beano, contains an enzyme that breaks down complex carbohydrates, making them more digestible and thus reducing gas production. Some people also might benefit from taking activated charcoal capsules."

If problems with excess gas and bloating continue despite diet changes and medications, you should ask your doctor for examination to rule out any significant disorders such as irritable bowel syndrome, Crohn's disease, colitis, malignancies or malabsorption syndromes.

"It's important for people to recognize how valuable their digestive health is," Dr. Veerappan says. "If you experience problems with your digestive system, don't hesitate to consult your physician."

Health & Wellness Seminar Information
Topic: Are You Suffering From Stomach Problems?
When: Tuesday, October 7
Time: 1 to 2:30 p.m.
Location: Conference Center adjacent to the Nakamura Clinic at 33077 Alvarado-Niles Road in Union City.
Call: (800) 963-7070 to register

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