Are indigestion and stomach troubles cramping your lifestyle? Gas, bloating and diarrhea can be embarrassing and debilitating. Find out what’s causing your gastric gremlins and how to ease the discomfort…
Gastrointestinal disorders like bloating and diarrhea are uncomfortable, upsetting – and on the rise. Hospital walk-in visits for heartburn, for example, increased 2,000% between 1975-2004, according to a 2008 government report.
What’s to blame for our rising stomach problems? Lots of things, including age, weight gain and stress. And women are at particular risk.
“The population is aging,” says David Rubin, M.D., co-director of the Inflammatory Bowel Disease Center at the University of Chicago Medical Center.
“As women age, the pelvic floor relaxes,” he says. “That changes the digestive organs’ positions, which can cause constipation, gas and bloating.”
When age and menopause relax the pelvic floor, the position of the colon shifts in relation to the rectum – and that spells tummy trouble. If osteoporosis compresses the back bones, it gets worse.
Not to mention that as you get older, the large intestine doesn’t squeeze and move things along as well as it once did.
Obesity and stress also contribute to stomach troubles, according to Rubin.
Fat, particularly if concentrated in the chest and abdomen, worsens heartburn and increases other stomach symptoms as well, although doctors don’t yet know why.
Stress also leads to poor eating habits and weight gain – and can also deprive you of sleep, which may bring on heartburn.
To tune in to your tummy, learn doctor-recommended tricks to treat the top 6 gastrointestinal complaints:
Tummy Trouble #1: Heartburn
What it is: The burning you feel in your chest after meals – especially if you lie down – is heartburn (also known as acid reflux or acid indigestion), a sign that the stomach’s contents are rising into your chest.
Why you get it: When your lower esophageal sphincter (the band of muscle around the bottom of your esophagus) relaxes, it lets stomach acid flow back into your esophagus, causing a burning that’s often mistaken for a heart problem.
“But some people have no symptoms, or atypical symptoms, like a chronic cough, jaw or ear pain, sinus problems or asthma,” Rubin says.
Age, weight, pregnancy, high blood pressure medications and lack of exercise increase your risk of heartburn.
How to fix it: Eat more slowly and consume less, avoiding heartburn triggers like tomatoes (they’re highly acidic) and peppermint and chocolate, which relax your sphincter muscle.
“If you have heartburn because you gained 10 pounds over the last year, losing even that small amount can reduce your symptoms,” Rubin says.
Cut down on caffeinated and alcoholic drinks, which can make heartburn worse. And toss the cigarettes.
For a quicker fix, try a natural remedy, like drinking aloe vera juice, or hit the medicine cabinet. Antacids like Tums and Rolaids neutralize acidity and are fine for occasional heartburn, Rubin says.
“But if you need to take them more than twice a week, see a doctor to get something stronger.”
Avoid antacid brands with calcium; they cause constipation, which increases heartburn. If you’re taking the mineral to build bones, talk to your doctor about a substitute.
Two types of drugs reduce stomach acid, but both come with caveats: The effects of H2 blockers like Zantac and Pepsid (which cut acid by blocking histamine2) last for six hours, but with steady use over two weeks they become less effective, so you may have to take more to get the same effect, Rubin says.
Proton pump inhibitors (PPIs) – like the prescription pill Nexium or over-the-counter drugs Prilosec or Prevacid – prevent the stomach’s acid pumps from producing acid, but only work when you take them every day, according to Rubin.
But daily doses aren’t a good idea, especially for older women because it raises infection risk.
“Stomach acid protects you from infection,” Rubin says. “Although long-term use of PPIs is necessary for some chronic conditions, patients should discuss this [treatment] with their doctor since there is a small risk of infection in older people.”
Tummy Trouble #2: Gassiness
What it is: Gas that unfortunately bubbles up at inopportune moments.
Why you get it: Gas comes from two sources: Air you ingest – through smoking, snoring, chewing gum and talking while you eat – or created by bacteria feeding on undigested foods in the large intestine.
You can’t avoid it completely because it’s a normal part of the digestive process.
“It’s only a problem when you have it in a larger amount than you’re used to,” says Jonathan Schreiber, M.D., a gastroenterologist at Mercy Medical Center in Baltimore.
Constipation (more on that later) makes it worse.
“Half of your solid waste is bacteria that you excrete,” Rubin explains. “When you’re constipated, there’s an overgrowth of bacteria, which causes more gas and odor.”
Severe gas can signal something more serious, like celiac disease (an inability to digest wheat protein or gluten, including wheat, oats, barley and rye) or Crohn’s, an inflammatory bowel disease that also causes diarrhea.
A gas-diarrhea combo could also mean lactose intolerance, an inability to digest the milk sugar lactase.
How to fix it: We all know beans, legumes and high-fiber foods can cause problems. But don’t avoid them, just watch how much you eat.
“You just need to know [what affects] your body and limit carbohydrates, sugars and excess fiber because bacteria love them,” Rubin says.
Gassiness doesn’t always comes from foods, though. If you wake up gassy, you may be snoring or swallowing air while you sleep. Try sleeping on your side to take in less air.
If you’re gassy at night, the culprits may be smoking, eating too fast or talking while you chew.
Charcoal tablets can absorb gasses and decrease gas odor. Simethicone tablets (Gas-X; Maalox Anti-Gas), another remedy, are made from an anti-foaming agent that breaks up gas bubbles.
“They work best for people swallowing air, but not for gas that comes from bacteria,” Rubin says.
If gas is severe, see a gastroenterologist. You may need antibiotics if bacteria is the cause. Or your doctor may recommend an over-the-counter probiotic like Align or Florastor – live bacteria that rebalance the growth of healthy gut cultures.
“Yogurt with live cultures, like Yoplait or Culturelle, may help too,” Rubin says. Yogurt works even if you’re lactose intolerance, because lactase is already broken down.
Tummy Trouble #3: Burping
What it is: A loud explosion of gas that escapes from your stomach via your mouth. “Gas can go up or down,” Schreiber says. “When it goes up, you burp.”
Why you get it: “You may just have a nervous habit of swallowing a lot of air,” Good says.
Or you may be drinking too much soda or fizzy water. Some medical conditions affecting the esophagus – heartburn, gastritis (an inflammation of the stomach lining), ulcers – can also be the culprit.
How to fix it: If swallowing air is a problem, eat slowly and chat less while you chow down to reduce your air intake.
Soda drinker? Switch to flat water. And if you notice burping with other GI conditions, like heartburn, address that problem too.
As with all these tummy troubles, if it doesn’t go away with simple lifestyle changes, see your doctor to find out if a more serious condition is the source.
Tummy Trouble #4: Bloating
What it is: When your stomach fills with gas, it expands and causes bloating.
Why you get it: Constipation, a poor absorption of sugar (due to a shortage of enzymes that aid digestion), and/or increased bacteria can all make you swell. So can fatty foods – which makes a slow exit from your stomach – stress and smoking.
A bloated belly can also indicate celiac disease, lactose intolerance or excessive bacterial growth in the small intestine.
Bloating also is the most common symptom of irritable bowel syndrome (IBS), a gastrointestinal condition characterized by diarrhea and/or constipation.
How to fix it: Go easy on foods that bring on bloat, like beans, apples and cruciferous vegetables like cabbage. And stay away from carbonated sodas, hard candy and gum, because they make you take in extra air.
Plus, “do aerobic exercise at least five days a week for 10-15 minutes,” Rubin says. It helps gas move through your system faster, preventing bloat.
But if symptoms persist, see a doctor. As with other GI disorders, bloating could be a sign of a more serious disease, like ovarian cancer.
Tummy Trouble #5: Constipation
What it is: Constipation means difficulty passing stools, says gastroenterologist Larry Good, M.D., assistant clinical professor of medicine at State University of New York at Stony Brook. It’s not related to how often you go, although it’s common to have a bowel movement once or twice a day.
“A person has to perceive a difficulty, because there’s no accepted norm,” Good says.
Why you get it: A poor diet and not drinking enough water can slow down bowel movements, he says.
“The stool becomes harder and more difficult to pass.”
Slow muscle contractions in the colon will also slow their passage.
In severe cases, the stool may be blocked by a tumor or diverticulosis, a condition in which pouches form on the colon wall. Colon cancer and diuretic medications can also stop you up.
How to fix it: Go when you feel the urge. Holding it in makes stool harder and more difficult to pass.
Eat more high-fiber foods, such as whole grains, fruits and vegetables. You need about 20-25 grams of soluble fiber (found in apples and oatmeal) a day, Good says.
And drink at least four to six 8-ounce glasses of water daily to soften your stool. Regular exercise also stimulates the intestine, which helps you go.
Over-the-counter fiber supplements or laxatives may do the trick too, Good says. Laxatives boost the secretion of fluid in the intestines or increase intestinal contractions.
“But don’t use laxatives for more than a day or two without getting a medical evaluation,” Good says. “Otherwise, you may mask a more serious situation.”
Tummy Trouble #6: Diarrhea
What it is: An intense urgency to move your bowels, accompanied by watery stool, are the most common trademarks of diarrhea. “Or it’s just abnormally frequent bowel movements,” Schreiber says.
Why you get it: Irritable bowel syndrome is the most common cause, Good says. But viruses, infections and some medications, such as antibiotics, can also start the tide.
When should you worry? If you see blood, pus or mucus when you go, it could mean intestinal inflammation, colorectal cancer or Crohn’s.
How to fix it: Keep drinking fluids to stay hydrated, Schreiber says: “If [your mouth] feels dry and you’re headachy, you’re dehydrated.”
Stay nourished: Schreiber suggests bananas, rice, applesauce and decaffeinated tea.
Also, learn its cause so you can adjust your diet: If it’s IBS, eating more fiber may help, Good says. Cut out wheat for Crohn’s disease and dairy for lactose intolerance.
If you have diarrhea for more than three days, see your doctor. Infection may be the source, which could require an antibiotic.
You might also be prescribed an over-the-counter anti-diarrheal medication, like Imodium or the prescription drugs Lomotil or Paregoric – but only after your doctor determines the cause of the condition.
When to Get Treatment
Just because we’re living with more of these symptoms doesn’t mean we have to.
If your stomach’s acting strangely – for example, you’re having shifts in bowel habits, gassiness, bloating, heartburn – see a doctor, Rubin says. Especially as you get older.
“If you’re over 35, any change in GI symptoms needs a careful workup,” Rubin says.
This could include a physical exam, blood tests, stool tests and an endoscopy (a procedure allowing the physician to look inside the body).
Why the concern?
“Sometimes a subtle change in bowel function or heartburn can [indicate] ovarian or uterine cancer,” he says.
For natural remedies and more tricks to get rid of indigestion ills, read What to Do When Your Tummy Hurts.
Health writer Dorothy Foltz-Gray is a frequent contributor to Lifescript.
What’s Your Indigestion IQ?
Far too many of us are familiar with the lingering discomforts associated with indigestion, heartburn, acid reflux, and other gastrointestinal issues. The good news is that you can take steps to prevent the unnecessary side effects brought on by certain behaviors. It's all about keeping your stomach happy.
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