(rewritten 24th November 2011)
When I was 16 years old I suffered from Juvenile Rheumatoid arthritis. To control the pain of the arthritis I used to take 6-7 aspirins every 3 hours, making a total of 50-60 aspirins every day for about 18 months. One of the side effects of aspirin in such large doses was gastric irritation. I used to feel a burning sensation in the centre of my chest, a sour taste in my mouth with the bitter taste of the aspirin and a pain in my upper abdomen. Taking an antacid gave me relief for a hour or two but invariably the pain returned.
I soon learnt that taking the aspirin after food caused less discomfort than taking it on an empty stomach. Having it with oily food prolonged the discomfort while taking it with a fruit like a banana eased the pain. Of course it was a great problem to find something to eat every 3 hours around the clock!
This was my introduction to Gastric Reflux Now called GERD or Gastro esophageal reflux disease! This condition affects hundreds of millions of people worldwide and causes a lot of avoidable suffering.
Functions of the Stomach
The functions of the stomach are to store food and release it slowly into the small intestine where it can be digested and absorbed into the blood stream. It also secretes hydrochloric acid which kills bacteria, fungus, parasites and viruses; by making it acid it also helps breakdown protein so it can be digested. It secretes pepsin an enzyme which also helps breakdown protein in the stomach. It stimulates the production of hormones which regulate the digestion and blood sugar.
This mixture of acid and enzymes is kept in the stomach by valves at the top and bottom of the stomach. The valve at the upper end of the stomach is called the gastro esophageal valve and it prevents acid reflux. The function of this valve is supplemented by the muscles of the diaphragm which surround the valve and also contract to prevent the reflux of food into the esophagus. The valve at the lower end of the stomach is called the pyloric valve and slowly releases the gastric fluid mixed with food into the duodenum for further digestion and absorption in the small intestines. The stomach and duodenum are protected from digesting itself by a thick coat of mucous which protects it from the acid and pepsin.
This protective lining of mucous can be damaged by alcohol, Nicotine from cigarettes, stress, pain killers, all anti-inflamatory drugs like aspirin, Ibuprofen, Diclofenac, Naprosyn and steroids. These substances also increase gastric acid secretions. The gastric acid can then penetrate through the damaged mucous layer to attack the stomach's lining and cause peptic ulcers. Food allergies, especially milk allergy increase gastric acid secretion and also damage the stomach lining. This damaged lining is damaged further when there is an excessive accumulation of acid in the stomach. Aluminium also damages this protective lining of mucous. Food cooked in aluminium utensils, aluminium foil and aluminium containing antacids are a common cause for peptic ulcers.
Fats are digested slowly and cause slow emptying of the stomach. The combination of high protein and high fat foods like fried meats or nuts cause increased gastric acid secretion accompanied by slow emptying of acid from the stomach. This acid stays in contact with the gastric lining and if it has been damaged by the factors mentioned above causes hyperacidity and peptic ulcers.
Peptic Ulcers, Heart burn and hyperacidity
Heart burn is a sign of reflux of gastric acid from the stomach up the esophagus to the throat. Heartburn and hyperacidity are among the commonest digestive problems. These afflict 20-30 per cent of all people at any time in their lives. The digestion of protein and fat rich foods like meats and nuts requires acid. That is why high protein foods like red meats & nuts stimulate the secretion of large amounts of acid in the stomach.
Alcohol, fat and spices also increase gastric acid secretion and hence alcohol is often used as an "aperitif" or digestive. High protein and high fat foods, like sweets, chips, fried foods like cutlets and fried meats all predispose to hyperacidity as they stimulate secretion of gastric acid. Alcohol, cigarette smoking, coffee, and acidic foods are important causative factors for hyperacidity. These problems may also be caused by anxiety, stress, hiatus hernia or by wrong foods. The ideal treatment for these conditions is to regulate the diet.
If the valve at the junction between the oesophagus and the stomach is loose, it causes regurgitation of the acid when the stomach contracts. This can cause pain or burning sensation in the centre of chest, and a sour taste in the mouth, which are the symptoms of heart burn. Coffee, fried foods, gas forming foods, cigarettes, alcohol and sweets should be avoided by people who suffer from heartburn. A simple remedy for heart burn and peptic ulcers is to take a table spoon of Fenugreek seeds (methi), boil it in one litre of water for 20 minutes, discard the seeds and drink 1 cup of this liquid every 3-4 hours for 21 days. This liquid forms a protective coating on the oesophagus and the stomach, preventing the acid from coming into contact with the lining of the stomach and oesophagus and so prevents burning sensation associated with the reflux of acid. This protective coat allows the stomach lining a chance to heal.
Conventional treatment of hyperacidity is with antacids like aluminium hydroxide, calcium carbonate, and magnesium hydroxide. These neutralize gastric acid thus relieving the pain. Aluminium also damages the mucous layer and is an important cause for peptic ulcers causing pain in the upper abdomen. The taking of antacids containing aluminium hydroxide can be hazardous for the reasons explained in the chapter hidden hazards in food. Antacids which only consist of calcium carbonate are much safer and as effective.
The next method of treatment is to use drugs which reduce gastric acid secretion like ranitidine, omeprazole, rabeprazole etc. These methods give good relief to the problem by reducing gastric acid secretions. However as they do not tackle the cause of the problem the problem usually recurs.
Measures which reduce gastric acid prevent the stomach from carrying out an important function. This is to kill bacteria, parasites and viruses from the food as well as from the secretions swallowed from the nose throat and lungs. As a result the peptic ulcers are often infected by an opportunistic bacteria which takes advantage of the low acid level called Heliobacter Pylori. Infection with H. Pylori prevents the healing of the ulcer and may require antibiotics or homeopathic treatment to heal.
Treatments with drugs which protect the stomach lining like sucralfate and bismuth sub oxide are far more rational forms of treatment.
Another effective alternative to antacids is to drink cold water which cools the stomach, reducing the acid secretion. Eating of alkaline foods (Refer to list of alkaline foods in Properties of Foods and avoiding high protein and fat foods, spices, alcohol, smoking and stress management are equally effective alternatives.
I have successfully treated many patients with hyperacidity and peptic ulcers who have not responded to repeated courses of antacids and anti-ulcer drugs, by telling them to stop milk and milk products. This is contrary to conventional ulcer treatment where cold milk is often prescribed as a part of the treatment. To stop the patient's milk is a cheap, safe & effective measure and the patient recovers promptly without needing any drugs.
Food is digested and should be expelled from the body as stools within fourteen to eighteen hours. If it takes longer than twenty four hours for the undigested food to be expelled we are constipated. If it takes less then twelve hours it means that intestine is moving the food along too fast and is often labeled as IBS or irritable bowel syndrome.
Flatulence is caused by the fermentation of undigested food in the small & large intestines. Putrefaction of carbohydrate and protein material occurs when the food is not properly digested leaving a residue which ferments.
Flatulence can indicate that the food is being inadequately absorbed and is staying in the intestine long enough for it to putrefy and decay. The process of decay, releases gas which can also be caused by bacterial, fungal or parasitic infections. Flatulence is also often due to food allergies commonly to dairy products and gluten (a protein present in wheat & corn). Lactose intolerance is a common cause of gas. People with a Vata constitution are also prone to gas. Diverticulitis often accompanies food allergies and leads to accumulation of undigested food in blind pockets. This food is unable to pass out through the digestive tract and can remain in these pockets for months till the decay is complete. The gas which accumulates in Diverticulitis is hard to pass and can be very uncomfortable.
Flatulence is often caused by by eating stale or gas forming foods. Bacteria grow quickly in all cooked foodsand slowly in uncooked foods .Eating freshly cooked food helps digestion. Eating stale foods causes flatulence and indigestion.
Foods which cause flatulence are beans, pulses, soya, radish, fermented foods like bread and other foods made with yeast, beer, wine, cooked cauliflower, Brussel sprouts, cabbage and broccoli. However cauliflower, cabbage & broccoli & other members of their family do not cause gas when eaten raw and in fact give protection against some forms of cancer. A high fibre diet containing raw vegetables and fruits, prevents flatulence. These foods stimulate the walls of the intestine to contract regularly and move the food forward through the intestine at the correct speed so that it does not accumulate and putrefy. Refer to list of Properties of Food for other foods which cause gas.
It is easier to prevent flatulence by eating the correct type of food, than it is to treat it by drugs. As treatment with drugs is purely symptomatic the problem will continue to recur, whenever the drugs are stopped. Taking paprika 1/2 teaspoon (or red chili powder if paprika is not available, black salt 1 pinch and cumin seed powder 1 teaspoon dissolved in warm water helps to relieve flatulence. The paprika moves the gas along, while cumin seed powder and black salt help to break up the gas bubbles in the intestines. Caraway seeds (ajwain) can also help relieve gas.
Jayan was an middle aged journalist who constantly suffered from heartburn and burping. If he ate a little food he felt full and was hungry again in an hour or two. If he ate more than a small amount, he would feel heaviness and pain in his chest. He would have difficulty in breathing, tightness in his chest, a feeling of unease and discomfort and would rush to the emergency room. Investigations for his heart invariably showed his heart was normal. He tried many treatments for his acidity and breathlessness without any improvement.
Jayan came to consult me, I diagnosed him as having a hiatus hernia, I modified his diet, reassured him and advised him to return to see after 10 days when his flatulence was better. On his next visit I massaged down the hernia , adjusted the muscles of the diaphragm and called him to see me again after a month or earlier if he had any trouble. On his next visit he was cheerful, and had not felt breathless for a month, his appetite was better and he had put on some weight after many years.
The symptoms described above are common symptoms with hiatus hernias.
A hernia is a protrusion of the contents of the abdomen through a weak spot in the abdominal wall. Flatulence is one of the commonest causes for people to get hernias and any successful treatment of any hernia has to first tackle the underlying flatulence or the problem will recur. When you wear tight clothes around the waist, bend forward after eating or overeat, strain to pass stool, do sit ups or stomach crunches, or have your child sit on your stomach, you increase the pressure in the abdomen. This compresses the distended loops of intestine in the abdomen which are forced out of any weak spot. This leads not only to hiatus hernias but also to inguinal and umbilical hernias.
After the cause of the flatulence has been tackled, an expert in soft tissue manipulation can return the herniated organs to their proper place. The herniated organ usually the stomach or intestine is gently massaged back into the abdomen. The patient feels immediate relief with this part of the treatment. The muscles around the hernia site are then mobilized and adjusted to close the opening through which the intestines have herniated. This gives added protection against a recurrence of the hernia.
If the patient takes care to avoid any measure which increases pressure on the abdomen like lifting heavy weights, sit ups, over eating, forward bending after eating and avoiding wearing tight clothes, this can often cure the Hiatus Hernia. It takes several months for the muscles to regain strength and elasticity to keep the opening closed, so great care is required to ensure the hernia does not recur. As the muscles never fully regain 100% strength care is required through life to prevent a recurrence of the problem. Thousands of my patients have benefited from this safe & easy treatment for hiatus hernia which takes a few minutes.
The food we eat is digested, the nutrients absorbed and the un digestible portion is passed out as stool after this process is complete. Most people pass out their waste material at least once during a 24 hour period. The urge to pass stool is initiated by fullness in the rectum. If this fullness is not there because of an inadequate amount of waste material the urge to pass stool may be absent. Constipation is the retaining of the food you eat for more than 24 hours. Many people suppress the urge to defecate because of unavailability of proper toilets. As the food remains in the rectum, the body may absorb the water and along with it some of the toxic waste products. This is especially likely if the water intake is inadequate, causing the stools to become hard.
In elderly people sensation in the lower abdomen may be reduced and they may not feel the urge to defecate causing constipation.
Symptoms of constipation include discomfort in the lower abdomen, a feeling of distension, gas, lower abdominal discomfort, uneasiness and headaches.
Straining the abdomen to pass stools can causes distention of the veins around the anal sphincter. These veins may also distend due to food allergies. Hard stools can scrape the lining of the anal sphincter during the passing of stools and cause pain bleeding from the rectum due to rupture of these veins. The distended veins may develop blood clots and become painful as well. This is called bleeding piles or Haemorrhoids.
High fibre diet with high fibre grains like oats, salads and lots of fruit prevent constipation. An adequate water intake of at least 3 litres per day are helpful in preventing constipation. The drinking of 2-4 glasses of warm water on waking up can often induce enough intestinal contractions to induce the passing of stools within an hour.
Diets consisting largely of low fibre foods like meats, white bread, chips, pasta and cheese which are popular in "developed countries" predispose to constipation. Passing a stool every two to three days is common in developed countries on a highly refined low fibre diet and is bad for health. Undigested food putrefies in the intestine, causing flatulence, gas and distension of the abdomen. The accumulation of putrefying food predisposes to cancer. It has been said that over 80% of people with any kind of cancer are constipated.
"Dr" Leo Schafer the Canadian herbalist was known as 'Canada's Cancer Doctor' for treating about 5000 patients of terminal cancers a year by herbs and diet with great success. He used to say "If a patient has cancer, he must be constipated ." Many natural treatments for cancer prescribe a high fibre diet, lots of fluids including vegetable juices, and a diet rich in antioxidants like Beta-carotene, Vitamin C, Vitamin E, lycopenes etc. These diets can also help prevent cancer.
While there is no one treatment for all forms of cancer, detoxification by encouraging proper elimination of waste products forms a significant part of most natural and rational treatments for cancer. The accumulation of waste products affects the ability of our immune system to eliminate abnormal cells including cancer cells and so predisposes to cancer and many other diseases.
The great increase in the incidence of cancer over the last 50 years is also related to our increasing preference for highly processed and refined foods.
A healthy diet contains more unprocessed food than processed foods. Foods made from whole grain, like whole wheat bread, chapatti (unleavened Indian Bread), oats, millet (bajra), ragi and brown rice are healthier than white bread and white rice. The indigestible portion of these foods slows down the absorption of carbohydrates and fats. Brown bread and whole wheat products contain more protein and are likely to contain more pesticide than white bread and refined flour products and so are more likely to cause food allergies. People with a gluten allergy get more trouble with brown bread than with white bread.