From 10 a.m. until 5 p.m. each day at work, I’m surrounded by patients describing all manner of bloated bellies in need of cures. There are many garden-variety types of bloating, each one with its own cause and set of remedies. A lot of emphasis in the digestive health world is placed on bloating caused by problems in the intestines — whether as a result of constipation, trapped gas or excessive flatulence from poorly absorbed carbohydrates or overgrowth of bacteria in the small bowel. But there are other forms of bloating that originate in the stomach, not in the intestines. One of the more common expressions of this type of bloating is what those of us in the business call “dyspepsia.”
Dyspepsia is characterized by a distended, uncomfortable belly after eating, often accompanied by belching, a pressure-type pain in the middle to upper portion of the stomach or both. Sufferers of dyspepsia often get attacks after having gone too long between meals and allowing themselves to get excessively hungry. Another common trigger is eating a very large portion of food, especially foods full of “roughage” like entree-sized salads or movie theater-sized popcorn. Often, people who suffer from dyspepsia also have concurrent issues with acid reflux. Sound familiar?
[See: How to Survive Acid Reflux Without a Pill.]
When explaining dyspepsia to my patients, I tell them that the stomach’s basic physiologic role is that of a blender: It must liquefy whatever we eat to such a consistency that it can squirt out of a tiny little passage leading into the intestines, a few milliliters at a time. The stomach-blender, I explain, has only two settings: acid and squeezing. To liquefy food, the stomach-blender secretes acid to chemically break down large particles of food into smaller ones. Simultaneously, the stomach-blender also contracts its muscular walls to mix and churn the stomach contents with the acid in order to facilitate the chemical digestion process.
Now, picture how little acid secretion and churning your stomach-blender has to complete in order to liquefy a bowl of vegetable soup. Compare that to how much churning your stomach-blender has to complete in order to liquefy a large bowl of Caesar salad. There’s probably a really big difference: It will take minimal acid and time to clear that vegetable soup for passage, while it will take far longer and far more acid for the salad to be pureed — especially if it’s been gobbled down in a 15-minute lunch break and still contains tough, fibrous romaine hearts that have been relatively un-chewed.
The result? As that belly full of acid and romaine hearts keeps churning and churning and churning, some people find it produces an uncomfortable feeling of fullness in the upper part of the stomach that may also be accompanied by some reflux or belching. In other words, the texture of your meal can play a big role in triggering symptoms of dyspepsia. So if it seems to be a problem for you, try opting for soups and sushi instead of salads; peanut butter instead of whole nuts; popcorn cakes instead of popcorn.
[See: Foods That Cause Bloating.]
Another scenario that often triggers dyspepsia is going too long in between meals. An empty stomach is an acidic stomach and for people with any sort of acid-related malady — from reflux to gastritis to ulcers — going more than three to four hours without eating will spell trouble. The hungry, empty stomach grows increasingly excited in anticipation of food to the point that when it is fed, it unleashes an enthusiastic torrent of acid for digestion that leaves predisposed people feeling distended, bloated and uncomfortable — no matter what they’ve eaten. All the worse if they’ve overeaten.
If this situation sounds familiar, the best remedy is to approach your eating in terms of evenly-distributed mini-meals throughout the day. The goal is to avoid being too empty and to avoid being too full. As such, I encourage patients to think about planning for small meals every three to three and a half hours, even if it means breaking up your usual meal portions into two sittings. Have half your breakfast at 7 a.m. — maybe a few slices of avocado toast — and the other half at 10 a.m., say, a banana and some yogurt. Then for lunch, have half of your sandwich and a piece of fruit at noon and save the other half of the sandwich and cup of vegetable soup for mid-afternoon. Finally, eat a small dinner — ideally one that includes cooked vegetables rather than raw ones paired with moist, soft proteins like fish, shellfish, tofu, eggs, turkey meatloaf or chicken — between 6 p.m. and 7 p.m. These small, frequent, softer-textured meals tend to keep dyspeptic stomach bloating very well-controlled.
[See: How to Break 7 Unhealthy Habits.]
Of course, sometimes life gets in the way, and you inevitably find yourself in a situation where you’ve gotten way too hungry — a surefire sign that the aftermath of the next meal isn’t going to be pretty. Or, perhaps you’re out with colleagues and wind up at a salad place for lunch with no soft-textured options. What to do? Such situations call for an ounce of prevention: Chew a calcium carbonate tablet like TUMS or Rolaids just moments before you start eating. Calcium carbonate neutralizes acid immediately and so can help prevent some of the post-meal discomfort you typically experience in such scenarios. And it’s good for your bones to boot.
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What Is Dyspepsia? originally appeared on usnews.com
