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Tag: GI Health

Man holding his chest with his two hands.

How Do You Know if it is Heartburn and Not a Heart Attack?

How do you know if it is heartburn and not a heart attack?

Did you ever have a painful sensation in the center of your chest during a regular after-dinner walk around the house or backyard? It could be your heartburn flaring up again or it may be something more serious like a heart attack.

Heartburn and a heart attack may have similar manifestations on the chest and their symptoms may sometimes be difficult to differentiate.

Heartburn is a common symptom of gastroesophageal reflux disease (GERD), often called acid reflux. This makes acid from the stomach move up into the esophagus, causing a painful burning sensation just behind the breastbone. Not surprisingly, heart attack may also present with a discomfort in the same area. In the emergency room alone, heartburn accounts for nearly half the cases in which actual heart problems are ruled out according to a study by Mousavi et al. in 2007.

Chest pain caused by a heart attack result from reduced blood flow from the heart muscles and is often described as a feeling of tightness, constriction or pressure rather than a burning sensation. But it is not always easy to tell the difference.

The symptoms of heartburn may mimic those of a heart attack. Here are the common symptoms that differentiate heartburn from a heart attack:

 Heartburn

• Burning chest pain that begins at the breastbone
• Pain that moves up toward the throat
• Pain or discomfort that does not typically radiate to the shoulders, neck or arms
• Sensation that food is coming back into the mouth
• Bitter or acidic taste at the back of the throat
• Pain that worsens when lying down or bending over
• The appearance of symptoms after a heavy or spicy meal

Heart attack

• Tightness, pressure, squeezing, stabbing or dull pain most often in the center of the chest
• Pain that spreads to the shoulders, neck or arms
• Irregular or rapid heartbeat
• Cold sweat or clammy skin
• Lightheadedness, weakness or dizziness
• Shortness of breath
• Nausea, indigestion and sometimes vomiting
• Symptoms are associated with physical exertion, extremes of emotions or stress

The treatment of the two conditions are entirely different. For heartburn, doctors may prescribe antacids and acid-suppressing drugs such as omeprazole and pantoprazole. 

For symptoms of a possible heart attack, immediate consult at the emergency room is necessary for prompt management. If you have symptoms and you are not sure as to what they are associated with, seek emergency medical consult especially if you feel chest tightness, have trouble breathing, have cold clammy perspiration or cold sweat, have a feeling of light headedness and there is body weakness, sudden dizziness, fatigue, paleness and pain in your chest or arm that may extend to your neck or jaw.

Always consult a doctor who can best tell you if your symptoms are caused by heartburn or a heart attack.

References:

Role of clinical presentation in diagnosing reflux-related non-cardiac chest pain.

Heartburn vs heart attack

Nine Tips for Healthy Digestion That You Can Do Now

Healthy digestion involves the breaking down and absorption of nutrients without distressing symptoms such as upset stomach, gas, heartburn, nausea, constipation, or diarrhea.

Your food and lifestyle have a direct impact on your digestive health. Improving these factors can support your digestive system’s function and boost your overall health and sense of well-being.

Simple Ways You Can Do Today for Healthy Digestion

You can implement plenty of ways to achieve healthy digestion, and here are simple practices that you can immediately do today.

     1. Eat Real Food – There are many ways to start eating real food. Consider a whole diet, limit your processed food intake, and avoid food additives, trans fats, and artificial sweeteners. These will not only improve your digestion but will protect you against digestive diseases as well.

     2. Get Plenty of Fiber- A high-fiber diet helps food keep moving through your digestive tract, making you less likely to get constipated.

     3. Eliminate the Fats – Fats stay and burn the longest in your system. Decrease your fat intakes, such as junk foods, burgers, fries, and other greasy meals. Be mindful in your cooking. Maybe you can choose steaming over frying most of the time.

     4. Stay Hydrated but Drink with Care – Water is essential to good health and normal bowel function. It helps keep stool soft but solid and well-formed. Avoid drinking beverages such as coffee or soda, especially if they trigger your digestive problems.

     5. Manage Your Stress – Stress hormones directly affect your digestion. As a result, stress can negatively impact your digestion. In fact, it is linked to irritable bowel syndrome, ulcers, constipation, and diarrhea.

     6. Eat Slowly and Mindfully – Mindful eating is the practice of paying attention to all aspects of your food and how you eat them. Eating slowly and mindfully may help prevent common digestive issues such as indigestion, bloating, and gas.

     7. Chew Your Food Well – Chewing thoroughly breaks down the food more easily. The act of chewing also produces saliva, which aids in mixing food in your stomach properly.

     8. Get Moving – Since exercise and gravity help food travel through your digestive system, it can improve your digestion and reduce constipation symptoms. In addition, it can also help reduce inflammation, which can prevent inflammatory bowel conditions.

     9. Consider Oral Digestive Enzymes – Consult your doctor for medicines that may help your dyspepsia, such as digestive enzymes.

Oral digestive enzyme supplements aid in the digestive process reducing symptoms of indigestion. Digestive enzyme supplementation is also reported to significantly reduce symptoms of flatulence, bloating, belching, and fullness after meals.

In case of recurring symptoms of indigestion, it is best to consult your doctor for appropriate evaluation and management.

Having a healthy digestion is an effective way to improve your overall health.  Paying attention to the above tips can make a huge difference.

Researchers Reported the Role of Digestive Enzymes Supplement in Functional Dyspepsia

Dyspepsia, also known to many as indigestion or difficult digestion, refers to a group of troublesome abdominal symptoms such as pain, discomfort in the stomach or chest, bloating, flatulence, belching and abdominal fullness which is affecting most populations around the globe.  

These disturbing symptoms, which are often experienced during or after eating, may vary in intensity and frequency. Symptoms of indigestion are often triggered by consuming certain foods such as fatty or spicy foods, beverages like caffeine, alcohol, soft-drinks and carbonated beverages, overeating, smoking, anxiety, as well as intake of certain medications such as antibiotics, anti- inflammatory drugs and iron supplements.

75% of Cases of Dyspepsia are Considered Functional Dyspepsia

For 25% of cases of dyspepsia, the symptoms could be due to an underlying peptic ulcer, reflux, infections, hepatitis, gallstone, pancreatitis, intestinal obstruction, or stomach cancer and would require appropriate and urgent medical care.

On the other hand, majority of cases of dyspepsia have no clear identifiable cause and would be classified as functional dyspepsia. Functional dyspepsia encompasses a group of symptoms of persistent or recurrent upper abdominal pain, discomfort, bloating, and belching in the absence of organic or structural disease that can likely explain the symptoms.

In an international survey published in the prestigious medical journal Lancet in 2018, approximately 10% of the adult population fulfils symptom-based criteria for functional dyspepsia.

One mechanism offered to explain the occurrence of functional dyspepsia is the deficiency of digestive enzymes. This is supported in a study done by a group of researchers from the Osaka City University Graduate School of Medicine in 2017 which found that approximately 70% of patients with treatment resistant functional dyspepsia had deficiencies in digestive enzymes.

Onkar Swami and Neel Shah authored a review on functional dyspepsia and the role of digestive enzymes published in the International Journal of Basic & Clinical Pharmacology. They found that digestive enzyme deficiency could either be an actual deficiency from organic causes such as abdominal diseases, gastrointestinal su rgery, and nutritional deficiency, or a relative deficiency from poor eating habits such as “eating on the run” or eating late in the day and inadequate chewing of food.  Secretion of the digestive enzyme may also be altered among aging individuals with linear decreasing trend reported after the fourth decade of life. Excessive consumption of fat and alcohol and high meat intake may also result in enzyme deficiency.

Dealing with Dyspepsia

Dealing with dyspepsia involves treatment of the underlying cause. Management of symptoms through medications such as antacids, prokinetics, acid suppressants, antibiotics for infection, and antidepressants to ease discomfort and pain could become a tricky exercise as the symptoms tend to recur and intake of some drugs brings unpleasant side effects.

To ease dyspepsia, patients are often advised to practice lifestyle modification that includes elimination of stress and adequate sleep. Avoiding smoking and regular exercise are part of lifestyle changes.

Eating the right food the right way is also central in the control of dyspepsia. Patients must remember to eat less fatty and spicy food, avoid alcohol, soft-drinks and coffee. Chewing the food gradually or slowly helps to avoid gas to enter the stomach.

Supplementation with oral enzymes is a commonly employed management approach for functional dyspepsia. Oral preparations of enzyme supplements deliver digestive actions generated by multiple enzymes which are naturally produced by the pancreas. The various digestive enzymes break down or digest the food nutrients, carbohydrates, fats and proteins to smaller units which are then assimilated by the body. Symptoms of dyspepsia are ameliorated by oral enzyme supplementation through their action of aiding the digestive process. Supplementation of digestive enzymes in functional dyspepsia are reported to significantly reduce the symptoms of flatulence, bloating, belching, fullness and distress after meals.

Digestive enzyme preparations, according to Swami and Shah enhance digestive power, help in the complete absorption of nutrients, and match the body’s natural metabolism. Preparations of digestive enzymes do not interfere with internal metabolism and are well tolerated with minimum side effects.

In a controlled trial published just this February 2020, Dr. G.S. Wang and a team of gastroenterologists and gerontologists examined how a blend of digestive enzymes compared with the administration of Mosapride, a drug that promotes gastric motility, in the treatment of symptoms of dyspepsia in the elderly, particularly the type most felt after eating, also known as post-prandial discomfort syndrome.  323 patients were either treated with digestive enzymes, Mosapride, or a combination of the two and it was found that the combination treatment as well as administering digestive enzymes alone had significantly better outcomes than when Mosapride was given alone.

In cases where patients are bothered by nagging or recurring symptoms of dyspepsia, they should consult their doctors for appropriate medical evaluation and management.

References:


Bytzer P, Talley NJ. Dyspepsia. Ann Intern Med.

Aziz I, Palsson OS, Törnblom H, Sperber AD, Whitehead WE, Simrén M. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol.

Fujikawa Y, Tominaga K, Tanaka F, et al. Postprandial Symptoms Felt at the Lower Part of the Epigastrium and a Possible Association of Pancreatic Exocrine Dysfunction with the Pathogenesis of Functional Dyspepsia. Intern Med.

Swami OC & Shah NJ, Functional dyspepsia and the role of digestive enzymes supplement in its therapy International Journal of Basic and Clinical Pharmacology.