4.2 Gastric Disorders and Dietary Interventions

Gastric disorders can wreak havoc on your digestion. From reflux and ulcers to bacterial infections, these issues cause discomfort and complications. Understanding the causes and symptoms is key to managing these conditions effectively.

Luckily, there are ways to find relief. Medications can reduce acid or neutralize it, while dietary changes can ease symptoms. By tweaking what and how you eat, you can soothe your stomach and improve your quality of life.

Gastric Disorders

Reflux and Ulcerative Conditions

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• Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the esophagus
  • Causes burning sensation in chest (heartburn) and regurgitation of food or sour liquid
  • Can lead to complications like esophagitis, Barrett's esophagus, and esophageal cancer if left untreated
• Peptic ulcer disease involves open sores that develop on the inner lining of stomach and upper small intestine
  • Caused by H. pylori bacteria or long-term use of NSAIDs
  • Symptoms include burning stomach pain, feeling of fullness, bloating, and nausea
• Gastritis refers to inflammation of the stomach lining
  • Can be acute (sudden onset) or chronic (long-lasting)
  • Causes include excessive alcohol use, stress, certain medications, and H. pylori infection

Digestive Discomfort and Bacterial Infection

• Dyspepsia, also known as indigestion, encompasses various symptoms in the upper abdomen
  • Includes feelings of fullness, bloating, nausea, and discomfort
  • Can be functional (no apparent cause) or organic (result of an identifiable condition)
• Helicobacter pylori, a spiral-shaped bacterium, infects the lining of the stomach
  • Discovered in 1982 by Barry Marshall and Robin Warren
  • Causes majority of peptic ulcers and increases risk of gastric cancer
  • Diagnosed through blood tests, breath tests, or endoscopy with biopsy

Pharmacological Interventions

Acid Reduction Medications

• Acid suppression therapy aims to reduce stomach acid production or neutralize existing acid
  • Helps alleviate symptoms of GERD, peptic ulcers, and gastritis
  • Various classes of medications used, including H2 blockers and proton pump inhibitors
• Proton pump inhibitors (PPIs) block acid production by inhibiting the proton pump in gastric parietal cells
  • Examples include omeprazole, esomeprazole, and pantoprazole
  • Most effective for long-term management of acid-related disorders
  • Potential side effects include vitamin B12 deficiency and increased risk of bone fractures

Quick-Acting Acid Neutralizers

• Antacids provide rapid relief by neutralizing stomach acid
  • Available over-the-counter in various forms (tablets, liquids, chewables)
  • Common ingredients include calcium carbonate, magnesium hydroxide, and aluminum hydroxide
  • Work best for occasional heartburn or indigestion
  • Not recommended for long-term use due to potential side effects (constipation, diarrhea)

Dietary Interventions

Specialized Diets for Symptom Management

• Low-FODMAP diet reduces intake of fermentable carbohydrates to alleviate digestive symptoms
  • FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols
  • Involves eliminating high-FODMAP foods (certain fruits, vegetables, dairy products) for 2-6 weeks
  • Followed by gradual reintroduction to identify trigger foods
• Elimination diet involves removing suspected trigger foods from the diet
  • Commonly eliminated foods include dairy, gluten, soy, eggs, and nuts
  • Foods are gradually reintroduced while monitoring symptoms
  • Helps identify specific food intolerances or sensitivities

Dietary Habits and Food Choices

• Small, frequent meals help reduce stomach acid production and ease digestion
  • Aim for 5-6 smaller meals throughout the day instead of 3 large meals
  • Helps prevent overloading the digestive system and reduces reflux symptoms
• Trigger foods vary among individuals but commonly include:
  • Spicy foods, citrus fruits, tomato-based products, chocolate, and caffeine
  • Identifying and avoiding personal trigger foods can significantly reduce symptoms
• Bland diet consists of soft, easily digestible foods that are gentle on the stomach
  • Includes foods like bananas, rice, applesauce, and toast (BRAT diet)
  • Useful for short-term management of acute gastritis or during flare-ups

Digestive Process Considerations

• Gastric emptying refers to the rate at which food leaves the stomach and enters the small intestine
  • Delayed gastric emptying can contribute to symptoms of dyspepsia and GERD
  • Certain foods and eating habits can affect gastric emptying rate:
    • High-fat meals slow gastric emptying
    • Liquids generally empty faster than solids
  • Improving gastric emptying through dietary modifications can help alleviate symptoms