This is a vague problem that is functional in nature and usually not due to an underlying structural cause. Belching, distension and abdominal sounds often occur associated with abdominal or epigastric pain. Dietary factors may be important in reducing symptoms. Because similar symptoms may be due to more serious conditions, it is important to have an accurate diagnosis.
The upper GI tract consists of the organs where food is initially taken into the body and digestion begins, including the esophagus, stomach, pylorus and duodenum. Numerous conditions are possible in this area, some of which are:
- Cardiospasm: Dilation of the esophagus due to the gastroesophageal sphincter failing to open properly and allow food into the stomach.
- Gastroesophageal Reflux Disease (GERD): Incompetent cardiac sphincter, causing backward flow of acid from the stomach up into the esophagus.
- Gastric Mucosal Tears: Lacerations in the mucosa of the gastroesophageal junction, where the esophagus passes through the diaphragm, or in the lining of the lower esophagus. Generally caused by repeated vomiting or retching (repetitive contractions of the abdominal muscles), it can cause profuse hemorrhaging.
- Esophageal Stricture: Narrowing of the esophagus due to scar tissue, resulting in difficulty swallowing.
- Esophageal Obstruction: Blockage of the esophagus caused by tumors or other foreign bodies such as improperly chewed food (often large pieces of meat) impacted in the lower esophagus.
- Esophageal Varices: Enlarged veins in the lower esophagus are a common complication of liver cirrhosis. If these veins rupture, massive bleeding may result.
- Hiatal Hernia: Movement of the upper part of the stomach up into the chest cavity resulting in retention of acid and other stomach contents which can then easily reflux into the lower esophagus.
- Dumping Syndrome: Rapid gastric emptying caused by the lower end of the small intestine (jejunum) filling too quickly with undigested food from the stomach. Symptoms include nausea, vomiting, diarrhea, bloating, shortness of breath, weakness, and dizziness. Stomach surgery is the main cause.
- Hypochlorhydria and achlorhydria: Insufficient stomach acid to sterilize the stomach and start protein digestion.
- Menetrier’s Disease: A chronic condition with an unknown cause. Giant folds of tissue, possibly inflamed or containing ulcers, grow in the wall of the stomach and can interfere with the body’s absorption of some proteins.
- Whipple’s Disease: A malabsorption disease caused by bacteria. Although it can affect any system of the body, it usually attacks the small intestine. It interferes with the body’s ability to absorb certain nutrients, causing weight loss, irregular breakdown of carbohydrates and fats, resistance to insulin, and malfunctions of the immune system. The disease can be cured, but if not recognized, it is usually fatal.
- Zollinger-Ellison Syndrome: Another disease of unknown cause leading to gastrin-secreting tumors in the pancreas, which promote an extreme form of peptic ulcer disease in both the stomach and duodenum.
- Peptic Ulcer Disease (PUD): Over 20 million Americans will suffer from a peptic ulcer in their lifetime.
Upper digestive symptoms are often due to hydrochloric acid (HCl) or pancreatic insufficiency. It can be difficult to distinguish between the two. The easiest way to find out is to do both an HCl and digestive enzyme trial, one at a time. A natural doctor’s assistance can be helpful in conducting these trials.
Signs, symptoms & indicators of Dyspepsia / Poor Digestion
Undigested food in stools
(Very/tendency to) infrequent stools
Must observe food combining rules or can eat poorly combined foods
There is a theory that different food groups are digested optimally when eaten in specific combinations. Proteins (beans, nuts, seeds, meat, fish, poultry) and starches (grains, pasta, breads, cereal, rice, carrots, etc.) should be eaten at separate meals. Proteins can be eaten with vegetables and starches can be combined with vegetables.
For some people, when foods are mixed in the digestive system inappropriately, digestive disturbances can occur.
Greasy food intolerance
Counter Indicators
Can eat poorly combined foods
There is a theory that different food groups are digested optimally when eaten in specific combinations. Proteins (beans, nuts, seeds, meat, fish, poultry) and starches (grains, pasta, breads, cereal, rice, carrots, etc.) should be eaten at separate meals. Proteins can be eaten with vegetables and starches can be combined with vegetables.
For some people, when foods are mixed in the digestive system inappropriately, digestive disturbances can occur.
Rarely/never eating breakfast or regular avoidance of breakfast
Distaste for meat
Meal-related bloating
Meal-related burping
General flatulence
Unexplained nausea
Vitamin-induced stomach upsets
Coated tongue
Reduced sense of taste or smell
Brittle fingernails
Conditions that suggest Dyspepsia / Poor Digestion
Psoriasis
Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in elevated levels of amino acids and polypeptides in the bowel. These are metabolized by bowel bacteria into several toxic compounds. The toxic metabolites of the amino acids arginine and ornithine are known as polyamines (e.g., putrescine, spermidine, and cadaverine) and have been shown to be increased in individuals with psoriasis. Polyamines contribute to the excessive rate of cell proliferation. Lowered skin and urinary levels of polyamines are associated with clinical improvement in psoriasis, so digestive function should be evaluated.
Risk factors for Dyspepsia / Poor Digestion
Excess Water Consumption
Excess water drinking can lower stomach acidity and impair digestion.
Aerobic Exercise Need
Exercise as a remedy for many digestive symptoms. Thirty minutes of some sort of aerobic exercise each day may make the symptoms disappear. Just make sure your fitness routine isn’t so bouncy or jarring that it aggravates your symptoms. Walking may be sufficient.
Not chewing food sufficiently
Chewing your food thoroughly begins the digestive process sooner by mixing amylase with the food in your mouth and promotes more normal digestion by increasing the surface area of the food particles being digested.
Counter Indicators
Chews food well
Chewing your food thoroughly begins the digestive process sooner by mixing amylase with the food in your mouth and promotes more normal digestion by increasing the surface area of the food particles being digested.
(Partial) vegetarian diet or raw food/vegan diet
History of unexplained nausea
Dyspepsia / Poor Digestion suggests the following may be present
Dyspepsia / Poor Digestion can lead to
Psoriasis
Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in elevated levels of amino acids and polypeptides in the bowel. These are metabolized by bowel bacteria into several toxic compounds. The toxic metabolites of the amino acids arginine and ornithine are known as polyamines (e.g., putrescine, spermidine, and cadaverine) and have been shown to be increased in individuals with psoriasis. Polyamines contribute to the excessive rate of cell proliferation. Lowered skin and urinary levels of polyamines are associated with clinical improvement in psoriasis, so digestive function should be evaluated.
Recommendations for Dyspepsia / Poor Digestion
Herbal Combinations
Digest RC is a multiple herbal extract formulation which was introduced in Europe over 45 years ago and today sells over 100 million doses annually. The primary mechanism of action promotes the release of bile from the liver to digest fat and protein. The various ingredients within Digest RC are delivered to the parts of the digestive system where they will be most effective by means of a “layered” delivery system (i.e., multiple timed-release). In this manner, Digest RC optimizes the operation of its ingredients to aid all digestive problems which other products usually only attack one at a time. Digest RC is particularly beneficial for those who have not responded to food elimination therapy, and those with the digestive problems associated with aging.
The ingredients in Digest RC have been able to:
Cayenne Pepper (Capsicum frutescens)
A few sources have recommended cayenne pepper as a potential treatment for dyspepsia, gastritis and even peptic ulcer, most modern herbal texts suggest avoiding the herb in persons with these conditions. A small clinical trial suggests that cayenne may be beneficial in some persons with functional dyspepsia. Approximately 850mg of cayenne powder in a capsule was given 3 times per day just before meals (0.7mg capsaicin per gram). [NEJM 2002;346: pp.947-48]
Turmeric Extract, Curcumin
Improves digestion by increasing the flow of bile from the gallbladder.
Ginger Root (Zingiber officinalis)
Because ginger soothes the digestive tract, it can be useful in relieving flatulence. Supplements or freshly grated ginger root mixed with diluted lime juice work well for this purpose.
Therapeutic Fasting
Fasting gives the digestive system a much-needed rest. After fasting, both digestion and elimination are invigorated.
Reduced Water Consumption
Although dyspepsia is a sign of dehydration, it is generally recommended that you do not drink during a substantial meal, or from 1/2 hour before to 2 hours afterwards.
Chewing Gum
If gas is a problem, one thing to keep in mind is the connection with sorbitol, a sweetener that’s used in many brands of sugar free gum. More than five or six sticks in a day and you may get a major case of wind and even diarrhea. “The bacteria that live in our colons absolutely love sorbitol,” says gastroenterologist Charlene Prather, of the Mayo Clinic in Minnesota, US. The bacteria breaks down the sorbitol, and that produces large amounts of gas that swell the colon and cause pain and cramps. So, cut back on gum containing sorbitol if your are using any.
Reading List
The Maker’s Diet by Dr. Jordan Rubin, NMD.
FreedomYou is a website which talks about the benefits of water and juice fasting. There are several books written by the husband/wife team which will help make this powerful healing practice become a reality for anyone in need of rejuvenation.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
Glossary
Epigastric
Relating to the area immediately above the stomach.
Gastrointestinal
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Esophagus
Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Pylorus
The sphincter muscle at the distal (lower) opening of the stomach. The pylorus only allows food to pass through after the digestive enzymes of the stomach have properly processed it. Once through the pylorus on its way to the duodenum, the food is still only partially digested.
Duodenum
First portion of the small intestine between the pylorus and jejunum.
Cardiospasm
A condition where the cardiac (gastroesophageal) sphincter fails to open properly and food cannot pass normally into the stomach. As a consequence the smooth muscle in the wall of the esophagus must contract more vigorously to force the food past the constricted sphincter. Eventually the muscle undergoes hypertrophy and the esophagus becomes dilated adjacent to the constricted sphincter because of retention of food.
Gastric Reflux Disease
Gastro-Esophageal Reflux Disease (GERD). A common relapsing condition affecting approximately 10% of the U.S. population and caused by an abnormal exposure of the lower esophagus to refluxed gastric contents, causing irritation and injury to the esophageal tissues. GERD develops as a result of relaxations of the transient lower esophageal sphincter. Typical presenting symptoms are heartburn, an epigastric burning sensation and acid regurgitation. However, some patients may present with atypical symptoms such as chest pain, shortness of breath, wheezing, and coughing.
Cardiac
Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.
Mucosa
Mucous tissue layer lining tubular structures (nasal passages, ear canal, etc.).
Diaphragm
The muscle separating the stomach from the chest.
Stricture
An abnormal narrowing of a bodily passage caused by, for example, scar tissue.
Scar Tissue
Fibrous tissue replacing normal tissues destroyed by injury or disease.
Cirrhosis
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Hiatal Hernia
Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Jejunum
The lower end of the small intestine.
Nausea
Symptoms resulting from an inclination to vomit.
Diarrhea
Excessive discharge of contents of bowel.
Hypochlorhydria
The condition of having low hydrochloric acid levels in the stomach, often the cause of digestive disorders.
Achlorhydria
The complete absence or failure of stomach acid secretion.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Ulcer
Lesion on the skin or mucous membrane.
Bacteria
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Carbohydrates
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Insulin
A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.
Immune System
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.
Peptic Ulcer
A general term for gastric ulcers (stomach) and duodenal ulcers (duodenum), open sores in the stomach or duodenum caused by digestive juices and stomach acid. Most ulcers are no larger than a pencil eraser, but they can cause tremendous discomfort and pain. They occur most frequently in the 60 to 70 age group, and slightly more often in men than in women. Doctors now know that there are two major causes of ulcers: most often patients are infected with the bacteria Helicobacter pylori (H. pylori); others are regular users of non-steroidal anti-inflammatory drugs (NSAIDS), which include common products like aspirin and ibuprofen.
Hydrochloric Acid
(HCl): An inorganic acidic compound, excreted by the stomach, that aids in digestion.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Metabolite
Any product (foodstuff, intermediate, waste product) of metabolism.
Arginine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. May promote the release of growth hormone. Involved in creatine synthesis, a compound that stores energy in muscle. Helps to remove ammonia from the body as part of the urea cycle.
Ornithine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. Manufactured from arginine and functions similarly to arginine, it stimulates the human growth hormone and is made by the digestion of proteins and some compounds made from arginine. The major difference between the two is that ornithine enters cell mitochondria. Arginine does not.
Psoriasis
An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.
Aerobic
Using oxygen. For example, aerobic exercises such as running, swimming, bicycling or playing tennis use up lots of oxygen and burn up lots of calories and fat.