INDIGESTION

THERE'S TOO MUCH FOOD ON YOUR PLATE, but it tastes so good.
Advertisements for some products might encourage you to go ahead and eat everything - simply take an antacid afterwards. But overindulging isn't the only reason you may find yourself wanting a stomach remedy.
Technically, indigestion means not being able to digest food properly. This covers everything from heartburn, acid over­production and stomach upset to pain, nausea and vomiting, heartburn with acid regurgitation, and wind that causes flatulence, burping or bloating.

Often indigestion results from an overproduction of stomach acid. Paradoxically, it can also result from a shortage of acid. Sometimes the culprit is the oesophageal sphincter, the valve between the stomach and oesophagus. If the sphincter fails to close properly, it allows partially digested food and acid to leave the stomach and come back up to the throat, causing heartburn. A sluggish digestive system may be at fault; so can bouts of stress and anxiety, which can be compounded by eating too quickly and not chewing your food thoroughly. Certain drugs can also produce indigestion as a side effect.

One thing you can be sure of: if any weak links exist in your digestive system, overeating or eating problematic foods is bound to bring on indigestion.
If your bouts of indigestion are long-term, they could signal an underlying problem. So be sure to let your doctor know. Peptic ulcer, gallbladder disease, chronic appendicitis, stomach inflammation, hiatus hernia and gastro-oesophageal reflux are just some of the long­term gastrointestinal ailments that can have indigestion as a symptom.

Simple and occasional indigestion can be helped with herbs. Some herbs help dispel wind and ease overactive bowels; others can be used before eating to set the stage for better digestion. Some soothe irritated tissues in the digestive tract; another category eases the spasms or cramps that sometimes accompany indigestion. Some herbs for digestion have more than one of these benefits.

DRUGS THAT MAY CAUSE INDIGESTION
Many widely used drugs can cause digestive disturbances. Here are just a few.
· Antibiotics
· spirin, ibuprofen and paracetamol
· Corticosteroids
· Digoxin (a heart medication)
Iron supplements
· Narcotic pain relievers
· TheophylIine (an asthma medication)

SIMPLE STEPS FOR AVOIDING INDIGESTION
A few easy precautions can help reduce digestive upset.
· Give yourself time for meals - don't eat on the run.
· Decrease your consumption of fat and sugar, which can increase wind.
· Eat smaller portions.
· Chew food thoroughly.
· Eat whole foods that contain fibre, which move more easily through your
intestines.
· Drink plenty of water, at least eight glasses per day, to help keep your
intestinal contents moving.

DRUG TREATMENT

Antacids
Activated dimeticone (Unigest, Windcheaters, others), aluminium hydroxide (Alu-Cap, Aludrox, Maalox, Mucogel, others), magnesium (Bismag, Bisodol, Carbellon, others), calcium carbonate (Turns). Function: neutralise excess acid and eliminate excess wind. Side effects: constipation or diarrhoea, white or pale stools, stomach cramps.

Histamine Antagonists
Ranitidine (Zantac), famotidine (Pepcid), cimetidine (Dyspamet,Tagamet). Function: reduce the secretion of acid and digestive enzymes in the stomach. Side effects: confusion.
Colloidal Bismuth Compounds
Bismuth (Bisma-Rex, Pepto-Bismol, Roter). Function: binds to and coats the lining of the stomach to protect it from irritation by excessstomach acid. Side effects: may cause skin rash, weakness, joint pain, diarrhoea or stomach irritation when taken in large. doses.

Proton Pump Inhibitors
Omeprazole (Losec), esomeprazole (Nexium). Function: block the mechanism that pumps acid into the stomach. Side effects: growth of bacteria in the stomach.

Prokinetic Agents
Cisapride (Prepulsid), metoclopramide (Maxolon). Function: decrease the amount of time food spends in the stomach and intestines. Cisapride side effects: dizziness, vomiting, sore throat, chest pain, fatigue, back pain, depression, dehydration, diarrhoea, abdominal pain, constipation, flatulence, runny nose. Metoclopramide side effects: fatigue, apathy, depression, rash.

Digestive Enzymes
Pancreatin (Creon, others). Function: promotes digestion and relaxes the intestines. Side effects: drowsiness, headache, dizziness, blurred vision, nausea, vomiting, hot and dry skin, difficulty swallowing, constipation.

HERBAL REMEDIES

Camomile (Matricaria recutita)
A time-honoured, soothing digestive herb, camomile helps dispel wind, soothe the stomach and relax the muscles that move food through the intestines. Many people use camomile as a sedative. It makes an excellent bedtime tonic for an upset stomach. Mix it with peppermint for a tasty, effective tea to treat indigestion. It may be more effective as a tincture than a tea since many of its components evaporate quickly. Typical dosage: 3 to 4 cups of tea per day (steep 1/2 to 1 teaspoon of dried flowers in 1/4 litre of hot water for 10 minutes); or 10 to 40 drops of tincture three times per day.

Peppermint (Mentha x piperita)
Any member of the mint family is good for indigestion, so if you don't care for the taste of peppermint, try lemon balm (Melissa officinalis). Mint acts as a muscle relaxant and can calm an overactive digestive tract. Typical dosage: 6 to 12 drops of essential oil in water three times per day; or I to 2 capsules three times per day after meals (if irritable bowel syndrome is a factor in your indigestion, use enteric-coated capsules); or up to 3 cups of tea per day (steep 1 1/2 teaspoons of dried leaf in 1/4 litre of hot water for 10 minutes); or 10 to 20 drops of tincture in water after meals. Caution: because peppermint relaxes the valve between the stomach and the oesophagus, it can worsen heartburn. If this is one of your symptoms, don't use peppermint.

Marshmallow (Althaea officinalis)
The root of this herb soothes the digestive tract's mucous membranes. It's also a mild immune-system stimulant, good for those whose indigestion may have a viral or bacterial cause. Usually the root is used, but the leaves also contain some of the substance that soothes an upset stomach. Typical dosage: up to six 400- to 500-milligram capsules per day; or I cup of tea per day, divided into three doses (simmer 1 teaspoon of dried root in 1/4 litre of hot water for 15 minutes); or 20 to 40 drops of tincture up to five times per day.

Angelica (Angelica archangelica)
The fruit, leaf and root of this herb stimulate digestion, help dispel wind and calm the nerves. Angelica is especially good when bloating or cramps are part of indigestion. You might see it included with other bitter herbs, such as dandelion, in commercial bitters preparations. Typical dosage: up to 3 cups of tea per day, taken 30 minutes before meals (steep 1 teaspoon of dried root in 1/4 litre of hot water for 10 minutes); or 10 to 40 drops of tincture up to three times per day. Caution: may cause sun sensitivity. Avoid if you are pregnant or breastfeeding.

Ginger (Zingiber officinale)
Ginger stimulates digestion and dispels wind, helps move food through the intestinal tract and reduce irritation. It also can prevent motion sickness. Typical dosage: up to eight 500- to 600-milligram capsules per day; or 1/2 to 1 teaspoon fresh ground root per day; or 10 to 20 drops of tincture in water three times per day.

Fennel (Foeniculum vulgare)
Fennel relieves wind and stimulates the digestive tract. If you are preparing a vegetable that you have trouble digesting, add fennel seeds to your recipe. Typical dosage: up to 2 teaspoons of raw seeds eaten after meals; or 1 cup of tea per day (simmer 2 to 3 teaspoons of crushed seeds in1/4 litre of hot water for 10 to 15 minutes); or 30 to 60 drops of tincture in water up to four times per day.

OTHER WAYS TO CALM AN UPSET STOMACH
Try these approaches for stubborn cases of indigestion.

· Take probiotics. Often referred to as the `good bacteria', these are similar to the bacteria that normally inhabit your intestinal tract. Probiotics include bacteria of the genus Lactobacillus and Bifidobacterium. They are beneficial for a number of reasons. They reduce the chances for harmful bacteria to proliferate and cause diarrhoea; they improve digestion; and they make B vitamins-especially niacin, vitamin B6 and folic acid - much easier to absorb. Often, they can calm an irritated digestive tract.

There are two other ways to get their benefits. You can eat yoghurt that contains live cultures (check the label to be sure that it does). Or you can eat more fruits, vegetables and grains, all of which encourage the growth of probiotic bacteria.

· Take digestive enzymes. For indigestion that might be caused by insufficient digestive enzymes, a few supplements may ease symptoms. Bromelain, from pineapple, and pancreatin, an extract of pancreatic enzymes, are two commonly used products. Typical dosage for bromelain: one to two 2,400 milk-clotting units or gelatin-dissolving units per day, taken with food. Typical dosage for pancreatin: 350 to 1,000 milligrams of product labelled 10X USP three times per day.