QUESTION: Hello Doctor, I always get heartburn when I eat posho and sweet potatoes. What causes it and what should I do?
ANSWER: Dear writer,
Heartburn and regurgitation describes retrosternal, burning discomfort, often rising up into the chest and sometimes accompanied by regurgitation of acidic or bitter fluid into the throat.
These symptoms often occur after meals on lying down, bending, straining, or heavy lifting, and are classical of gastroesophageal reflux.
The war
The stomach is a battle ground between the forces of attack and defense.
The forces include an acid (hydrochloric), an enzyme (pepsin), bacteria (Helicobacter pylori), and salt (bile), whereas the protection involves secretion of mucus (mucin and cellular mucus), a buffer (bicarbonate), mucosal blood flow and cell turnover.
This war has symptoms that include epigastria pain, often related to hunger, specific foods, or time of day with or without bloating, fullness after meals and heartburn (retro sternal pain + reflux); the sign of the war is tender epigastrium.
Danger signs
Some of the symptoms and signs are alarm symptoms and require further investigation.
These may include anemia (iron deficiency), loss of weight, anorexia (loss of appetite).
Recent onset/progressive symptoms; bloody stool/vomiting blood and difficulty when swallowing.
Management
– Dietary changes- avoid any aggravating foods.
– Take antacids or acid suppression as prescribed by your doctor.
– Purge stress and reduce alcohol and tobacco use.
– Investigation is not required, but in patients over 55 years of age, those with alarm symptoms or atypical features, urgent endoscopy is necessary and follow-up.
– For those less than 55 years H. pylori serology, stool antigen, 13C urea breath test may be performed which when positive, H. pylori eradication treatment is given and no follow-up after symptoms resolve.
