Do all NSAIDs have the same side-effects?
Most NSAIDs (non-steroidal anti-inflammatory drugs) have an effect on the stomach
which may cause problems for some people. There are subtle differences between NSAIDs
(and differences between people) that could make one drug more suitable for you
than another. No drug is absolutely free of side effects therefore the aim of treatment
with prescribed drugs is to produce beneficial effects that outweigh the risks when
used appropriately. The aim of treatment with prescribed drugs is to produce beneficial
effects that outweigh the risks when used appropriately.
What is H. pylori?
Helicobacter pylori is a type of bacteria that lives in the human stomach. It was
discovered in Australia in 1984, and is now known to be the main cause of peptic
ulcer disease. Although H. pylori infection is very common, it usually causes no
symptoms. Only about 15% of people infected go on to develop peptic ulcer disease.
In the rest, the bacteria lives in the mucus layer in the stomach without causing
problems. There are many strains of H. pylori.
That means immunity to one strain will not protect you against infection by another.
Similarly, one type of antibiotic therapy may be effective against some strains
but ineffective against others.What is H. pylori? Helicobacter pylori is a type
of bacteria that lives in the human stomach. It was discovered in Australia in 1984,
and is now known to be the main cause of peptic ulcer disease. Although H. pylori
infection is very common, it usually causes no symptoms. Only about 15% of people
infected go on to develop peptic ulcer disease. In the rest, the bacteria lives
in the mucus layer in the stomach without causing problems. There are many strains
of H. pylori.
Can children have reflux?
Reflux is common in infancy, with most babies regurgitating (posseting) a little
after feeds. However, in most cases this settles spontaneously between 12-18 months
of age. However, if babies cannot keep their food down they will fail to grow. Medical
help may be needed to make sure the baby is well nourished while a normal feeding
pattern is established. Reflux oesophagitis can occur in childhood but is much more
common in adulthood.
Why does reflux occur in pregnancy?
Not all pregnancies are accompanied by reflux. Reflux may occur later on as a result
of the womb becoming so large that it puts upward pressure on the stomach. It is
important to avoid taking medicines in pregnancy, especially in the early months.
The midwife and doctor will provide appropriate help.
What is a stricture and how is it treated?
A stricture of the oesophagus is a rare complication of reflux disease. The stricture
is a narrowing of the oesophagus near the stomach. This makes swallowing difficult.
The condition is quite rare, and usually affects people (more women than men) in
the older age groups. Treatment includes acid suppression and widening the oesophagus
at the site of the stricture. This is carried out in a hospital by a specialist,
who uses a small balloon device that is inflated at the site of the stricture.
What is a motility disorder?
Just as mobility depends on the proper functioning of your skeletal muscles, so
movement of food through your gut (motility) depends on a normal pattern of contractions
by the muscles of your digestive tract. In tubes, such as the oesophagus and the
gut, these muscles contract in a sequence that helps push food along. These muscles
help you swallow. There are also muscles forming the valves at the top and bottom
of the stomach. The one at the top relaxes when you swallow to allow food and drink
into your stomach. The one at the bottom (the pyloric sphincter) relaxes to allow
partially digested food to enter the duodenum. Disorders of motility result in disordered
patterns of contraction, causing pain in the gut. Valve disorders can be a cause
of reflux and also interfere with stomach emptying leading to bloating and discomfort
after meals.
What is anaemia?
Anaemia means lack of blood, though the word is used to describe a lack of haemoglobin.
This is the red pigment that carries oxygen in the red blood cells in your blood.
If you have anaemia you may feel weak and tired. Where your skin is normally pink,
it may be pale. Anaemia is a worry if you have a digestive disorder because the
cause may be bleeding from the lining of the digestive tract.
Does duodenal ulcer disease run in families?
The main risk factors for duodenal ulcer disease include H. pylori infection (which
is found in 95% of cases), smoking and the use of drugs such as NSAIDs and oral
steroids. However, there is some evidence to show that certain families are more
prone to duodenal ulcer disease than others. There also seem to be more cases of
duodenal ulcer in those who have blood group O than in those with other blood groups.
This suggests that you could inherit a tendency to develop ulcers and need to be
even more careful to reduce risk.
If I have no symptoms, is my reflux disease cured?
Not necessarily.Your symptoms are not always an easy guide to the damage that may
be present in your oesophagus. About 60% of people with reflux symptoms have no
significant damage to their oesophagus. However, of the people who do have visible
signs of oesophagitis, about half have no symptoms. Consequently it would be difficult
to be certain of the state of your oesophagus without having a look at it through
an endoscope periodically.Your doctor is best placed to decide if and when this
might be necessary.
Angina or heartburn?
Heartburn is a burning sensation which usually occurs after a meal and when bending
or lying flat. It may be accompanied by regurgitation or belching. In contrast,
angina is a crushing type pain which often comes on with exercise. However, a few
people may experience an oesophageal spasm, which is like cramp in the muscles of
the gullet. This pain may be very similar to angina and the drugs used to treat
angina will often relieve the pain of oesophageal spasm. In contrast, oesophageal
spasm may also be relieved using antacids or acid suppressant medicines, whereas
angina will not. If you experience either pain for the first time, you should seek
medical advice.
What food may make the symptoms of my acid-related disorder worse?
The following food and drinks may be associated with a triggering or worsening of
symptoms: Food: citrus fruits, high fat foods, chocolate, tomatoes, onions Drink:
full cream milk, coffee and tea (including decaffeinated), very hot drinks, acidic
fruit drinks (e.g. orange or grapefruit juice), fizzy drinks, alcoholic drinks.
It maybe helpful for you to keep a food diary to help you identify foods and drinks
that may trigger your symptoms. If you suffer severe or persistent symptoms you
should consult your doctor.
What is a balanced diet?
A balanced diet contains the right proportions of carbohydrates (including fibre),
proteins and fats. It should also contain adequate amounts of vitamins, minerals
and water. All these can be obtained by eating ordinary food. See this section and this section for more information.
It is recommended that we should be eating at least five portions of fruit and vegetables
each day. what is a portion?
- 1 apple, banana, pear, orange or other similar sized fruit
- 2 plums or similar sized fruit
- A grapefruit or avocado
- 1 slice of a large fruit, such as melon or pineapple
- 3 heaped tablespoons of vegetables (raw, cooked, frozen or canned)
- 3 heaped tablespoons of beans and pulses (however much you eat, beans and pulses
count as a maximum of one portion a day)
- 3 heaped tablespoons of fruit salad (fresh or canned in fruit juice) or stewed
fruit
- 1 heaped tablespoon of dried fruit (such as raisins and apricots)
- 1 cupful of grapes, cherries or berries
- A dessert bowl of salad
- A glass (150 ml) of fruit juice (however much you drink, fruit juice counts as
a maximum of one portion a day)
How can I fit five portions of fruit or vegetables into my daily diet?
This can easily be achieved by having one portion of fruit at breakfast and lunch
and three portions of vegetables spread over lunch and dinner.