Is it just indigestion? Why it's harder to enjoy buffets and suppers as you get old
In this series on digestive health, CNA Lifestyle finds out why it's not just about overeating but also stress and anxiety. Plus tips on what you can do about it.
Eating is one of the greatest pleasures in life, and you might feel like your body has let you down when your digestive system starts to turn in a less-than-stellar performance as you age. What’s up with your body? Here, we look at indigestion.
WHAT’S HAPPENING IN MY GUT?
You know the feeling you get after a big meal: An uncomfortable sense of fullness, a burning sensation in the upper abdomen and maybe even pain in the abdomen.
That’s because your digestive system is under a lot of stress to process the large amount of food you’ve eaten.
For one, your stomach has to expand beyond its normal size to accommodate the food quantity. This causes the stomach to push against other organs, making you feel uncomfortable, said Erma Levy, a research dietitian at MD Anderson Center, on its website.
Furthermore, your digestive organs such as the liver and pancreas have to work extra hard to process the amount of food. “They secrete extra hormones and enzymes to break the food down,” said Levy.
Your stomach, too, produces hydrochloric acid to digest the food but it can get backed up into the oesophagus, said Levy, because the stomach can’t accommodate. The result is that classic burning sensation in your upper abdomen known as heartburn.
Collectively, these signs are what many recognise as indigestion, or what’s medically known as dyspepsia, according to Dr Kewin Siah, a consultant with National University Hospital’s Division of Gastroenterology and Hepatology.
“Signs of indigestion may be vague but can include nausea and vomiting, heartburn and excessive gaseous symptoms like bloating, belching and flatulence.”
Dyspepsia isn’t always caused by overeating. More serious medical issues such as peptic ulcer disease, infection with Helicobacter pylori, gallstone, inflammation of the stomach or pancreas, food intolerance (such as lactose intolerance) and Irritable Bowel Syndrome (IBS) can also give rise to indigestion, said Dr Siah.
A lot of people who suffer from constipation may also think that the source of [indigestion] is from the stomach but, in fact, it is from a very full colon.
“Dyspepsia is especially common in patients with constipation type IBS. A lot of people who suffer from constipation may also think that the source of discomfort is from the stomach but, in fact, it is from a very full colon,” he said.
Medications are other potential causes of indigestion, including steroids, anti-hypertensive drugs, statins and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, said Dr Siah.
WHY IS IT ONLY HAPPENING NOW THAT I’M OLDER?
Do your stress levels go up the older you get? Are you more anxious and worried, especially since the pandemic struck? As it turns out, your brain has a direct line to your gut via the vagus nerve, so your emotions can affect how your gut functions and feels.
In fact, many patients with indigestion may sometimes have anxiety or depression disorders, said Dr Siah, highlighting that the COVID-19 situation introduces yet more stress.
“A lot of less resilient people are not able to cope with new situations during the pandemic, and some of them may be at risk of developing long-term indigestion.”
Furthermore, stress makes your body produce the hormone cortisol, which has a few effects on you, said Professor Susan Albers on the Cleveland Clinic website. It can cause you to ignore your hunger cues and refrain from eating for long stretches. Or it can turn you into a mindless muncher to distract yourself from the stress.
If you’re a stress eater, Prof Albers said that cortisol is likely to make you crave sugary, salty and fatty foods – the latter of the lot, said Dr Siah, can wreak havoc on your digestive system and cause indigestion.
Functionally, your gut also takes a beating the older you get. “As we age, our gut function declines, including delayed stomach emptying and constipation,” said Dr Siah. “Ageing is also associated with a blunted absorption of nutrients.”
WHAT’S THE SOLUTION?
The most obvious solution would be to stop eating large meals – no buffets, no big tze char dinners and no late-night suppers – and avoid aggravating items such as fatty foods.
And instead of three meals a day, consider eating smaller but frequent meals. When eating, chew your food more slowly and drink less water or soup, advised the National Cancer Centre Singapore website.
For indigestion that worsens at night, place pillows behind your back and sleep in a semi-upright position to prevent the back-flow of stomach acid, advised the website.
If your indigestion keeps recurring, or what Dr Siah calls functional dyspepsia, be assured that while it is a long-term issue, it will not cause death. You can minimise the discomfort by reducing stress and anxiety levels, he said.
Dr Siah added: “However, if you have more serious indigestion or the worrying symptoms mentioned above (such as peptic ulcer disease, infection with Helicobacter pylori, gallstone or IBS), you need to seek help from a medical practitioner. Depending on your condition and symptoms, doctors may order blood tests, Helicobacter pylori test, imaging of the abdomen or an endoscopy of the gastrointestinal tract”.
And you may be prescribed acid-suppressive medication to improve gut motility or other drugs to modulate your gut-brain connection, he said.