Dr. Hideg: Moderation key for the holidays
We are in the midst of another holiday season of parties, dinners, fundraisers and other gatherings filled with friends, food and drink.
In addition to larger portions, many holiday foods have more sugar and fats than we normally eat. How is your stomach doing with all this holiday cheer?
Many people experience bouts of heartburn, bloating, cramping, constipation, diarrhea, sour stomach and gas – even vomiting when they really overdo it.
The simplest way to avoid these problems is to eat and drink smaller portions and to avoid particularly rich foods that you know you will pay for later. But it is the holidays and that second piece of fruitcake is calling your name.
I just love fruitcake. Really, I do. For you it may not be the fruitcake, but you know what I mean.
If you know you will be indulging in things that will cause problems later, an over-the-counter acid reducer before you eat may help. Some acid reducers are delayed release, so you either need to choose one that is not delayed release or plan well in advance for when to take it.
If you forget to take something in advance or you eat something spur-of-the-moment, then bland foods, antacids and other stomach soothers may be in order. The BRAT diet (bananas, rice, unsweetened applesauce, toast) and slightly salty fluids in small, frequent portions can help get your stomach back online.
If you reach for antacids and other stomach remedies, check the ingredients and choose something that will address your particular symptoms.
Calcium and magnesium carbonate neutralize excess acid (I like calcium-based antacids for a little extra calcium for my bones); simethicone helps with gas and bloating; loperamide can lessen diarrhea; and bismuth subsalicylate eases diarrhea and nausea.
Fiber supplements are the first choice for constipation; taken daily they can also reduce symptoms of irritable bowel syndrome. Docusate and bisacodyl also treat constipation.
Heartburn or upper middle abdominal pain that lasts a month or longer, happens more than once a week or does not respond to over-the-counter medication should be treated by your healthcare provider. Untreated heartburn increases the risk of esophageal cancer.
Often, medications such as ranitidine and omeprazole are prescribed to reduce stomach acid. They are also available without a prescription, but if you need them continuously for more than a couple of weeks get medical evaluation and advice.
A bacterial infection called H. pylori causes heartburn and ulcers. It is easily treated once diagnosed; untreated, it can cause bleeding in the stomach or intestines. If you have bloody or black stools, see a health care provider.
What about stomach trouble you cannot connect to something you ate?
Mild nausea, vomiting, diarrhea, diffuse discomfort that is mostly cramping and a low-grade fever are usually symptoms of a viral infection. Again, the BRAT diet and slightly salty/sugary fluids in small, frequent portions help you feel better.
If your symptoms escalate to high fever, distending abdomen, vomiting that does not stop or inability to move without pain, you should be seen immediately.
For children, any signs of dehydration, significant pain, high fever or loss of appetite for more than a day are signs that your doctor should be consulted. The younger the child the greater the risk and children under 1 year old cannot go more than a few hours without drinking fluids.
Pain in your abdomen can sometimes be a sign of something more serious than indigestion. In the upper right part of your abdomen, pain can be a sign of gallbladder problems, in the upper left it can mean pancreas problems and in the lower right it could be appendicitis.
Maintaining healthy bacteria in your stomach and colon can help prevent problems for people with irritable bowel or other frequent stomach complaints.
I eat a half-cup of yogurt with live cultures every day. I choose yogurt without many sweeteners and with many different types of cultures, like L. bulgaricus, S. thermophilus, L. acidophilus, B. bifidus, L. Casei, and L. rhamnosus.
Taking a daily probiotic supplement made up of these bacteria can help, too.
Enjoy the rest of the holidays, keep your tummy happy and pay attention to symptoms that might be more than just a sign of too much fruitcake.
Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to firstname.lastname@example.org.