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Moving Beyond PPIs

Integrative treatment options for indigestion

By Amy Patel, ND

Heartburn medication is the fifth most purchased over-the-counter medication. Dyspepsia or indigestion affects 21 percent of people, commonly women and smokers. The most common symptoms include abdominal discomfort, burning pain, bloating, nausea, or getting full as soon as you start to eat. 

There are a variety of reasons one may have indigestion, including infection, ulcers, specific drug use, malignancy, or functional dyspepsia, which is indigestion with no known cause. It’s important not to assume you have functional dyspepsia, as known causes can and should be treated. If all other causes are ruled out, and you are diagnosed with functional dyspepsia, you will likely be prescribed a proton pump inhibitor (PPI), which is a class of medications that block gastric acid production. 

There is growing concern about the long-term use of PPIs for symptom relief and they should be used with caution. Fortunately, there are many integrative treatment options that not only reduce symptoms but have few side effects and may even be curative. 

Lifestyle and dietary changes. The first and simplest treatment is to make diet and lifestyle changes to prevent symptoms. Delayed emptying of your stomach can cause the stomach contents to come back up, causing indigestion and heartburn. Two common reasons for delayed gastric emptying are eating large volume meals and high-fat meals, which take longer to digest. Avoiding aggravating foods are also important for prevention, including tomatoes, chocolates, cheese and coffee. Alcohol and tobacco use can also aggravate indigestion. Try to eat your last meal three to four hours before bedtime, as eating late at night and lying flat
after meals can also aggravate symptoms. 

Herbal supplements. If dietary changes alone don’t work, herbal medicines have long been used to treat a variety of gastrointestinal symptoms. Readily available herbs like ginger and fennel can be made into teas or added to foods to soothe indigestion. Licorice root, lemon balm, and caraway seeds have also been shown to improve symptoms. 

Homeopathy. If indigestion continues even while taking herbal medicine, homeopathy is another great option. Homeopathy, a system of medicine that utilizes diluted potencies of substances, is prescribed based on a patient’s individual symptoms. For example, two hypothetical patients were diagnosed with dyspepsia by their primary care physician and present for heartburn treatment; one person has burning pain and early satiety, which started after a life-altering event. The other person has a burning pain in their stomach, but only at night when they get migraines. They both are experiencing heartburn, similar symptoms, but their individual symptoms and how they are experiencing it are varied, thus, therapies would differ. Classical homeopathy by a licensed professional can help treat symptoms from within to find a remedy that is best suited for each person’s case. 

Acupuncture. Acupuncture is another great alternative as it addresses the individual patient’s disease process, rather than individual symptoms.  

If you have longstanding functional dyspepsia, there are other options to PPIs which can soothe your symptoms safely with long-lasting results. Always talk to your doctor when you have new or worsening symptoms to find the best option for you. 

Dr. Patel is a primary care naturopathic doctor and resident at Live Well Clinic in La Quinta. She can be reached at (760) 771.5970 or www.LiveWellClinic.org.

Sources:
1) Madisch A, Holtmann G, Mayr G, Vinson B, Hotz J. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion. 2004;69(1):45-52. doi: 10.1159/000076546. Epub 2004 Jan 30. PMID: 14755152;
2) OTC Use Statistics. Consumer Healthcare Products Association. https://www.chpa.org/about-consumer-healthcare/research-data/otc-use-statistics;
3)  Voiosu TA, Giurcan R, Voiosu AM, Voiosu MR. Functional dyspepsia today. Maedica (Bucur). 2013;8(1):68-74. 

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