The term indigestion is often used to describe heartburn and/or upper abdominal pain as well as a feeling of gaseousness, difficulty swallowing, feelings of pressure or heaviness after eating, sensations of bloating after eating, stomach or abdominal pains and cramps, or fullness in the abdomen. The medical terms used to describe indigestion include functional dyspepsia (FD), nonulcer dyspepsia (NUD), and gastroesophageal reflux disorder (GERD). These are among the most popular diagnoses in North America and yet several review articles have concluded that “the efficacy of current drugs on the market is limited at best.”
Why OTC and Prescription Drugs Make Indigestion Worse
Over-the-counter (OTC) and prescription drugs for indigestion often cause more problems than they help. The most popular are acid-blocking drugs. These drugs work by blocking one of the most important digestive processes—the secretion of hydrochloric acid by the stomach. The problem is, acid-blocking drugs also block digestion! Although blocking the production of stomach acid can reduce symptoms, it also substantially blocks a normal body process. Acid-blocking drugs are associated with numerous side effects such as digestive disturbances like nausea, constipation, and diarrhea.
Four Natural Approaches that Are Safe and Effective
In the person with chronic indigestion, rather than focus on blocking the digestive process with antacids, the rational approach is to focus on aiding digestion. Indigestion can be attributed to a great many causes, including not only increased secretion of acid but also decreased secretion of acid and other digestive factors and enzymes. In fact, most nutrition-oriented physicians believe that lack of acid, not excess, is the true culprit in many patients with indigestion. Here are four approaches that can help.
1. Change your diet. The first step is eliminating common dietary causes of GERD/NUD, which includes overeating, obesity, coffee, chocolate, fried foods, carbonated beverages (soft drinks), and alcohol. In many cases, simply eliminating or reducing the causative food(s) or beverage is all that’s necessary to completely relieve GERD/NUD. Other tips: decrease the size of portions at mealtime; chew food thoroughly; eat in a leisurely manner in a calm, relaxed atmosphere; and don’t eat within two hours of bedtime.
2. Try hydrochloric acid supplementation. Although much is said about hyperacidity conditions, a more common cause of indigestion is a lack of gastric acid secretion. Hydrochloric acid (HCl) supplementation can produce complete relief of indigestion in many individuals. Since not everyone can have detailed gastric acid analysis to determine the need for gastric acid supplementation, here is a popular practical method to determine need and/or dosage:
- Begin by taking one tablet or capsule containing 500-600 mg of HCl at your next large meal. If this does not aggravate your symptoms, at every meal after that of the same size, take one more tablet or capsule (1 at the next meal, 2 at the meal after that, then 3 at the next meal.)
- Continue to increase the dose until you reach 7 tablets or when you feel warmth in your stomach, whichever occurs first. A feeling of warmth in the stomach means that you have taken too many tablets for that meal, and you need to take one less tablet for that meal size. It’s a good idea to try the larger dose again at another meal to make sure that it was the HCl that caused the warmth and not something else.
- After you have found that the largest dose that you can take at your large meals without feeling any warmth, maintain that dose at all of meals of similar size. You will need to take less at smaller meals.
- When taking a number of tablets or capsules it’s best to take them throughout the meal.
- As your stomach begins to regain the ability to produce the amount of HCl needed to properly digest your food, you will notice the warm feeling again and will have to cut down the dose level.
3. Take digestive enzymes. Lack of digestive enzymes from the pancreas is another functional cause of indigestion. Typically when heartburn, abdominal bloating and discomfort, and gas occur within the first 15 to 30 minutes after eating, it is usually a lack of HCl secretion. If they occur after 45 minutes, it is usually a sign of lack of pancreatic enzymes. Keep in mind that the secretion of pancreatic enzymes is triggered by the HCl secreted in the stomach. So, sometimes taking HCl supplements can lead to improved release of pancreatic enzymes. Digestive enzyme products are the most effective treatment for pancreatic insufficiency. These preparations can include enzymes from fresh hog pancreas (pancreatin); vegetarian sources such as bromelain and papain (protein-digesting enzymes from pineapple and papaya, respectively); and fungal enzymes. I have found that the best results are found from multi-enzyme preparations that focus on the vegetarian and fungal sources. They are definitely more resistant to digestive secretions and have a broader range of activity. Simply follow label instructions for proper dosage.
4. Use enteric-coated peppermint oil. Another valuable natural product for indigestion is peppermint oil placed in special capsules that are coated to prevent their breakdown in the stomach (enteric-coated). Peppermint has been shown to be quite helpful in improving gastrointestinal function in individuals suffering from irritable bowel syndrome (IBS), a common functional disorder of the large intestine characterized by some combination of: (1) abdominal pain, (2) altered bowel function, constipation, or diarrhea, (3) hypersecretion of colonic mucus, (4) dyspeptic symptoms (flatulence, nausea, anorexia), and (5) varying degrees of anxiety or depression. In several double-blind studies, enteric-coated peppermint oil (ECPO) has been shown to be effective in relieving all symptoms of IBS in approximately 70–85% of cases within a 2-4 week period. In addition to its effects in IBS, enteric-coated peppermint oil exerts benefits in NUD, and GERD. The usual dosage of enteric-coated capsules containing peppermint and caraway seed oil is 1-2 capsules (200 mg/capsule) up to three times daily between meals.