Indigestion

Indigestion, also known as dyspepsia, is pain or discomfort in the upper abdomen. People with indigestion may experience a number of symptoms, including: heartburn, regurgitation, bloating, nausea and vomiting.

Is it indigestion?

It’s important to understand the difference between heartburn and indigestion and know how they can be treated and prevented. There are differences between the symptoms; Heartburn, also known as acid reflux, is the hot, burning pain felt when acid from the stomach refluxes into the oesophagus. Unlike the stomach lining, however, the lining in the oesophagus isn’t designed to protect against stomach acid. So, if acid gets into the oesophagus, it can cause pain. Sufferers often described the feeling as: • A hot pain or burning sensation • A tight feeling • An acidic taste (with or without the feeling of sickness) The affected area usually is centered around the chest, often behind the breast bone (sternum) and the back of the throat can feel hoarse, accompanied by a bitter taste. The feeling may last for a minute or two, several minutes, or even several hours with severe episodes. Indigestion can involve several symptoms, which are all associated with digestive processes - the symptoms are usually experienced after eating or drinking. Food and drink can stimulate the stomach to produce excess acid which, in the case of indigestion, begins to break down the protective stomach lining. This is the innermost layer of the stomach that’s directly in contact with its contents - including stomach acid. As a result, people can experience: • Pain in the lower chest, abdomen or top of the stomach

• Feeling bloated • Gas build up - needing to burp or pass wind • Nausea or vomiting • A loss of appetite

Indigestion and heartburn causes

The two conditions are closely associated, since stomach acid is involved in both. In fact, 73% of people can experience indigestion and heartburn interchangeably. They can have the same causes too, and almost anyone can suffer, even people with a generally healthy lifestyle. Causes include:

• Eating big meals, irregular meals or eating on the run • Drinking caffeinated drinks, alcohol, very hot drinks or citrus juices • Pregnancy - hormonal changes and/or the pressure put on the stomach and digestive tract by a growing baby • Various medicines

• Carrying a little too much weight • Wearing tight clothes • Smoking • Stress

Preventing and treating indigestion

A good way to discover triggers is to start a food diary. Using this, people will be able to determine which foods induce it more, and tailor their actions appropriately. These actions may include eating smaller amounts or cutting down on spicy foods. Or it may occur due to changing circumstances, such as becoming pregnant or taking on a particularly stressful new job. Therefore, it can vary from person to person and at different stages of their lives.

Indigestion in Pregnancy

Most people are affected by indigestion from time to time, but women are often affected by it while they are pregnant. As many as 8 out of 10 women experience indigestion at some point during their pregnancy. Indigestion tends to become more common as the baby develops. Indigestion during pregnancy is mainly due to changes that occur in the body, such as rising levels of hormones and increased pressure on the abdomen. These changes can often result in acid reflux, the most common cause of indigestion. Acid reflux occurs when stomach acid flows back up from the stomach into the oesophagus and irritates the lining. A number of lifestyle changes may help improve the symptoms of indigestion, such as eating smaller meals or cutting out certain foods. There are also medicines, such as antacids, that can be taken safely during pregnancy to treat indigestion. Some women may find that their indigestion gets worse as their pregnancy progresses. However, in most cases, after giving birth, the symptoms disappear. Indigestion during pregnancy rarely causes complications. Pregnant women can be more likely to get indigestion during pregnancy if: • She experienced indigestion before she became pregnant • She has been pregnant before • She is in the latter stages of pregnancy

When to refer

Women should be advised to see their GP or midwife if they are pregnant and experience severe or recurring indigestion. Their GP will usually be able to diagnose indigestion from their symptoms and by asking them a number of questions. For example, they may ask: • how the symptoms are affecting her day-to-day life • what her usual eating habits are • if she has tried any treatments already • if she experienced indigestion or any other stomach conditions before she was pregnant

WWho? 73% of people can experience indigestion and heartburn

interchangeably. As many as 8 out of 10 women experience indigestion at some point during their pregnancy

WWhat are the symptoms? Pain in the lower chest, abdomen or top of the

stomach, feeling bloated, needing to burp or pass wind, Nausea or vomiting and loss of appetite

HHow long have they had the symptoms? The symptoms are usually

experienced after eating or drinking, but there can sometimes be a delay between eating a meal and developing indigestion. Women may experience indigestion at any point during their pregnancy. Symptoms may be more frequent and severe during the third trimester

AAction already taken? People may have taken antacids but not be aware

how to eliminate triggers until they start to keep a food diary

MMedication? Antacids can be taken safely during pregnancy to

treat indigestion

52 CHILD HEALTH CONSULATATION:

PHARMACY ASSISTANTS Q & A SESSION ON INFANTILE COLIC

Infantile Colic is a common ailment which can affect the whole family. The intense crying that defines the condition makes it highly distressing for both baby and parents and can have a major impact on family life.

The aim of this training guide is to provide information and reassurance about the condition and offer practical advice on a non-medicinal solution.

Explain what Colic is

Colic is the name given to excessive, frequent crying in a baby who appears to be otherwise healthy. It’s a common problem with almost half of babies in the UK developing Colic*.

Colic is very distressing for both baby and parent!

Reassure parents as to what the signs and symptoms of Colic are

Colic is defined by:

• Intense crying bouts

• Crying in the late afternoon or evening that lasts at least 3 hours a day, 3 days per week.

• Baby’s face may become red and flushed when they cry

• Baby will tend to clench their fists, draw their knees up to their tummy, and arch their back while crying

Caring for a baby with colic can be very difficult for parents, particularly first-time parents.

Explain the common causes of Infantile Colic

1)78% of Healthcare Professionals agree that the most common cause of colic in young babies is caused by digestive or feeding problems, including swallowing air and trapped wind*

2)Temporary gut sensitivity to certain proteins and sugars found in breast milk and formula milk, such as Lactose Intolerance. 3)Gastro-Oesophageal Reflux Disease (GORD)

Reassure parents that Colic will not harm baby?

Explain that a baby suffering from colic may appear to be in pain but the condition is not harmful to baby’s health in the long term, as long as baby continue to feed and gain weight normally.

Practical Advice for Parents?

Preventing baby from swallowing air is extremely important in helping to avoid wind related colic and choosing the right baby bottle can help.

Traditional and restrictive vented bottles tend to develop vacuums because babies have to suck progressively harder on the one hole in the bottle to obtain the liquid. This causes teat collapse and baby has to stop feeding. Air enters the bottle when the teat reinflates; the air is ingested which can cause the colic symptoms.

There are also a number of techniques you can advise parents to try that can help alleviate the symptoms of windy colic:

• Burp baby after feeds • Gently rock baby over your shoulder

• Bath baby in a warm bath

• Gently massaging baby’s tummy

Product Options: There is a natural solution – suggest to parents to change their baby bottle to Dr Brown’s Options bottles or recommend they use Dr Brown’s from day one as prevention is better than cure!

Dr Brown’s Options™ Baby Bottles feature a unique system with a removable green vent designed to create a “vacuum free” environment. Dr Brown’s is clinically proven to help reduce wind related colic by removing the air bubbles in the feed*.

As baby becomes more developed and no longer experiences feeding issues parents now have the convenient option to remove the vent. Without the vent Dr Brown’s Options™ provides a feeding experience similar to most teat-vented bottles. The teat venting creates a controlled flow,