Your Health your amazing stomach

Your stomach and you

“What you eat today walks and talks tomorrow” … the saying is tired but true, and tried and proven about three times a day by most of us!

Most of us don’t think much about our stomachs or what they do. We just eat and forget – unless we get indigestion and rue that last meal and those extra drinks. And then at 2am have to look for Enos or Gaviscon. Yet stomachs are the first organ in the process of fueling us. Your stomach performs a huge digestive transformation, maintaining your wellbeing and metabolism. From yesterday’s steak and eggs in outback Oz to leafy vegetarian meals, or Eastern dishes including unidentifiable creatures, to Western meat-lovers’ diets, from Icelandic rotten shark to South America’s ubiquitous gut-burning chillies … somehow a stomach deals with massive variety. Whatever you’re eating, your front teeth cut your food and your back teeth squash it, mixing it with saliva and digestive enzymes. Bolting food in large chunks leaves too much work for the stomach and can lead to indigestion. So chew well.

Stomach structure

gastrointestinal tract, the stomach has layers of muscle in different directions on the outside. These muscles churn your food with hydrochloric acid and digestive chemicals made there. The innermost layer makes the digestive and breakdown secretions that do the job. Its various cells make enzymes, hydrochloric acid and a protective mucus layer to protect the stomach. Your food ends up as a slurry that passes down to the small bowel for further digestion and absorption. As for the conditions that can cause grief… GORD or Gastro Intestinal Reflux Disease is extremely common, and its symptoms are likely felt lying flat on your back after a big meal. It becomes a problem when the valve at the top of the stomach gets floppy and allows stomach contents and their acidity to flush up the oesophagus to the back of the mouth. Indigestion at any time is acid burning the oesophagus, itself unprotected by a mucus layer. Often reflux wakes people at night after a big, late meal and too many drinks. There’s a plethora of antacids out there but troublesome symptoms need investigation and treatment. Until two Western Australian pathologists found this bacterium a few years ago, nobody thought a bacterium could live in the stomach’s acid environment. They won a Nobel prize for their discovery. Helicobacter can cause indigestion and lead to general irritation and to gastritis – inflammation of the stomach lining. Gastritis contributes to peptic ulcers and cancer. Another cause of gastritis is an immune response that destroys stomach lining cells and leads to anaemia, vitamin deficiencies and cancer. It's complex.

Gastroenteritis

This is usually caused by a viral, bacterial or amoebic infection. A viral ‘gastro’ starts with intense nausea and vomiting then diahorrea, as the bug affects the lower bowel. If viral, it’s usually over in 24-48 hours if viral. Causes? Think food, flies and faeces. Bacterial infections such as Campylobacter pylori or Salmonella feature gut pain, high temperatures and bowel looseness usually for at least several days. These often require antibiotics depending on severity. With amoebic infection there’s tiredness, weight loss and intermittent diahorrea.

Non-ulcer dyspepsia

N.U. dyspepsia has no obvious cause. It usually persists, even for years. It is seen more often in women and the elderly. Precipitants include anti-inflammatories, smoking, anxiety and, interestingly, those abused in childhood. Symptoms include burning, bloating, fullness after meals and nausea.

Peptic ulcers, cancer and Crohn’s disease

Peptic ulcer and stomach cancer rates have fallen a lot since it became possible to treat Helicobacter. Symptoms include a mix and match of the above with the possibility of catastrophic bleeding and perforation. Crohns, that horrible bowel condition, can spread to the stomach. With any of these symptoms, do see your doctor. And remember indigestion can be a mimic: the coronary care ward is full of people with ‘a touch of indigestion’.

Words by Dr Tim David