SUNDAY STAR, 3 JUNE 2018
DIGESTIVE HEALTH & YOU
HELICOBACTER pylori (H. pylori) is
a common bacterium that resides
in the stomach and causes peptic
(duodenal and gastric) ulcers.
In the past, it was thought that
peptic ulcers were caused by
intake of spicy food and alcohol,
smoking, and stress. The discovery
of this bacterium in 1982 led to it
being identified as the root cause
of most types of peptic ulcers.
H. pylori grows in the
gastrointestinal (GI) tract and, in
the right conditions, attacks the
stomach lining. The most
dangerous thing about this
bacterium is its capability to
withstand high acidity levels,
which lets it survive the harsh
acidic environment of the stomach
and duodenum.
The bacterium is spiral-shaped,
hence the name “helicobacter”
(helicon is Latin for “spiral”). Its
shape lets it puncture the
stomach’s protective lining that
protects the inner wall from the
strong acid secreted for digestion.
A puncture in the lining means
that acid reaches the inner
stomach wall. The acid can cause
open sores, commonly known as
ulcers.
Since H. pylori spreads easily
and thrives in unsanitary
conditions, it usually infects
people who do not have access
to clean water or live in places
that are overcrowded.
It commonly spreads from
person to person through
contaminated saliva,
vomitus or faecal matter.
Another known way for
the bacterium to
spread is through food
and water that have
been in contact with
Keeping bacteria in check
H. pylori-contaminated faecal
matter.
Identify the telltale signs
Normally acquired during
childhood, approximately 60% of
the world population have H.
pylori in their systems. However,
most do not develop ulcers or
experience symptoms of an
infection during their lifetime.
In early stages of an active
H. pylori infection, symptoms
include bloating, heartburn,
nausea and abdominal pain,
anaemia, appetite loss and
unexplained weight loss.
“People aged above 70
usually take a combination of
medications, including non-
steroidal anti-inflammatory drugs,
which increases their risk of
developing bleeding ulcers with
concurrent H. pylori infections,”
says Dr Saravana Kumar
Karunanathy, consultant physician,
gastroenterologist and hepatologist
at ParkCity Medical Centre.
If you have any of these
symptoms, it is imperative to
consult a doctor to rule out the
possibility of a H. pylori infection.
If left undetected and untreated,
the bacterium can cause gastritis
or persistent inflammation of the
stomach and, in more severe cases,
stomach cancer.
“If you have a family history of
gastric cancer, it is advisable to
get a check-up, because your risk
of developing it increases six-fold
when you have a H. pylori
infection,” he says.
Tests for a H. pylori infection
include:
l Stool test – A stool sample is
tested for traces of H. pylori
antigens, which indicate an
infection.
l Blood test – Analysis
of a blood sample may
reveal evidence of an
active or previous H.
pylori infection.
However, breath
and stool tests are
better at
detecting active
H. pylori
infections than
a blood test.
People aged
above 70 usually
take a combination
of medications,
including
non-steroidal
anti-inflammatory
drugs, which
increases their
risk of developing
bleeding ulcers with
concurrent H. pylori
infections.
Dr Saravana Kumar Karunanathy
l Urea breath test – Before
undergoing a breath test, you
swallow a pill that contains tagged
carbon molecules.
If you have H. pylori infection,
carbon is released when the
solution is broken down in your
stomach.
You will be asked to exhale
into a bag and your breath
analysed. If a H. pylori
infection is present, the
patient’s exhaled breath
will contain isotope-
labelled carbon dioxide.
For accurate results,
patients are required to
fast the day before
and avoid taking
antibiotics or
proton-pump
inhibitors for at
least two weeks
prior to the
procedure.
l Endoscopy –
Also known as a
gastroscopy, this test
is done using a thin flexible tube
with a small camera fitted on one
end. The tube is passed through
the oesophagus of the patient and
into thestomach.
The camera lets the endoscopist
view the interior of the stomach
and detect abnormalities such as
growths or ulcers.
An endoscopy is usually
performed if the patient is
experiencing symptoms such as
bloody stools, recurrent abdominal
pain or rapid weight loss.
This procedure can help doctors
determine the presence of ulcers
and detect bleeding or stomach
cancer. During this procedure,
tissue samples are biopsied and
analysed for H. pylori.
Since it is an invasive procedure,
patients are normally lightly
sedated for its duration.
Treating a H. pylori
infection
The most common treatment
offered is a course of antibiotics,
taken over 10 to 14 days. Since
H. pylori is rather resistant, two
types of antibiotics are prescribed,
along with a proton-pump
inhibitor to regulate gastric acidity.
In 80% of patients, this first
line of defence will be effective
in eradicating their H. pylori
infection.
Two weeks after treatment, the
patient is tested again, usually with
the urea breath test. If traces of a
H. pylori infection are still present,
a second course of treatment is
pursued.
“Taking antibiotics can be
unpleasant. Patients may
experience side effects during
treatment. However, the
medication is necessary to get rid
of the bacteria completely. For this
reason, it is essential that patients
complete the full course of
antibiotics,” says Dr Saravana
Kumar.
However, someone who has
been diagnosed, treated and
completely cured of a H. pylori
infection can be infected again.
Stay clean, stay safe
The only way to stop H. pylori
from spreading is by maintaining
satisfactory hygiene. It is essential
to wash your hands thoroughly
and sanitise your surroundings as
much as possible.
On the bright side, there has
been a significant decrease in
H. pylori infections in Malaysia
due to increase in awareness.
Dr Saravana Kumar shares,
“In the late 1980s and early 1990s,
H. pylori infections were prevalent
in 50% of the population. That
figure has dropped by 14% to 15%
over the years.”
For unknown reasons, Indians
are more affected by this
bacterium than other ethnic
groups in Malaysia. However,
H. pylori infections that develop
into stomach cancer are mostly
observed in people of Chinese
descent.
Research is still ongoing to find
out why this bacterium affects
some people more than others and
why some people do not display
symptoms of a H. pylori infection.
For as long as these questions
remain unanswered, it is best to
maintain hygiene to reduce the
chances of infection.
n For more information, call
03-5639 1212.
2 Digestive Health & You SUNDAY STAR, 3 JUNE 2018

Unlocking nutrients
A COMPLETE and balanced
nutrition helps maintain healthy
body functions. However, this

with multi-enzymes
can only happen when the body
can optimally carry out its
digestive process, which involves
food ingestion, food digestion,
nutrient absorption and
utilisation.
Even the most complete diet
will not benefit the body if it is
not properly broken down into
nutrients that are readily absorbed
and used.
Poorly digested food may
lead to occasional abdominal
discomfort, bloating and other
undesirable symptoms.
Enzymes are specifically
produced by our body to assist
in the breakdown of food and
“unlocking” of nutrients, allowing
them to be effectively absorbed
and used by the body.
However, ageing, unhealthy
lifestyles and poor eating habits
can interfere with the body’s
ability to produce an adequate
supply of enzymes for the above
process.
In addition, certain cooking Biogrow
methods and processing Mixed
technology can destroy the natural Berries
enzymes in raw foods. with Multi
For these reasons, obtaining an Enzymes is
alternative source of enzymes is available in
important to maintain optimum bottles of
health.
60 or 120
Biogrow Mixed Berries with
chewable
Multi Enzymes contains a broad
spectrum of 10 natural plant and tablets.
microbial derived enzymes
imported from the United States
that can work in a broad pH range proprietary enzymes – Peptizyme Multi Enzymes is formulated with one or two chewable tablets after This article is brought to
– from pH3 to pH9 – throughout SP and HemiSeb, which possess a delicious blend of mixed berries every meal to supply the body with you by Legosan (Malaysia) Sdn
the body. broad specificity for various types for enhanced flavour and tooth- natural enzymes that complement Bhd.
This enzymatic combination of food such as cereal grains, friendly sweetener, xylitol. your daily diet.
includes amylase, protease, lipase, legumes, dairy products, meat It is available in chewable tablet Biogrow Mixed Berries with n For more information, call
cellulase, lactase, maltase, and other foods. form, making it suitable for kids, Multi Enzymes is available at all 03-7956 2220 or e-mail info@
invertase, bromelain and two Biogrow Mixed Berries with adults and the elderly. Just chew leading pharmacies nationwide. biogrow.com.my
THE STAR, TUESDAY 3 JUNE 2018 3
4 Digestive Health & You
HEARTBURN occurs when the acidic
contents of the stomach rise into the
oesophagus, causing pain in the
chest area. It is caused by the
weakening of the lower oesophageal
sphincter (LOS) – the muscles that
form a gateway between the
oesophagus and stomach.
This allows acid to escape the
stomach. Stomach acid is almost as
corrosive as battery acid and can
cause moderate to severe pain
known as heartburn, when it comes
in contact with the oesophageal
lining.
Chronic heartburn can lead to a
condition called gastroesophageal
reflux disease (GERD), which
happens when there is continuous,
long-term damage to the
oesophageal lining by stomach
acid.
The prevalence of GERD in
Malaysia has
doubled in the
last 10 years,
likely due to
the rise in
Settling the stomach
smoking and obesity.
With Malaysia being the fattest
nation in South-East Asia, it is no
wonder that GERD affects so many
of us.
Smoking aggravates GERD as the
nicotine in cigarettes causes the LOS
to relax, allowing more stomach acid
to escape into the oesophagus.
Scientists have found that people
are more sensitive to stomach acid
when they are stressed. Besides that,
increased belly weight can worsen
GERD because the extra weight
creates pressure on the LOS and
causes more acid to leak from the
stomach.
GERD is not only a burden on
quality of life, it is also a risk factor
for developing oesophageal cancer.
Treatment options
Heartburn and GERD are usually
treated with proton pump inhibitors
(PPIs). As powerful, fast-acting
stomach acid suppressants, PPIs are
a popular treatment option.
However, the suppression of acid
production in the stomach severely
compromises digestion and the
body’s natural defence mechanisms
– leading to myriad side effects
such as kidney damage,
pneumonia and osteoporosis.
Current guidelines recommend
that PPIs be used for only four
to six weeks, after which patients
are advised to seek milder
therapy. However, since symptoms
tend to recur, patients continue
using PPIs indefinitely.
With the advance of research
into natural therapies for
gastrointestinal disorders, patients
with heartburn or GERD can now
consider an alternative way of
managing their condition.
Alternative therapy
The conifer green needle
complex known as Bioeffective
A is the result of an extensive
botanical research programme
spanning over 80 years.
Bioeffective A helps strengthen
damaged or weakened oesophageal
valves, which are a key defect in
GERD patients.
Clinical studies found that
patients treated with Bioeffective A
experienced a 92% improvement
in dyspeptic symptoms caused by
GERD, including gastritis, gas and
bowel disorders.
Patients also experienced a
return of normal stomach
functionality and reduction in
precancerous lesions.
This article is brought to you
by the Nuvaceuticals Division of
Nuvanta Sdn Bhd.
n For further information, call
03-5636 3758/1300 881 712 or
e-mail pharmacist@nuvanta.com
A supplement rich in soluble and insoluble fibre can improve irregular
bowel movement or constipation.
Regulating
the bowel
“ALL disease begins in the gut”
is a quote attributed to
Hippocrates, the father of
modern medicine, and still
holds true today.
Diets low in fibre but high in
red meat, physical inactivity,
alcohol abuse, chronic laxative
use and colon inflammation
from bacterial infection are
common causes of poor gut
health.
A study in the International
Journal of Cancer suggested that
nearly 40% of cancer-related
deaths in Australia, including
colorectal cancer, are caused by
low intake of fruit, non-starchy
vegetables and dietary fibre, and
high intake of red and processed
meat.
Laxative caution
According to the American
Journal of Gastroentology,
irregular bowel movement
or constipation affects nearly
a quarter of the world
population.
Most individuals resort to
laxatives as a quick fix for
irregular bowel movement.
However, long-term use of
laxatives can cause bowels to
become dependent on the
medicine and lose normal
function, which eventually leads
to a condition known as lazy
bowel syndrome.
Consultant physician and
geriatrician Datuk Dr Rajbans
Singh shares, “Chronic use of
laxatives depletes our body of
minerals and hydration, and
disrupts gut microbiota.
“Consumers are advised
to be highly cautious when
using supplements that
contain drug-like ingredients
such as senna or cassia
(usually used as herbal
laxatives), even though they
are usually marketed as natural
ingredients.”
A study in the World Applied
Sciences Journal showed that
people with constipation have
lower levels of Bifidobacteria in
the large intestine. According to
Dr Rajbans, diets high in soluble
and insoluble fibre that contain
plenty of beneficial bacteria are
key to improving bowel
movement and restoring gut
function.
Biogrow ProGut is made from
all-natural Swedish oat fibre
formulated with dual action
from the well-researched Oat
BG22 fibre powder and
Bifidobacterium lactis BB-12
probiotic strain from Denmark –
a strain of Bifidobacterium with
SUNDAY STAR, 3 JUNE 2018
Chronic
use of laxatives
depletes our
body of minerals
and hydration,
and disrupts gut
microbiota.
Datuk Dr Rajbans Singh
more than 300 scientific
publications and over 130
clinical studies carried out on it.
One sachet daily provides a
synergistic effect for improved
intestinal function and a
balanced gut microbiota.
To consume, mix one sachet
(≈ 7g) with cold water, fruit juice,
cereal or yoghurt. One or two
sachets a day after meals or
whenever convenient is
recommended.
Each sachet contains 2.4g
soluble and insoluble fibres
with one billion colony-forming
units (CFU) of live probiotic
cultures.
The dose of one billion CFU of
BB-12 has been clinically tested
and shown to have benefits on
defaecation and bowel
frequency, according to a study
published in the British Journal
of Nutrition in 2015.
Biogrow ProGut is suitable for
individuals who wish to
maintain or improve gut health
as it offers a natural way to
manage bowel movement with
fibre and probiotics.
It contains no added sugar or
artificial ingredients and is high
in protein, iron, magnesium and
zinc. It is available in all
pharmacies nationwide.
This article is brought to you
by Legosan (Malaysia) Sdn Bhd.
n For more information, call
03-7956 2220 (9am to 5pm) or
e-mail info@biogrow.com.my
SUNDAY STAR, 3 JUNE 2018
Choosing the right probiotics
PROBIOTICS, as defined by the
Food and Agriculture Organization
of the United Nations (FAO) and
World Health Organization (WHO),
are live microorganisms which,
when administered in adequate
amounts, confer a health benefit
on the host.
The interest in probiotics has
been growing in the past few years
due to their potential health
benefits on humans.
Various studies have
demonstrated that probiotics may
positively change the intestinal
flora, inhibit the growth of bad
bacteria (pathogenic), promote
better digestion, enhance immune
function as well as alleviate
stomach upset.
Choosing the right
probiotics
Nowadays, it is easy for
consumers to get probiotic
supplements from pharmacies.
However, how do we know if we
are taking the right probiotics that
truly benefit our gut?
According to Expert Panel of the
United Nations and WHO, a
probiotic should meet the criteria
below:
l Clinically identified strains
(eg. L. acidophilus Rosell-52)
l Safety assessment
l Clinical efficacy evidence
l Shelf-stable formulation
The determination and
confirmation of strain identity is
key. Many consumers may not
Digestive Health & You 5
be aware that the benefits and only live probiotics confer health well as have higher survival better gut health. It is available at
properties of certain probiotics are benefits to us, not the dead ones. rate. all leading pharmacies.
strain-specific. It consists of three different
For example, general L.
acidophilus may not work the
Biogrow Probiotics – your strains (L. acidophilus Rosell-52,
L. rhamnosus Rosell-11 and B.
This article is contributed by
Legosan (Malaysia) Sdn Bhd.
same as L. acidophilus Rosell-52. choice of probiotics longum Rosell-175).
Therefore, a clinically identified Each strain is supported n For more information, call
probiotic strain is a must because it Biogrow Probiotics provides by scientific studies to ensure 03-76288831/03-7956 2220 or visit
assures consumers of the safety highly stable microencapsulated consumers get the right probiotics www.biogrow.com.my
and quality of this particular strain strains made from the patented that are truly safe and beneficial to This is a supplement product
of probiotics. Probiocap Microencapsulation their guts. advertisement.
Technology from Institut Rosell- Get Biogrow Probiotics now for KKLIU No.0084/2017
Are your probiotics getting Lallemand, Canada, which ensures
the probiotics are resistant to
through? heat shock up to 50°C, resistant
to gastric acid and bile acid as
Besides probiotic strains, it is
also crucial to choose probiotics
that are able to withstand gastric
acid, bile acid and attach strongly
to your intestinal lining in order to
exert beneficial effects.
However, it would be difficult
for certain probiotics to get
through this “harsh environment”
without proper technology.
Hence, experts have provided
the solution – Probiocap
Microencapsulation Technology.
This technology protects probiotics
in harsh conditions such as
gastric acidity, compression as well
as thermal shock up to 50°C, thus
ensuring better survival rate of
probiotics during the intestinal
transit.
According to a scientific study,
microencapsulated probiotics are
five times more efficient than the
same uncoated strains in terms of
gut colonisation and the amount of
bacteria detected in faeces.
The survival of probiotics is Biogrow Probiotics contains stable microencapsulated probiotic strains that can withstand the
of utmost importance because harsh environment of your gut.
6 Digestive Health & You
Hepatitis a burden
CELEBRATED on May 29 every year, World
Digestive Health Day is dedicated to
spreading knowledge about the latest
research, diagnoses, treatments and issues
related to digestive health.
The World Gastroenterology Organisation
initiated this day of awareness in 2004 to
mark its 45th anniversary of incorporation,
with all its member societies coming together
to organise various awareness events.
The theme for this year is “Viral Hepatitis B
and C: Lift the Global Burden”, which was
chosen because there is an estimated 325
million people worldwide who live with
chronic hepatitis B and C, according to data
published by the World Health Organization
(WHO) in 2015.
Hepatitis refers to inflammation of the
liver, which can be caused by several factors
including alcoholism, fat accumulation in the
liver and autoimmune diseases. However, the
most common type of hepatitis worldwide is
viral.
There are five types of viral hepatitis –
hepatitis A, B, C, D and E. Only hepatitis A, B
and D are preventable by vaccination.
Among the five, hepatitis A, B and C are the
most common. Hepatitis B and C are more
dangerous as both can develop into chronic
conditions.
When someone is first infected, she is
considered an acute hepatitis patient. If she
does not recover from the infection within six
months, the infection is considered chronic. A
blood test can reveal whether someone is
infected with acute or chronic viral hepatitis.
The chances of an acute hepatitis C
infection turning chronic is 90% while the
risk of an acute hepatitis B infection turning
chronic decreases with age.
According to WHO, 5% to 10% of adults
develop chronic infections when infected
with hepatitis B, while 50% of children
infected between one and five years old
develop chronic infections. This risk increases
dramatically when infants below one year old
are infected, with up to 90% of cases turning
chronic.
Chronic hepatitis B and C can often lead to
complications such as liver cancer and
cirrhosis. WHO estimates that around 1.34
million people worldwide died of these types
of hepatitis in 2015.
The WHO-mandated Western Pacific
region, which includes Malaysia, accounts for
50% of all chronic hepatitis B cases. Malaysia
also belongs to the global high-prevalence
belt for hepatitis B (8%) and C (2.5%), which
includes Thailand, Indonesia, the Philippines,
China, South Korea and Taiwan.
For chronic hepatitis C, WHO estimates that
Malaysia has 454,000 infected individuals out
SUNDAY STAR, 3 JUNE 2018
of 140 million
worldwide,
according to Prof
Lee Yeong Yeh,
professor of
medicine and
consultant of
gastroenterology,
hepatology and
internal medicine at
Universiti Sains
Malaysia.
Hepatitis B is
preventable with
proper vaccination,
but a vaccine for
hepatitis C has not
yet been found.
Prof Lee shares, “Most people
with acute hepatitis B will recover,
but not hepatitis C patients since it
can result in a chronic infection even with
proper, timely treatment.
“However, hepatitis B causes more deaths
Adults who are
than hepatitis C in Malaysia. This will be already infected need
to continue being
even more apparent in the next few years
as effective therapy is not yet available for
hepatitis B.”
Prof Lee believes that, currently, the only
treated, especially
way to prevent viral hepatitis B and C is to if they are pregnant
and have a high viral
be vigilant.
“Both hepatitis B and C are blood-borne
infections. Therefore, preventing the
transmission of infected blood is important. load. It is common for
“Having unsafe sex with one or multiple
partners and using unsterilised equipment
the virus to pass from
for body piercings or tattoos are some mother to foetus.
common ways that hepatitis B and C can
spread. Prof Lee Yeong Yeh
“For healthcare workers, not wearing
protective clothing or properly disposing
of contaminated objects can put them at believes it will take time to achieve this
risk.” goal.
WHO is advocating for elimination of “Some misconceptions have caused
hepatitis B and C by 2030, and Malaysia is people to avoid vaccinating their children,
wholeheartedly supporting the call. so we need more education and
“There has been tremendous awareness.
development in the treatment of hepatitis “Adults who are already infected need to
C with 90% of cases effectively cured continue being treated, especially if they are
with direct-acting antivirals,” says Prof pregnant and have a high viral load. It is
Lee. common for the virus to pass from mother
“These drugs are expensive, but they to foetus,” says Prof Lee.
became more affordable and accessible this Only time will tell if these government
year when the Government issued a licence initiatives will be enough to eradicate
that allowed for import or production of hepatitis B and C in Malaysia by 2030.
generic versions of these drugs.” Until then, Malaysians need to do their
The Government has made hepatitis B part by educating themselves and getting
immunisation compulsory for newborns vaccinated against preventable types of
to eradicate the condition, but Prof Lee viral hepatitis.
SUNDAY STAR, 3 JUNE 2018
AS children, most of us had to
battle our parents during
mealtimes. We were probably
confused as to why adults kept
wheedling us into eating the
“icky” green stuff on our
plates.
Despite the tantrums that often
involved crying, screaming and
vomiting, vegetables always made
it past our lips while our parents
tried to educate us about their
nutritional value. Even so,
vegetables rarely became a
childhood favourite.
As we grew up, we eventually
learnt the benefits of eating
vegetables and they started making
their way into our stomachs,
becoming an essential part of our
diet that we now cannot live
without.
Not just food
Fibre is commonly categorised
as soluble or insoluble fibre.
Soluble fibre dissolves in water
to form a gel-like substance while
insoluble fibre increases stool
bulk and prevents constipation.
It does more than just promote
bowel movement. Dietary fibre
also:
l Aids in forming healthier
eating habits – An increase in
dietary fibre intake is often
associated with better management
of body weight. Fibre can make
you feel fuller during meals,
reducing your chances of
overeating.
Fibre-rich foods tend to require
more chewing than low-fibre
foods, which slows down your
eating and decreases your chances
of developing indigestion.
l Helps regulate blood sugar
levels – Soluble fibre from whole
The goodness of fibre
grains and fruits can slow the
absorption of sugar into the
bloodstream and help improve
blood sugar levels in prediabetics
or diabetics. Insoluble fibre, which
can be found in most leafy
vegetables, can reduce one’s risk of
developing type 2 diabetes.
l Lowers blood cholesterol
levels – One of the ways soluble
fibre may achieve this is by
interfering with the reabsorption
of bile in the intestines. If not
reabsorbed, bile is excreted in
the faeces.
To make up for this loss of bile,
the liver makes more bile salts
by increasing its production of low-
density lipoprotein (LDL)
receptors. These receptors pull
cholesterol out of LDL molecules in
the bloodstream to synthesise bile,
hence lowering LDL levels in the
body.
l Lowers risk of heart disease
– Due to its effect on LDL
cholesterol levels, an increase in
fibre intake may reduce the risk of
heart attacks.
A 2016 article in the British
Digestive Health & You 7
Medical Journal, which compiled
data from several studies, found
that people who maintained a
Fibre-rich foods
high-fibre diet (30g to 40g of whole tend to require
more chewing
grains per meal) saw a 40%
decrease in their risk of developing
heart disease.
than low-fibre
l Promotes bowel health –
Increased fibre intake can
foods, which slows
down your eating
decrease the risk of developing
haemorrhoids, diverticular disease
and diverticulitis, and colorectal and decreases
cancer.
Diverticulitis is the infection or
your chances
inflammation of pouches that form of developing
indigestion.
in the wall of the colon and can
be very painful to endure.
Doctors do not know what
exactly causes diverticulitis, but it
is believed that a low-fibre diet
plays a role.
Vitamode Daily Cleanse Fiber
Drink contains a unique mixture of
different types of soluble fibre,
including organic psyllium husk,
wheat dextrin, prebiotics such as
inulin and fructo-oligosaccharides,
and electrolytes.
Taking one sachet daily can help
prevent constipation and keep
your gut healthy.
This article is brought to you by
Vitamode.
n For more information, call
1300 800 228 or e-mail enquiry@
medispec.com.my
8 Digestive Health & You
Trust your gut
DURING celebrations such as
the upcoming Hari Raya, it is not
uncommon to see antacids being
passed around after everyone is
done feasting. Bloating, abdominal
discomfort and difficulty breathing
after meals may be a normal thing
for you, but it could be a sign of a
more serious problem.
Dyspepsia, commonly known
as indigestion, is a chronic disorder
of sensation and movement
(peristalsis) in the upper digestive
tract. It can cause abdominal
and upper gastrointestinal (GI)
tract discomfort, especially after
a meal.
According to a study in
Alimentary Pharmacology &
Therapeutics, the prevalence of
this disorder is around 20% in
Malaysian adults, whether due to
heavy chilli intake, use of analgesia
or chronic illness.
“A lot of people with this
problem will not seek medical
treatment because it is a self-
limited condition, which means
that it resolves spontaneously with
or without specific treatment,” says
Dr Cheong Kuan Loong, consultant
physician, gastroenterologist and
hepatologist at Columbia Asia
Hospital, Puchong.
“In 25% of patients, we can
identify a structural, metabolic
or biochemical defect that causes
dyspepsia. The remaining 75%
have functional dyspepsia.
Functional dyspepsia is difficult
to treat and control due to the
lack of apparent symptoms and
underlying causes.”
Some conditions that can lead to
Dr Cheong Kuan Loong.
or exacerbate functional dyspepsia
are:
l Gastric dysmotility – A group
of conditions that includes delayed
or rapid stomach emptying after
meals and subsequent satiety
issues, hypermotility, gastric
arrhythmia and impaired gastric
accommodation (in males).
l Visceral hypersensitivity –
Bloating is sometimes painful, but
some people find it more painful
than others. A lower pain
threshold when it comes to
bloating, a condition called visceral
hypersensitivity, could signify
digestive problems.
l Bacterial infection –
Helicobacter pylori has been
identified as a possible cause of
functional dyspepsia. It could also
be a reason for gastric dysmotility
or contribute to smooth muscle
dysfunction.
l Psychosocial dysfunction –
Dyspepsia has been associated with
generalised anxiety disorder,
amnesia and depression. Patients
with these conditions regularly
report feeling nauseous or having
GI discomfort during periods of
high stress.
Dr Cheong says, “Patients who
come in with gastric problems are
classified by age. If a patient is
more than 60 years old, an upper
endoscopy with gastric biopsy is
performed. Younger patients only
need an endoscopy if they display
four important symptoms.”
These symptoms are:
l Clinically significant weight
loss, which is defined by a 5% to
10% weight loss over a six- to
12-month period.
l Overt GI bleeding that is
characterised by vomiting blood or
passing tarry stools
l More than two alarm features
l Rapidly progressive alarm
features
Alarm features for GI tract
problems are:
l Difficulty swallowing
l Painful swallowing
l Unexplained iron-deficient
anaemia
l Persistent vomiting
l Palpable mass in the abdomen
l Palpable lymph nodes
l Family history of cancer in the
upper GI tract
According to Dr Cheong, antacids
are not a cure-all and should not be
SUNDAY STAR, 3 JUNE 2018
treated as such. Proper diagnosis
and medication are needed,
especially in cases of persistent
gastrointestinal problems.
If drug therapy is not effective,
he says doctors may put their
patients through less popular
treatments such as psychotherapy
or gastric emptying studies.
People can develop dyspepsia
no matter their age. However, if GI
tract problems occur at a later age,
caution should be exercised by
consulting a physician because
these problems could indicate
cancer, peptic ulcer disease or
other organic problems.
n For more information, call
03-8064 8688.