Plop, plop, fizz, fizz. Oh, what a relief it is! The jingle sung by “Speedy” Alka-Seltzer still resonates in my brain from time to time. I also know that some misguided souls spell relief R O L A I D S. Heartburn, indigestion, and other abdominal woes have been a prominent part of our culture for many years.

Things do not seem to be getting better. In a recent survey 40 % of adults in the United States reported that they had experienced at least one episode of abdominal pain, bloating, or diarrhea during the previous month. Sixty-five percent of them characterized the symptoms as being moderate to severe in nature. A very high percentage of people who consult with me are on at least one drug for control of abdominal symptoms. It appears that a great many people are experiencing stomach and intestinal problems on a regular basis.

Three factors account for most of these problems. They are lack of pure water intake, imprudent eating habits, and inactivity. Correct these factors and most abdominal symptoms will disappear.

Pure water intake is important for several reasons. It is helpful to replace other beverages with water. Carbonated beverages contribute greatly to excessive gassiness and bloating. Coffee and tea tend to have a diuretic effect, meaning that they cause the body to lose more water than they contain. This can cause stools to become hard and dry and aggravate constipation.

Most people underestimate their body’s need for water. To estimate the amount of water required divide your body weight (in pounds) by 2. This represents the number of ounces of water that should be drunk on a daily basis. When optimum amounts of water are provided stools will remain softer and move through more easily.

Water should not contain chemicals such as chlorine. Chlorinated water consumption interferes with the growth of protective bacteria in the stomach and intestinal tract. This allows other organisms to move in and cause problems. For example, it is now known that nearly all stomach and duodenal (small intestinal) ulcers are caused by the presence of H Pylori, a bacterium that is normally kept under control by helpful bacteria such as lactobacilli. Dysbiosis, an imbalance of intestinal bacteria, can cause cramping, diarrhea, bloating and other symptoms.

Indigestion is at the root of most gastrointestinal problems. When “in” is placed in front of “digestion” it forms a word than means poor or incomplete digestion. Indigestion that moves up becomes heartburn while indigestion that moves down leads to gassiness and bloating.

Incomplete digestion of foods is a major cause of food allergies. When proteins are broken into their constituent amino acids prior to being absorbed the body makes good use of them. When undigested proteins are absorbed the body often views them as undesirable foreign invaders and forms antibodies against them. When re-exposed to these proteins the body will react with an allergic response.

One of the leading causes of indigestion is a diet that is too low in what may be called “live” foods. . Live foods are foods that contain enzymes that aid in digestion. The main sources of live foods in the diet are raw or lightly steamed fruits and vegetables. Cereal grains that have been simmered rather than boiled will also contain some active enzymes.

Heat destroys enzymes. Foods that are cooked no longer contain the enzymes needed for their digestion. This is easily demonstrated. If not eaten within a short period of time fresh fruits will begin to rot. The enzymes present are actually digesting the fruit. If the fruit is cooked, however, it will remain stable for a much longer period of time. It may mold, but it will not decompose.

The same phenomenon occurs when the food is eaten. If enzymes are present it will in essence digest itself. If the food has been cooked and the enzymes destroyed it will remain undigested unless the body is able to provide adequate amounts of enzymes to do the job.

The body’s ability to provide enzymes for purposes of digestion diminishes with age. That is why young people can commonly eat almost anything at any time and experience no discomfort while those in their fifties and beyond will suffer heartburn and bloating when they consume the same foods. By experimenting with the percentage of raw or lightly steamed foods in a meal one will soon discover what ratio is required to avoid the symptoms of poor digestion.

Increasing the percentage of live foods in the diet will also help correct another problem, lack of adequate fiber intake. Low dietary fiber predisposes us to constipation, hemorrhoids, diverticuli, cancer, and diabetes and may be a risk factor for other degenerative conditions. The main dietary sources of fiber are fruits and vegetables with skin, legumes (beans and peas), crucifers (cabbage, broccoli, cauliflower, Brussels sprouts), bran products, nuts & berries.

Physical activity stimulates intestinal action. This promotes regularity and helps prevent constipation. I find that many people do not realize that two or three bowel movements daily are required for optimum health. Some are content with one bowel movement every two or three days! Food intake should trigger a reflex emptying of the bowel. Food in, waste out. When this does not occur toxins remain in the intestinal tract increasing the risk of colon cancer and degenerative diseases.

Optimum water intake, adequate amounts of live foods and foods rich in fiber, and physical activity will eliminate most abdominal symptoms. In some cases additional steps may be necessary, however.

Stomach acid is needed to enhance digestion and stop harmful germs from moving into the intestinal tract. Many minerals, including calcium and iron, cannot be absorbed efficiently without adequate amounts of stomach acid.

Just as enzyme production slows as we age so does the production of stomach acid. When the level of acid in the stomach drops the normal tightness of the lower esophagus is lost. This allows the stomach contents to “reflux”, to come up into the esophagus. The result is what is referred to as heartburn or reflux esophagitis.

The first step that should be taken to correct heartburn if increasing the ratio of live foods in each meal has not solved the problem should be to increase the level of acid in the stomach. Unfortunately the opposite is typically done. Antacids and H₂ blockers including Tagamet, Zantac, Pepcid and Axid that reduce the level of stomach acid are what most people use to ease their symptoms.

Some of the most widely prescribed medications today are proton pump inhibitors such as Aciphex, Prilosec and Prevacid. These drugs effectively stop the production of nearly all stomach acid. This is promoted as being highly desirable, but from the perspective of the body’s design absence of stomach acid is a very serious problem. Once started, these medications can be difficult to stop. The body is trying to overcome the acid blockade, and when it is removed the rebound in acid production can cause a temporary flare in heartburn or stomach pain.

Whenever possible, an effort to ease symptoms by increasing stomach acid should be tried before acid suppressing medications are employed.

Stomach acid production can be stimulated by drinking the juice of ¼ to ½ lemon in a glass of water 15 to 20 minutes before meals. If needed, betaine supplements may be used to increase hydrochloric acid levels.

Digestive enzyme supplements may be taken with meals. If indigestion has been a frequent or persistent problem 3 or 4 tablets or capsules may be required initially to correct the problem. As the body “catches up” the number of enzyme supplements required will diminish.

Probiotic supplements are also available. Taking 2 billion units of lactobacillus acidophilus or bifidus two or three times daily can effectively correct dysbiosis and restore balance to the GI tract. This can often correct persistent abdominal symptoms.

If there is a magic potion for abdominal symptoms it is dietary fiber. When foods alone do not seem to be adequate supplements containing psyllium should be added. These are very safe and may be titrated to any amount required to control the problem. Psyllium is actually a moderator of bowel activity. It is able to absorb many times its weight in water and so will firm up loose stools. Because it adds bulk to the stool and is not absorbed it promotes movement throughout the bowel and can eliminate constipation.

These measures – drinking pure water, making wise food choices, increasing activities, promoting acid production, supplementing digestive enzymes, providing beneficial bacteria, & titrating fiber intake – should result in a smoothly functioning gastrointestinal tract, free of discomfort. If symptoms persist steps should be taken to identify the precise cause of the problem and corrective measures instituted. That’s how you should spell relief.