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Hot topic - Fast eating may cause indigestion

6 September 2004 - written by Bupa's Health Information Team

Eating food quickly may cause a type of indigestion called gastrooesophageal reflux, a new study in the September 2004 edition of the American Journal of Gastroenterology has shown.1

What is gastrooesophageal reflux?

Gastrooesophageal reflux is when the stomach contents (eg food, stomach acid and other digestive juices) travel back from the stomach into the oesophagus. This causes a burning pain, often called heartburn.

Many people get gastrooesophageal reflux occasionally, especially after large meals. If it happens frequently or causes severe symptoms, it is called gastrooesophageal reflux disease (GORD).2

How common is gastrooesophageal reflux?

About one third of people get some gastrooesophageal reflux at least once every six months.2 About five percent of adults have gastrooesophageal reflux disease (GORD).4 In most people, reflux occurs during the day, usually after eating.

What causes gastrooesophageal reflux disease (GORD)?

Gastrooesophageal reflux happens when the muscular sphincter (valve) between the stomach and the oesophagus relaxes, allowing food and digestive juices in the stomach to travel back up the oesophagus.3 Having a full stomach makes this more likely to happen as this puts extra pressure on the valve.

For people with gastrooesophageal disease (GORD), the sphincter does not work properly and relaxes more often than usual. The reason why this happens is not fully understood.

What are the symptoms of gastrooesophageal reflux disease (GORD)?

The main symptom of gastrooesophageal reflux disease (GORD) is heartburn - a burning pain felt in the centre of the chest or behind the sternum (breastbone). The stomach has a mucous lining to protect it from damage by stomach acid. However, this mucous lining is not present in the oesophagus, so stomach acid irritates the oesophagus, causing a burning sensation.4,5,6 If severe, the pain can be hard to distinguish from a heart attack. Anyone who develops severe chest pain should seek urgent medical advice or call 999 for an ambulance.

Occasionally, food is regurgitated from the stomach back into the mouth.5

Severe cases of GORD can lead to inflammation of the oesophagus (oesophagitis) which results in scarring and narrowing of the oesophagus, making it difficult to swallow.6

For more information, please see the Bupa factsheet on indigestion at: http://hcd2.bupa.co.uk/fact_sheets/html/Dyspepsia.html

What did this study show?

This study showed that reflux occurs more often when a standard meal is eaten fast, in five minutes, compared with the same meal eaten slowly, over 30 minutes.

Researchers found that the increase was mainly due to an increase in non-acid reflux in the first hour after the meal.1 Non-acid reflux includes reflux of stomach contents other than acid eg food.

Why does eating faster increase the risk of gastrooesophageal reflux?

One theory is that eating quickly increases the amount of food in the oesophagus at any one time, increasing the pressure on the base of the oesophagus. This causes the sphincter between the oesophagus and stomach to relax more often, increasing the amount of gastrooesophageal reflux.3

What can I do to reduce the risk of gastrooesophageal reflux disease (GORD)?

Eating meals slowly may help to reduce the risk of gastrooesophageal reflux. Other advice includes:

  • eat small regular meals - this will help to reduce pressure on the upper part of the stomach caused by eating large meals
  • avoid eating late in the evening to ensure that the stomach is empty at bedtime
  • drink alcohol only in moderation with meals
  • avoid smoking
  • maintain a healthy weight - being overweight can cause upward pressure on the base of the oesophagus
  • wear loose clothing
  • avoid bending too often, especially after meals
  • sleep in a slightly upright position to prevent stomach contents from rising up into the oesophagus5,6

What is the treatment for gastrooesophageal reflux disease (GORD)?

A range of medicines is available for the treatment of gastrooesophageal reflux disease (GORD).

Antacids are medicines that work by neutralising any acid in the oesophagus. They can be taken either in liquid or tablet. Alginates are another common ingredient of heartburn remedies and can also be useful for treating GORD.4,5,6

If antacids do not work, or if large quantities are required, stronger drugs known as H2-blockers (H2-agonists) may be bought at a pharmacy. H2-blockers work by reducing the amount of acid produced by the stomach.4,5

If symptoms persist, prescription-only drugs called proton pump inhibitors also work by reducng the amount of stomach acid produced.4,5

Medicines that help the oesophagus to move normally may also be helpful.5

In more severe cases of GORD, laparoscopic (key-hole) surgery can be performed to tighten the tissue around the lower oesophagus and decrease or prevent reflux.5

How was this study carried out?

On two separate days, 20 healthy volunteers were given a meal and asked to finish it within five or 30 minutes. The participants reported any reflux (acid and non-acid) they experienced over a two-hour period following the meal.1

Further information

Bupa resources:

External resources:

References

  1. Am J Gastroenterol Vol.99 No.9 "The influence of rapid food intake on postprandial reflux: Studies in health volunteers", S.M. Wildi et al.
  2. Oxford Textbook of Medicine, Third edition Vol.2 Chapter 14.6 "Diseases of the oesophagus", D.J. Weatherall et al. (Ed.) Oxford University Press.
  3. MEDWIRE Online news and conference reports. Consumer health news 31 August 2004: "Eating slowly may help reduce GERD symptoms".
  4. Oxford Handbook of General Practice. Section 14: The gastrointestinal tract. C Simon et al. Oxford University Press.
  5. Digestive Disorders Foundation. Factsheet: Reflux oesophagitis. http://www.digestivedisorders.org.uk/Default.aspx?docname=doc_reflux
  6. Digestive Disorders Foundation. Factsheet: Heartburn and hiatus hernia. http://www.digestivedisorders.org.uk/Default.aspx?docname=doc_hiatushernia

 

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