"The Best Diet for Upset Stomach"
Dyspepsia is just a fancy word for an upset stomach--
feelings of fullness, discomfort, nausea, bloating, belching--
affecting up to one in five individuals.
In my last video I talked about the risks
associated with proton pump inhibitor drugs like Nexium,
as well as folk remedies like baking soda.
So, all in all, studies have emphasized
the unmet need for medications to treat patients with dyspepsia,
but why not try food?
One study put amalaki to the test,
which is just another name for amla.
They call it an Ayurvedic drug,
but it’s just a fruit—powdered Indian gooseberries.
One teaspoon of dried Indian gooseberry powder
three times a day versus an ounce
of some gel antacid every three hours.
And both worked just as well, significant decreases
in peak acid output, and a cutting of dyspepsia
symptom scores in half.
They conclude that amla is therefore better,
about a hundred times cheaper
(about a penny a week instead of a dollar a week),
and more convenient than downing antacids six times a day.
Though amla may be a safe, simple, natural remedy,
such an approach is still very much
in the pharmaceutical model of treating the symptoms,
rather than the underlying cause.
I mean dyspepsia is not caused by a gooseberry deficiency.
What is it caused by?
Well, about one in seven people describing
a range of gastrointestinal symptoms feel better
cutting out gluten, but for the other 86% of people,
the most well-characterized trigger is high fat meals.
If you give people a fatty soup— just broth with added fat—
it takes three times longer to empty from your stomach
compared to the broth alone, like an hour and a half
versus just a half an hour.
Now the emptying rate didn’t necessarily correlate
with how people felt, but regardless, the fatty broth increased the
severity and frequency of dyspepsia over the regular broth.
What happens in dyspepsia is people become hypersensitive
to the stretching of the stomach when you eat.
But, it also matters what you eat.
The human stomach can normally accommodate
about a quart of food, a thousand milliliters,
four cups, but if you stick a balloon into people’s stomachs
attached to a hose, people with dyspepsia
will start feeling discomfort about here,
only at about one- and-a-half cups,
when the stomach is less than half full.
But that’s when you’re dripping fat into their gut,
but if you're instead dripping sugar into their gut
while you’re blowing up the balloon,
it can get up to here before causing discomfort in dyspeptics-
about 70% more.
And the same with fullness and nausea.
Increase the pressure in the stomach with fat in there,
and fullness and nausea shoot up.
With fake fat in your stomach instead,
the same pressures resulted in significantly
less feelings of fullness and nausea.
These studies show that during distension of the stomach
as the stomach fills up— dietary fats are a major
trigger of dyspeptic symptoms such as
nausea, pain, bloating, and fullness,
and they modulate symptoms in a dose-related fashion,
meaning more fat the worse people felt.
These were some pretty elegant experiments,
but also a bit artificial.
I mean we don’t typically eat with balloons in our stomach.
So how about an experiment using actual food?
They compared yogurts high in sugar/low in fat,
versus high in fat/low in sugar.
Eating the low-fat yogurt there wasn’t as much
difference in the nausea, pain, and bloating scores
between those with dyspepsia and healthy subjects.
But give them the same amount of high-fat yogurt,
and dyspepsia symptoms shot up almost immediately.
So, one of our major findings was that the induction of
gastrointestinal symptoms after the test meals were
“nutrient-specific.”
The consumption of a high- fat test meal was associated
with a substantially greater increase in nausea and pain
when compared to a high-carbohydrate meal
among those with dyspepsia, with the symptoms scores
increasing immediately after eating.
This would suggest that sufferers not only reduce
the amount of food they eat, which is the typical advice,
but also try to keep the fat content down,
a message echoed by a recent review
of all such studies put together.
Current studies show that fatty foods
are associated with occurrence of dyspeptic symptoms,
and reduction of fat intake may help alleviate symptoms.