DYSPEPSIA, GERD, IBS AND DIVERTICULAR DISEASE

Indigestion (dyspepsia) is a mild discomfort in the upper belly or abdomen,it occurs during or right after eating. It may feel like:

-A feeling of heat, burning, or pain in the area between the navel and the lower part of the breastbone.

-An unpleasant feeling of fullness that comes on soon after a meal begins or when the meal is over.

Antacids and simeticone, indicated for dyspepsia.

1. Aluminium and magnesium-containing antacids:

-Aluminium hydroxide (Alu-Cap, Maalox, Mucogel).

-Magnesium carbonate

-Magnesium trisilicate

2. Aluminium-magnesium complexes:

-Hydrotalcite

3. Antacid preparations containing simeticone (Altacite Plus, Asilone, Maalox Plus).

4. Simeticone alone (Dentinox, Infacol).

Gastroesophageal reflux disease

Your esophagus is the tube that carries food from your mouth to your stomach. Gastroesophageal reflux disease (GERD) happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.

You may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. If you have these symptoms more than twice a week, you may have GERD. You can also have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.

Compound alginates and proprietary indigestion preparations

Alginate taken in combination with an antacid increases the viscosity of stomach contents and can protect the oesophageal mucosa from acid reflux. Some alginate-containing preparations form a viscous gel (raft) that floats on the surface of the stomach contents, thereby reducing symptoms of reflux. 

1. Alginate raft-forming oral suspensions: Acidex, Peptac.

2. Other compound alginate preparations: Gastrocote, Gaviscon Advance, Gaviscon Infant, Rennie Duo, Topal.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder have constipation. Some have diarrhea. Others go back and forth between the two. 

Diverticular disease

Diverticula are small pouches that bulge outward through the colon, or large intestine. If you have these pouches, you have a condition called diverticulosis. It becomes more common as people age. About half of all people over age 60 have it. Doctors believe the main cause is a low-fiber diet.

Most people with diverticulosis don't have symptoms. Sometimes it causes mild cramps, bloating or constipation.

Antispasmodics and other drugs altering gut motility

The smooth muscle relaxant properties of antimuscarinic and other antispasmodic drugs may be useful in irritable bowel syndrome and in diverticular disease.

1. Antimuscarinics:

-Atropine sulphate: Atropine.

-Dicycloverine hydrochloride: Merbentyl, Kolanticon.

-Hyoscine butylbromide: Buscopan.

-Propantheline bromide: Pro-banthine.

2. Other antispasmodics:

-Alverine citrate: Spasmonal.

-Mebeverine hydrochloride: Mebeverine, Colofac, Fybogel Mebeverine.

-Peppermint oil: Colpermin, Mintec.

Sources:

http://www.nlm.nih.gov/medlineplus

BNF 57 March 2009