Best Life - April 2009

WELLNESS

Is It an Ulcer…or Worse?

Use this cheat sheet to help differentiate between garden-variety
abdominal pain and something more serious

ASK
THE
WELL-
NESS
DOC

Like many successful guys in their forties, Jeff Ingalls, a

Houston-based commercial real-estate broker, knew how

to celebrate a deal (a rib-eye and a bottle of Bordeaux) and

how to treat heartburn (Tums and a glass of water). So when

he felt a dull ache in his belly at a recent party, he didn’t think

much of it—he just eased up on the wine. But at 3 A.M., the pain became

searing and a fever kicked in. He assumed he had food poisoning and

wanted to soldier on through the night, but his wife persuaded him to go

to the emergency room.

Abdominal pain is the number one reason for all visits to the E.R.,

according to the National Center for Health Statistics, but the actual

cause of the pain is tough to pin down. “The E.R. can be a fast,

practical option for rapid evaluation,” says Mark Moyad, MD, director

of preventative and alternative medicine at the University of Michigan

Medical Center. “Abdominal pain should be taken seriously, because

it can be fatal.” An ultrasound determined that Ingalls had diverticulitis,

an infection of the large intestine that required immediate surgery.

Here’s how to determine the severity of abdominal pain and how to

prevent it. CURTIS PESMEN

An essential guide to everlasting health

GUT CHECK Stop your bellyaching.

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5

I just
developed
a new allergy
to shrimp.
What
gives?

To be honest,
I don’t know.
Allergies can
develop at any
age, seemingly
out of nowhere,
and science
is at a loss to
explain why. We
do know that
your immune
system identifies
certain shellfish
proteins as
harmful, so your
body produces
antibodies to
neutralize them.
The immune
system releases
histamine and
other chemicals
during later
encounters with
the offending
seafood. Once
you develop
an allergy, you
usually have it
for life, so stop
eating shellfish
in general, and
don’t order
any fried food
in restaurants
that serve fried
shellfish. Ask
your doctor for
an ImmunoCAP
test (a complete
allergy profile),
and keep an
EpiPen on
hand for severe
reactions.

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1 I SYMPTOMS: Searing pain at the base of the esophagus and pressure in the upper abdomen What it is: HEARTBURN What to do: Take an OTC antacid (Zantac or Pepcid) or a proton-pump inhibitor (Prilosec). But these should be taken only occasionally, says the Cleveland Clinic’s Raul Seballos, MD. If pain persists, see a doctor. Prevent it: Losing t wo pounds or an inch off your waist can really help, says Dr. Moyad. He also advises taking a 500-milligram calcium carbonate supplement daily, such as Os-Cal.

Another strategy is to eat six small meals a day, says Nancy Rao, ND, a naturopathic physician in Boulder, Colorado.

2 I SYMPTOMS: Burning pain in the central abdominal area. May flare up when you lie down or when your stomach is empty. What it is: PEPTIC ULCER What to do: See your doctor, who will likely prescribe antibiotics, antacids, or proton-pump inhibitors. The majority of ulcers are linked to the bacterium Heliobacter pylori and are not caused by diet or stress. However, spicy foods, stress, alcohol, and smoking can exacerbate ulcers, as can nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, and naproxen. Prevent it: Limit alcohol, don’t smoke, and take NSAIDs with food or replace them with acetaminophen.

3 I SYMPTOMS: A sharp, sudden pain that grabs you just below the ribs, in the upper-right quadrant What it is: GALLSTONE What to do: See your doctor. Though painful, gallstone attacks are usually caused by normal digestive processes run amok due to dehydration and the overeating of fatty foods, eggs, onions, and garlic. In severe cases, physicians may prescribe drugs to dissolve the gallstone. Prevent it: Lose weight and avoid all fried and fatty foods, while increasing your consumption of fruits, vegetables, unprocessed grains, monounsaturated oils, and water, says Rao.

4 I SYMPTOMS: A dull ache in the lower-left quadrant that becomes increasingly sharper What it is: DIVERTICULITIS What to do: Go to the emergency room. Diverticulitis requires immediate treatment with antibiotics. It occurs when marble-size pouches form along the walls of the large intestine and fill with waste, leading to infection. Surgery is required in acute cases. Prevent it: “Eat a high-fiber diet: vegetables, nuts, fruits, beans, bran cereals, and whole grains,” says Dr. Moyad. “Aim for 30 to 40 grams of fiber a day.”

5 I SYMPTOMS: Incisive pain that starts at the navel and migrates to the lower-right quadrant, becoming more intense

What it is: APPENDICITIS What to do: Rush to the E.R. “Acute lower-right quadrant pain signals something grave,” says Dr. Seballos. The cause is unclear, but it is typically an obstruction or infection, and it requires surgery.

NOTE: Head to the emergency room within four hours if your abdominal pain is accompanied by fever, vomiting, blood in the stool or urine, dizziness, or shortness of breath.