Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Americans have more peptic ulcers than any other people. The way we live promotes ulcers. Most peptic ulcers could be prevented by proper care. The three commonest causes of peptic ulcers are alcohol, aspirin, and vinegar. These substances all irritate the lining of the stomach and cause gastritis. The irritation leads to overproduction of pepsin and hydrochloric acid which taxes and weakens the stomach.

Other stomach irritants are black and red pepper, spices, sweets, soft drinks, and caffeinated drinks such as coffee, tea, and colas. The eating of fruits and vegetables at the same meal increases stomach acidity, thereby setting the stage for ulcers. Drinking fluids with a meal makes the stomach work harder. The increased work is from the extra acid needed to readjust the acidity after the fluid dilutes the stomach acid, and the extra length of time the food must stay in the stomach before digestion can be completed. A simple rule is helpful: "Eat without drinking at meals, and drink without eating between meals." That means only water between meals.

Many people make a serious mistake in feeling that they should eat many times each day to keep the stomach acid from "eating up the stomach." But since acid is produced only in response to the presence of food in the stomach, frequent feedings are actually harmful. If the person would eat his meal, and then refrain from all eating for five or preferably more hours until the next, he would give the stomach time to finish its work and rest and replenish its supplies before having to work again. Even an apple between meals, or some fruit juice, will cause the stomach and intestinal tract, the liver, gallbladder, and pancreas to crank up all of their "big machines" to take care of a small amount of food. Tests show that a person can usually empty his stomach within 3-6 hours if an ordinary size meal with not too much fat is taken. However, if new food is introduced before the first food has cleared the stomach, some of the original food may remain in the stomach up to 14 hours.

If there is a delay in emptying the stomach of food several unwanted things happen. First, bacteria can more readily grow in the central portion of partly digested food. If the stomach is not working efficiently it may not be able to regulate the amount of pepsin and acid it produces and it may produce too much or too little. Too much weakens the wall of the stomach. Energy is spent in making the chemicals, and this brings on a sense of fatigue or faintness. The person may think that his weakness is due to hunger and may actually eat again, hoping to relieve his discomfort. The overworked stomach then must try to dispose of even more food until it eventually begins to get inflamed or ulcerated.

If too little digestive juices are produced, incomplete breaking up of the long chain food molecules into the smallest possible size occurs. Intermediate length molecules are formed, many of which are poisonous to the blood. Headaches, colds, and a general weakening of the constitution result.

A centenarian was asked what she felt was the reason for her living to be 150 years old. She replied that she never ate when she was not hungry, and she chewed her food until it became a cream in her mouth before she "turned it loose." No better advice could be given. If eating were controlled by hunger, and one stopped eating when hunger was satisfied, and if he would train the body to wait for food for five or more hours after the end of the last meal, he would have a lot more strength and vitality. Ninety percent of fatigue is associated with overeating in one way or another.

Few people chew their food adequately. When I was first exposed to the autopsy room as a medical student, I was astonished at the number of stomachs we found with large chunks of unchewed, partly digested food. Make an unobserved survey of your friends and you will find that there are few who chew even very large mouthfuls more than five or six times. Large chunks of food require much strong digestive juice to break them into small enough particles to be sent to the small intestine. It is a rule of digestion that the benefit we derive from our food, as well as the satisfaction from it, depends more on the length of time the food spends in the mouth than on the quantity eaten. Many stomach complaints and much overweight could be avoided by taking small bites and chewing well.

The intestinal tract is so designed that mild exercise promotes digestion and activity in the intestine, while heavy exercise reduces the motion and the digestive juices of the intestine. We can help digestion by mild physical activity after meals, such as washing dishes, working in a hobby shop, or taking a stroll.