The potency and duration of drug effects vary. Choose gastrointestinal drugs carefully to combat satiety.

Text◇Chen Zhenji “Ming Pao”

(Hong Kong News) During festivals, there is a big meal of fish and meat. After overindulgence, the digestive system is overwhelmed. When they experience satiety, stomach pain, bloating, vomiting, diarrhea, etc., many people go to pharmacies to buy gastrointestinal medicines to relieve their urgent needs.

However, there are various kinds of gastrointestinal medicines, ranging from neutralizing gastric acid to regulating stomach and intestines, and other different Chinese and Western patent medicines. How do you choose the medicine that suits you?

Indulgent eating can cause gastrointestinal discomfort, especially during the Lunar New Year, eating many high-fat and high-sugar New Year cakes, such as rice cakes, carrot cakes and other difficult-to-digest foods, or overeating, eating quickly without fully chewing.

“Pharmacy Connection” registered pharmacist Brian Chen said that the above situations will increase the load on the stomach, which can easily lead to excessive secretion of gastric acid, leading to heartburn, acid reflux and other indigestion symptoms.

Medications that neutralize stomach acid last for a short time

If they suspect that they have eaten too much and caused gastrointestinal discomfort, many people will seek stomach medicine as soon as possible. He pointed out that commonly available patent medicines for gastric acid problems are mainly divided into two categories: drugs that neutralize gastric acid and drugs that inhibit gastric acid. The two categories basically depend on the strength and duration of the drug (see “Comparison of the Three Major Stomach Drugs” for details).

Anti-acid medicines (antacids)

The drug takes effect quickly but lasts for a short time. It can instantly neutralize gastric acid and relieve discomfort symptoms. The ingredients are weakly alkaline and can reduce the stimulation of gastric cells by gastric acid. Common ingredients include magnesium hydroxide, calcium carbonate, aluminum hydroxide, etc. Magnesium hydroxide may cause mild diarrhea, while aluminum hydroxide may cause mild constipation. Therefore, a combination of gastric acid neutralizing drugs is generally used to balance the side effects.

Stomach acid suppressing medicine

Drugs that inhibit gastric acid are further subdivided into H2 receptor antagonists (H2RA) and proton pump inhibitors (PPI). The former can inhibit about 70% of gastric acid secretion, and the effect lasts for 8 to 10 hours; the latter can inhibit more than 90% of gastric acid secretion, but it needs to be taken in the morning before meals to achieve the best effect, and the effect usually lasts for a whole day.

Chen Zhipeng pointed out that due to the relatively strong and long-lasting effects of proton pump inhibitors, and strict supervision, most of them are prescribed by doctors. Only drugs such as omeprazole and specific dosage forms of pantoprazole can be found in pharmaceuticals. Purchase at registered pharmacies under the supervision of a professional. Others, including gastric acid neutralizers and H2 receptor blockers, can be purchased by yourself without a doctor’s prescription.

Taking digestive enzymes will make you eat more

However, how to choose the stomach medicine that suits you? He said that the ingredients of the above three types of drugs are mild and do not have major side effects. “If the stomach pain is purely occasional and the symptoms are mild, such as caused by eating too full or too fatty, and there is no history of gastric disease, take gastric acid neutralizing drugs and H2 “Receptor antagonists are sufficient”; but if you have a history of gastric disease, such as frequent stomach pain, or even gastric ulcers or gastric bleeding, or you are taking some drugs that can hurt the stomach and increase the risk of gastric bleeding, such as blood thinners or anti-inflammatory analgesics, etc.

“It is usually recommended to use proton pump inhibitors directly because they are more effective and can suppress gastric acid better, so gastric acid will cause less irritation to the stomach.”

He added that although drugs to control gastric acid can relieve most indigestion, some symptoms may have nothing to do with gastric acid, and taking the above-mentioned gastric drugs will not be effective. Other drugs may be needed, such as gastric qi-reducing drugs, digestive enzymes, and intestinal spasm-relieving drugs.

“Most of the proprietary medicines in the market include combinations of several types of medicines at the same time. The most common combination is a combination of medicines that neutralize gastric acidity and medicines that reduce gastric qi. They can not only relieve symptoms such as stomach pain and heartburn, but also remove gas and relieve bloating. However, if stomach discomfort persists, it is recommended to see a doctor for detailed examination.”

However, some people take digestive enzymes to help them eat more. Chen Zhipeng pointed out that this approach is not ideal and “may lead to over-reliance on digestive aid products and neglect of proper dietary management to maintain digestive health.” Long-term use of digestive enzymes is not recommended unless there is a specific medical need.

Do not take medicine to replenish electrolytes for diarrhea

What medicine should be used if diarrhea occurs? He said that in general, there is no need to take medication for relief. “According to the recommendations of the World Health Organization (WHO), when you have diarrhea, you do not take medicine directly, but replenish electrolytes and drink water. Diarrhea is actually caused by the intestinal tract being exposed to some irritants, which may be oil, bacteria, microorganisms, etc., so diarrhea is a natural reaction. To fight against foreign invaders, if we forcefully use drugs to stop diarrhea, we are actually putting the cart before the horse.”

Comparison of 3 major stomach medicines

Avoid gastrointestinal upset

Diet control is the first priority

From the perspective of traditional Chinese medicine, if gastrointestinal discomfort occurs after overeating, the first step is to control your diet to reduce the burden on the gastrointestinal tract.

Guo Yingying, a Chinese medicine practitioner, pointed out that the most common Chinese medicines used to help digestion are Baohe Pills, which include Shenqu, Pinellia ternata, hawthorn, forsythia, tangerine peel, radish seed, poria and other Chinese medicinal materials, and can be added or subtracted according to the patient’s condition.

Po Chai Pills relieve satiety and bloating

“For example, if the stomach is obviously bloated, you will add agarwood and amomum villosum to promote qi; for acid reflux, you can add gastric acid astringent drugs, such as jellyfish, turmeric, etc.” If vomiting or diarrhea only occurs 1 to 2 times, the patient will notice it after defecation. Don’t worry too much if your gastrointestinal condition is comfortable. Just replenish electrolytes and water appropriately.

The main ingredients of gastrointestinal Chinese patent medicines on the market, such as Po Chai Pills, Zhengchang Pills, Zhenglu Pills, Huoxiang Zhengqi Powder, etc., include perilla, tangerine peel, Poria, Pinellia ternata, Huoxiang, etc. Guo Yingying said that these Chinese patent medicines have similar effects, and the medicinal materials are all aromatic in nature and flavor and reduce dampness. “For example, perilla is fragrant and can remove stagnation; tangerine peel can dissolve dampness, harmonize the stomach and strengthen the spleen, and enter the gastrointestinal meridian. It is a commonly used medicinal material in traditional Chinese medicine to soothe the stomach and relieve gastrointestinal discomforts such as bloating, nausea, and diarrhea.”

Guo Yingying pointed out that if the discomfort associated with indigestion is mainly due to abdominal distension, choose Magnolia officinalis, Perilla leaves, etc.; if the main problem is nausea, choose Pinellia ternata, Patchouli, and Tangerine peel. Po Chai Pills are suitable to be taken when you are full and bloated; if the main problem is diarrhea, choose Atractylodes Rhizome, Phellodendron Cortex, Creosote, Zhengchang Pills and Zhenglu Pills, which have a strong antidiarrheal effect; Huoxiang Zhengqi Powder is mainly used for treating diarrhea. It is more suitable for those with cold and dampness in the intestines and stomach, or gastroenteritis and colds combined with wind and cold.

Identify the cause to avoid delaying treatment

She reminded that before taking traditional Chinese medicine, you must first distinguish between cold and heat in your body constitution. People with a cold body constitution should not take too many medicinal materials with a cool nature and flavor such as cork bark and raw coix seed, so as not to cause further gastrointestinal discomfort. Those with a damp-heat constitution should not consume too much perilla leaf, patchouli, etc. When recurring stomach pain occurs, it may be caused by excessive stress, digestive system problems, or celiac disease. Guo Yingying reminds that the cause should be identified first to avoid delaying treatment.

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