Part 34

=Nervous Indigestion= is due to the general nerve condition. In such cases the entire nervous system should be regulated through exercise, breathing, relaxation and a change of thought. Physicians usually recommend change of scene to direct change of thought.

The diet should be light and laxative and low in protein. Cream soup, bread and milk, crackers and milk, custards, egg lemonade, and gruels, furnish an easily digested list. No tea, coffee, very little meat and no fried food. Where the walls of the stomach are weak and distended, light food six times a day is preferable to a hearty meal, which distends the stomach walls.

Where a loss of weight occurs, it usually indicates a failure to assimilate a sufficient amount of food, rather than a failure to eat sufficient. A good circulation, particularly through the vital organs, deep full breathing of fresh air, and regular and complete rest periods, should be observed. Usually a dietitian, or a physician, is not called in chronic cases until the condition has prevailed for so long that other complications have set in and the patient has lost much flesh. It takes months to pull the system down and it takes months of following of proper hygiene to build it up.

* * * * *

=Gastritis or Catarrh of the Stomach= involving an inflammation of the mucous lining of the stomach, is a most common phase of indigestion. In acute cases the physician is called at once. He can treat the case in its initial stages and bring about a much more rapid recovery.

* * * * *

=Acute Gastritis= is accompanied by nausea and vomiting and the patient should rest from all food and drink for two days. If the mouth is dry, water or ice may be given frequently and held in the mouth, but not swallowed.

After two days rest, begin the nourishment with water and a small portion of liquid food (not over two ounces) every two hours. Toast tea, made by pouring hot water over toast, oatmeal, or barley gruel (thoroughly strained so that no coarse matter may irritate the stomach), limewater and milk, and egg lemonade are easily digested foods to begin to eat. Increase the quantity the fourth day and lengthen the time between feedings to three hours. Gradually increase the diet by semi-liquid food, soft boiled eggs, moistened toast, raw oysters, etc., slowly returning to the regular bill of fare.

Avoid, as you do so, any food difficult of digestion and any vegetable containing coarse fibre. Tea, coffee, pickles, and alcoholic drinks should be avoided.

* * * * *

=Chronic Gastritis= is accompanied with a thickening of the mucous lining of the stomach. It is usually caused by prolonged use of irritating foods and the regulation of the diet is of utmost importance. Alcohol is a common cause. The difficulty begins gradually and the relief must likewise be gradual.

The stomach needs water. If the drinking of water causes nausea it is well to wash it out with a stomach pump each morning before breakfast.

If not convenient to use the stomach pump the washing may be accomplished by drinking two glasses of water at least an hour before breakfast, followed by stomach exercises, to cause a regurgitation of the water through the stomach. This will be uncomfortable at first, with a very full feeling and one may begin by drinking one glass, followed by stomach exercises, gradually taking another glass within a half hour of the first. This, with the exercises, will wash out the mucus. In many cases as much as a pint of slimy mucus collects in the stomach during the night. Where the stomach cleansing is impossible, in above manner, the stomach tube should be used.

Chronic gastritis, in any of its phases, is frequently accompanied by constipation, and the diet should be so selected as to be as laxative as possible, without irritating the lining of the stomach. The liquid diet assists the intestines, to a certain extent, particularly if the stomach be cleansed by the water in the morning, as indicated under Mucous Gastritis below.

Fruit in the morning and just before retiring aid the intestines. Two prunes chopped up with one fig or a bunch of grapes or an apple just before retiring assist the action of the intestines and the kidneys.

Almost all fruits contain acid, which increases peristalsis, and the resultant flow of gastric juice. Cooked pears, stewed or baked apples, prunes and dates are mild fruits which may be used if they agree with the patient. The juice of an orange upon first arising may be used, except in case of a diminution, or absence, of hydrochloric acid.

Peptonized milk is an excellent food both for chronic and acute cases especially in severe cases. This is prepared by putting “pancreatin,” a pancreatic ferment, (trypsin), into fresh milk. Preparations of “pancreatin” are sold in the drug stores. The peptonized milk does not form curds and readily passes through the stomach for digestion in the intestine. This may be given for a few days, followed by milk and limewater, barley and toast water, kumyss, oatmeal gruel, meat juices, scraped meat (raw, boiled or roasted), broths thickened with thoroughly cooked cereals, ice cream, egg lemonade, gelatins and whipped cream, custards, raw oysters.

After one week gradually assume the regular diet of easily digested foods. All cereals should be thoroughly cooked. The white meat of chicken is readily digested. As the solid food diet is assumed, regularity of food, in small amounts, and thorough mastication are important. If the patient imagines he is chewing it will help him to keep chewing until the food is reduced to a pulp.

Avoid meat with tough fibre, too fat meat (pork), sausage, lobster, salmon, chicken salads, mayonnaise, cucumbers, pickles, cabbage, tea, coffee and alcohol.

Four or five light meals a day are preferable to three heavy meals.

The regulation of the flow of gastric juices is constitutional. The general circulation must be forceful, the habit of deep breathing and of regular periods of complete rest of body and mind established.

Since one with chronic gastritis is liable to have many idiosyncracies, he should not be urged to eat foods for which he has a dislike. The easily digested foods should be prepared in various ways and served in an appetizing, dainty manner.

There are four special phases of chronic gastritis, Mucous Gastritis, Hyperchlorhydria, Hypochlorhydria and Achlorhydria.

In Mucous Gastritis there is a profuse secretion of mucus into the stomach. In this case it is always well to wash out the stomach before introducing food, as suggested above.

The same general diet, suggested above for acute gastritis, should be followed.

Hyperchlorhydria. The condition known as Hyperchlorhydria shows a liberal excess of hydrochloric acid. The condition is common, and is brought on by worry, nervous excitement, eating when overtired, irregularity of food, imperfect mastication and excessive use of alcohol. The diet should be a mixed one, in about normal proportions. If anything, it should incline more to proteins than to starches. The hydrochloric acid is necessary for the digestion of proteins. It reduces the protein to acid albumin, which is less irritating to the stomach. However the proteins are stimulating to the stomach and the protein proportion should not be carried to excess.

The juice of one-fourth of a lemon taken one half hour before the meal will decrease the secretion of hydrochloric acid into the stomach.

Limewater and milk may constitute the diet for two days; alkaline, effervescing mineral water may be used and then the diet should follow the general principles for chronic gastritis. Avoid all irritating foods.