One of the common complaints I hear in my offices is about effects of stress on the stomach. These can include acid reflux, upper abdominal pains, waking up with gas or wet “burps” full of acid.

Doctors are trained to take a history, examine the patient, then take images (X-rays, ultrasound or MRI’s) that could shed light on the diagnosis.  Even blood tests are helpful, to rule out anemia from blood loss in the stomach, to checking for an antibody to the bacteria H. Pylori, a  cause of ulcers that can be found in the stomach.  But once such steps have been taken, the usual direction is to take medication, such as the proton-inhibitor Nexium.  A good drug, but before it is given, I always like to look at one other very important factor: the speed of eating.

Aerophagia , or, literally “air-eating” is a huge problem when people are under stress.  It can be insidious, or it can be obvious.  Gulping audibly is one obvious form of air-eating, another is “slurping” drinks through a straw.  A third way is to drink fizzy liquids, like beer or carbonated waters.  But even if all these are avoided, then a major factor can be speed.  When food is taken quickly, it almost always involves a huge intake of air. 

That’s why our parents admonished us to eat with our mouths closed, and to chew our food “twenty times” for good measure.  Actually the latter suggestion increases the pre-digestion of food by mixing it with amylase from the salivary glands, to start to digest the proteins before they even hit the stomach.

So take a look at your plate when you finish eating, and compare it with those of your meal-mates.  If you are finishing first, you are probably wolfing down your food, and will likely be paying the consequences later. 

So take time to relax during eating, and don’t treat meal times like the Formula 1 race cars’ 9 second pit-refueling binge. 

Place your food in an artistic fashion on the plate (don’t eat out of the bag or box), and set the table for civility, even if only with paper napkins and water glasses.  Take time to converse, if company is available, or to listen to relaxing music.  If you are alone, reading can also relax your meal time. 

Further advice from our grandparents might also include never talking about politics or religion during meals, as it can certainly lead to arguments unless you are sure your table-mates share your opinions.

When you are under stress, don’t assume you will therefore get an ulcer or heartburn, and will therefore have to take drugs.  Its easier to operate on your eating style than to operate on your stomach.  Bon apetit!