Friday, 21 November 2008

Heartburn, stress, itching

hi. for the past few months i have been getting quite alot of heartburn, plus all over body itching mainly after a bath and keeps me awake at night,

i have had a cough where i am constantly coughing to clear my throat too but last 3 days given up smoking and thats seems to have calmed down,(using a nicotine patch) and now my bad eye gone more blurry and eyes are itchy and sore,i am under alot of stress as got a disabled child and more so now with the smoking and wondered if that y my eye gone bad, i suffer from anxiety attacks to so don't leave house often, plz help!!! worried!!! age 38 don't drink,hight 5ft 5in weight 8 halkf stone

Thank you for your consultation,

Heartburn - by which I assume you mean pain in the lower part of the chest, associated with food, possibly acid coming back into the mouth, and possibly pain as you swallow food, is caused by the stomach acid coming back up the gullet and causing inflammation in the gullet.

Stomach acid is a strong acid, in pH terms it can be as low as pH 2 or 3. The lower the "pH" of an acid the stronger it is, 7 is neutral. If stomach acid gets outside the stomach - which has a strong protective lining, when healthy, it damages tissues. If people vomit regularly, for whatever reason, stomach acid can damage the teeth.

Heartburn means that stomach acid is getting back up the gullet.

In a normal unstressed person, the activity of the autonomic nervous system (the housekeeping part of the nervous system) stops the stomach producing acid when it isn't needed and when a person is relaxed the autonomic nervous system works on helping the stomach digest food, by producing acid and making sure the stomach works normally. Under stress, the autonomic system does not work so well and this can cause havoc with the digestive system. Instead of the guts being "switched off" and inactive when they are not needed to digest food, they are constantly active. This causes a range of symptoms from heartburn, indigestion to irritable bowel,

Cigarettes and sugary drinks such as coke seem to encourage the stomach to make more acid and make the problem worse, so well done on stopping smoking - that will help, at least in the longer term.

In the short term, heartburn and indigestion can be helped by drugs that stop the stomach producing acid, but in the longer term it is best to look at the cause of the problem, which is stress.

It is enormously difficult to look after a disabled child, as you well know. You have my respect, it is probably one of the hardest things to do in modern society. Not only do you have the extra physical and mental work that comes with needing to help them more than a child without those problems, but you also have a daily fight with the NHS, Social Services etc to get at least some of the resources you need. You do not say how old your child is, but this in itself is exhausting and with time you become exhausted by it and your body becomes stressed by the sheer weight of the demands placed upon it. Your anxiety attacks als reflect this stress.


It looks as though you are under a lot of stress, this is almost certainly because of everything you have to do, to look after you and your child. It is easy to say this, and I know someone has to look after your child - the problem is that you also have to look after you, so you can look after her or him. It is not selfish to put your own needs first in order for you to stay healthy.

Stress for me, means that a person has more demands than they can meet. This is a very general way of looking at it. To begin with people use up their reserves, and then when their reserves are drained, it is as though they are functioning on emergency power only and this is a state of stress.

Stress is caused by an outpouring of adrenaline as the mind and body desparately tries to get everything to work harder and faster. Pressure in the short term is good for us and can be exciting, but relentless demands day after day, pushing a person and their body to its limits is not good. It drains a person's reserves and damages the body, body and spirit. 

There are only two ways out of stress

1) To work efficiently so no effort is wasted. This can be difficult because under stress people tend (understandably!) to do what is quickest and easiest even if may not be the best in the long term - eg grab a ready processed quick meal and put it in the microwave, rather than cook a proper meal. Most people under stress are already working as efficiently as they can, and there is rarely much room for manoeuvre, as at the very least it takes energy to learn to do things differently - its easier just to carry on with what you are already doing.

More importantly - Do less
2) Do less and get help. In many ways this is harder, because often by the time you have found someone to help with something it is easier to do it yourself but it is important. Under stress, people have to do less to reduce their exhaustion and give themselves a chance to recover, so that they can plan more efficient ways of working.

ie Only do what is absolutely essential. 

This starts to give you a chance to get back on your feet, start to feel better and do the things that help you feel better and make sure everything is done as efficiently as possible

And accept every offer (at least all reasonable offers) of help. If someone offers to help, accept the offer and then find them something they can do. People only offer to help if they want to help, and ideally you need an army of volunteers each doing a little bit to help make you and your child's life a bit easier.  It does people good to do something for someone else, especially a child, so you are helping them by letting them help you! 

However like all armies, volunteers need training! If someone offers help - say yes, then find them something easy to do so that they feel they can help without it being too difficult. With time you can get them to do more complicated and difficult tasks, but start with something easy, so you both feel good. To begin with it may feel as though it is easier to do everything yourself, but people learn to help in all kinds of ingenious ways.

You may find it difficult to ask for help or fed up with how little help that is forthcoming - from neighbours to the social service. Some people are naturally helpful but increasingly, everyone lives in their own world, not involving themselves with what is going on around them. And Social Services are a nightmare. Nonetheless, human beings are a social species and we need for our own sanity to look after each other. There are ways round even the largest obstacles. 


The itching you describe sounds more like a form of hives, as in the first post, rather than the possibly liver related itching in the previous post. It follows a warm bath/shower which can trigger Hives or urticaria, and again it tends to be worse under stress. 

Urticaria is an allergic reaction where the body releases histamine in response to a stimulus, in your case a warm bath. It may be that the body is oversensitive to heat and is behaving as though it had been scalded, rather than warmed slightly. Adrenaline from stress, increases peoples' sensitivity to a lot of things, including noise, and light touch. 

Have you tried cool baths - just slightly warm? if  you can, you may find a not too warm (not cold!) shower most refreshing. Also avoid the bubble baths and too many bath products - simple soap is best, as other things can irritate the skin

In conclusion

A lot of this sounds as though it is stress related and you need a plan to reduce the amount you do, so that you can get a breathing space and plan something for yourself, whether there are things you want to do or change, and for this you need help 

Heartburn is awful - try and eat a healthy diet where possible, avoid sugar. Stopping smoking will definitely help (it will also help the cough) 
In the short term, your GP can prescribe you with tablets to reduce the acid in the stomach, but in the longer term, you need to do something about the large amount of stress you are under 

Itching - try cooler showers and avoid a bath at night 

Your eyes, I am not sure what is happening there - dry eyes can be a sign of stress, a bit like a dry mouth - more details please!

You may also find counselling helpful, if nothing else than to have someone to talk to and bounce ideas off about how you can reduce the amount of stress/things you have to do. Your GP can arrange this for you and I am sure would be happy to do so. 

I hope this helps 

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