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


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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.

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. 


Itching

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 

After cholecystectomy

Anonymous said...
1)uncomfortable feeling in my upper abdomen, across the top of my ribs and radiates down just above my belly button. pain also goes through to my upper back around my rib cage. colic pains and feeling very full rather than out and out pain. Also having twinges and pain spasms below my belly button to the left.

2)only get the uncomfortable feelings after eating in upper abdomen, lower pain below button is constant.

3)every time i eat, and constant pain below belly button

4) always in same 3 places, lower left side belly button, upper abdomen and back.

5)can't work at the moment due to constantly feeling sick when i eat, not sleeping and i can't sleep on my side, skin itching.

6)had keyhole gallbladder removal surgery 3 weeks ago, i think it is still associated with that.

7) gallstones, havent had follow up since surgery.

8) same as 7

9) no further treatment planned since surgery

10)february 2008

11) ibs, me, glandular fever

12) cut out alcohol and fatty foods since being diagnosed, although since surgery eating normally but having the pains all the time, whereas before it was only when i ate fatty foods. bowels opening every other day.

13) self employed no problems at work except not working at the moment.

32
female
none
none
5'7
15'7
walking

Hi,

Thanks for this - as you say it is likely to be related to your recent surgery to your gallbladder. Even though you had keyhole surgery, this is still a major disruption to your abdomen. It is a lot of trauma, the gallbladder is a large organ, between two and three inches across. It sits under the lower surface of the liver and has to be taken off from the liver. Again, the operation is done under a general anaesthetic, which also takes its toll on the body.

The gallbladder is part of the "gastro intestinal tract", which from a practical perspective extends from the mouth to the anus. It is run by the "autonomic nervous system" which are the nerves that do the housekeeping for the body, making sure food gets sorted, digested and converted into waste. The autonomic nervous system looks after all the bits that we are generally not conscious of - so that the conscious part of the brain can get on with earning a living. 

The autonomic nervous system gets affected by stress, by a poor diet,  physically damaged by straining or pushing - either to have your bowels open, or during difficult deliveries and childbirth. 

Eating, from the moment you even think about food, starts the digestive process. Remember the mouth watering cakes from childhood?, even thinking about them starts a person salivating!

The digestive process is continuous and coordinated. Food is chewed in the mouth, releasing saliva, this is swallowed, goes into the stomach where it is churned and separated into its various components. 

The stomach produces acid and enzymes to help the digestive process, squirts some of the meal into the next part of the gut, where the guts adds bile and enzymes from the pancreas. The churning and mixing continues until the food gets digested, passed along the gut until it finally gets expelled. 

Ideally bowel movements, and this is the part people don't often talk about should be large, bulky and soft, be passed easily in the morning and again perhaps midday. Burkitt did a lot of work photographing african stools and comparing them to Western stools, drawing the links between what diseases were common and the patterns of stools. This led to a lot of people recommending fibre in the diet. However almost certainly the link was not just the size and weight of the stools, but the ease with which they were passed. 

Western lifestyles do not lend themselves to the easy passage of stools!, from the sit up and beg toilet ware, as opposed to the african squat, to the time pressures to get on with life and work, as opposed to relaxing and letting nature do her work.

I am sure that this is already more than you wanted to know!! and from your position at the moment, it is likely that you are still nauseous because the surgery has upset your gastrointestinal tract and it is taking its time to settle down. 

However, several points in your history worry me. Firstly that you took the time to find this site and post your question. In other words, this is not something trivial that just needs reassurance. Secondly that you are getting pain when you lie in a particular position only, which may suggest that there is some fluid in your abdomen that is moving around. This may indicate that there has been a little bit of bleeding or even a slight infection and thirdly that you describe "itching". Itching can be an early sign of jaundice which may mean that the liver is upset in some way, and that it is not draining bile as it should be. 

And finally, you are not getting better - the body heals, if everything is going according to plan the body gets better from day to day. You are not getting better and it sounds as though you may even be getting worse. 

What to do:

I believe you need to see your GP as soon as possible, certainly within the next two days. If you were my patient, I would arrange an ultrasound scan of your abdomen and for you to be seen urgently by the surgical team. It may be that your GP will be reassured by examining your abdomen that nothing serious is going on, but obviously over the Internet, it is not possible to do that (yet!). I would also arrange some blood tests to check whether there is an infection and to check on the state of your liver.  

In the longer term, you will benefit from keeping to a healthy diet, avoiding processed food, chewing your food well to help digestion, exercise as that also helps the gut function. Aiming to have your bowels open easily and daily!

Many thanks for such a clear history

Itching, hives, allergies

1)Patches of itching, can be aywhere on my body..this happens virtually every day..starts as a tingling that I feel the need to "rub" then have to scratch...scratching leads to huge "hives"...after about 20 mins the hives disappear...my skin isnt broken or sore before or after the itching/scratching....it seems to be under my skin. Have tried to identify what I could be allergic to, have had a cat in the house for a year but this problem only started three months ago. It also happens when away from home, even abroad!
2) have had about 3-4 night sweats over the past couple of months....wake up in the night and the bed is drenched in sweat... wondering if these could be related?

2) It's generally uncomforatble when the intching starts and until the hives have gone down.


This problem can occur anywhere over my body....both on exposed and unexposed skin.

Cannot find anyway to relieve or stop this. Have tried Piriton... not much help as on the whole this itching and hives thing is self limiting.


5) Becoming incredibly irritating...and looks unsightly when the hives appear....and I cant stop scratching!!

This feels like an allergy but ,have never had anything like this before...I just have a nagging feeling that it's a systemic thing as opposed to an allergy.


8) none

9) none

10) Over three months now since I last felt right

Never had allergies before.

11) I rarely visit my GP, as I am a generally healthy individual.. I am concsicous of not wasting his time....also, as this itching and hives thing comes and goes throughout the day...I may not be having "attack!" when in the surgery and therefore wont have the symptoms for him to see!!.. So my question is....coulD this be a systemic thing that could be investigated or is there some allergy testing kit I could try at home first to see if there is a simple answer to this.

28 September 2008 14:34
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