Indigestion: The fire in my belly

Like thousands of other people, Conrad Williams has been a martyr to indigestion for years. Finally, he decided to do something about his condition. But what he discovered was not what he expected
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Indy Lifestyle Online

I was standing in the bathroom at 4am recently, swigging Gaviscon directly from the bottle, when I caught sight of myself in the mirror. Puffy-eyed, my face screwed up in pain, I was a sad old sight. My bathroom cabinet is a shrine to antacids. Zantac, Settlers, Rennie, Remegel, I've popped them all. I know chewy and chalky, aniseed, spearmint and new lemon flavour. I'm a regular calcium-carbonate junkie. Have been for a third of my life. I can't quite put my finger on when it started, that nagging flare of pain, but it must have been when I was 18 or 19. Initially I put it down to too much curry, or beer, or even stress. I went through the upheaval of leaving home to study in Bristol around then. Maybe that was the trigger. Meanwhile, in my bathroom, the Gaviscon wasn't having any effect on what felt like a bonfire raging in the centre of my chest – had it ever, really? – and I resolved on the spot to get my indigestion sorted out once and for all.

I was standing in the bathroom at 4am recently, swigging Gaviscon directly from the bottle, when I caught sight of myself in the mirror. Puffy-eyed, my face screwed up in pain, I was a sad old sight. My bathroom cabinet is a shrine to antacids. Zantac, Settlers, Rennie, Remegel, I've popped them all. I know chewy and chalky, aniseed, spearmint and new lemon flavour. I'm a regular calcium-carbonate junkie. Have been for a third of my life. I can't quite put my finger on when it started, that nagging flare of pain, but it must have been when I was 18 or 19. Initially I put it down to too much curry, or beer, or even stress. I went through the upheaval of leaving home to study in Bristol around then. Maybe that was the trigger. Meanwhile, in my bathroom, the Gaviscon wasn't having any effect on what felt like a bonfire raging in the centre of my chest – had it ever, really? – and I resolved on the spot to get my indigestion sorted out once and for all.

Indigestion is a funny thing. It doesn't particularly strike you as being serious enough to whinge about at the doctor's. But there's also the worry, squatting at the back of your mind, that it might actually be worse than you think. In the end, it was the fear that my acid-stripped innards might give up on me, like a worn tyre, that propelled me to the local surgery.

I had been before, around 10 years ago, when the pain was becoming a bit too frequent for comfort, but my GP told me to get some Gaviscon and try sleeping while sitting up in bed. That worked for a while, but soon the pain came back and I put up with it. Most people with indigestion seem to put up with it. It's that kind of thing, like earache or cramp. It's something that we all get from time to time. I found I was getting that searing thrust of pain after meals, before meals, and deep into the night when it would force me from bed to gawp at poorly acted hair restorer commercials on TV until it eased off. Nothing would appease it. Milk, dry crackers, peppermint tea, fervent prayer... it didn't occur to me that this little tummy Krakatoa of mine might not be as straightforward as indigestion.

My dad has always been a bit of a Rennie addict. He has a box of the little tablets by his corner of the living room. I've spotted boxes of the stuff in the male half of various medicine cabinets over the years. It's the dad's disease. It's not really, obviously – plenty of women know the horrors of heartburn (my pregnant girlfriend is currently experiencing her first ever bouts of indigestion), but men appear to be particularly prone to the curse. And Rennie is the front line of defence, the first thing you reach for. Well, it was in my case. At poly I was asking "Got any Rennie?" when my peers were asking "Whose round is it?" or "Where are my trousers?"

Created in Leeds in the 1930s by John Rennie, today half a billion tablets are sold in the UK annually (around one and a half million per day). I shudder to think how many of them I've crunched. As good as they are, and I'll always have a soft spot for them, I was moving into a different league. My acid was looking at the oncoming rush of minty chalk and sneering. It was like a toothless poodle trying to bite the ankle of an elephant. A friend who works in a lab told me about Zantac. Unlike Rennie and its ilk, which neutralises the acid in your system, Zantac inhibits the production of acid, cutting it off at the source. Excess stomach acid is not necessarily caused by indigestion, so antacids are not an appropriate treatment. Maybe I had been attacking what I thought was the problem in the wrong way. That said, I was a little wary at first. Zantac is a proper drug, interfering with the body's processes, whereas everything else I'd taken was getting down and dirty with the problem at the scene of the crime. I had visions of food lying undigested in my gut for weeks because there was nothing to break it down. But the agony was such that I was ready to try anything. I bought a pack of 12 tablets over the counter at Boots. A couple of hours after taking the first tablet, the incessant burn was gone. I slept soundly for the first time in months. I took another tablet the next day, before dinner, then boldly gobbled a chicken jalfrezi and knocked back half a bottle of gutsy red wine. Not a peep of discomfort. I was so happy I almost went out into the street to hug strangers.

Zantac, although effective at first, slowly lost its powers as my body developed a tolerance to it. Before long I was in a situation where two tablets were needed before I could find any relief. Soon I was back at square one, my acid gurgling happily away, flicking the Vs at whatever I threw down my gullet to fight it. By this time I was living round the corner from a surgery. I was working from home, so any appointment was going to be easy to keep. I looked at the empty Zantac box and it said: "If symptoms persist, consult your doctor." That night in the bathroom, creeping around like an alcoholic trying to remember where he's hidden the gin, Gaviscon smeared around my lips, I thought, "That's enough."

When I'd finally found my way to the GP's surgery, she listened to my description of the last dozen years, nodded and said, "It sounds as if it could be Helicobacter pylori." Wow. It was polysyllabic. How could it be anything but curtains? I nearly asked: "OK. So how long have I got left?"

H pylori was discovered only as recently as 1982. Approximately two-thirds of the world's population is infected with it. It is a spiral-shaped bacterium found in the gastric mucous layer or sticking to the lining of the stomach. It causes symptoms by causing ulcers – more than 90 per cent of duodenal ulcers, and up to 80 per cent of gastric ulcers. Left unchecked, H pylori can be a nasty creature indeed. It is classified as a grade-one carcinogen, the same classification given to cigarette smoking. That said, the subsequent risk of developing stomach cancers is small. According to John Atherton, professor of gastroenterology at the University of Nottingham, "People with H pylori infection are much more likely to die from unrelated causes that other people die of, like heart attacks or even other cancers, than from gastric cancer."

In the United Kingdom, over half of the population aged 50 or over is infected, though not all will be troubled by the nasty tricks in H pylori's repertoire of torture. It is not known exactly how H pylori is transmitted or why some patients become symptomatic while others don't. It can remain dormant in the gut for years before it becomes active. I found it difficult to accept that these critters might have been swarming around my innards since I was a toddler, but relieved that an attempt to diagnose my discomfort, no matter how sketchy, was being made.

The discovery of H pylori completely changed the way that people with stomach and duodenal ulcers were treated. "Previously," says Professor Atherton, "we would treat them with acid-reducing drugs that would heal the ulcer, but after treatment stopped the ulcer would return. If the problem kept recurring, surgery was often the next step; either cutting the nerves that trigger acid production or taking a section of the stomach out. Now we treat patients for the bacterium, and this gets rid of the ulcer for good."

My doctor prescribed Zoton, a brand name for Lansoprazole, another medicine from the acid-inhibitor family. Like Zantac it works by reducing the amount of acid the stomach produces, but it does so much more effectively. The doctor also arranged an appointment with a specialist at the gastroenterology department at St Mary's Hospital in a month's time. I've got that to look forward to. In the meantime, I've taken all 28 of my Zoton capsules. Again, from the first, my acid was in abeyance and the pain was banished. It's been a couple of days since I took the last capsule and, depressingly, the pain has returned. More fire in the hold at 4am.

There is a back-up plan. Zoton can be combined with two antibiotics to blitz H pylori with a triple-pronged attack. Whatever happens, I feel much more optimistic now that something is being done. There will be others reading this who are in the same boat as me. David, perhaps, the photographer from The Independent who took my photograph for this article. He commented that for the first time in 18 months, as he was on his way to meet me he had had an attack of indigestion. Ordinarily I might have nodded in sympathy and offered him a crafty Rennie, but if it persists he'd be much better off nipping round to his local sawbones. He might find that there's something other than sausages and mash swirling around in his stomach.

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