Good health depends not just on what you eat but how you eat, explains Dr Sarah Brewer 

Indigestion and heartburn

Indigestion, or dyspepsia, is the term for any discomfort after eating, and includes feelings of distension, flatulence, nausea, heartburn, acidity, abdominal pain and sensations of burning. Heartburn is a more specific term, referring to a hot, burning sensation behind the chest bone or in the upper abdomen, which may spread towards your throat. It is caused by regurgitated stomach acids and enzymes coming into contact with the sensitive lining of the oesophagus (the tube connecting the mouth and stomach), a process that can also trigger painful spasms. In fact, the symptoms of gastro-oesophageal reflux can be severe enough to mimic angina or a heart attack - it is reckoned that 20 per cent of people admitted to coronary care have reflux rather than heart disease.

If you suffer from recurrent indigestion or heartburn, it is important to tell your doctor. One in ten people taking regular antacids - especially those over the age of 40 - could have a more serious underlying problem which might not be picked up at an early, treatable stage unless medical advice is sought. Medical treatment includes antacids and more powerful drugs that switch off stomach acid production.

Self-help measures:

• Avoid hot, acid, spicy and pastry foods;
• Avoid tea, coffee and acidic fruit juices;
• Eat little and often - avoid heavy meals, especially in the evening;
• Do not stoop, bend or lie down immediately after eating;
• Cut back on alcohol intake;
• Lose any excess weight;
• If you are a smoker, quit;
• Wear loose clothing, especially around the waist;
• Elevate the head of your bed 15-20cm (e.g. by c putting books under the legs at the top end) to help reduce heartburn at night.

Supplements that could help:

• Ginger can relieve indigestion;
• Flaxseed and omega-3 fish oils provide essential fatty acids which help to reduce inflammation caused by excess acid;
• Vitamin B supplements may be recommended if indigestion is thought to be a symptom of B vitamin deficiency - common in those over 50 due to reduced absorption from the diet;
• Aloe vera has a soothing antacid and analgesic action;
• If taking vitamin C triggers indigestion, switch to non-acidic ester-C.

Helicobacter pylori

This is a type of bacteria found in the stomachs of at least 20 per cent of younger adults and 50 per cent of those aged over 50. It burrows into the stomach lining leaving a small breach through which acids can attack the stomach wall. Helicobacter also coats itself with a small bubble of ammonia gas, which contributes to irritation and inflammation of the stomach lining. Although it doesn't cause symptoms in everyone, virtually all patients with duodenal ulcers are infected, plus three-quarters of those with gastric ulcers. H pylori infection is also associated with an increased risk of stomach cancer. If you have recurrent indigestion or heartburn you will usually be checked for the presence of this intestinal infection. If identified, eradication is attempted with a course of powerful antacids and antibiotics.

Supplements that could help:

• Cranberries have properties that reduce the ability of bacteria to stick to cell walls. Although cranberries are best known for treating urinary tract infections, preliminary research suggests they could also prevent Helicobacter pylori sticking to cells in the stomach lining.
• Manuka honey contains natural antibiotics that can eradicate H pylori. It is usually taken on an empty stomach at a dose of four teaspoons, four times per day, for eight weeks (avoid if you have diabetes).
• Resinous mastic gum, derived from a Greek tree, has a powerful antibiotic action against H pylori including antibiotic-resistant strains.
• Eating live bio yoghurt or taking probiotic supplements can inhibit the growth of Helicobacter pylori as well as help maintain overall intestinal health.