I have heartburn and high blood pressure

Dr Flo,
How can I recover from heartburn and high blood pressure? Chris

Dear Chris,
Heartburn usually occurs when stomach contents (excess stomach acid and digestive enzymes) reflux or go back up into the oesophagus. This causes irritation within the oesophagus and in the stomach, which can lead to a burning sensation, abdominal, chest and back pain, throat irritation, bitter taste, cough and even irritation in the lungs, if the stomach contents spill over into the windpipe. When this process goes on for some time, it can lead to formation of an ulcer, which is an open wound on the lining of the stomach, the lower part of the oesophagus or the duodenum (first part of the small intestines).

The symptoms may come when hungry, or just after eating, or it may be worse at night. You may also be bloated, vomit, have nausea, constipation, or occasional diarrhoea. If there’s an ulcer, you may have blood in the vomit, dark coloured stool, weight loss and severe pain. You can get headache, tremors, general burning sensation or feeling faint because of the stomach irritation, due to impaired nutrient absorption, or low blood level, or the anxiety that is triggered by the symptoms.
The symptoms mostly resolve on their own, or with medication. The symptoms usually come back from time to time, especially when triggered for instance by taking some pain killers, binge drinking, staying hungry, taking particular foods among others.
To manage the illness, stop taking alcohol, stop smoking and avoid use of NSAIDs (pain killers like aspirin, brufen, diclofenac, mefenamic acid). Some medication help to manage the symptoms, including proton pump inhibitors like omeprazole; sucralfate, antacid syrups, and antibiotics (if you have the H pylori infection).
If you have had the symptoms for a long time, you should be reviewed by a gastroenterologist, and you will have several tests done, including an endoscopy.
The blood pressure reading is a measure of the force at which your heart is pumping blood, and the resistance to the blood flow within the blood vessels. These two measures give the two figures we use for blood pressure reading. Normal blood pressure is between 90/60mmhg and 140/90mmhg. Anything above 140/90mmhg is considered high blood pressure or hypertension.
In a few people, about five to 10 per cent of those with high blood pressure, there is an exact cause for it such as kidney disease, hormonal disorders, pregnancy, anaemia, tumours, drugs or some medication. For this people, once the cause has been identified and dealt with, then the blood pressure can be dealt with
In a majority of the people, about 90 to 95 per cent of those with high blood pressure, there is no known cause. It goes higher with age, and by the time it is being said to be high, it has been rising slowly over many years, and continues to do so. There are some factors associated with this rise such as age (being over 40), being male, being African, having a close relative with high blood pressure, high-salt, high-calorie, high-fat diet; lack of exercise, obesity, taking too much alcohol, smoking and a stressful lifestyle. Because the blood pressure rises over many years, it is not possible to cure it with medication taken for a short time. This is because the changes in the vascular system are not reversible.
Unfortunately, most of the time, you cannot tell that your blood pressure is high unless it is measured. Therefore, you may be feeling fine, but the blood pressure is high and it continues to cause damage to the blood vessels and can cause stroke, heart disease, kidney failure, even loss of vision.
To prevent this long-term effects, you are put on medicine to lower the blood pressure to normal levels. If the blood pressure readings are normal, then the medicine is working. If you stop the medicine, the blood pressure goes back up, which is why it is very important for you to keep taking the medicine; it is life-saving.
In addition to that, reduce the amount of salt in your diet, reduce the amount of fat and starch in your diet to healthy levels, reduce alcohol intake, stop smoking, reduce weight to healthy levels, exercise, eat a lot of vegetables and fruits, have enough sleep and manage stress.
 

Dr Flo,
Every time I go for a long call, I see spots of blood. Please help me.
Vundi

Dear Vundi,
Bleeding after passing stool could be due to a tear in the lining of the anus or rectum, because of friction from passing large stool, hard stool, or from diarrhoea. It could also be due to an abnormal growth in the intestines or rectum. The bleeding could also be due to haemorrhoids, otherwise known as piles. These are veins that bulge in the lower part of the rectum and anus. The walls of the veins stretch and get irritated, and easily get a tear and bleed. They can occur due to straining when passing stool for instance due to constipation or diarrhoea; or any activity that causes repeated high pressure in the abdominal region such as a persistent cough and lifting weights.

Alcohol can cause irritation of the stomach lining and development of an ulcer, but if this is the cause of the bleeding, then the blood is dark and clotted.
To manage it, prevent constipation by taking a lot of fluid and a high-fibre diet every day, exercise, schedule time each day for a bowel movement, and take your time; use baby wipes instead of toilet paper and, you can also take a sitz bath (sit in warm water) for about 20 minutes twice a day to help soothe the injured tissue. The doctor can prescribe stool softeners and suppositories to help heal the injured tissue.
It would be advisable to see a surgeon, so that an examination can be done to visualise the lining of your anus, rectum and large intestines to see the cause of the bleeding and get the way forward.

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