ASK THE DOC
Surgeon and lecturer Dr Sarah Rayne weighs in on the pros and cons of tea and coffee, and what might be causing late-night indigestion.
Q: Whenever I eat bread or heavy carbs just before bedtime, I wake up during the night with pain that feels like it’s in the middle of my back. Previously the pain was so bad that only vomiting or passing stools would give me some relief. Nowadays it no longer makes me feel nauseous but it goes away only if I move about continuously. Is it related to digestion?
A: Before I get on to what could be causing this problem, I want to stress the importance of getting checked out by a doctor if you have any health matter that’s been going on for a long time, or is getting worse. People worry about doctors thinking they are weak or fussy, but nothing makes us happier than helping someone understand their body, making them feel better, or finding out why they don’t.
That said, it sounds as if this could be related to indigestion. Indigestion is a diverse set of symptoms based around stomach acid irritating the lining of the stomach and causing heartburn, bloating, belching, passing wind and nausea. Lying down in bed after a heavy meal can trigger this (that’s why it helps you to move around), as can some foods and drinks (caffeine is a big culprit!). There are over-the-counter meds that can help, but if this has been going on for a long time, it is worth seeing your doctor who can ask you some more questions and rule out any other important diseases like a stomach ulcer or cancer.
Q: I have tried different types of green tea, but it always gives me heartburn. Why? Most people don’t seem to have this side-effect.
A: As I mention below, coffee is a really complicated product. Well, guess what? Tea is too! Green tea is full of different bioactive compounds well known for their healthy properties such as catechin, which can be antioxidative, anti-inflammatory, anti-cancer and antibacterial. But green tea also contains caffeine, and drinking a cup gives you the same amount of caffeine as half a cup of tea, or a quarter cup of coffee.
In your stomach, the lower oesophageal sphincter closes off the oesophagus and prevents reflux of stomach acid up into the throat. Caffeine stops this working well. The caffeine level in green tea can also depend on how you brew it; brewing it for longer or in cooler water reduces caffeine content. I’d suggest trying a herbal tisane or decaf tea to see if that helps. If not, consult your doctor about treatments for heartburn.
Q: Is coffee (no sugar) good or bad for diabetics? Dr Google can’t seem to give me a straight answer. Some sites say ‘yes’, others, ‘no’.
A: News stories on the internet can be confusing when you’re trying to make decisions about your health. They often report absolutes: ‘you must do this’ or ‘this causes cancer’ when the actual research quoted says ‘might’, ‘could’ or ‘suggests’. The trick is to read trustworthy websites with a moderate approach.
Coffee is a complicated product and can be altered by how it’s made. A ‘cup of coffee’ could refer to both a milky Ricoffy and a single-bean double shot! So what is good and what is bad for diabetes?
Coffee beans contain lots of bioactive compounds like chlorogenic acids, cafestol and of course caffeine. It seems that some of these compounds reduce the risk of getting diabetes, either because they are good for you, or because people drinking coffee may eat less and not be obese (the biggest risk factor for more than 90% of people with type 2 diabetes). But some small studies have found that, for people with new type 2 diabetes, high levels of caffeine (not coffee) can lower sensitivity to insulin and affect blood sugar.
Everyone agrees on one thing though: the best drink for diabetics is water, as part of a change in diet and increase in exercise, to help reduce your risk of complications from the disease.✤