Dyspepsia and driving

Digestive diseases are very frequent and account for over 20% of visits to primary care physician, 15% of the total hospital admissions, and 14% of mortality in the general population.

Smoking and alcohol abuse cause many of the serious digestive diseases, and also are cause of the tragedy of many traffic accidents.

Alcohol affects the central nervous system and smoking causes respiratory diseases and distractions with loss of control of the car and the road, when smoking while driving.

Dyspepsia is a poorly specific term, characterized by abdominal symptoms

referred to the proximal digestive tract, and interpreted by the patient as “poor digestion” or “heavy stomach.”

30% of the general population show dyspepsia during their life, though only a fourth of them visit a physician.

This is probably the disease with the highest self-medication rate.

The most common symptoms of dyspepsia are flatulence, meteorism, belching, epigastric or retrosternal pain, burning, pyrosis, abdominal distention and nausea. In some cases, anorexia and changes in bowel movements are described.

States of dysphoria, with anxiety or depression, are often seen.

Food can aggravate or relieve the pain.

The patient suffocates with the symptoms and, to obtain relief, uses a high number of over-the-counter drugs, that he usually takes in the pockets and in the glove compartment of the car.

The patient visits the physician when he does not improve, or is afraid of suffering a serious disease.

These disorders are generally difficult to understand and treat, since in many cases, they do not meet the conditions of a specific disease.

It is unlikely that the patient recognizes that he eats bad, quickly, too much or at odd times. And it is more complicated that he tells us that he abuses of alcohol or that he smokes.

If we look at drivers, we often see them eating while driving –snack bags, sunflower seeds, sandwiches, sweets, chewing gums, candies, etc., or taking cola drinks.

All these products taken at any time while driving enhance dyspepsia and also cause distraction and the risk of accident.

In consumption by Spaniards, the group of drugs for the digestive system ranks second after cardiovascular ones, and “antiulcer agents” account for almost 70% of the total.

The work of physicians in case of dyspepsia is to identify specific gastroduodenal disorders related to inflammatory injuries, gastric secretion and emptying disorders, food intolerances, motility disorders, etc.

Symptoms of dyspepsia can be seen in patients with cardiac ischemia, gastroesophageal reflux, diffuse esophageal spasticity, peptic ulcer, gastritis, bile disease, celiac disease, intolerance to lactose, etc.

The psychological causes include most remarkably anxiety, conversion disorders, somatization of depression or hypochondria.

The drugs most frequently causing dyspepsia are digitalis, non-steroid antiinflammatory drugs, some antibiotics, bronchodilators, iron and potassium.

Various metabolic disorders can cause dyspepsia such as diabetes, hypothyroidism, hyperparathyroidism, suprarenal insufficiency, uremia, hyperkalemia, etc.

In almost 50% of the cases, after performing the relevant tests, we found no organic or metabolic cause of the symptoms, and we diagnose “functional dyspepsia” to the patient.

This group includes some subjects with primary gains, such as not going to work or getting more family care, and they are the most demanding and heavy drug consumers to justify their advantageous situation.

Advice on Dyspepsia

When a trip starts, the driver susceptible to suffering dyspepsia should avoid abundant meals that enhance the uncomfortable digestive symptoms, and the worst enemy of the driver, somnolence.
We should advise all our patients with dyspepsia that, when they are to drive for a long time, they should do it after a good rest and never with an empty stomach.
Light, frequent foods along the day are better than those spaced and abundant, and, in any case, they should not exceed 2500 kcal/day.
They should avoid highly salted, dressed foods, rich in animal fat, and those causing flatulence, such as soft drinks.
It is not advisable to abuse of coffee, tea, cola and energy drinks to avoid drowsiness, as they are highly irritant for the digestive system.
The main problem of the driver is to keep his capacity of attention and react fast in case of any event.
Hence, alcohol cannot be consumed before driving, it is disabling for driving and also enhances dyspepsia.
The driving position, with the fastened safety belt, worsens the sensation of flatulence and makes belching difficult. The driver, uncomfortable with this situation, can lose concentration in the road and the environment, causing an accident.
Adding to this the search for antacids through the multiple nooks, drawers, glove compartment, pockets, etc., distraction while driving is assured.
In this case, it is recommended to stop the car in an area of rest, to stretch their legs, walk for a while, and take the medication that relieves the symptoms without causing drowsiness.
Easily digestible food without fat will help to keep attention, to react fast and will avoid the manifestations of dyspepsia.
It is dangerous to repress the hunger sensation, because the driver feels tired, gets nervous, attention and reaction speed decrease, and the risk of accident increases substantially.