The Symptoms of Bilious Or Foul Dyspepsia

Those of slow digestion with occasional acute attacks in which there is loss of appetite; nausea and vomiting or regurgitation of bile; undefined distress or uneasiness at the stomach; soreness under lower border of ribs on right side; bowels sometimes constipated, often loose; bitter taste in mouth; tongue coated, usually creamy or yellowish color; fetid eructations; throbbing pain in forehead and temples, often described as " splitting pain in eyes; countenance sallow.

The term "bilious" is used to distinguish this form of indigestion, not because either the liver or the bile is the immediate cause of it, but because of the bilious vomiting and jaundiced appearance of the skin which usually occur in this class of cases. This is what is generally known as biliousness." Acute dyspepsia of the same sort is termed "a bilious attack," or "sick-headache." This is not real sick-headache, however, as it is often termed, that difficulty being of a neuralgic character, and affecting only one side of the head at a time.

As in acid dyspepsia, this form of indigestion differs from slow digestion chiefly in the exaggeration of the morbid conditions present in that disease. Digestion being still slower than in add dyspepsia, the characteristic symptoms occur more remote from the time of eating. The usual time for the appearance of the most marked symptoms is the morning, before breakfast. Headache, great flatulence, a very foul tongue, a bitter taste in the mouth, with nausea and finally vomiting of undigested and partially decayed food in a very foul state, indicate the inactivity of the digestive organs present in this form of dyspepsia. When vomiting is continued, bile is generally expelled, the duodenum becoming affected and taking part in the expulsive action. Diarrhea often accompanies, and in some cases replaces, the vomiting.

Owing to this thorough clearing out of the stomach and bowels, these attacks do not occur at very brief intervals. They are often periodical, however, recurring sometimes as often as once or twice a week, and again not more often than once in two to four weeks.

Farinaceous foods give much less trouble than meats, especially fat meats. Vegetables eaten with fat, pastry, oily nuts, meat which has been kept too long, sometimes eggs, especially those not perfectly fresh, with albuminous and fatty foods generally, increase the symptoms peculiar to bilious dyspepsia, and bring on the attacks.

The Causes of Bilious Or Foul Dyspepsia

This form of dyspepsia, like the preceding, grows out of slow digestion, a form of decomposition known as butyric acid fermentation taking place instead of the acetous fermentation present in acid dyspepsia. The most common exciting causes are the use in excess of sugar and sweet foods, fats, flesh food, tea and coffee, tobacco, and alcoholic liquors. The attack is usually excited by overeating, eating warm bread and butter, sweet foods, fried foods, rich pastry, and similar foods.

The Treatment of Bilious Or Foul Dyspepsia

In this form of indigestion, the greatest simplicity in diet is necessary. Complicated dishes, stews, etc., must be wholly interdicted. Pastry is practically synonymous with poison, for these patients. Fats, as butter, lard, etc., and fat meats, together with nuts and fruits containing oils, must be entirely discarded. Sweets of all sorts are about equally injurious. Many persons suffering with this form of dyspepsia can trace the cause of the attack to eating freely of sugar or sweetmeats.

Vegetables, being difficult of digestion, are very productive of gas, and hence should be for a time avoided by persons subject to bilious dyspepsia. Grains, as oatmeal, wheat meal, rice, and ripe fruits, are adapted to this class of cases. Meat should be taken sparingly, and in many cases can be advantageously discarded altogether for a time. The other treatment should be that recommended for acute dyspepsia at the, time of the attacks, to be followed by the treatment suggested for slow digestion. The most important measure of treatment is the regulation of the diet and the avoidance of all the causes of the disease.