MR SAMUEL PICKWICK had the shape of Humpty Dumpty, the very physique that is associated with a host of gastrointestinal problems, as well as heart disease. His girth and neck size betrayed his diet and would have given his doctors an indication of his likely prognosis, but this didn’t stop him enjoying life.

Mr Pickwick’s adventures were published in book form when Dickens was only 25. In 1837, treatment for indigestion was limited — there was no Lomotil or Imodium to soothe and quieten his troubled guts. Chlorodyne would have been available to pacify Mr Pickwick’s protesting digestive tract; however, Dr John Collis Browne’s celebrated preparation of it that had served him and the Army so well when he was practising medicine in India was brought back to the UK only in 1854.

National Gut Week, July 18 to 24, serves to remind everyone of the progress that has been made over the past 30 years in the treatment of everyday gastrointestinal problems, as well as serious conditions. The simple remedies once used for the indigestion, dyspepsia, heartburn and acid regurgitation (now known as GORD, gastro-oesophageal reflux disease) suffered by those of Mr Pickwick’s shape included rhubarb, and antacids such as sodium bicarbonate.

Antacids, although now improved and often mixed with other medication, still have a great use as first-aid measures. There are other preparations. For years I have never attended a heavy dinner, or even lunch with the Pickwick Club, without carrying Losec with me. Losec is one of the drugs known as a proton pump inhibitor; these act as powerful antacids. The good news is that Losec is now out of patent and can be bought as Zanprol from the chemist without a prescription. There are other products in this group that are fractionally more effective, for example Nexium, but they still need a prescription.

Anyone with a longstanding problem with recurrent symptoms of heartburn, reflux and oesophageal pain needs to see their doctor. People who have difficulty swallowing, or if food seems to stick on the way down, need immediate attention. Those who suffer acute symptoms of indigestion will, thanks to modern antacids or a proton pump inhibitor, be able to slump in their chair after a generous meal, just as Mr Pickwick did — but without the discomfort he suffered.

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