What is indigestion (dyspepsia)?
Indigestion – also called dyspepsia or stomach upset – is a general term describing discomfort in the upper abdomen. Indigestion is not a disease, but rather some of the symptoms you experience, including abdominal pain and a feeling of fullness soon after you start eating. Although indigestion is common, everyone may experience indigestion in a slightly different way. Indigestion symptoms can be felt occasionally or often every day.
Dyspepsia can be a side effect of another stomach-related illness. Indigestion not caused by an underlying disease can be eased with lifestyle changes and medication.
The following symptoms of indigestion are also common:
- The feeling of fullness or satiety
- Feeling of bloating
In uncommon cases, indigestion might be an indication of stomach cancer. Mild indigestion rarely needs further investigation and should not be a cause for concern. A visit to a doctor is not required unless symptoms persist for more than two weeks.
Seek emergency treatment if the pain is severe and any of the following also occurs:
- Loss of appetite or weight loss
- Black stools
- Shortness of breath
- Yellow colouring in the eyes and skin
- Inability to swallow
- Chest pain during exertion
- Chest pain that spreads to the jaw, arm, or neck
Heartburn is often confused with indigestion, but they are two separate conditions although they occur regularly at the same time. Heartburn is a symptom of acid reflux and is described as a burning feeling behind the breastbone that usually occurs after eating.
What causes indigestion?
Lots of factors can cause indigestion. These factors may include:
- Eat certain foods that are difficult to process, such as spicy foods, fats, acid, and/or fibre
- Eating late in the day
- Drinking alcohol
- Eat a lot of caffeine
- Take some medications
- Lack of sleep
Digestive problems or other health problems can cause indigestion. These include:
- Acid reflux, gastroesophageal reflux (GER), or gastroesophageal reflux disease (GERD): A reaction to food and drink as the contents return from your stomach. Acid can reach the esophagus, which is the tube-like organ that connects your mouth to your stomach. Acid reflux can also lead to vomiting. This condition causes heartburn due to high acid content.
- Irritable bowel syndrome: A disorder that affects the intestine. Symptoms include stomach pain, bloating, gas, constipation, and diarrhea.
- Infection: A bacterial infection from Helicobacter pylori (H. pylori) can cause indigestion.
- Gastroparesis: A condition that affects digestion. If the muscles in your digestive system stop working, your body slows down or stops the movement of food. Symptoms include nausea, vomiting, stomach pain, bloating, and acid reflux.
- Ulcer: An ulcer in the lining of the stomach (peptic ulcer), small intestine, or esophagus.
- Gastritis: Inflammation of the lining of your stomach.
- Stomach cancer: This is a rare condition, but indigestion could be one of its signs.
Lifestyle changes may help relieve indigestion. Your doctor may recommend:
- Avoid foods that cause indigestion
- Eat five or six small meals a day instead of three large meals
- Reducing or eliminating alcohol and caffeine intake
- Avoid certain pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), and naproxen sodium (Aleve)
- Find alternatives to medications that cause indigestion
- Control stress and anxiety
If your indigestion persists, medications may help. Over-the-counter antacids are usually the first choice. Other options include:
- Proton pump inhibitors (PPIs), which can reduce stomach acid. Proton pump inhibitors may be recommended if you have heartburn with indigestion.
- H-2 receptor antagonists (H2RAs), which can also reduce stomach acid.
- Prokinetics, which may be helpful if your stomach empties slowly.
- Antibiotics, if H.pylori is causing indigestion.
- Antidepressants or anti-anxiety medications, which may relieve the discomfort of indigestion by reducing the perception of pain.
Poor digestion is a common problem. However, you shouldn’t ignore indigestion:
- unresponsive to over-the-counter medication
If the symptoms of indigestion are left untreated, they may interfere with your quality of life.
If you can’t handle indigestion at home, talk to your doctor. They can help determine the underlying cause of your digestive problems.
Complications of indigestion
Much of the time, indigestion (dyspepsia) is mellow and just happens at times. However, severe indigestion can cause complications, some of which are mentioned below.
Indigestion most often results from acid reflux, which occurs when stomach acid leaks into the esophagus (esophagus) and irritates the lining. If this irritation worsens over time, it can cause scarring of the esophagus. Scarring can eventually lead to narrowing and narrowing of the esophagus (known as esophageal stricture).
If you have esophageal narrowing, you may have symptoms such as:
- Difficulty swallowing (dysphagia)
- Food that becomes lodged in your throat
- Chest pain
Esophageal narrowing is often treated with surgery to widen the esophagus.
Like esophageal stricture, pyloric stenosis is caused by long-term irritation of the lining of the digestive tract from stomach acid.
Pyloric stenosis occurs when the passage between the stomach and the small intestine (known as the pylorus) becomes scarred and narrowed. This causes regurgitating and forestalls any food you eat from being appropriately processed.
In most cases, pyloric stenosis is treated with surgery to return the pyloric to its proper width.
Repeated episodes of gastroesophageal reflux disease (GORD) can lead to changes in the cells lining the lower esophagus. This condition is known as Barrett’s esophagus.
It is estimated that 1 in 10 people with GORD will develop Barrett’s esophagus. Most cases of Barrett’s esophagus first appear in people between the ages of 50 and 70. The mean age at diagnosis is 62.
Barrett’s esophagus does not usually cause noticeable symptoms other than those associated with GORD.
The concern is that Barrett’s esophagus is a precancerous condition. This means that while the changes in the cells are not cancerous, there is a small risk that they could develop into a “full pulse” cancer in the future. This will then lead to esophageal cancer.
How is indigestion diagnosed?
If you have symptoms of dyspepsia, make an appointment to see your doctor. Since dyspepsia is a broad term, it helps to give your doctor an accurate description of your discomfort. When describing symptoms, try to determine where the abdominal discomfort usually occurs.
Your doctor will rule out any underlying conditions that may be causing your symptoms. Your doctor may perform several blood tests and you may undergo an X-ray of your stomach or small intestine. Your doctor may also suggest an upper endoscopy to look more closely at the inside of the stomach. During the procedure, an endoscope – a flexible tube that contains a light and a camera to produce images of the inside of your body – is used to look inside your stomach.
How can I prevent indigestion?
The best way to prevent dyspepsia is to avoid foods and situations that seem to cause it. Keeping a food diary is helpful in identifying foods that are causing dyspepsia. Here are some other suggestions:
- Eat small meals so that the stomach does not have to work as hard or long.
- Eat slowly.
- Avoid foods that contain high amounts of acids, such as citrus fruits and tomatoes.
- Minimize or avoid foods and drinks that contain caffeine.
- If stress is the cause of dyspepsia, learn new ways to manage stress, such as relaxation techniques and biofeedback.
- If you smoke, stop smoking. Smoking can irritate the stomach lining.
- Reduce your alcohol consumption, as alcohol can also irritate the stomach lining.
- Avoid wearing tight clothing as it tends to put pressure on the stomach, which may cause its contents to enter the esophagus.
- Do not exercise a full stomach. Instead, get exercise before a meal or at least an hour after a meal.
- Do not lie down right after eating.
- Wait at least three hours after your last meal of the day before going to bed.
- Sleep with your head raised (at least 6 inches) above your feet, and use pillows to support yourself. This will help allow the digestive juices to flow into the intestine instead of the esophagus.