Indigestion

Also known as dyspepsia

Indigestion is a word used to describe stomach pain or discomfort after eating. It is not a disease on its own, but a group of symptoms (such as stomach pain, bloating, or a sense of fullness) you feel soon after eating.

Indigestion is common, affecting up to 40% (4 in 10) adults in New Zealand every year. It is often confused with heartburn.

Heartburn is a burning feeling rising from the stomach into the chest and up towards the neck. Frequent heartburn is most commonly a symptom of reflux disease (GORD). 

What causes indigestion?

The most common type of indigestion is known as functional dyspepsia. The exact cause of functional dyspepsia is unknown but it is often related to lifestyle. It may be triggered by food, drink or medication. For example:

  • eating too much or too quickly
  • fatty, greasy or spicy foods
  • too much caffeine, alcohol, chocolate or carbonated drinks
  • taking over-the-counter medications such as ibuprofen or aspirin
  • stress or anxiety.

Functional dyspepsia accounts for 70% of cases of indigestion. Other causes include:

  • Stomach ulcers (15 to 20%).
  • Acid reflux (5 to 15%).
  • Some people get ulcers in their stomach or intestines from bacteria called Helicobacter pylori. Infection from this bacteria can cause indigestion.
  • Other causes, such as cancer, heart disease, disease of the digestive tract and medication effects are rare.

What are the symptoms of indigestion?

People with indigestion often experience:

  • early fullness during a meal or uncomfortable fullness after eating
  • a gnawing or burning stomach pain
  • nausea and vomiting
  • bloating
  • burping.

When to see your doctor about indigestion

Mild indigestion that happens now and again is common and usually nothing to worry about. However, it is important to see your doctor if the discomfort is severe and ongoing, or if you have indigestion in combination with the following symptoms or risk factors:

  • unintended weight loss
  • difficulty swallowing
  • persistent vomiting
  • blood in dark coloured stools (poos)
  • tightness or discomfort in your chest with exercise
  • family history of cancer.

These symptoms could indicate a more serious underlying medical condition and can be easily confused with heart problems, such as angina. Sometimes indigestion can be a symptom of another digestive disease, such as stomach ulcers or acid reflux.  

How is indigestion diagnosed?

To diagnosis indigestion, your doctor will  take a detailed history and conduct a physical examination to try to identify any possible causes for your indigestion. 

Sometimes your doctor might want you to have an endoscopy. This may be because your symptoms suggest a disease of your digestive track, or it may be because you:

  • have had no improvement in symptoms after making lifestyle changes and
  • still have stomach pain after taking an indigestion medicine for 8 weeks.

Self care for indigestion

In about 8 out of 10 people, indigestion symptoms can settle by making some simple changes such as healthier eating or losing weight. The following tips may help prevent indigestion: 

  • stop taking over-the-counter anti-inflammatory medicines
  • drink less alcohol
  • cut down on coffee and fizzy drinks
  • quit smoking
  • avoid large meals in the evening
  • remove foods from your diet that makes symptoms worse (i.e: fatty or spicy foods)
  • reduce your weight if you are overweight
  • find ways to reduce the amount of stress you are under or explore healthy ways of coping with it. Talk to your doctor if you feel that stress is getting on top of you.

What are the treatment options for indigestion?

For mild indigestion that happens now and again, antacids may be helpful in relieving the symptoms. These work by neutralising stomach acid.

If your symptoms are causing ongoing pain and discomfort, see your doctor for a proper check. Treatment will depend on what is causing your indigestion:

  • If you have discomfort, bloating, feeling full and nausea, you may need to take a medication that helps gut movement (eg, domperidone
  • If you have a stomach ulcer or acid reflux, you may need to take an acid-blocking medicine such as ranitidine, famotidine or a proton pump inhibitor.
  • If a bacterial infection is causing your symptoms, antibiotics will be prescribed.
  • If your doctor thinks that a medicine you're taking may be causing your indigestion, you might need to change medicines.
  • If depression or anxiety is thought to be leading to stomach pain, antidepressant or anti-anxiety medication may be prescribed.

Tell your doctor if your symptoms persist after taking the prescribed medication. Your medicine may need to be changed or further tests arranged. 

Learn more

Indigestion NHS Choices, UK
Indigestion
 Mayo Clinic Online (US), 2013
Dyspepsia  Best Practice Journal (NZ), 2011

References

Dyspepsia and heartburn clinical pathway Northern Region, NZ
Managing dyspepsia and heartburn in general practice – an update
 Best Practice Journal, Feb 2011
Management of dyspepsia and heartburn New Zealand Guidelines Group, Ministry of Health NZ, 2004

Credits: Editorial team. Reviewed By: Dr Derek JY Luo, MBChB (Otago) FRACP, Consultant Gastroenterologist Last reviewed: 23 Sep 2016