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Indigestion

(Dyspepsia; Non-ulcer Dyspepsia; Non-ulcer Stomach Pain)

Definition

Indigestion is discomfort in the upper abdomen or chest. It is often linked to nausea, belching, or bloating.
Locations of Indigestion Symptoms
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Causes

The exact cause is not known. Most often, the condition is linked to a number of unhealthy lifestyle factors. These factors can result in poor digestion.

Risk Factors

The following lifestyle factors increase your chances of experiencing indigestion:
  • Overeating
  • Eating too quickly or at irregular intervals
  • Eating greasy, high-fat, or spicy foods
  • Drinking caffeine, alcohol, or soft drinks in excess
  • Taking nonsteroidal anti-inflammatory drugs (eg, aspirin , ibuprofen )
  • Smoking
  • Psychological stress

Symptoms

Indigestion is characterized by a variety of symptoms, including:
  • Pain or burning sensation in the upper abdomen or chest
  • Nausea
  • Abdominal bloating
  • Belching or regurgitation

When Should I Call My Doctor?

It is common to have indigestion occasionally. If the episodes worsen or happen more frequently, make an appointment to see your doctor. If you have indigestion, important reasons to call your doctor include:
  • Having trouble swallowing
  • Vomiting with most episodes
  • Experiencing weight loss
  • Being aged 55 or older
  • Having a family history of cancer

When Should I Call for Medical Help Immediately?

Call for medical help or go to the emergency room right away if you have:
  • Severe abdominal pain
  • Blood in your stool or dark black stool
  • Blood in the vomit
  • Trouble breathing
  • Chest pain

Diagnosis

Your doctor will ask about your symptoms and medical history. Indigestion is diagnosed mainly on the symptoms listed above.
Tests may be ordered if your symptoms worsen or you have more serious symptoms, like severe abdominal pain. Examples of tests that may be ordered include:
  • Laboratory blood work
  • Barium x-ray —a chalky solution is used to highlight the upper digestive tract in an x-ray
  • Ultrasound —high-frequency sound waves a used to view and examine the organs of the abdominal cavity
  • Endoscopy—a long, thin tube affixed with a light and camera is inserted into the throat to examine the lining of the esophagus, stomach, and upper part of the small intestine
  • Gastric emptying study—food containing a small amount of radioactive material is tracked to help determine the rate at which the stomach empties of food

Treatment

Your doctor will suggest a plan based on the severity of your symptoms. Treatment options may include the following:

Dietary and Lifestyle Changes

Your doctor may advise you to:
  • Reduce your intake of fatty and spicy foods.
  • Eat smaller meals throughout the day (instead of three large meals).
  • Reduce your intake of alcohol, caffeine, and carbonated beverages.
  • If you smoke, quit .
  • Avoid nonsteroidal anti-inflammatory drugs (NSAIDs).
  • If stress is related to your symptoms, find ways to manage stress.
  • Lose weight if you are overweight.
  • Exercise regularly .

Medications

Medicines your doctor may recommend include:
  • Antacids (eg, Rolaids , Maalox Advanced Regular Strength, Mylanta)—to help neutralize stomach acid
  • Acid suppression agents (eg Zantac , Pepcid , or Prilosec )
  • Prokinetic agents—to help the stomach empty its contents more quickly
  • Antidepressants—to treat the pain associated with indigestion
  • Antibiotics—to treat a bacterial infection ( Helicobacter pylori ) (only used if tests confirm that you have this infection)
If the discomfort persists, your doctor may order tests to determine if the symptoms are related to a more serious condition, such as:

Prevention

To prevent indigestion:
  • Avoid overeating.
  • Eat slowly and regularly.
  • Avoid greasy, high-fat foods.
  • Limit spicy foods.
  • Do not smoke.
  • Drink coffee, alcohol, and caffeinated beverages in moderation.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Practice relaxation techniques .

RESOURCES

The American College of Gastroenterology http://www.acg.gi.org/

American Gastroenterological Association http://www.gastro.org/

CANADIAN RESOURCES

The Canadian Association of Gastroenterology http://www.cag-acg.org/

The College of Family Physicians of Canada http://www.cfpc.ca/

References

Dyspepsia: treatment. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/dyspepsia/treatment.html . Updated November 2010. Accessed January 17, 2012.

Functional dyspepsia. University of North Carolina School of Medicine website. Available at: http://www.med.unc.edu/wrkunits/2depts/medicine/fgidc/collateral/functional%5Fdyspepsia%5F06132005.pdf#search=%22dyspepsia%22 .

Functional dyspepsia (non-ulcer dyspepsia). The Merck Manual website. Available at: http://www.merck.com/mrkshared/mmanual/section3/chapter21/21c.jsp .

Karamanolis G, Caenepeel P, Arts J, Tack J. Association of the predominant symptom with clinical characteristics and pathophysiological mechanisms in functional dyspepsia. Gastroenterology . 2006; 130:296

Indigestion: lifestyle and home remedies. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/indigestion/DS01141/DSECTION=lifestyle-and-home-remedies . Updated April 29, 2011. Accessed January 17, 2012.

Mertz H, Fullerton S, Naliboff B, Mayer EA. Symptoms and visceral perception in severe functional organic dyspepsia. Gut. 1998; 42:814.

Non-ulcer stomach pain. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/stomach-pain/DS00524 .

Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology . 2006; 130:466

3/1/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm . Published February 17, 2010. Accessed March 2, 2010.

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 09/2012 -
  • Update Date: 00/91/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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