Indigestion

Indigestion, also known as dyspepsia is feeling of pain or discomfort in the upper abdomen region. Indigestion may manifest as burning or pain in the region between the navel and the lower part of breastbone. You may feel that the stomach is full immediately after starting or after completing the meal. You may also feel burning sensation deep inside the chest when stomach acid rises into the oesophagus.

Signs and symptoms

Indigestion itself is a sign of upper abdomen disorders such as gastro-oesophageal reflux disease (GERD), gallbladder disease or gastrointestinal ulcers.

Symptoms of indigestion are:

  • bloating
  • belching
  • nausea and vomiting
  • stomach growling
  • acid taste in the mouth
  • feeling full stomach during or immediately after a meal
  • burning sensation in the stomach or upper abdomen
  • pain in the upper abdomen

Causes

Many diseases are associated with indigestion. They include gastritis, gallstones, stomach ulcer, peptic ulcer, gall bladder inflammation, cirrhosis, generalised anxiety disorder, pregnancy, ovarian cysts, and congestive heart failure, etc.

Many diseases are associated with indigestion. They include gastritis, gallstones, stomach ulcer, peptic ulcer, gall bladder inflammation, cirrhosis, generalised anxiety disorder, pregnancy, ovarian cysts, and congestive heart failure, etc.

Some medications such as aspirin, NSAIDs (ibuprofen, naproxen), oestrogen and oral contraceptives, thyroid medicines, steroids, and certain antibiotics also cause indigestion.

Eating too much or too fast, eating in stressful condition or eating high-fat food, excessive alcohol consumption, smoking (chemicals of inhaled cigarette smoke causes acid reflux, leading to indigestion), fatigue or stress are some of the lifestyle factors that can cause indigestion.

Prevention

You should remain away from foods and situations causing indigestion. One should have a diary and enlist foods causing indigestion in the diary. Other ways to prevent indigestion are as follows:

  • Avoid citrus foods and tomatoes as they enhance acid production.
  • Eat small portions of food to reduce work of stomach.
  • Eat meals slowly.
  • Avoid foods and drinks containing caffeine.
  • Perform relaxation and biofeedback techniques regularly, if indigestion is caused by stress.
  • Quit smoking and limit alcohol intake.
  • Do not wear tight fitting clothes.
  • Perform exercise before or one hour after a meal.
  • Do not lie down immediately after eating.
  • Eat three hours before going to bed.

Treatment of indigestion depends on the type or underlying cause:

Indigestion with mild to moderate symptoms:It can be treated with antacids or alginates. Antacids work by neutralising acid in the stomach. Antacids are over the counter medicines and are available as tablets and oral liquids. Antacids should be taken after meals or at bedtime so that they can stay in the stomach for a longer time resulting longer duration of action. Persistent indigestion:If indigestion is persistent or recurring, symptoms may not be effectively controlled by antacids and alginates. Proton pump inhibitors and H2 receptor antagonists are the drug of choice.

Proton pump inhibitors (PPI) reduce the production of acid in the stomach. If the stomach juice backs up into the oesophagus, it causes less irritation. Proton pump inhibitors are used to get relief from GERD symptoms, heal inflammation of the oesophagus, and prevent recurrence of esophagitis. It generally takes few days for relieving symptoms of GERD.

SH2 receptor antagonists (H2 blockers) reduce the production of acid in the stomach. The stomach juice becomes less acidic and less irritating upon entering the oesophagus. H2 blockers can be taken orally or intravenously. Uses of H2 blockers are similar to proton pump inhibitors.

Evaluation of health history and thorough physical examination by a doctor is sufficient to diagnose mild indigestion if symptoms such as weight loss and repeated vomiting are absent. If a person is suffering from acute indigestion with severe symptoms, the doctor may recommend for following examinations:

  • Lab tests - to evaluate the thyroid function (T3, T3RU, T4 and TSH) and other metabolic disorders such as diabetes
  • Stool test – to detect the presence of Helicobacter pylori (associated with peptic ulcer)
  • Endoscopy - to examine upper abdomen (oesophagus, stomach and duodenum)
  • Biopsy - to examine the tissue sample
  • Imaging tests (X-ray or CT scan) - to check intestinal obstruction