Overview

Indigestion is a common problem and presents as a vague feeling of abdominal discomfort possibly including a feeling of fullness, belching, bloating, and nausea.

Indigestion may be triggered by eating particular foods, drinking wine or carbonated drinks. It may also be caused by overeating, eating too quickly or eating too late at night. Some people may find that spicy foods, high-fibre foods, fatty foods, or too much caffeine can all aggravate this problem. Symptoms may also be worsened by stress, anxiety and depression.

Another commonly used term is “dyspepsia”. Dyspepsia is a pain or an uncomfortable feeling in the upper middle part of your stomach and is more specific than indigestion. The pain might come and go, but it's usually there most of the time. A high percentage of individuals get dyspepsia at some time and this can be caused by a number of problems including simple food related indigestion.

Sometimes a stomach ulcer or acid reflux disease can cause dyspepsia. If you have acid reflux disease, stomach acid backs up into your oesophagus (the tube leading from your mouth to your stomach). This causes pain in your chest and possibly the throat regions. If you have dyspepsia, your doctor will ask if you take certain medicines. Some medicines, such as anti-inflammatory medicines, can exacerbate dyspepsia.

Rarely, dyspepsia is caused by stomach cancer, so although this is unlikely you should take this problem seriously. Sometimes no cause of dyspepsia can be found.

What are the symptoms?

Symptoms of indigestion are generally related to the ingestion of food, hence the term indigestion. Dyspepsia on the other hand may have more clinical relevance and only an examination by a doctor and possible Gastroscopy will give a diagnosis. This grey area causes confusion and therefore suggests the need for further investigation especially if prolonged or accompanied by more serious symptoms such as blood in the saliva, or difficulty swallowing.

• Abdominal discomfort
• Fullness
• Belching
• Bloating

• A gnawing or burning stomach pain
• Heartburn (stomach contents coming back up into your throat)
• Upset stomach (nausea)
• Vomiting
• Belching

Without wishing to cause concern the following combination of symptoms are very important to note and require an immediate appointment with your doctor:

• You're over 50 years of age
• You recently lost weight without trying to
• You have trouble swallowing
• You have severe vomiting
• You have black, tarry bowel movements
• You can feel a mass in your stomach area

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What causes indigestion or dyspepsia?

Often, there is no cause, and the best advice is to monitor lifestyle and diet. However there are a number of clinical reasons why this occurs. It may be simple irritation of the gut mucosa, over production of acid in the stomach, causing "heartburn" and "reflux", it may be caused by a recent infection of Helicobacter pylori (H.pylori)or a more protracted infection that has damaged the stomach mucosa.

A condition called Oesophageal Reflux is associated with Indigestion and Dyspepsia, and is a common condition that often occurs without symptoms after meals. In some people, this reflux is related to a problem with the lower oesophageal sphincter, a band of muscle fibres that usually closes off the oesophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the oesophagus and may cause the symptoms. This reflux condition is better known as "Heartburn". Even this can be categorised dependent on how it is caused, its onset and duration.

In more serious cases of dyspepsia the symptoms can be caused by stomach (peptic) ulcers, the majority of which are caused by the bacterium, Helicobacter pylori. More rarely the early stages of gastric cancer can present with these symptoms. Although gastric cancer is relatively rare, it should not be forgotten and needs to be diagnosed early for successful treatment. Those individuals with a family history should have regular check ups.

Please visit the section on the GastroView page to see an explanation of the examination, its ability to detect infection and its ability to determine the health status of your stomach mucosa.

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What should you do?

If your indigestion is sporadic and is associated with foods or particular situations then allow time for leisurely meals. Chew food carefully and thoroughly, avoid dietary conflicts during meals, avoid excitement or exercise immediately after a meal. Also avoid chewing gum, it may cause swallowing of air. A calm environment and rest may help relieve stress-related indigestion and dyspepsia.

If your symptoms are more prolonged, or there are more serious symptoms, then visit your GP. If you have a stomach ulcer or have been diagnosed with an H. pylori infection a course of antibiotic treatment is likely and a gastroscopy may be recommended.

Avoid aspirin and drugs that will irritate the stomach mucosa. If you must take them, do so on a full stomach. Antacids freely available from the chemists may relieve indigestion. Stronger medications are available over-the-counter, such as ranitidine (Zantac). Your doctor may prescribe more potent ones such as Protein Pump Inhibitors (PPI's), which is often the first course of action. This will relieve symptoms but does not uncover the cause of the problem.

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