What Is Indigestion?
Indigestion, also known as dyspepsia, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier than expected when eating.
Dyspepsia is a common problem and is frequently caused by gastroesophageal reflux disease (GERD) or gastritis. In a small minority of cases, it may be the first symptom of peptic ulcer disease (an ulcer of the stomach or duodenum) and, occasionally, cancer.
Hence, unexplained newly onset dyspepsia in people over 55 or the presence of other alarming symptoms may require further investigations. Functional indigestion (previously called non-ulcer dyspepsia) is indigestion “without evidence of an organic disease that is likely to explain the symptoms”. Functional indigestion is estimated to affect about 15% of the general population in western countries.
What Are the Signs and Symptoms of Indigestion?
- abdominal pain,
- heartburn or acid indigestion (acid reflux),
- bloating,
- gas,
- nausea,
- acidic taste in the mouth,
- stomach discomfort,
- constipation or diarrhea, and
- decreased appetite.
- Indigestion has many causes including medical conditions, medications, diet, and lifestyle. Stress and anxiety often can make indigestion worse.
- Tests to diagnose indigestion include blood tests, abdominal ultrasound, endoscopy, colonoscopy, upper GI and small bowel X-ray series, CT scan or MRI of the abdomen, and a gastric emptying study.
- The first line of treatment for many cases of indigestion is
- lifestyle changes including eating slower, eating smaller amounts,
- avoiding alcohol and caffeine,
- quitting smoking,
- avoiding trigger foods, and
- losing weight.
- Medications to treat indigestion include antacids and acid blockers.
- Treatment of indigestion is centered on treating the underlying cause.
- The prognosis for indigestion is generally good if indigestion is caused by lifestyle factors. The outlook for indigestion caused by a disease or medical condition varies depending on the resolution of that condition.
What Causes Indigestion?
Indigestion something that results from overeating or eating too fast. Spicy, greasy, and fatty foods also increase the risk of indigestion. Lying down too soon after eating can make it harder to digest food. This increases your risk of abdominal discomfort.
Other common causes of poor digestion include:
- smoking
- drinking too much alcohol
- side effects of medications
Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen, are one class of medications that can cause side effects.
Eating habits and lifestyle choices can cause. Symptoms of indigestion can also be caused by:
- acid reflux disease (GERD)
- gastric cancer
- pancreatic or bile duct abnormalities
- peptic ulcers
Peptic ulcers are sores in the lining of the stomach, esophagus, or duodenum that can be caused by H. pylori bacteria.
Sometimes, there’s no known cause of indigestion, which is referred to as functional dyspepsia. Functional dyspepsia may be caused by abnormal muscle motility, like a squeezing action, in the area where the stomach muscles digest and move food into the small intestine.
Is burping (belching) a symptom of indigestion?
It is appropriate to discuss belching in detail since it is a commonly misunderstood symptom associated with indigestion.
- The ability to belch is almost universal.
- Belching, also known as burping or eructating, is the act of expelling gas from the stomach out through the mouth.
- The usual cause of belching is a distended (inflated) stomach that is caused by swallowed air or gas.
- The distention of the stomach causes abdominal discomfort, and the belching expels the air and relieves the discomfort.
- The common reasons for swallowing large amounts of air (aerophagia) or gas are
- gulping food or drink too rapidly,
- anxiety, and
- carbonated beverages.
- People often are unaware that they are swallowing air.
- “Burping” infants during bottle or breastfeeding is important in order to expel air in the stomach that has been swallowed with the formula or milk.
Excessive air in the stomach is not the only cause of belching.
- For some people, belching becomes a habit and does not reflect the amount of air in their stomachs.
- For others, belching is a response to any type of abdominal discomfort and not just to discomfort due to increased gas.
How long does indigestion (dyspepsia) last?
Indigestion is a chronic disease that usually lasts years, if not a lifetime. It does, however, display periodicity, which means that the symptoms may be more frequent or severe for days, weeks, or months and then less frequent or severe for days, weeks, or months. The reasons for these fluctuations are unknown. Because of the fluctuations, it is important to judge the effects of treatment over many weeks or months to be certain that any improvement is due to treatment and not simply to natural fluctuation in the frequency or severity of the disease.
What Diseases or Conditions Cause Indigestion?
Disease or conditions that may cause indigestion to include:
- Ulcers (gastric or duodenal ulcer)
- GERD (gastroesophageal reflux disease)
- Esophagitis
- Hiatal hernia
- Gallstones
- Pregnancy (especially late-term)
- Inflammation of the pancreas (acute or chronic pancreatitis)
- Inflammation of the stomach (acute or chronic gastritis)
- Stomach infections and food poisoning
- Irritable bowel syndrome (IBS)
- Gastroparesis (a condition where the stomach doesn’t empty properly; this often occurs in people with diabetes)
- Food allergies or sensitivities (such as lactose intolerance)
- Heart disease, angina, heart attack
- Thyroid disease
- Depression
- Stomach cancer (rare)
Diagnosing indigestion
Your doctor will likely start by asking questions about your medical history and eating habits. You’ll also undergo a physical examination. Your doctor may order X-rays of your abdomen to see if there are any abnormalities in your digestive tract.
They may also collect blood, breath, and stool samples to check for a type of bacteria that causes peptic ulcers.
Your doctor can order an endoscopic exam to check your upper digestive tract for abnormalities.
During an endoscopy, your doctor passes a small tube with a camera and biopsy tool through your esophagus into your stomach. They can then check the lining of the digestive tract for diseases and collect tissue samples. You’ll be mildly sedated for this procedure.
An upper gastrointestinal (GI) endoscopy can diagnose the following:
- reflux esophagitis
- ulcers
- inflammatory diseases
- infection of cancer
Treatment options for indigestion
Medications
Several medications can be used to treat indigestion, but they may cause side effects. Over-the-counter antacids like Maalox and Mylanta help neutralize stomach acid but may cause diarrhea or constipation.
H2 receptor antagonists (H2RAs) like Zantac and Pepcid reduce stomach acid. Side effects are uncommon, but can include:
- nausea
- vomiting
- diarrhea
- rash or itching
- constipation
- headache
- bleeding or bruising
Prokinetics, like prescription medications Reglan and Motilium, improve the muscle action — or motility — of the digestive tract. These medications may cause:
- depression
- anxiety
- involuntary movements or spasms
- fatigue
Proton pump inhibitors (PPIs) like Prilosec reduce stomach acid but are stronger than H2RAs. Side effects include:
- nausea and vomiting
- constipation
- diarrhea
- cough
- headache
- backache
- dizziness
- abdominal pain
Both PPIs and H2 drugs are typically used to treat peptic ulcers. If H. pylori are the cause of ulcers, these drugs are used in combination with antibiotics like clarithromycin and amoxicillin.
Lifestyle changes and home care
Medication isn’t the only treatment for indigestion. You may be able to improve digestion and relieve uncomfortable symptoms with lifestyle adjustments. For example:
- Eat smaller meals throughout the day.
- Avoid spicy, fatty foods that can trigger heartburn.
- Eat slower and don’t eat before lying down.
- Stop smoking, if you smoke.
- Lose excess body weight.
- Reduce the amount of coffee, soft drinks, and alcohol you consume.
- Get plenty of rest.
- Stop taking medications that can irritate the stomach lining, such as NSAIDs
- Reduce stress through yoga or relaxation therapy.
Outlook
Poor digestion is a common problem. However, you shouldn’t ignore indigestion that’s:
- chronic
- severe
- unresponsive to over-the-counter medication
If left untreated, the symptoms of indigestion may interfere with your quality of life.
If you’re can’t manage indigestion at home, speak with your doctor. They can help determine the underlying cause of your digestion issues.
How to Treat Indigestion at Home
1. Peppermint tea
Peppermint is more than a breath freshener. It also has an antispasmodic effect on the body, making it a great choice for relieving stomach problems like nausea and indigestion. Drink a cup of peppermint tea after meals to quickly soothe your stomach or keep a few pieces of peppermint in your pocket and suck on the candy after eating.
While peppermint can ease indigestion, you shouldn’t drink or eat peppermint when indigestion is caused by acid reflux. Because peppermint relaxes the lower esophageal sphincter — the muscle between the stomach and the esophagus — drinking or eating it can cause stomach acid to flow back into the esophagus and worsen acid reflux. Peppermint tea is not recommended for people with GERD or ulcers.
2. Chamomile tea
Chamomile tea is known to help induce sleep and calm anxiety. This herb can also ease gut discomfort and relieve indigestion by reducing stomach acid in the gastrointestinal tract. Chamomile also acts as an anti-inflammatory to stop the pain.
To prepare chamomile tea, place one or two tea bags in boiling water for 10 minutes. Pour in a cup and add honey, if desired. Drink the tea as needed to stop indigestion.
Consult a doctor before drinking chamomile tea if you take a blood thinner. Chamomile contains an ingredient that acts as an anticoagulant, so there’s the risk of bleeding when combined with a blood thinner.
6. Baking soda (sodium bicarbonate)
Baking soda can quickly neutralize stomach acid and relieve indigestion, bloating, and gas after eating. For this remedy, add 1/2 teaspoon of baking soda to 4 ounces of warm water and drink.
Sodium bicarbonate is generally safe and nontoxic. But drinking large amounts of baking soda can bring on a few unwelcome side effects, such as constipation, diarrhea, irritability, vomiting, and muscle spasms. If you drink a solution containing 1/2 teaspoon of baking soda for indigestion, don’t repeat for at least two hours.
According to a 2013 studyTrusted Source, adults should have no more than seven 1/2 teaspoons in a 24-hour period and no more than three 1/2 teaspoons if over the age of 60.
7. Lemon water
The alkaline effect of lemon water also neutralizes stomach acid and improves digestion. Mix a tablespoon of lemon juice in hot or warm water and drink a few minutes before eating.Along with easing indigestion, lemon water is also an excellent source of vitamin C. However, too much lemon water can wear down tooth enamel and cause increased urination. To protect your teeth, rinse your mouth with water after drinking lemon water.
8. Licorice root
Licorice root can calm muscle spasms and inflammation in the gastrointestinal tract, which both can trigger indigestion. Chew licorice root for relief or add licorice root to boiling water and drink the mixture.
Although effective for indigestion, licorice root can cause sodium and potassium imbalances and high blood pressure in large doses. Consume no more than 2.5 grams of dried licorice root per day for fast relief. Eat or drink licorice root 30 minutes before eating or one hour after eating for indigestion.
Frequently Asked Questions About Indigestion
When should I take an antacid vs. a Famotidine(Pepcid-AC) or Omeprazole (Prilosec)-like product?
Let’s start with the basics. Antacids neutralize excess stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset. They are sometimes prescribed in addition to other meds to help relieve the pain of stomach and duodenal ulcers. Some antacids also contain simethicone, an ingredient that helps eliminate excess gas.
You should take antacids exactly as directed by your doctor, or according to the manufacturer’s directions. For stomach or duodenal ulcers, take the medicine for as long as your doctor tells you. If you are using the tablets, chew them well before swallowing for faster relief.
Serious side effects can occur with an overdose or overuse of antacids. Side effects include constipation, diarrhea, change in the color of bowel movements, and stomach cramps. Products containing calcium may cause kidney stones and are more likely to cause constipation.
Products like famotidine (Pepcid-AC) are called histamine-2 blockers or H2 blockers. These drugs reduce the production of stomach acid. Pepcid AC and other H2 blockers, such as ranitidine (Zantac 75) are available in prescription-strength or in lower doses in over-the-counter varieties. These products are for the relief of heartburn, acid indigestion, sour stomach, and other conditions, such as stomach ulcers.
PPIs generally cause few side effects, but they do interact with other common drugs such as warfarin (Coumadin), some heart medications and antibiotics, so it is important to review all medications with your doctor.
Antacids work the quickest to relieve occasional heartburn. For patients who do not respond to antacids, H2 blockers and PPIs are alternatives. Remember, though, that frequent or severe episodes of reflux should always be discussed with your doctor.
Your doctor may want you to take antacids when you start taking H2 blockers to help control your symptoms until the H2 blocker takes effect. If your doctor prescribes an antacid, take it an hour before or an hour after H2 blockers. Take H2 blockers regularly for as long as directed by your doctor, even if you do not have any pain or your symptoms improve.
Possible serious side effects that need to be reported to your doctor right away include confusion, chest tightness, bleeding, sore throat, fever, irregular heartbeat, weakness, and unusual fatigue. Other less serious side effects include mild headache, dizziness, and diarrhea, which are usually temporary and will likely go away on their own.
It seems that my husband has heartburn every night. I think he should see a doctor. He thinks he should just continue taking antacids. Who’s right?
Occasional heartburn is common and generally not serious. However, prolonged heartburn can be a symptom of a serious problem, such as esophagitis. Esophagitis is an inflammation of the lining of the esophagus, the food tube. Esophagitis occurs when stomach acid repeatedly comes into contact with the lining of the esophagus. If esophagitis is severe, the person can develop Barrett’s esophagus and even cancer. Over time, this condition can narrow the passageway from the esophagus to the stomach. Your husband should consult his doctor for further evaluation. When a person requires more than twice-weekly over-the-counter drugs for heartburn, a doctor should be consulted. An endoscopy to visualize his esophagus may also be recommended.
I am a 55-year-old male who is about 30 pounds overweight. Lately, I’ve been experiencing frequent heartburn and have an acid taste in the back of my throat. Now, my doctor is telling me I have a hiatal hernia. Is this a serious problem? Will it require surgery?
A hernia is the pressing of an organ through an opening in the muscle wall of the cavity that protects it. With a hiatal hernia, a portion of the stomach pushes through the hole where the esophagus and the stomach join.
The most common cause of a hiatal hernia is an increase in pressure on the abdominal cavity. Pressure can come from coughing, vomiting, straining during a bowel movement, heavy lifting, or physical strain. Pregnancy, obesity, or excess fluid in the abdomen also can cause Hiatal hernias.
A hiatal hernia can develop in people of all ages and both sexes, although it frequently affects middle-aged people. In fact, the majority of otherwise healthy people over age 50 have small Hiatal hernias.
Many people with a hiatal hernia never have any symptoms. In some people, acid and digestive juices escape from the stomach into the esophagus (gastroesophageal reflux). This causes:
- Heartburn
- A bitter or sour taste in the back of the throat
- Bloating and belching
- Discomfort or pain in the stomach or esophagus
- Vomiting
Most Hiatal hernias do not cause problems and rarely need treatment. Successful treatment of Hiatal hernias usually involves treating the symptoms of gastroesophageal reflux disease (GERD) that are triggered by the additional pressure in the abdomen.
- Losing weight, if you are overweight, and maintaining a healthy weight
- Having a common-sense approach to eating, such as eating moderate to small portions of foods, and limiting fatty foods, acidic foods (such as tomatoes and citrus fruits or juices), foods containing caffeine, and alcoholic beverages
- Eating meals at least three to four hours before lying down and avoiding bedtime snacks
- Elevating the head of your bed by 6 inches (this helps allow gravity to keep the stomach contents in the stomach)
- Not smoking
- Wearing looser clothing, especially around the waistline
- Taking medications, such as over-the-counter antacids or H2 blockers or PPIs. Note: If you take over-the-counter drugs and see no improvement or take them for longer than two weeks, see your doctor. He or she may prescribe a stronger medication.
If medications and lifestyle changes are not effective in treating your symptoms, diagnostic tests may be performed to determine if surgery is necessary.
People with a hiatal hernia who also have severe, chronic esophageal reflux may need surgery to correct the problem if their symptoms are not relieved through these management techniques. Surgery may also be needed to reduce the size of the hernia if it is in danger of becoming constricted or strangulated (so that the blood supply is cut off). During surgery, gastroesophageal reflux is corrected by pulling the hiatal hernia back into the abdomen and creating an improved valve mechanism at the bottom of the esophagus. The surgeon wraps the upper part of the stomach (called the fundus) around the lower portion of the esophagus. This creates a tighter sphincter so that food will not reflux back into the esophagus.
Hiatal hernia surgery can be performed either by opening the abdominal cavity or laparoscopically. During laparoscopic surgery, five or six small (5 to 10 millimeter) incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these incisions. The surgeon is guided by the laparoscope, which transmits a picture of the internal organs on a monitor. The advantages of laparoscopic surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery.
I am pregnant and have terrible heartburn. Is there anything I can do to get relief?
More than half of all pregnant women report heartburn, particularly during their third trimester. Heartburn occurs during pregnancy, in part, because your digestive system works more slowly due to changing hormone levels. Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward.
Here are some ways you can reduce your heartburn during pregnancy:
- Eat several small meals each day instead of three large ones.
- Eat slowly.
- Avoid fried, spicy, or rich foods, or any foods that seem to increase your heartburn.
- Don’t lie down directly after eating.
- Keep the head of your bed higher than the foot of your bed.
- Ask your doctor about trying over-the-counter heartburn relievers such as Tums or Maalox.
If your heartburn persists, see your doctor. He or she may prescribe drugs that are safe to take during pregnancy.
What foods should a person avoid if he or she has heartburn, GERD, or Barrett’s esophagus?
What’s on your plate can impact heartburn, GERD, and Barrett’s esophagus. Eating certain foods, including onions, peppermint, and high-fat foods, as well as drinking alcohol, can cause the lower esophageal sphincter muscle, which controls the opening between the esophagus and the stomach, to relax. Usually, this muscle remains tightly closed except when food is swallowed. However, when this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus, producing a burning sensation commonly referred to as heartburn.
Caffeinated beverages and foods (such as coffee, tea, colas, and chocolate) can also aggravate heartburn and gastroesophageal reflux disease (GERD). Tomatoes, citrus fruits, or juices also contribute additional acid that can irritate the esophagus.
In addition, smoking relaxes the lower esophageal sphincter, contributing to heartburn and GERD.
Improving your eating habits can also reduce reflux. After eating, keep an upright posture. Eat moderate portions of food and smaller meals. Lastly, eat meals at least three to four hours before lying down, and avoid bedtime snacks.
What is Barrett’s esophagus and how is it treated?
Barrett’s esophagus is a change in the lining of the lower esophagus that develops in some people who have chronic GERD or inflammation of the esophagus.
The treatment of Barrett’s esophagus is similar to the treatment of reflux. This includes lifestyle changes, such as avoiding certain foods and eating late in the evening, smoking cessation, and wearing loose-fitting clothing, along with using medications that will decrease acid production by the stomach.
Patients with Barrett’s esophagus typically need PPI drugs to reduce acid.
Barrett’s esophagus may lead to the development of cancer of the esophagus in some patients, although this risk is smaller than once thought. Up to 0.5% of those with Barrett’s esophagus will develop esophageal cancer each year.
Esophageal cancer develops through a sequence of changes in the cells of the esophagus known as dysplasia. Dysplasia can only be detected by a biopsy. Patients with Barrett’s esophagus should talk to their doctors about having regular screening exams to detect cancer at an early and potentially curable stage.
Studies are in progress to develop a more effective treatment for Barrett’s esophagus. One treatment, known as ablation therapy, removes the abnormal cells with heat or laser light. Other new treatments are also under development.
What is GERD?
Gastroesophageal reflux disease (GERD) is a condition where stomach contents flow back (reflux) into the esophagus (food tube) causing troublesome symptoms and/or possible damage to the esophagus. GERD is a chronic disease for which long-term medical therapy is usually effective.
What are the signs and symptoms of GERD?
The most common symptom of GERD is heartburn. Another typical symptom is the reflux of fluid into the mouth.
Some of the other less common symptoms may include difficulty or pain when swallowing, the sensation of food sticking in the esophagus, hoarseness, throat-clearing, chronic sore throat, wheezing, or chronic cough.
How do I know if I have GERD?
Only a doctor can make a diagnosis of GERD. Talk to your doctor if:
- Your heartburn happens 2 or more times a week
- Your heartburn gets worse
- Your heartburn wakes you from sleep at night
- You’ve had heartburn now and then for several years
- You have difficulty or pain when swallowing
- Your discomfort interferes with daily activities
GERD can usually be diagnosed based on the signs and symptoms. Tests may be done to confirm or exclude a GERD diagnosis.
What causes GERD?
There is no known single cause of GERD. Reflux occurs when the muscle barrier between the stomach and the esophagus does not work as it should or is somehow overwhelmed.
How is GERD treated?
Treatment of GERD is long-term. The goals are to control or reduce symptoms, heal an injured esophagus, and manage or prevent complications.
Treatment options include lifestyle changes, medicines, surgery, or a combination of approaches.
Lifestyle changes – This means changing things you have control over. Try to identify and avoid things that may bring on symptoms or make them worse. Ask your doctor about diet. Let your doctor know about any medicines you take as some can worsen symptoms.
Medicines – Over-the-counter medicines provide only temporary relief of heartburn. Tell your doctor if you need to take one for more than two weeks.
The most commonly prescribed medicines to treat GERD are H2 blockers and the more powerful PPIs (proton pump inhibitors). These reduce or limit acid secretion in your stomach.
Surgery – For some people, surgery to strengthen the barrier between the stomach and the esophagus may be an option. Medicine may still need to be taken after surgery to control symptoms. Before having surgery, review all aspects of the procedure with your primary care doctor or gastroenterologist and the surgeon.
Ask your doctor questions about your treatment plan and options. Ask why the treatment is important for you. If you need to take a medicine long-term, at later visits ask your doctor if your effective dosage can be reduced. Ask about risks as well as benefits. Ask about side effects; these can occur with any treatment. Learn what to do if they occur, and how to minimize or avoid them.
Learn more about the treatment of GERD.
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