Alternative names: Dyspepsia, indigestion, heartburn, hyperacidity, stomachache
Indigestion is defined as pain or discomfort in the stomach that is associated with difficulty digesting food. It is often a sign of underlying disease.
Indigestion is a vague problem that is functional in nature and usually not due to an underlying structural cause. Belching, distension and abdominal sounds often occur in association with abdominal or epigastric pain. Because similar symptoms may be due to more serious conditions, it is important to have an accurate diagnosis.
Aside from indigestion, numerous other conditions are possible in this area, some of which may cause, be caused by, or be mistaken for, indigestion. These include:
Indigestion is usually related to eating, which causes the stomach to produce acid and stretch. The most common causes and risk factors include:
Symptoms (see below) usually occur soon after eating or drinking, but there can be a delay between eating and getting indigestion.
When diagnosing possible indigestion, it is important to first understand the patient's symptoms, eating and drinking habits, and medicine use. A physical exam would then look for bloating, abdominal sounds, tenderness, pain, or lumps.
If a problem is suspected in the upper gastrointestinal (GI) tract, an endoscopy may be performed in order to see what is taking place inside. This involves passing a flexible tube with a camera at the end through the mouth and into the upper GI tract.
It is important to determine the cause of indigestion so that it – and therefore also the indigestion – can be treated. An upper GI endoscopy can detect conditions such as gastritis, gastroesophageal reflux disease (GERD), peptic ulcer disease, stomach cancer, narrowing of the esophagus, blockages, and so on.
Treatment of indigestion depends on its cause and severity. Dietary factors are often important in reducing symptoms, and diet/lifestyle changes may be all that is needed: losing weight, exercising, healthy diet, smaller meals, avoiding rich, spicy or fatty foods, avoiding caffeine and alcohol, and stopping smoking.
Going to bed with a full stomach increases risk of indigestion, so eating earlier can reduce risk. Sleeping on a sloping bed, with head and chest slightly elevated, can also help keep stomach acid in the stomach.
Antacids provide immediate relief by neutralizing stomach acid and come in tablet or liquid form.
Proton pump inhibitors (PPIs) restrict the amount of acid produced in the stomach.
Alginates (which form a foam barrier above the stomach acid) and H2-receptor antagonists (which reduce stomach acidity) are other options.
If the cause of indigestion is H. pylori infection, then simple antibiotic treatment is available.
In a person with weakened digestion or weakened immune response, blastocystis can produce a host of symptoms which appear to come and go and are very unpredictable.
Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in elevated levels of amino acids and polypeptides in the bowel. These are metabolized by bowel bacteria into several toxic compounds. The toxic metabolites of the amino acids arginine and ornithine are known as polyamines (e.g., putrescine, spermidine, and cadaverine) and have been shown to be increased in individuals with psoriasis. Polyamines contribute to the excessive rate of cell proliferation. Lowered skin and urinary levels of polyamines are associated with clinical improvement in psoriasis, so digestive function should be evaluated.
Studies have shown that ingested fluoride damages gastroduodenal mucosa. Gastrointestinal discomfort can be an early warning sign of fluorosis, so fluoride toxicity should be considered a possible reason for non-ulcer dyspepsia and gastrointestinal discomfort in the form of dyspeptic symptoms should be an important diagnostic feature when identifying fluorosis patients and should not be dismissed as non-specific. [Susheela AK, Das TK, Gupta IP, Tandon RK, Kacker SK, Ghosh P, and Deka, Fluoride ingestion and its correlation with gastrointestinal discomfort, Fluoride, 1992, 25:l, pp.5-22]
The gastro-intestinal system is one of the most sensitive systems in the body to react adversely to fluoride toxicity. There are now many case histories available to establish the correlation of fluoride toxicity to gastro-intestinal problems.
Although a few sources have recommended cayenne pepper as a potential treatment for dyspepsia, gastritis and even peptic ulcers, most modern herbal texts suggest avoiding the herb for persons with these conditions. A small clinical trial suggests that cayenne may be beneficial in some persons with functional dyspepsia. Approximately 850mg of cayenne powder in a capsule was given 3 times per day just before meals (0.7mg capsaicin per gram). [NEJM 2002;346: pp.947-48]
Fasting gives the digestive system a much-needed rest. After fasting, both digestion and elimination are invigorated.
Although dyspepsia is a sign of dehydration, it is generally recommended that you do not drink during a substantial meal, or from 1⁄2 hour before to 2 hours afterwards.
Upper digestive symptoms are often due to hydrochloric acid (HCl) or pancreatic insufficiency and it can be difficult to distinguish between the two. The easiest way to find out is to do both an HCl and digestive enzyme trial, one at a time. Often a doctor's assistance is helpful in conducting these trials.
Your body is a highly complex, interconnected system. Instead of guessing at what might be wrong, let us help you discover what is really going on inside your body based on the many clues it is giving.
Our multiple symptom checker provides in-depth health analysis by The Analyst™ with full explanations, recommendations and (optionally) doctors available for case review and answering your specific questions.