Dyspepsia: Indigestion. A condition characterized by upper abdominal symptoms that may include pain or discomfort, bloating, feeling of fullness with very little intake of food , feeling of unusual fullness following meals, nausea, loss of appetite, heartburn, regurgitation of food or acid, and belching. The term dyspepsia is often used for these symptoms when they are not typical of a well-described disease (for example, gastrointestinal reflux) and the cause is not clear. After a cause for the symptoms has been determined, the term dyspepsia is usually dropped in favor of a more specific diagnosis.
Indigestion has many possible causes. Often, indigestion is related to lifestyle and may be triggered by food, drink or medication. Common causes of indigestion include:
- Overeating or eating too quickly
- Fatty, greasy or spicy foods
- Too much caffeine, alcohol, chocolate or carbonated beverages
- Certain antibiotics, pain relievers and iron supplements
Sometimes indigestion is caused by other digestive conditions, including:
- Peptic ulcers
- Celiac disease
- Pancreas inflammation (pancreatitis)
- Stomach cancer
- Intestinal blockage
- Reduced blood flow in the intestine (intestinal ischemia)
Indigestion with no obvious cause is known as functional dyspepsia or nonulcer stomach pain.
Functional dyspepsia is a symptom complex characterised by postprandial upper abdominal discomfort or pain, early satiety, nausea, vomiting, abdominal distension, bloating, and anorexia in the absence of organic disease. Gastrointestinal motor abnormalities, altered visceral sensation, and psychosocial factors have all been identified as major pathophysiological mechanisms. This perspective has now replaced the earlier view that the condition was the result of a sole motor or sensory disorder of the stomach. Future therapeutic strategies should be aimed at reducing nociception as well as enhancing the accommodation response.
Most people with indigestion feel pain and discomfort in the stomach or chest area. The sensation generally appears soon after consuming food or drink. In some cases symptoms may appear sometime after a meal. Some people feel full during a meal, even if they have not eaten much.
Heartburn and indigestion are two separate conditions. Heartburn is a burning feeling behind the breastbone, usually after eating.
The following symptoms of dyspepsia are also common:
- Feeling bloated (very full)
In very rare cases indigestion may be a symptom of stomach cancer.
An endoscopic examination of the upper digestive tract can also be used to check for abnormalities. With an endoscopy, your doctor gently passes a small tube with a camera and biopsy tool through your esophagus and into your stomach. This allows your doctor to check the lining of the digestive tract for diseases, and collect tissue samples to be tested for infection or cancer. You’ll be mildly sedated for this procedure. An upper gastrointestinal (GI) endoscopy can diagnose GERD, ulcers, infection, and cancer.
Lifestyle changes may help ease indigestion. Your doctor may recommend:
- Avoiding foods that trigger indigestion
- Eating five or six small meals a day instead of three large meals
- Reducing or eliminating the use of alcohol and caffeine
- Avoiding certain pain relievers, such as aspirin, ibuprofen and naproxen
- Finding alternatives for medications that trigger indigestion
- Controlling stress and anxiety
If your indigestion persists, medications may help. Over-the-counter antacids are generally the first choice. Other options include:
- Proton pump inhibitors (PPIs), which can reduce stomach acid. PPIs may be recommended if you experience heartburn along with indigestion.
- H-2-receptor antagonists (H2RAs), which also can reduce stomach acid.
- Prokinetics, which may be helpful if your stomach empties slowly.
- Antibiotics, if H. pylori bacteria are causing your indigestion.
- Antidepressants or anti-anxiety medications, which may ease the discomfort from indigestion by decreasing your sensation of pain.