Indigestion

Definition

Indigestion is a vague feeling of abdominal discomfort -- possibly including belching, heartburn, a feeling of fullness, bloating, and nausea.

Alternative Names

Dyspepsia; Uncomfortable fullness after meals

Considerations

Indigestion is usually not a serious health problem, unless other symptoms also occur such as weight loss or trouble swallowing.

Indigestion is a common problem. It may be triggered by eating particular foods, or drinking alcoholic or carbonated drinks. It may also be caused by eating too fast or by overeating. Some people may find that spicy foods, high-fiber foods, fatty foods, or too much caffeine can all make this problem worse. Symptoms may be worsened by anxiety and depression.

Rarely, the discomfort of a heart attack is mistaken for indigestion.

Common Causes

• Drinking too much alcohol
• Eating spicy foods
• Eating fatty or greasy foods
• Eating too much (overeating)
• Eating too fast
• Emotional stress or nervousness
• Gallstones
• Inflammation of the pancreas (acute or chronic pancreatitis)
• Inflammation of the stomach (acute or chronic gastritis)
• Tobacco smoking
• Too much caffeine
• Ulcers (gastric or duodenal ulcer)
• Use of certain drugs such as antibiotics, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs)

Home Care

• Allow enough time for meals.
• Chew food carefully and completely.
• Avoid arguments during meals.
• Avoid excitement or exercise immediately after a meal.
• A calm environment and rest may help relieve stress-related indigestion.
• Avoid aspirin and other NSAIDs. If you must take them, do so on a full stomach.
• Antacids may relieve indigestion. Stronger medications are available over-the-counter, such as ranitidine (Zantac) and omeprazole (Prilosec OTC). Your doctor may prescribe similar medications in higher doses or for longer periods of time than over-the-counter drugs recommend.

Call your health care provider if

Seek immediate medical help if your symptoms include jaw pain, chest pain, back pain, profuse sweating, anxiety, or a feeling of impending doom. These are possible heart attack symptoms.

Call your health care provider if:

• Indigestion symptoms change noticeably
• Symptoms last longer than a few days
• You have unexplained weight loss
• You have sudden, severe abdominal pain
• You have trouble swallowing
• You have yellow coloring of the skin and eyes (jaundice)
• You vomit blood or pass blood in the stool

What to expect at your health care provider's office

Your doctor will perform a physical examination, paying special attention to the stomach area and digestive tract. You will be asked questions about your symptoms, including:

• Does the discomfort begin or get worse after eating particular foods?
• Does it begin or get worse after drinking alcoholic or carbonated drinks?
• Do you eat fast?
• Have you been overeating?
• Have you changed your diet?
• Have you had any spicy, high-fiber, or fatty foods?
• Do you drink a lot of caffeinated beverages (tea, soda, coffee)?
• What medications are you taking?
• Have you changed medications recently?
• What other symptoms do you have? For example, stomach pain or vomiting.

The following tests may be performed:

• Abdominal ultrasound
• Blood tests (depending on the suspected cause)
• Esophagogastroduodenoscopy (EGD )
• Upper GI and small bowel series

References

Talley N. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, and noncardiac chest pain. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 139.