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Indigestion

Key points

  • Indigestion causes pain or discomfort in your upper abdomen (tummy) or chest, usually after you eat a meal.
  • Nearly everyone will get indigestion at some point in their life.
  • You can usually manage the symptoms of indigestion at home.
  • Medicines called antacids can relieve symptoms of indigestion by neutralising acid in your stomach.

Indigestion is a condition that causes symptoms such as pain or discomfort in your upper abdomen (tummy) or chest, usually after you eat a meal.

About indigestion

Indigestion (dyspepsia) is most common after eating but you can get it at any time. You might get it every day or once in a while. Nearly everyone will get indigestion at some point in their life.

Illustration showing the digestive system

Symptoms of indigestion

If you have indigestion, you may have one or more of the following symptoms.

  • Pain, fullness or discomfort in the upper part of your abdomen or chest.
  • A burning feeling (heartburn).
  • Feeling sick.
  • Belching.

Your symptoms may range from mild to severe, depending on what is causing your indigestion. They may also go very quickly, come and go, or they may be regular and last for a long time.

You probably won’t need to see your GP if you have these symptoms as you can usually manage them at home. However, if your symptoms are severe, come on after exercising or are different to your usual symptoms of indigestion, see your GP for advice. Also do this if your symptoms get worse, or don’t improve after you take over-the-counter medicines.

Indigestion can sometimes be a symptom of a more serious condition. See your GP if you have:

  • unexplained weight loss
  • persistent symptoms of indigestion for the first time and you’re 55 or older
  • difficulty swallowing
  • vomiting
  • blood in your vomit or faeces

Call for emergency help if you have:

  • tightness or heaviness in your chest
  • palpitations (when you can feel your heart beating fast or irregularly)
  • sweating
  • difficulty breathing

Occasionally a heart attack can cause indigestion-like symptoms.

Causes of indigestion

Indigestion can be caused by a number of health conditions (see Underlying health conditions below). You’re also more likely to get indigestion if you’re overweight. Sometimes the cause isn't clear. However, certain things may trigger the symptoms of indigestion, such as:

  • drinking too much alcohol
  • eating certain foods, such as spicy or fatty foods
  • smoking
  • stress and anxiety
  • medicines, such as aspirin and non-steroidal anti-inflammatory medicines (NSAIDs)

Underlying health conditions

Some health conditions can cause symptoms of indigestion.

  • Having a peptic ulcer can cause symptoms of indigestion. This is a break in the lining of your stomach or small bowel. You can get a peptic ulcer if stomach acid, which helps digest your food, damages your stomach lining. Bacteria called Helicobacter pylori that sometimes live in your stomach can also damage your stomach lining by increasing acid production. However, not everybody infected with H. pylori will get a peptic ulcer.
  • A condition called gastro-oesophageal reflux disease (GORD) may cause indigestion. This is when acid leaks out of your stomach and into your oesophagus (the pipe that goes from your mouth to your stomach).
  • Stomach (gastric) cancer can also cause the symptoms of indigestion.
  • Other conditions can cause symptoms that are the same as those of indigestion. Occasionally these can be caused by a heart attack.

Pregnancy

You may get indigestion during pregnancy. This may be triggered by changes to the levels of the female hormones progesterone and oestrogen. As your uterus (womb) expands to accommodate your growing baby, this may also cause symptoms of indigestion as it presses on your stomach.

Diagnosis of indigestion

Your GP will ask about your symptoms and examine you. He or she will also ask you about your medical history.

If you have made changes to your lifestyle and taken medicines for indigestion but they haven't improved your symptoms, your GP may recommend further tests. These may include the following.

  • Breath tests, blood tests or faecal (stool) tests. These will detect H. pylori.
  • An upper gastrointestinal endoscopy (gastroscopy). This is a procedure to look inside your oesophagus, stomach and the first part of your small bowel (duodenum). During a gastroscopy, your doctor may take a biopsy (a small sample of tissue). This will be sent to a laboratory for testing.
  • A barium meal X-ray. If you have a barium meal, you will be asked to drink fluid containing barium (a substance that shows up on X-rays). X-ray images of your abdomen will then show the inside of your stomach and small bowel more clearly.

Treatment of indigestion

Self-help

There are a few things you can do to reduce the symptoms of indigestion, which include the following.

  • Lose excess weight.
  • Cut down on foods that you think may trigger your symptoms. It may help to keep a food diary to track what you eat and your symptoms.
  • Stop smoking.
  • Drink less alcohol.
  • Sleep in a more upright position by raising the head of your bed with blocks of wood or bricks.
  • Don’t eat within three to four hours of going to bed.
  • Try to reduce your stress levels.
  • Eat a healthy, balanced diet.
  • Don’t eat too much or too quickly.

Medicines

Over-the-counter medicines

You can buy a range of indigestion medicines from your pharmacist without a prescription. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Antacids are medicines that can relieve symptoms of indigestion by neutralising acid in your stomach. They usually contain magnesium or aluminium. They work quickly but usually only for a short time.

If antacids don’t work, or you need to take them frequently to relieve your symptoms, your pharmacist may recommend H2 receptor antagonists (H2RAs). These work by reducing the amount of acid that your stomach produces. They don’t work as quickly as antacids but their effect lasts for longer. Examples of H2RAs are cimetidine and ranitidine.

If your symptoms continue, your pharmacist may suggest you try a low dose of another type of medicine called a proton pump inhibitor. Proton pump inhibitors work by reducing your stomach acid. You can take an over-the-counter proton pump inhibitor for up to four weeks.

Prescription-only medicines

If a proton pump inhibitor controls your symptoms well, your GP may prescribe you one for longer-term use (depending on your individual circumstances). Your GP will usually suggest you take a lower dose once your symptoms are under control. Alternatively, you may be prescribed a H2RA. Ask your GP for more information.

If you have an H. pylori infection, your GP may recommend you take a combination of antibiotics to kill off the bacterial infection. To get rid of H. pylori you usually need to take a proton pump inhibitor combined with two different antibiotics for a week.

Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

Surgery

Surgery for indigestion is now rare. However, if your quality of life is severely affected you may be offered an operation. You will usually only be recommended surgery if medicines haven’t worked or you don’t want to take proton pump inhibitors for long periods of time.

Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, May 2014.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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