Dyspepsia, also known as indigestion, is a term that describes discomfort or pain in the upper abdomen. It is not a disease.

The term refers to a group of symptoms that often include bloating, discomfort, nausea, and burping.

In the majority of cases, indigestion is linked to eating or drinking. It can also be caused by infections or the use of certain medications.

What is dyspepsia?

Dyspepsia is a group of symptoms rather than a specific condition.

Most people with indigestion feel pain and discomfort in the stomach or chest. The sensation generally occurs soon after consuming food or drink. It may make a person feel full or uncomfortable during a meal, even if they have not eaten a large amount of food.

Dyspepsia symptoms

The following symptoms of dyspepsia are also common:

• nausea
• belching
• pain
• a feeling of fullness, or satiety
• feeling bloated

In very rare cases, indigestion may be a symptom of stomach cancer.

Mild dyspepsia rarely needs further investigation, and should not be a cause for concern. A visit to a doctor is only needed if symptoms continue for more than 2 weeks.

Seek emergency treatment if the pain is severe and any of the following also occurs:

• loss of appetite or weight loss
• vomiting
• inability to swallow
• black stools
• yellow coloring in the eyes and skin
• chest pain during exertion
• shortness of breath
• sweating
• chest pain that spreads to the jaw, arm, or neck

Heartburn and dyspepsia are often confused for one another, but they are two separate conditions despite regularly occurring at the same time. Heartburn is a symptom of acid reflux, described as a burning feeling behind the breastbone that usually occurs after eating.

Causes

Indigestion is usually caused by the lifestyle of an individual and the foods they eat. It can also be related to an infection or other digestive conditions.

The symptoms are normally triggered by stomach acid coming into contact with the mucosa. Stomach acids break down the mucosa, causing irritation and inflammation. This triggers the uncomfortable symptoms of indigestion.

Common causes of indigestion include:

• eating too much or too rapidly
• eating fatty, greasy, or spicy foods
• drinking too much caffeine or alcohol
• consuming too much chocolate or soda
• emotional trauma
• gallstones
• gastritis, or inflammation of the stomach
• hiatus hernia
• infection, especially with a bacteria called Helicobacter pylori (H. pylori)
• nervousness
• obesity
• pancreatitis, or inflammation of the pancreas
• peptic ulcers
• smoking
• certain medications, such as antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs)
• stomach cancer

When a doctor cannot find a cause for indigestion, the individual may have functional dyspepsia. This is a type of indigestion without any structural or metabolic disease to explain the symptoms. It may be caused by an impairment of the stomach that prevents it from accepting and digesting food in a normal way.

Diagnosis

Dyspepsia is mild and infrequent for most people with symptoms. In such cases, no treatment is needed.

People who experience regular indigestion or severe abdominal pain should see a primary care physician.

A doctor will ask the person experiencing dyspepsia about their symptoms. They will also find out about their medical and family histories and examine the chest and stomach. This may involve pressing down on different areas of the abdomen to find out whether any are sensitive, tender, or painful under pressure.

If the doctor suspects an underlying cause, they can use the following diagnostic tests to identify any underlying health problems:

• Blood test: If the person with indigestion also has any symptoms of anemia, the doctor may order a blood test.
• Endoscopy: People who have not responded to previous treatment for dyspepsia may be referred for a more detailed examination of the upper gastrointestinal (GI) tract. A long thin tube with a camera at the end is inserted through the mouth and into the stomach. This produces clear images of the mucosa. The doctor can also perform a biopsy during this procedure to test for cancer.
• Tests to diagnose H. pylori infection: These may include a urea breath test, a stool antigen test, and a blood test. An endoscopy would also identify H. pylori as well as any peptic ulcers that are present. Peptic ulcers are often caused by H. pylori.
• Liver function test: If the doctor suspects a problem with the bile ducts in the liver, they may request a blood test to assess how the liver is working.
• X-rays: X-ray images are taken of the esophagus, stomach, and small intestine.
• Abdominal ultrasound: High-frequency soundwaves make images showing movement, structure, and blood flow in the abdomen. A gel is applied to the abdomen and a hand-held device pressed against the skin. The device gives off sound waves, and the doctor can see a detailed picture of the inside of the abdomen on a monitor.
• Abdominal CT scan: This may involve injecting a dye into the veins. The dye shows up on the monitor. The CT scan takes a series of X-ray images to produce a 3D image of the inside of the abdomen.

Further examinations are often only used in severe cases.

Complications

Dyspepsia is mild and infrequent in most cases. However, severe indigestion can occasionally cause the following complications.

Esophageal stricture: Acid reflux can cause indigestion. This is a condition in which stomach acids leak back up into the esophagus and irritate the sensitive lining of the stomach, known as the mucosa. The irritation can scar the esophagus, which then becomes narrow and constricted.

People with esophageal stricture may start to find swallowing difficult. Food can get stuck in the throat, causing chest pain. Esophageal dilatation is sometimes needed to widen the esophagus.

Pyloric stenosis: This occurs when stomach acid causes long-term irritation of the lining of the digestive system. The pylorus is the passage between the stomach and the small intestine. In pyloric stenosis, it becomes scarred and narrowed. As a result, food is not properly digested.

Surgery may be required to widen the pylorus.

Treatments

Treatment for indigestion depends on the cause and severity of symptoms.

If symptoms are mild and infrequent, lifestyle changes will probably ease them. This usually involves consuming fewer fatty and spicy foods and less caffeine, alcohol, and chocolate. Sleeping for at least 7 hours every night may also help to ease mild indigestion.

Exercising regularly and quitting smoking are also important lifestyle changes in treating indigestion.

Medications

In severe or frequent cases of indigestion, a doctor may prescribe medication.

Antacids: These counter the effects of stomach acid. Examples include Alka-Seltzer, Maalox, Rolaids, Riopan, and Mylanta. These are over-the-counter (OTC) medicines that do not need a prescription. A doctor will usually recommend an antacid medication as one of the first treatments for dyspepsia.

H-2-receptor antagonists: These reduce stomach acid levels and last longer than antacids. However, antacids act more quickly. Examples include Zantac, Tagamet, Pepcid, and Axid. Some of these are OTC, while others are only available on prescription.

Some people may experience nausea, vomiting, constipation, diarrhea, and headaches after taking these. Other side effects may include bruising or bleeding.

Proton pump inhibitors (PPIs): Examples include Aciphex, Nexium, Prevacid, Prilosec, Protonix, and Zegerid. PPIs are highly effective for people who also have gastroesophageal reflux disease (GERD). They reduce stomach acid and are stronger than H-2-receptor antagonists.

Speak to a doctor about possible side effects.

Dyspepsia diet

A high-fiber diet is a good way to manage digestive health. It has the effect of clearing out the intestine and making digestion a smoother, cleaner process.

Fruits, nuts, legumes, and wholegrain foods are packed with fiber and an excellent choice for protecting against indigestion. Many yogurts and cereals have also been fortified with fiber.

Eating a balanced diet that excludes spicy or greasy foods is key. Be sure to consume fluids with every meal, as this helps to move food through the digestive tract.

Consuming four or five smaller meals in a day as opposed to three larger ones can also help the digestive system.