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by Scheinberg D
(Dyspepsia; Non-ulcer Dyspepsia; Non-ulcer Stomach Pain)

Definition

Indigestion is discomfort in the upper belly or chest. It may result in pain or a burning feeling after eating. A person may also have nausea, belching, or bloating.

Location of Indigestion Symptoms
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Causes

The exact cause is not known. It is due to an action in the stomach or intestine.

Most often, it is linked to unhealthy lifestyle habits. These habits can make it hard for the body to properly digest food.

Risk Factors

These lifestyle habits may raise the risk:

  • Overeating
  • Eating too quickly or at irregular intervals
  • Eating greasy, high-fat, or spicy foods
  • Drinking large amounts of caffeine, alcohol, or soft drinks
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
  • Smoking
  • Stress

Symptoms

Problems may be:

  • Pain or burning in the upper belly or chest
  • Nausea
  • Abdominal bloating
  • Burping or swallowed food that comes back up to the mouth

When Should I Call My Doctor?

It is common to have indigestion from time to time. If it gets worse or happens more often, make an appointment to see the doctor.

You should also call the doctor if you have:

  • Trouble swallowing
  • Vomiting with most episodes
  • Weight loss
  • A family history of cancer
  • Been taking medicines for more than one month to try to ease symptoms

When Should I Call for Medical Help Right Away?

Most indigestion is not serious. However, sometimes it is a sign of a more serious health problem. Call for medical help or go to the emergency room right away if you have:

  • Severe belly pain
  • Bloody or dark black stool
  • Bloody vomit
  • Problems breathing
  • Chest pain

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

Underlying causes will need to be treated. The goal of treatment is to manage symptoms. Choices are:

Diet and Lifestyle Changes

It may help to eat smaller meals throughout the day instead of three large meals. A dietitian can help with meal planning. Avoiding foods and drinks that trigger symptoms may also help, such as:

  • Eating less fatty and spicy foods
  • Drinking less alcohol, caffeine, and fizzy drinks
  • Eating foods that contain probiotics, such as yogurt

Lifestyle changes that may help are:

  • Not smoking
  • Avoiding nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen

Medications

Medicines may be given to ease symptoms, such as:

  • Antacids and acid suppression agents to control stomach acid
  • Prokinetic agents to help the stomach empty more quickly

Probiotics and prebiotics may also be advised.

People who are not helped by these methods may benefit from counseling. It may help ease symptoms.

Prevention

Healthy diet and lifestyle habits may lower the risk of indigestion.

  • Not overeating
  • Eating slowly and regularly
  • Avoiding greasy, high-fat foods
  • Limiting spicy foods
  • Not smoking
  • Limiting alcohol, caffeine, and fizzy drinks

RESOURCES

American College of Gastroenterology  http://gi.org 

American Gastroenterological Association  http://www.gastro.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

The College of Family Physicians of Canada  http://www.cfpc.ca 

References

Chisty A. (2021). Update on Indigestion. The Medical clinics of North America, 105(1), 19–30.

Dyspepsia. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/dyspepsia. Accessed February 3, 2021.

Functional dyspepsia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/functional-dyspepsia. Accessed February 3, 2021.

Indigestion (dyspepsia). National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia. Accessed February 3, 2021.

Moayyedi PM, Lacy BE, et al. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.

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