Indigestion

Indigestion is not a distinct condition, but it may be a sign of an underlying intestinal disorder such as peptic ulcer, gallbladder disease or chronic appendicitis.

Indigestion, also known as upset stomach or dyspepsia, is a painful or burning feeling in the upper abdomen. 

What are some of the symptoms associated with indigestion?
Some characteristic symptoms of indigestion are burning in the stomach or upper abdomen, heartburn, abdominal pain, bloating (full feeling), belching and gas, nausea, vomiting, acidic taste, "growling" stomach, and sometimes diarrhea.  Symptoms of indigestion usually increase in times of stress, and decrease in times of relaxation. 

Who is at greater risk for having indigestion?
People of all ages and of both sexes are affected by indigestion. An individual's risk is increased with excess alcohol consumption, use of drugs that may irritate the stomach, other functional disorders such as gastroesophageal reflux disease (GERD), and emotional problems such as anxiety or depression. 

What causes indigestion?
A disease or an ulcer in the digestive tract might cause indigestion. However, for most people, it is the result of eating too much, eating too fast, eating high-fat foods, or eating during stressful situations. Indigestion is not caused by excess stomach acid. Swallowing excessive air when eating may increase the symptoms of belching and bloating which are often associated with indigestion. Some medications can also irritate the stomach lining and cause indigestion.

Being tired or stressed, smoking, or drinking too much alcohol or caffeinated beverages can cause indigestion or make it worse. These factors can also worsen underlying conditions that cause indigestion, such as hiatal hernias and gastroesophageal reflux disorder (GERD). Emotional stress or other psychological conditions may result in abdominal pain.

Sometimes people have persistent indigestion that is not related to any of these factors. This type of indigestion is called functional, or nonulcer, and is caused by a problem associated with how food moves through the digestive tract. 

How is indigestion diagnosed?
Because indigestion is such a broad term, it is helpful to provide your physician with a precise description of the discomfort you are experiencing. In describing the symptoms, try to define where in the abdomen the discomfort usually occurs. Simply reporting indigestion as pain in the stomach is not detailed enough for your physician to help identify and treat your problem.

To diagnose indigestion, your physician must first rule out any underlying conditions such as ulcers. You may have X-rays of the stomach or small intestine. Your physician may also use an instrument to look closely at the inside of the stomach, referred to as an endoscope. An endoscope is a flexible tube that contains a light and a camera to produce images of the stomach and intestines in a procedure called endoscopy. A gastroscopy is a similar procedure used to evaluate just the inside of the stomach. 

How can indigestion be treated?
Because indigestion is a symptom rather than a disease, treatment usually depends upon the underlying condition causing the indigestion. Keep in mind that excess stomach acid does not cause indigestion, so using antacids will not help your indigestion.

Often, episodes of indigestion go away within hours without medical attention. However, if your symptoms become worse, you should consult a physician. Avoiding foods and situations that cause indigestion are the best ways to treat it. Changing the following eating habits that cause you to swallow too much air can help relieve indigestion:

• chewing with your mouth open, 
• talking while chewing and
• eating food too fast

Drink fluids after rather than during meals, and avoid late-night eating. Try to relax after meals. Avoid spicy foods, smoking, and alcoholic beverages. Sometimes aspirin can irritate the stomach lining. If this occurs, switch to acetaminophen.

If indigestion is a functional, or nonulcer condition, your physician may prescribe medications that affect stomach function.

How can indigestion be prevented?
The best way to treat indigestion is to prevent it by avoiding the foods and situations that seem to cause indigestion. Keeping a food diary is helpful in identifying foods that cause indigestion. Here are some other suggestions:

• Eat small meals so the stomach does not have to work as hard or as long.
• Eat slowly.
• Avoid foods that contain high amounts of acids, such as citrus fruits and tomatoes.
• Caffeine causes the stomach to produce more acid, so reduce or avoid foods and beverages that contain caffeine.
• If stress is a trigger for your indigestion, reevaluating your lifestyle may help to reduce stress. Learn new methods for managing stress, such as relaxation and biofeedback techniques.
• Smokers should consider quitting smoking, or at least not smoking right before eating, as smoking can irritate the stomach lining.
• Cut back on alcohol consumption because alcohol can irritate the stomach lining.
• Avoid wearing tight-fitting garments because they tend to compress the stomach, which can cause its contents to enter the esophagus.
• Do not exercise with a full stomach. Rather, exercise before a meal or at least one hour after eating a meal.
• Do not lie down right after eating.
• Wait at least 3 hours after your last meal of the day before going to bed.
• Sleep with your head elevated (at least six inches) above your feet and use pillows to prop yourself up. This will allow digestive juices to flow into the intestines rather than to the esophagus.

When should I call the doctor?
Because indigestion can be a sign of a more serious health problem, call your physician if you have any of the following symptoms:

• Vomiting or blood in vomit (the vomit may look like coffee grounds)
• Weight loss
• Loss of appetite
• Black, tarry stools or visible blood in stools
• Severe pain in upper right abdomen
• Discomfort unrelated to eating

Symptoms similar to indigestion may be caused by heart attacks. If indigestion is accompanied by shortness of breath, sweating, or pain radiating to the jaw, neck or arm, seek medical attention immediately.