The term ‘indigestion’ is a layman’s term and is used to cover the symptoms of a few different medical conditions. It generally refers to an uncomfortable sensation in your lower chest or upper abdomen during or after a meal, perhaps accompanied by belching or bloating.
Some of the symptoms described as indigestion are pain and a feeling of fullness, discomfort or a burning sensation in the chest and upper abdomen (heartburn). Heartburn is caused by regurgitation of the acidic stomach contents up into the oesophagus and possibly the throat, known as gastro-oesophageal reflux by doctors.
Indigestion may be accompanied by other symptoms such as:
- upper abdominal discomfort;
- constipation or diarrhoea;
- loss of appetite;
- feeling full longer than you expect after a meal;
- vomiting; and
Indigestion mainly happens after a meal. Most people will suffer from episodes of indigestion from time to time — for example, if they eat too quickly, or eat too much. However, if you have a recurring problem or suddenly suffer from indigestion when you haven’t before, you should see your doctor.
Medical conditions that are often described as indigestion and which can have indigestion as a symptom include:
- gastro-oesophageal reflux disease;
- peptic ulcers;
- non-ulcer dyspepsia (when you have symptoms of an ulcer but no sign of ulcer on investigation);
- food intolerance, e.g. lactose intolerance; and
- bloating and flatulence.
What causes indigestion?
Some of the causes of indigestion include:
- anxiety or stress;
- eating too much, or too quickly;
- consuming alcohol when eating;
- intestinal diseases and disorders such as irritable bowel syndrome and gastritis (inflammation of the stomach);
- lactose intolerance;
- being overweight;
- swallowing excess air (aerophagia);
- some medicines;
- exercising with a full stomach; and
- stomach ulcers.
When to see your doctor about indigestion
Indigestion usually presents with only short-lived, minor symptoms, which happen to most people occasionally. However, sometimes indigestion can be an indication of a more serious condition. So see your doctor if any of the following happen:
- your indigestion persists for more than a few weeks;
- your indigestion does not respond to simple measures;
- you start to lose weight;
- you lose your appetite;
- you have nausea or vomiting;
- your indigestion is a new symptom for you;
- your pain is severe or wakes you at night, or
- you have pain on the top right-hand side of your abdomen.
This is particularly important if you are over 45 and have a history of gastrointestinal problems in the family, especially if you regularly take aspirin or pain killers, and regularly smoke or consume alcohol.
See your doctor urgently if you experience any of the following:
- prolonged vomiting, particularly if you are vomiting blood or material that looks like coffee grounds;
- pain in the chest, jaw, neck, arm or back;
- black stools; or
- difficulty swallowing.
Diagnosis and tests
If you have persistent or troubling indigestion, see your GP (general practitioner). Your doctor will ask about your symptoms and perform a physical examination looking for possible causes of your indigestion.
Your doctor may also suggest some tests.
- A gastroscopy is a type of endoscopy, where a long tube is passed down your throat to view your stomach and the first part of your small intestine. This test is usually done by a gastroenterologist (a specialist in digestive system disorders), so you will need a referral from your GP.
- If your doctor suspects gallstones, they may recommend you have an abdominal ultrasound scan.
- Blood tests and other imaging tests may also be recommended to help with the diagnosis.
Treatment for your indigestion will depend on the cause.
Your doctor can advise you whether medicines are necessary to treat your symptoms. They will also help you to identify any lifestyle triggers for your indigestion and suggest ways to modify your lifestyle and eating habits to try to avoid it. Examples of self-care measures for heartburn include eating smaller meals more frequently (rather than 3 large meals) and cutting down on particular foods and alcohol.