Indigestion

Did you know?

• More than 1 in 10 people suffer with indigestion
• Half of all pregnant women are thought to suffer with indigestion
• Around 6 in 10 people with recurring bouts of indigestion have non-ulcer dyspepsia

Causes of indigestion

Indigestion is the irritation of the lining of the oesophagus, stomach or duodenum (the upper part of the small intestine) by stomach acid. This triggers symptoms such as pain and discomfort in the abdomen, heartburn and nausea.

In the majority of cases, indigestion is caused by acid reflux (acid from the stomach being forced into the oesophagus) but indigestion can be a sign of an underlying health problem if symptoms are persistent.

Medical conditions which can cause indigestion include:

H pylori infection – The Heliobacter pylori bacteria can be a cause of frequent bouts of indigestion. The infection can damage the stomach lining causing a build up of acid.

Hiatus hernia – This type of hernia is caused by part of the stomach pushing up into the diaphragm and preventing the oesophageal sphincter from closing properly. This results in stomach acid escaping into the oesophagus.

Gastro-oesophageal reflux disease (GORD) – Known as 'acid reflux', this is a chronic problem caused by the weakening of the muscle which allows food to pass into the stomach at the base of the oesophagus (the oesophageal sphincter). After opening, the muscle fails to close properly causing stomach acid to escape back up into the gullet.

Medications – Aspirin and ibuprofen can trigger indigestion particularly if previous stomach problems such as ulcers have been diagnosed.

Obesity – Obesity places excess pressure on the abdomen forcing the muscle at the opening of the stomach (known as the oesophageal sphincter) to open and stomach acid to escape into the oesophagus (gullet).

Peptic ulcers – Often referred to as stomach ulcers, peptic ulcers can also appear at the top of the small intestine (duodenum) and form from damage to the lining of the stomach or duodenum wall by stomach acid. Peptic ulcers usually occur due to an H pylori bacterial infection.

Stomach cancer – Persistent indigestion can be a symptom of stomach cancer as cancerous cells break down the mucosa (the protective sticky lining in the stomach) allowing acid to irritate the stomach wall.

Symptoms of indigestion

The common symptom of indigestion is pain or discomfort in the abdominal area or chest usually after eating or drinking. However, indigestion can be delayed with a few hours passing between eating and the symptoms appearing.

Indigestion pain is often described as an aching, heavy sensation or burning in the stomach and chest. Heart burn may also be experienced and is a burning sensation behind the breastbone.

Other symptoms that may accompany indigestion include:

• Wind
• Nausea
• Feeling full (bloated)

You should seek medical treatment immediately if you experience recurring indigestion and you:

• Are aged over 55
• Have unexplained weight loss
• Have difficulty swallowing
• Have frequent bouts of vomiting
• Feel tired
• Feel breathless
• Have an irregular heart beat
• Have a lump in your stomach

In rare cases this may be a sign of stomach cancer.

Diagnosis of indigestion

In the majority of cases, indigestion is mild and happens infrequently so a diagnosis from a healthcare professional is not necessary. If you're experiencing frequent bouts of indigestion which is causing pain or discomfort and having an impact on your life then in the first instance you should visit your GP.

Your GP will examine your abdominal area pressing gently to see if you experience any pain. The GP may also refer you for blood tests to check if you're anaemic (lacking red blood cells).

If the GP needs to investigate the cause of your indigestion further, they may refer you for an endoscopy. This will take place in hospital and a surgeon will examine your oesophagus and stomach using a long thin tube with a camera at one end. This is gently fed down the throat and into the stomach.

If you have previously been prescribed proton pump inhibitors (PPIs) or H2-recepter antagonists for your stomach problems then you'll need to stop taking these two weeks before your procedure as these medications can mask some of the problems that would otherwise be picked up.

If an H pylori infection is suspected, your GP can use a number of tests to identify the bacteria. The tests are: a urea breath test, a stool antigen test or a blood test.

Related terms

Abdominal pain
Stomach ache
Stomach upset
Bloated
Overeating
Dyspepsia
Antacids
PPIs
Acid reflux
Heartburn
Digestion