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Indigestion

Definition

Indigestion (dyspepsia) is a vague feeling of discomfort in the upper belly or abdomen during or right after eating. This may include:

• A feeling of heat, burning, or pain in the area between the navel and the lower part of the breastbone
• A feeling of fullness that is bothersome and occurs soon after the meal begins or when it is over

Bloating or nausea are less common symptoms.

Indigestion is NOT the same as heartburn.

Alternative Names

Dyspepsia; Uncomfortable fullness after meals

Considerations

Indigestion is usually not a sign of a more serious health problem, unless other symptoms also occur, such as weight loss or trouble swallowing.

Indigestion is a common problem.

Rarely, the discomfort of a heart attack is mistaken for indigestion.

Common Causes

Indigestion may be triggered by:

• Drinking too much alcohol
• Eating spicy, fatty, or greasy foods
• Eating too much (overeating)
• Eating too fast
• Emotional stress or nervousness
• High-fiber foods
• Tobacco smoking
• Too much caffeine

Other causes of indigestion are:

• Gallstones
• Gastritis (when the lining of hte stomach becomes inflamed or swollen)
• Swelling of the pancreas (pancreatitis)
• Ulcers (stomach or intestinal ulcer)
• Use of certain drugs such as antibiotics, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs)

Home Care

Changing the way you eat may relieve your symptoms.

• Allow enough time for meals.
• Chew food carefully and completely.
• Avoid arguments during meals.
• Avoid excitement or exercise right after a meal.
• A calm environment and rest may help relieve stress-related indigestion.

Avoid aspirin and other NSAIDs. If you must take them, do so on a full stomach.

Antacids may relieve indigestion.

Medications you can buy without a prescription, such as ranitidine (Zantac) and omeprazole (Prilosec OTC) can relieve symptoms. Your doctor may also prescribe these medicines in higher doses or for longer periods of time.

Call your health care provider if

Seek immediate medical help if your symptoms include jaw pain, chest pain, back pain, profuse sweating, anxiety, or a feeling of impending doom. These are possible heart attack symptoms.

Call your health care provider if:

• Indigestion symptoms change noticeably
• Symptoms last longer than a few days
• You have unexplained weight loss
• You have sudden, severe abdominal pain
• You have trouble swallowing
• You have yellow coloring of the skin and eyes (jaundice)
• You vomit blood or pass blood in the stool

What to expect at your health care provider's office

Your doctor will perform a physical examination, paying special attention to the stomach area and digestive tract. You will be asked questions about your symptoms, including:

• Does the discomfort begin or get worse after eating certain foods?
• Does it begin or get worse after drinking alcoholic or carbonated drinks?
• Do you eat quickly?
• Have you been overeating?
• Have you changed your diet?
• Have you had any spicy, high-fiber, or fatty foods?
• Do you drink a lot of caffeinated beverages (tea, soda, coffee)?
• What medications are you taking?
• Have you changed medications recently?
• What other symptoms do you have? For example, stomach pain or vomiting.

The following tests may be performed:

• Abdominal ultrasound
• Blood tests (depending on the suspected cause)
• Esophagogastroduodenoscopy (EGD )
• Upper GI and small bowel series

Prevention

References

Tack J. Dyspepsia. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 13.

Talley N. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, and noncardiac chest pain. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 139.