Dyspepsia

Indigestion — also called dyspepsia or an upset stomach — is a general term that describes discomfort in your upper abdomen. Indigestion is not a disease, but rather some symptoms you experience, including abdominal pain and a feeling of fullness soon after you start eating. Although indigestion is common, how you experience indigestion may differ from other people. Symptoms of indigestion may be felt occasionally or as often as daily.

Indigestion can be a symptom of another digestive disease. Indigestion that isn’t caused by an underlying disease may be eased with lifestyle changes and medication.

Symptoms

People with indigestion may have one or more of the following symptoms:

  • Early fullness during a meal. You haven’t eaten much of your meal, but you already feel full and may not be able to finish eating.
  • Uncomfortable fullness after a meal. Fullness lasts longer than it should.
  • Discomfort in the upper abdomen. You feel a mild to severe pain in the area between the bottom of your breastbone (sternum) and your navel.
  • Burning in the upper abdomen. You feel an uncomfortable heat or burning sensation between the bottom of the breastbone and navel.
  • Bloating in the upper abdomen. You feel an uncomfortable sensation of tightness.

Less frequent symptoms include vomiting and belching. Sometimes people with indigestion also experience heartburn, but heartburn and indigestion are two separate conditions. Heartburn is a pain or burning feeling in the center of your chest that may radiate into your neck or back during or after eating.

Causes

Indigestion has many possible causes. Often, indigestion is related to lifestyle and may be triggered by food, drink or medication. Common causes of indigestion include:

  • Overeating or eating too quickly
  • Fatty, greasy or spicy foods
  • Too much caffeine, alcohol, chocolate or carbonated beverages
  • Smoking
  • Anxiety
  • Certain antibiotics, pain relievers and iron supplements
Sometimes indigestion is caused by other digestive conditions, including:
  • Gastritis
  • Peptic ulcers
  • Celiac disease
  • Gallstones
  • Constipation
  • Pancreas inflammation (pancreatitis)
  • Stomach cancer
  • Intestinal blockage
  • Reduced blood flow in the intestine (intestinal ischemia)

Indigestion with no obvious cause is known as functional dyspepsia or nonulcer stomach pain.

Complications

Although indigestion doesn’t usually have serious complications, it can affect your quality of life by making you feel uncomfortable and causing you to eat less. When indigestion is caused by an underlying condition, that condition can also have its own complications.

Tests and diagnosis

Your doctor is likely to start with a health history and a thorough physical exam. Those evaluations may be sufficient if your indigestion is mild and you’re not experiencing certain symptoms, such as weight loss and repeated vomiting.

But if your indigestion began suddenly, and you are experiencing severe symptoms or are older than age 50, your doctor may recommend:

  • Laboratory tests, to check for thyroid problems or other metabolic disorders.
  • Endoscopy, to check for abnormalities in your upper digestive tract. A tissue sample (biopsy) may be taken for analysis.
  • Imaging tests (X-ray or CT scan), to check for intestinal obstruction.

If initial testing fails to provide a cause, your doctor may diagnose functional dyspepsia.

Treatments and drugs

Lifestyle changes may help ease indigestion. Your doctor may recommend:

  • Avoiding foods that trigger indigestion
  • Eating five or six small meals a day instead of three large meals
  • Reducing or eliminating the use of alcohol and caffeine
  • Avoiding certain pain relievers, such as aspirin, ibuprofen and naproxen
  • Finding alternatives for medications that trigger indigestion
  • Controlling stress and anxiety

If your indigestion persists, medications may help. Over-the-counter antacids are generally the first choice. Other options include:

  • Proton pump inhibitors (PPIs), which can reduce stomach acid. PPIs may be recommended if you experience heartburn along with indigestion.
  • H-2-receptor antagonists (H2RAs), which also can reduce stomach acid.
  • Prokinetics, which may be helpful if your stomach empties slowly.
  • Antibiotics, if H. pylori bacteria are causing your indigestion.
  • Antidepressants or anti-anxiety medications, which may ease the discomfort from indigestion by decreasing your sensation of pain.