Indigestion symptoms, causes and treatments

Most of us know the discomfort and pain of indigestion (known to medical professionals as dyspepsia). If we’re lucky, it can just cause mild discomfort but it can be accompanied by other uncomfortable symptoms. These can include 

• feeling over-full or bloated
• burping
• retching
• feeling and being sick
• having pain in your upper abdomen that may reach as far as your back

Acid reflux, where the acid in your stomach comes back up into your oesophagus, is another cause of indigestion, and may create a painful burning feeling, known as heartburn. However, your doctor is more likely to refer to this as a separate condition - gastro-oesophageal reflux (GORD).

Indigestion is a symptom rather than a condition, and the symptoms you have can help identify the cause of your indigestion.  

For instance, if you don’t have indigestion very often, it may be due to something you’ve just eaten. A large, rather heavy meal, spicy or fatty food or just eating too quickly can bring on indigestion. 

Steadily eating too much over a relatively short period of time – at Christmas for instance – can easily cause indigestion. 

Common causes of indigestion

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are major causes of stomach ulcers, which cause indigestion. These drugs damage the mucus that lines the stomach and protects it. Damaging this coating of mucus allows the acid in the stomach to make contact with the lining of the stomach, creating stomach ulcers. 

Stomach ulcers (gastric and duodenal), are a well-known cause of indigestion. The Helicobacter pylori bacteria (H.pylori), is another main cause of stomach ulcers. Some people are more affected by these bacteria than others, and it appears that smokers may be at greater risk of reacting to them. 

Some families appear to be more prone to stomach ulcers, so there may be a hereditary risk. And you may be infected with H.pylori without realising it, as it doesn’t always produce symptoms. However, if you suffer from indigestion it’s worth talking to your GP about having a test for H.pylori. 

Treatment for indigestion

You can start combating mild and occasional indigestion with some self-help measures.

• Keep a diary of what you were eating, and what you were doing immediately before recent bouts of indigestion. This may help you pin down the cause of your discomfort. If you can see that indigestion tends to follow large, fatty or spicy meals, try to steer clear of these for a month or two, and see if the indigestion returns.
• It may be that particular foods, for instance cucumbers, tomatoes, bananas and citrus fruit, trigger digestive pain. Keeping a food diary can help you identify probable culprits, that you can then avoid.
• You should also think about cutting back on cigarettes etc. if you smoke, look at how you eat – whether you’re always rushing -  and whether your medicine could be to blame.

Talk to your pharmacist about indigestion

It’s worth talking to your local pharmacist, to see what they recommend for treating indigestion. Many patients manage the discomfort of indigestion with over-the-counter medicines bought from their pharmacy.

If these don’t work, or if you’re having indigestion more often, and it’s more painful and you’re 55 years old or over, or you’re losing weight unintentionally, it’s time to see your GP. If you’re worried you may have signs of internal bleeding, get medical advice as soon as possible.

Talk to your GP about indigestion

If your GP is concerned about your symptoms, they may refer you for an upper gastrointestinal endoscopy (gastroscopy). This involves having an endoscope (a fibre-optic telescope) passed in through your mouth, and down your oesophagus, to your stomach. Once in place, it can provide important information about your gullet and stomach, and allows your specialist to take samples.

If you don’t want to have an endoscopy, there are alternatives. Your doctor can take a blood sample for testing, to see if you have H.pylori. If this is positive, your GP can prescribe antibiotics to treat the infection. They may then be able to arrange a breath test to see if the infection has cleared up. 

Indigestion is rarely a sign of something more serious, but don’t ignore it if it becomes severe, and doesn’t clear up or keeps returning.