Overview

Indigestion or an upset stomach is a term used to describe discomfort in the upper part of the abdomen. It is not a disease or disorder, but instead, some type of symptoms that you experience, such as the feeling of fullness or stomach pain right after you begin eating. Even if indigestion is quite popular, experiences with this symptom vary from person to person. Symptoms of indigestion vary in frequency from daily to occasionally. Furthermore, indigestion can also be an indication of another digestive disorder. Indigestion that is not caused by a specific disorder might be relieved with medication and lifestyle changes.

Causes of Indigestion

Stomach acid exposed to the protective and sensitive lining of the digestive system, which is called mucosa, may cause indigestion. Then, the stomach acid performs what it does best and breaks down the lining, resulting in inflammation and irritation, which is often very painful. In most cases of indigestion, the patients don’t experience any inflammation in their digestive system. Instead, the symptoms are usually due to the high sensitivity of the mucosa, which further leads to stretching or acidity and nausea.

Indigestion is usually a symptom of various kinds of medical conditions. It is typically associated with a functional complication of the gastrointestinal tract, which could result in problems processing stomach acids and foods. Lifestyle, medications, and illnesses often cause this complication of the gastrointestinal system.

Furthermore, anxiety and stress can also impact the body and increase the risk and symptoms that are associated with indigestion. Physiological stress caused by stress and anxiety can significantly impact indigestion. Since anxiety, diet, and lifestyle, or an underlying health problem, can trigger indigestion diagnosis might be difficult. Consult your doctor to determine if anxiety is the number one cause of your indigestion, and to assist you in handling your anxiety if it is improving the symptoms of indigestion.

The health conditions and illnesses that may cause indigestion include the following:

• Esophagitis
• Ulcers (duodenal or gastric ulcer)
• Hiatal hernia
• GERD or gastroesophageal reflux disease
• Pregnancy (particularly later-term)
• Gallstones
• Food poisoning and stomach infections
• Inflammation of the pancreas (chronic or acute pancreatitis)
• Irritable bowel syndrome or IBS
• Inflammation of the stomach (chronic or acute gastritis)
• Stomach cancer
• Depression
• Thyroid disease
• Heart attack, angina, heart disease
• Food sensitivities or allergies like lactose intolerance
• Gastroparesis, a condition wherein the abdomen doesn’t digest appropriately; it usually occurs among people with diabetes

The medications that can cause indigestion include the following:

• Oral contraceptives and estrogen
• Aspirin and other types of painkillers like nonsteroidal anti-inflammatory drugs or NSAIDs
• Medication for thyroid
• Steroids including Decadrone, prednisone, and methylprednisolone (such as Medrol Dosepak and Medrol)
• Medications for blood pressure
• Medications for pain like codeine and other forms of narcotics
• Antibiotics including tetracycline and erythromycin
• Medications for cholesterol such as statins

The lifestyle factors that can cause indigestion are:

• caffeine
• smoking
• too much alcohol intake
• anxiety, fatigue, and stress
• eating too fast or eating too much
• moderate to extreme exercise right after eating
• consuming spicy, greasy, or fatty foods

Diagnosis and Treatment

It is best to consult your primary care doctor (family or general practitioner) to diagnose your indigestion. It might be necessary to refer you to a gastroenterologist, an expert in complications that are related to the gastrointestinal or GI tract. If your complication demands surgery like severe gallstones or ulcers, see a general surgeon.

Apart from the physical tests and questions about the symptoms you experience, the doctor might carry out these tests:

• Blood tests
• kidney function test
• lipase, amylase, liver panel (particularly for pancreatitis)
• complete blood count or CBC
• guaiac test (a specific test that for blood in the stool)
• Esophagogastroduodenoscopy (endoscopy or EGD)
• capsule endoscopy
• Abdominal ultrasound
• Helicobacter pylori or H. Pylori testing, either through a breath test or stool test
• Colonoscopy
• Gastric emptying study
• MRI or CT scan of the abdomen
• small bowel or Upper GI X-ray series

Since indigestion is usually a symptom of underlying health conditions, the treatment often varies according to the cause. If the cause is related to lifestyle, the most effective way to address the symptoms is prevention. 

Several over-the-counter medications might also help reduce indigestion pain. These include:

• acid blockers such as omeprazole (Prilosec OTC) or ranitidine (Zantac)
• antacids including Rolaids or Tums

Other indigestion treatments to relieve the symptoms include the following:

• drink water or milk to alleviate the stomach acid
• Don’t lay down flatly since doing this can worsen the symptoms

If indigestion is due to severe ulcers, gastritis, stomach acid, esophagitis, or GERD, the doctor might prescribe strong and powerful acid blockers, including:

• dexlansoprazole (Dexilant)
• esomeprazole (Nexium)
• pantoprazole (Protonix)
• omeprazole (Zegerid, Prilosec)
• rabeprazole (Aciphex)
• lansoprazole (Prevacid)

A few of the medications above have available over-the-counter or OTC forms. If Helicobacter pylori or H. Pylori is the cause of indigestion, doctors prescribe acid blockers for several months. If gastroparesis causes indigestion, prescribing pro-motility drugs like metoclopramide (Raglan) is necessary.

If the primary cause of indigestion is associated with anxiety or depression, the doctor might suggest antidepressants for a short period. If the primary cause of indigestion is determined to be a medication that you are presently consuming, don’t suddenly discontinue the medication. Consult with your doctor or physician to know about any significant alternatives to ease indigestion. Lastly, if the indigestion is due to lifestyle choices, the above medications might help ease the symptoms. However, significant lifestyle changes such as decreasing stress, eating a well-balanced diet, and quitting smoking can yield excellent results for your condition. 

What are the normal conditions?

Most cases of indigestion usually subside after a few hours without the need to take any medication or see a doctor. Indigestion generally affects the abdomen and its ability to digest food and process stomach acids. About this, it is incredibly vital to maintaining the normal function of your stomach to avoid indigestion. You must:

• avoid greasy and spicy foods
• chew food carefully and eat at a slow pace
• avoid late-night eating
• drink liquids after each meal instead of during
• avoid alcoholic drinks
• stop smoking
• avoid caffeine
• always drink NSAIDs and aspirin with food
• wait for about one after eating before you exercise
• meditate to help relieve indigestion if it is due to anxiety or stress
• avoid eating aggravating foods especially if you are allergic to particular food or lactose intolerant 

Risk of having indigestion

If you ignore the symptoms, even if this is a prevalent condition, indigestion can lead to life-threatening health complications. Indigestion affects people of all ages, and there are certain groups of individual that are at higher risk, including those that:

• utilize drugs that can irritate or upset the stomach
• consume too many alcoholic beverages
• have emotional problems including depression or anxiety
• have other functional complications like gastroesophageal reflux disease

Severe and untreated indigestion can also result in more significant health complications, including:

• Pyloric stenosis – caused by long-term damage to the lining of the digestive system due to stomach acid.
• Oesophageal stricture – caused by long-term irritation to the mucosa
• Peritonitis – caused by severe and long-term indigestion that infects the peritoneum or intestinal tract lining

When to seek medical attention

There is no need to worry about mild indigestion. Reach out to your doctor or healthcare provider in case the discomfort continues for over two weeks. Call your doctor as soon as possible if the pain starts to become severe or accompanied by the following:

• Continuous vomiting or vomiting that comes with blood that can be vibrant red or dark-colored, almost similar to coffee grounds
• Unexplained loss of appetite or weight loss
• Weakness or fatigue that could be a sign of anemia
• Problems swallowing that progresses and worsens
• Black, tarry stools or appearance of blood in stools
• Jaundice or yellow coloring of the eyes and skin
• extreme pain in the upper right abdomen
• Abrupt, severe stomach pain, specifically on the right portion where the appendix, gallbladder, and liver are situated
• the discomfort that is not related to eating
• fainting, dizziness, and light-headedness due to symptoms 

Heart attacks might cause specific symptoms that are usually mistaken for indigestion. Seek medical attention immediately in case you experience any of these:

• chest pain due to exertion or stress
• sweating, shortness of breath, or chest pain that spreads up to the arm, neck, and jaw

Table of Medications

• omeprazole
• ranitidine
• Prilosec
• Zantac
• Pepto-Bismol
• Prilosec OTC
• famotidine
• Milk of Magnesia
• Kaopectate
• Pepcid