Indigestion: Causes, Signs, Symptoms, and Treatment

Understanding Indigestion: Causes, Symptoms, and Treatment

Indigestion, or dyspepsia, is a widespread problem with eating, and most people will have it at some time in their lives. Dyspepsia is the medical term given to a group of symptoms occurring in the upper abdomen. Although indigestion is not usually serious, it can be uncomfortable and tend to impact on the quality of life. In this article, we will be looking at what indigestion is, the causes, symptoms, and treatment options.

What is Indigestion?

The term indigestion covers a global spectrum of symptoms that can occur in the upper digestive tract (i.e, stomach) including a sensation of fullness and bloating, an excessive amount of gas generation (e.g, belching), nausea, and, on occasion, a burning sensation in the stomach and upper abdomen. It is an umbrella term that lacks a defined anatomical border and collectively describes a spectrum of symptoms. Indigestion is not a disease alone, but the presentation of symptoms that could be caused by a range of underlying reasons.

Prevalence and Risk Factors

Indigestion has a global prevalence of 7-40%. The prevalence varies with the geographical region. Estimates on its incidence for Western countries stand at around 25% versus a prevalence rate of 7.6–49% in India. The geographical studies from Asia mirror the global figure with a prevalence rate of 10-20%.

It can happen at any age but if you’re older you’re more likely to have it. Indigestion is more common in women than in men, and it’s a condition more common during pregnancy.

Some health problems, including anxiety disorders, depression and irritable bowel syndrome (IBS) make you more likely to suffer from indigestion pain.

Causes of Indigestion

There are several factors that can contribute to indigestion. Some common indigestion causes include:

• Diet: Certain foods and drinks can trigger indigestion, such as:
• Spicy foods: Chilli peppers, curry, or hot sauces contain capsaicin, which stimulates sensory nerve endings by irritating the stomach lining.
• Fatty foods: Foods which are fried, rich meats such as burgers and MILKSHAKES and many other rich desserts can cause your digestion to be sluggish and you will be at risk of heartburn.
• Acidic foods: citrus fruits, tomatoes and vinegar-based dressings increase stomach acid and may worsen indigestion symptoms.
• Carbonated beverages: Sodas and sparkling water can increase bloating and gas.
• Caffeine and alcohol: Each can also slacken the LES and allow stomach acid to sneak up the conduit to your oesophagus, where it will burn like hell.
• Eating too much in a single meal at a time, or even eating too fast, leads to indigestion as the stomach struggles to dissolve a massive load of food.
• Lifestyle factors:
• Obesity can be a risk factor for indigestion, because as well as excess fat, it carries increased visceral fat, which can put added pressure on the stomach.
• Smoking irritates the oesophagus and stomach and increases the likelihood of peptic ulcers.
• Stress and a lack of sleep can both lead to indigestion because they cause changes to the production of digestive enzymes and rates of gastric acid production.
• Medications: Certain drugs irritate the stomach lining or affect digestion (see below), causing indigestion. For instance:
• Antibiotics: Certain antibiotics, such as erythromycin and tetracycline, can cause stomach upset and indigestion.
• Painkillers: Because nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can irritate the stomach lining and can increase risk of peptic ulcers.
• Iron supplements: Iron can cause stomach irritation and constipation, which can worsen indigestion symptoms.
• Chemotherapy drugs: Some cancer treatment medications can cause nausea, vomiting, and indigestion.

 Indigestion can sometimes be a symptom of a medical condition, such as:

• GERD (gastroesophageal reflux disease): A chronic disorder in which stomach acid splashes into the food pipe (esophagus) and causes heartburn, indigestion and acid regurgitation.
• Peptic ulcers: Open wound in the protective lining of the stomach or duodenum, usually from a bacterial infection or from previous long-term use of NSAIDs.
• Gallstones: Hard pebbles of bile that can lead to discomfort and indigestion in the stomach area. The pain can intensify when you eat fatty foods.
• Stomach cancer: Though very rare, years of indigestion can be a warning sign of stomach cancer, especially if accompanied by unwanted weight loss, nausea and vomiting. 

Symptoms of Indigestion

If you’ve ever experienced indigestion, you might have experienced one or more of the symptoms below:

• A feeling of fullness or heaviness in the stomach, especially after eating
• Bloating or a feeling of trapped gas in the abdomen
• Belching or burping
• Nausea or vomiting
• A burning sensation in the stomach or upper abdomen (heartburn)
• Acidic taste in the mouth
• Abdominal pain or discomfort

And while these symptoms are often associated with indigestion, they can also be linked to other digestive problems or medical illnesses. If symptoms persist or worsen with time, or failure to alleviate, it’s important to see a medical professional for further diagnosis and a treatment plan.

Diagnosing Indigestion

In many cases, a patient’s description of his symptoms, often with a physical exam thrown in for good measure, is enough for a doctor to diagnose an episode of indigestion. If symptoms are severe or otherwise concerning, or if symptoms persist, additional testing might be indicated.

• Blood tests: A complete blood count (CBC) will check your red blood cells for anaemia, which can be caused by chronic blood loss (perhaps from a peptic ulcer) or stomach cancer. Other blood tests might attempt to find celiac disease or thyroid disorders as potential underlying contributors to your indigestion.

• Stool tests: A stool sample may be tested for the presence of blood, which could show digestive tract bleeding. Stool tests can also screen for invasive organisms such as Helicobacter pylori (H pylori), a common culprit of peptic ulcers.

• Upper endoscopy: In this procedure, a long thin flexible tube with a camera on the end (endoscope) is passed through the mouth into the oesophagus, stomach and upper small intestine (duodenum). In this way, the gastrointestinal (GI) tract can be viewed from the inside. This technique can be used to look for a problem ­– such as inflammation, ulcers or tumours – by visualising the lining of the digestive tract. Tissue samples (biopsies) can sometimes be taken from the area being explored for more detailed investigations in a lab.

• Abdominal ultrasound: This imaging test uses sound waves to make pictures of the gallbladder and other organs inside the abdomen. It’s used when doctors are trying to rule out problems with the bile ducts that could be causing indigestion.

• Gastric emptying study: This test measures how quickly food is appearing in the small intestine. If your stomach takes too long to empty (gastroparesis), you might have indigestion, bloating, and nausea. You eat a small meal with a harmless radioactive marker in it, and images are taken periodically for hours so that doctors can see how the food is moving through your digestive tract.

Treating Indigestion

Treatment for indigestion depends on its severity and the actual cause of the symptoms. Symptoms can usually be alleviated with simple lifestyle changes and over-the-counter products:

• Dietary measures: Staying away from trigger foods, reducing meal portion sizes, and eating slowly can help prevent indigestion. For some people, reducing fatty, spicy or acidic foods, as well as caffeine and alcohol, might work. Eating smaller, more frequent meals and avoiding eating near bedtime might help a lot.

• Weight: Eating a healthy diet and staying at a healthy weight helps to prevent indigestion. Losing weight if you are overweight can also take pressure off your stomach and lower the risk of GERD.

• Stress reduction: complimentary therapies such as progressive muscle relaxation, guided imagery, meditation and yoga can help. Relaxing activities, sufficient sleep and professional support (from a friend, relative, therapist, coach or counsellor) can also be useful.

• Antacids and anti-reflux (alginates).

• Other non-prescription medications include the class of H2 blockers and the class of proton pump inhibitors . These medications work by reducing acid production in the stomach, not neutralising it like an antacid, and therefore provides relief for longer periods of time. However, these medications should not be taken too often and one must stay within the recommended dose and consult a doctor before taking these medications for prolonged periods.

 For more severe or persistent indigestion, prescription drugs or other treatments may be necessary:

• Stronger versions of H2 blockers or PPIs prescribed by a doctor
• Prokinetics such as metoclopramide that help the stomach empty faster and so mitigate nausea and vomiting.
• Antibiotics, if an H. pylori infection is causing indigestion or peptic ulcers
• Surgery (but only if some specific underlying condition such as, say, GERD or peptic ulcers, calls for a more drastic surgical treatment such as fundoplication, or wrapping the upper part of the stomach around the lower oesophagus to prevent acid reflux).

Lifestyle Tips for Managing Indigestion

Alongside the above-mentioned treatments, there are several lifestyle strategies to help manage your indigestion:

• Planning meals and snacks ahead of time by making a grocery list and trying out new healthy recipes is a great way to maintain a balanced, nutritious diet that limits your trigger foods. In addition, if you track what you are eating and drinking in a food diary, you can discern which foods or beverages are contributing to the most indigestion symptoms.
• Mindful eating: eat slowly to aid digestion and chew your food thoroughly. Avoid distractions such as watching TV or using your phone while eating – these habits can lead to overeating or chowing down too fast.
• Stress-reduction strategies: Use stress-management strategies daily, such as deep diaphragmatic breathing, progressive muscle relaxation or mindfulness meditation. Regular physical exercise programmes such as yoga, tai chi or walking can also promote the ability to handle stress, and will improve your digestion.
• Postural issues: Sit upright and don’t lie flat within an hour of a meal (which may exacerbate acid reflux). Wear loose, non-constrictive clothing, especially anything that tightens at your stomach or waist.
• Hydration: Drink plenty of fluids throughout the day to keep your bowels working well. But don't drink a lot with a meal, because that will wash the digestive enzymes into your intestines before they have done their job and cause you to be indigestion prone.

When to Seek Medical Advice?:

Even though indigestion is usually not a life-threatening condition, and most symptoms can be managed at home, there are times when professional medical attention is necessary:

• Indigestion symptoms that persist for more than two weeks despite home treatment
• Severe abdominal pain or discomfort
• Unintended weight loss
• Difficulty swallowing or painful swallowing.
• Vomiting blood or dark, tarry stools (which may indicate digestive tract bleeding)
• Difficulty breathing; difficulty swallowing; sweating; chest pain (can be signs of a heart attack)

Conclusion

• Indigestion is a common digestive health concern that can create discomfort and negatively impact a person’s quality of life. Fortunately, with an understanding of the causes, symptoms, and treatments associated with indigestion, the condition can often be adequately treated and managed.
• Mild indigestion can sometimes be alleviated with simple lifestyle changes, including the adjustment of your diet, stress management, and a healthy weight. Medications may also offer relief for mild to moderate indigestion symptoms.
• However, when indigestion becomes chronic or you experience severe symptoms, it’s important to consult with a healthcare professional for proper diagnosis and treatment. Working closely with your doctor and making necessary lifestyle changes can help alleviate your indigestion symptoms and improve your digestive health.

References:

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