Dyspepsia (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ajay Gade MD[2]]

Indigestion (dyspepsia) is a vague feeling of discomfort in the upper belly or abdomen during or right after eating. Indigestion is a common problem.

Symptoms 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.

NOTE: Indigestion is NOT the same as heartburn.

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 the 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)

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

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

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

The following tests may be performed:

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

Changing the way you eat may relieve your symptoms. Antacids may also 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.

• A calm environment and rest may help relieve stress-related indigestion.
• Allow enough time for meals.
• Avoid arguments during meals.
• Avoid aspirin and other NSAIDs. If you must take them, do so on a full stomach.
• Avoid excitement or exercise right after a meal.
• Chew food carefully and completely.\

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:

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

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