What is Indigestion?
Indigestion is a general term used to describe discomfort
or pain in the upper abdomen or chest, usually after meals. An alternative term is ‘dyspepsia’. When a burning discomfort is felt behind the breast bone, it is
known as heartburn.
Pain in the upper abdomen may come and go. For some people
it can be relieved by food, especially if it feels like a hunger pain, although for others
it can occur after eating. It can occur by day or at night, when it may be relieved by a
snack or a drink of milk. Alternatively, it can occur without any relation to food at all.
The stomach may feel full soon after starting to eat, so
that it is difficult to finish a meal, or there may be an uncomfortable sense of fullness
or bloating after a meal. The word ‘indigestion’ may also be used to describe
nausea, retching or even vomiting after food.
Symptoms of indigestion include discomfort of pain in the upper abdomen of chest.
Possible Causes
Most indigestion symptoms are harmless but annoying. Very
often tests are not needed. When tests are performed and no cause is found, the term ‘non-ulcer
dyspepsia’ may be used, meaning that no ulcer
has been found to account for the symptoms. An ulcer is a break in the lining of the
stomach of duodenum (the first part of the small intestine), resembling ulcers which some
people get from time to time in the mouth.
Because of a component of digestive juice, called pepsin,
they are often described as a ‘peptic ulcer’.
Indigestion symptoms may be caused by inflammation of the
stomach lining, which can occur as a result of over-indulgence in alcohol, the use of
aspirin-like drugs, or due to infection. Another cause can be inflammation of the
oesophagus (gullet), described as ‘oesophagitis’. This is
usually caused by digestive juices (acid) repeatedly moving upward from the stomach to the
gullet.
Other recognisable causes of indigestion include disorders
of the intestine, gallbladder or pancreas. Sometimes indigestion may be caused by drugs
commonly taken for arthritis which can cause irritation of the stomach lining.
How Can I Avoid Indigestion?
Although more research is necessary to determine all the
risk factors, the following steps should help.
don’t smoke
eat meals at regular times
do not rush meals
enjoy eating and drinking, but do so in moderation
avoid those foods you associate with symptoms
don’t take aspirin for headaches, colds and coughs - take paracetamol instead
avoid taking anti-arthritis pain killers if at all possible: your doctor will
advise
try not to let stressful situations upset you.
How Can I Avoid Heartburn?
eat your evening meal well before going to bed so that it has time to digest
raise the head of the bed six to eight inches on blocks: this will help keep the
acid down in the stomach where it belongs
avoid being overweight; try to lose weight if you are
avoid excessive caffeine, fats and alcohol
avoid tight belts or clothing
avoid bending down or lying flat after meals.
Why Can Indigestion be Confused
with Heart Disease?
Indigestion is characterised by pain centred in the upper
abdomen. Heartburn is a burning pain in the chest, often made worse by bending or lying
down.
Pain from the heart is also felt in the chest and
sometimes in the upper abdomen. There are two kinds of heart pain. The first - angina - is
a pain in the chest due to a temporary shortage of oxygen being carried in the blood to
the heart muscle. Angina should be suspected if the chest pain is brought on by exercise
and relieved by rest.
The second is the more severe and prolonged pain of a
heart attack. A heart attack should be suspected if the pain is felt intensely in the
centre of the chest, spreading perhaps to one or both arms (especially the left) and into
the lower jaw; or feels like a heavy pressure or is ‘vice-like’.
Potentially dangerous confusion can arise when someone
neglects their heart pain believing it to be indigestion.
When Should I Seek Help?
Many people who suffer occasional indigestion and
heartburn can obtain relief from simple antacid tablets which are available from the
chemist.
You should see your doctor if:
you suffer from heartburn regularly (every week or every day)
your indigestion symptoms - persist for more than two weeks, especially if this is
a new symptom - do not respond to antacids - interfere with work, leisure and/or sleep.
This advice is particularly important if you are:
over 45
have a family history of gastric problems
drink or smoke heavily
take aspirin regularly
take regular anti-arthritis pain killers.
You should consult your doctor urgently if you experience:
severe prolonged chest pain
red or altered blood (like coffee grounds) in vomit
black ‘tarry’ stools
rapid weight loss
recurrent vomiting
difficulty in swallowing
yellowing of the skin (jaundice)
pain radiating to the back.
What Investigations may be
Necessary?
Many people do not require investigation, but as
persistent indigestion may suggest a more serious underlying complaint, the doctor may
decide to arrange:
an endoscopy - which involves swallowing a slim flexible telescope with a light in
the end to enable the doctor to look into the stomach.
a barium meal test, which involves swallowing a liquid which enables the outline of
the stomach to show up on X-ray.
an ultrasound scan - a technique using reflected soundwaves to show the structure
of abdominal organs. This technique does not involve passing any tubes into the body.
a blood test to detect anaemia or other abnormality.
What Treatment is Available?
General advice, an explanation of the symptoms and
reassurance will be offered by the doctor. Advice will be given if there are factors in
your lifestyle which may be contributing to the difficulties. Medicine may be prescribed,
ranging from antacids to more powerful drugs, depending on the cause of the problems.
Complementary medicine is also a possible option but the DDF recommends that you discuss
this with your doctor. Surgical treatment may be needed for gallstones and, sometimes, for
other conditions.
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