Indigestion
Also known as Dyspepsia, Upset stomach
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is indigestion?
Indigestion is discomfort, fullness or burning in the upper abdomen, often related to eating. Most cases are functional, meaning no structural cause is found, though it can reflect reflux, an ulcer or Helicobacter pylori infection. New indigestion over the age of 55, or with any alarm symptom, needs investigation rather than reassurance.
Causes
- Functional dyspepsia with no structural abnormality
- Acid reflux
- Helicobacter pylori infection
- Peptic ulcer
- Anti inflammatory painkillers
- Alcohol, caffeine, fatty and spicy foods
- Stress and anxiety
Symptoms
- Burning or discomfort in the upper abdomen
- Feeling uncomfortably full during or after meals
- Bloating and belching
- Nausea
- Symptoms triggered by certain foods
- A sour taste or acid coming up
Risk factors
- Regular use of anti inflammatory painkillers
- Smoking and alcohol
- Obesity
- Stress
- Helicobacter pylori infection
- Late heavy meals
Diagnosis
- Clinical assessment and review of medicines
- Testing for Helicobacter pylori by breath or stool test
- Full blood count to check for anaemia
- Endoscopy where alarm features are present or symptoms persist
- Stopping acid suppression before H pylori testing to avoid false negatives
Treatment
- Antacids or alginates for immediate relief
- Proton pump inhibitor for a trial period
- Helicobacter pylori eradication if positive
- Stopping or reducing anti inflammatory painkillers
- Dietary and lifestyle changes
- Low dose antidepressants for persistent functional dyspepsia
Self care
- Eat smaller meals more slowly
- Avoid eating within three hours of lying down
- Raise the head of the bed if symptoms are worse at night
- Cut back alcohol, caffeine and fatty or spicy food
- Stop smoking
- Lose weight if overweight
- Take anti inflammatory painkillers with food, or avoid them
When to see a doctor
Book an appointment if:
- Indigestion most days for three weeks or more
- First developing over the age of 55
- Needing antacids regularly to function
- Symptoms returning as soon as treatment stops
- Taking regular anti inflammatory painkillers
- Family history of stomach or oesophageal cancer
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Eat regular moderate meals and avoid late eating
- Limit alcohol, caffeine and known trigger foods
- Stop smoking
- Keep to a healthy weight
- Use anti inflammatory painkillers sparingly
- Manage stress
Outlook
Most indigestion responds well to lifestyle change and acid suppression. Where Helicobacter pylori is found, eradication cures the majority and prevents ulcer recurrence. Functional dyspepsia tends to relapse and remit over years but does not damage the stomach or shorten life.
Common questions
Could my indigestion be my heart?
Cardiac pain can feel exactly like indigestion. Discomfort brought on by exertion, or with sweating, breathlessness or pain in the arm or jaw, should be treated as a possible heart problem and assessed urgently.
Why stop acid medicines before an H pylori test?
Proton pump inhibitors suppress the bacteria enough to produce a false negative. They usually need stopping for two weeks before a breath or stool test for the result to be reliable.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.