Dyspepsia, the medical term for indigestion, refers to discomfort or pain in the upper abdomen, often after eating or drinking. It is not a disease but a symptom of gastroesophageal reflux disease (GERD) and other conditions.
Dyspepsia is a common problem, affecting up to 20% of the population. Common symptoms include bloating, discomfort, feeling too full, nausea, and gas.
In most cases, it happens after eating or drinking. Lifestyle changes can often help.
Other causes include medical conditions, such as gastroesophageal reflux disease (GERD), and the use of certain medications.
Treatment for dyspepsia depends on the cause and severity. Often, treating an underlying condition or changing a person’s medication will reduce dyspepsia.
Lifestyle changes
For mild and infrequent symptoms, lifestyle changes may help. These include:
avoiding or limiting the intake of trigger foods, such as fried foods, mint, tomatoes, and some spices
avoiding lying down for at least two hours after eating
if a person is overweight, losing weight may provide some relief to the digestive tract
elevating the head of the bed by roughly six inches (by propping up the mattress or bed frame)
Medications
FDA warning.
In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the United States market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance.
For severe or frequent symptoms, a doctor may recommend medication. People should speak to their doctor about suitable options and possible side effects.
There are various medications and treatments available, depending on the cause of dyspepsia.
Medication options include:
Antacids
These counter the effects of stomach acid. Examples include Alka-Seltzer, Maalox, Rolaids, Riopan, and Mylanta. These are over-the-counter (OTC) medicines that do not need a prescription. However, it is important to note that some antacids contain nonsteroidal anti-inflammatory drugs (NSAIDs), which may actually exacerbate dyspeptic symptoms and peptic ulcer disease.
H-2-receptor antagonists
These reduce stomach acid levels and are more effective than antacids. Examples include Tagamet and Pepcid. Some are available OTC, while others are by prescription only. Some may carry a risk of adverse effects. A doctor can help a person choose a suitable H-2-receptor option.
Proton pump inhibitors (PPIs)
PPIs reduce stomach acid and are stronger than H-2-receptor antagonists. Examples are Aciphex, Nexium, Prevacid, Prilosec, Protonix, and Zegerid.
Prokinetics
These can help boost the movement of food through the stomach. Examples include metoclopramide (Reglan). While this medication can be effective, it is typically reserved for people with severe symptoms. Side effects may include tiredness, depression, anxiety, and muscle spasms.
Some medications that are used for gastrointestinal neuromodulation are of the same class of drugs used for mood disorders, although typically at lower doses.
Counseling
Chronic indigestion can affect a person’s quality of life and overall well-being. Counseling may help some people manage these issues.
Dyspepsia is common during pregnancy, especially in the last trimester. This is due to hormonal changes and the way the fetus presses against the stomach.
A doctor or pharmacist can recommend safe ways to manage indigestion during pregnancy.
any other health conditions and medications that they are taking
their dietary habits
They may also examine the chest and stomach. This may involve pressing down on different parts of the abdomen to check for areas that may be sensitive, tender, or painful under pressure.
In some cases, a doctor may use the following tests to rule out an underlying health condition:
Blood test: This can assess for anemia, liver problems, and other conditions.
Tests for H. pylori infection: In addition to a blood test, these tests may include a urea breath test and a stool antigen test.
Endoscopy: The doctor will use a long, thin tube with a camera to take images of the gastrointestinal tract during this procedure. They may also take a tissue sample for a biopsy. This can help them diagnose an ulcer or a tumor.
In very rare cases, severe and persistent indigestion can lead to complications. These include:
Esophageal stricture
Persistent exposure to stomach acid can cause scarring in the upper gastrointestinal tract. The tract can become narrow and constricted, causing difficulty with swallowing and chest pain. Surgery may be necessary to widen the esophagus for a person with an esophageal stricture.
Pyloric stenosis
In some cases, stomach acid can cause long-term irritation of the pylorus, the passage between the stomach and the small intestine. If the pylorus becomes scarred, it can narrow. If that happens, a person may not be able to digest food properly, and they may need surgery for pyloric stenosis.
Peritonitis
Over time, stomach acid can cause the lining of the digestive system to break down, leading to an infection called peritonitis. Medication or surgery may be necessary.
To get rid of mild dyspepsia, the following lifestyle changes may help:
avoiding or limiting the intake of trigger foods, such as fried foods, mint, tomatoes, and some spices
avoiding large portions at mealtime
eating smaller meals more often
avoiding lying down for at least two hours after eating
For more severe or frequent dyspepsia, a doctor may recommend medications such as antacids, H-2-receptor antagonists, or Proton pump inhibitors (PPIs).
Dyspepsia, also known as indigestion, refers to discomfort or pain in the upper abdomen, often after eating or drinking.
It is often mild, and people can make dietary and lifestyle changes to help manage it. If these do not work, a doctor can prescribe medications.
In some cases, there may be a more serious underlying cause. Anyone who has concerns about new, severe, or ongoing dyspepsia should seek medical advice.
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