Indigestion

What is indigestion?

Indigestion, also commonly known as dyspepsia (an upset stomach) is a general term used to describe pain or discomfort in the upper abdomen. The discomfort is of varying degrees and indigestion symptoms experienced may be very mild or so severe that they can be mistaken for a heart attack.

Indigestion is a common problem - it is estimated that around 41% of the population have experienced the symptoms of indigestion at some point in their lives.

The symptoms of indigestion

Indigestion is characterised by a wide variety of symptoms including one or more of the following:

• Mild or severe discomfort in the upper abdominal area
• Feeling full or bloated soon after starting or finishing a meal
• Nausea and vomiting after a meal
• Flatulence
• Loss of appetite
• Heartburn (a burning or heavy sensation down the centre of the chest) Burning in the epigastric area – part of the tummy just under the breast bone

Indigestion can occur before or after a meal, day or night and can be variable, lasting only a few minutes or for many hours.

Causes of indigestion

The stomach produces acid which is essential for the normal digestion of food.

However, the stomach is sensitive to this acid and because of this, is normally covered by a protective lining.

At times, this protective lining becomes inadequate and when this happens, acid comes into contact with the cells lining the stomach, leading to irritation and inflammation, giving rise to symptoms of indigestion.

In the majority of cases, indigestion is related to eating, although in some cases it may be related to an infection or taking certain types of medications.

Stomach lining inflammation can be caused by the following factors:

• Over-indulgence in food, alcohol or both
• Slumped posture whilst eating
• Spicy or fatty foods
• Not eating food regularly enough (acidity levels in the stomach decrease with eating and therefore if the time between meals is too long, the acidity levels will build up)
• The use of non-steroidal anti-inflammatories (NSAIDs such as aspirin and ibuprofen)
• An infection Inflammation of the gullet (oesophagus) – the tube leading from the mouth to the stomach because of acid moving up from the stomach
• Disorders of the intestines, gallbladder or pancreas

What can be done to avoid indigestion?

The following steps can be taken to help avoid indigestion:

• Stop smoking
• Lose weight if you are overweight
• Chew your food properly
• Eat regularly
• Don't rush eating
• Try to avoid over-indulging in food and alcohol
• Keep a food diary to take note of indigestion-causing foods and avoid them
• Avoid stressful situations as much as possible as stress affects the digestive system. Stress levels may be decreased by relaxation techniques and yoga
• Take care when taking medicines that may cause indigestion and take these medicines with or after food to decrease the possibility of indigestion
• Don't eat last thing at night, giving your evening meal time to be digested
• Refrain from drinking coffee and carbonated beverages
• Raise the head of the bed by 6-8 inches to help keep acid down
• Avoid wearing tight clothing or tight belts
• Avoid bending down or lying flat soon after meals

Possible complications of indigestion

Sometimes, indigestion can be a sign of a more serious underlying condition. Consult a doctor if any of the following occur:

• Severe and prolonged chest pain
• Vomit that is red in colour or like coffee-beans
• Black tarry stools
• Rapid unexplained weight loss
• Recurrent vomiting
• Difficulty or painful swallowing
• Yellowing of the skin
• Pain radiating to the back If you are over 55 and having indigestion for the first time If symptoms are getting worse
• Abdominal pain in the non-epigastric area Indigestion followed by shortness of breath, sweating or pain that radiates to the jaw, neck or arm
• Symptoms persisting for more than two weeks
• If indigestion interferes with normal everyday activities such as work, leisure or sleep

In 70% of all patients with indigestion, no disease can be found which means that, in the majority of cases indigestion, is a minor complaint that can be self-managed very easily.

What indigestion remedies are available?

As symptoms of indigestion vary greatly, treatment very much depends upon the type and severity of symptoms experienced.

Some common indigestion remedies include:

• Antacids work by helping to neutralise the acid in the stomach
• Alginates provide a coating to the stomach wall, acting as a barrier to reflux
• H2 Receptor antagonists act by slowing the production of acid in the stomach
• Proton pump inhibitors work by blocking production of the enzyme in the stomach wall that is responsible for producing acid used in the digestion process
• Herbal remedies – bitter herbs, also known as 'stomach bitters' such as centaurium, artichoke and dandelion have been used traditionally for the relief of symptoms of indigestion.