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Dyspepsia

Dyspepsia, or indigestion, may cause upper abdominal pain, burning or heat, and the stomach feeling full during or after eating.
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Overview
Symptoms
Causes
Tests
Treatment
Complications

What is dyspepsia?

Dyspepsia, also known as indigestion, can have multiple symptoms. Feelings of indigestion happen during or after eating.

If you have indigestion you might feel:

  • Full during a meal.
  • Painful fullness after a meal.
  • Heat, burning or pain between your belly button and lower breastbone (upper belly).
Both men and women can get indigestion. People of any age, even infants, can get indigestion. About one of every four people get indigestion at some point.
 
Indigestion can happen once in a while for some, or as often as every day for others.
 
Indigestion is known to affect people of all ethnic backgrounds but thought to be more common in Caucasians compared to Asians.
Illustration of a normal stomach, a stomach showing GERD, H pylori infection, and stomach ulcer.
Indigestion is not the same as heartburn, but you may have symptoms of both health issues. If you suspect you have heartburn, ask your doctor for more information.

Symptoms of dyspepsia

You may have one or more of these feelings if you are experiencing indigestion:

  • The feeling of being full or getting full quickly during a meal (and being unable to
    complete the meal).
  • Painful fullness after a meal (as if food is staying in the stomach too long and not
    moving).
  • Heat, burning or pain between your belly button and lower breastbone (in the upper
    belly); this pain can range from mild to very bad.

Some less frequent feelings that could be linked to indigestion are:

  • Bloating (bad swelling in the stomach).
  • Excessive gas in the abdomen.
  • Throwing up.
  • Burping or belching.
  • Nausea.
  • Flatulence or feeling “windy.”

Talk to your doctor if:

  • Your indigestion lasts more than two weeks.
  • Your symptoms change (they get a lot worse or become more common or ongoing).
  • You see blood in your stool (or you start throwing up blood).
  • You experience sudden weight loss for no reason.
  • You start having really bad belly pain.
  • You have trouble swallowing.
  • You start experiencing jaundice (when your skin and/or the whites of your eyes turn yellow).

Causes of dyspepsia or indigestion

There are a number of things that could cause the symptoms of indigestion. For some, certain actions can cause feelings of indigestion, such as:

  • Eating too fast.
  • Eating too much in one sitting.
  • Eating high-fat, greasy or spicy foods.
  • Smoking.
  • Drinking alcohol.
  • Consuming too much caffeine.
  • Experiencing stress.
  • Taking some drugs.
  • Taking too many painkillers (for example, for headaches or muscle/joint pain).
If your indigestion lasts for more than two weeks, or you are having symptoms like bleeding, weight loss or trouble swallowing along with your indigestion, call your doctor as soon as possible, as it could be a sign of a more serious health problem.

Other causes of indigestion (non-ulcer dyspepsia) could be

Functional dyspepsia

For some, indigestion may continue, but no direct cause can be found. This is called functional dyspepsia and could be linked to your stomach muscle not working as it should to move food to the small intestine. If this is the case, work with your doctor to figure out some life changes that could help your symptoms.

Tests for dyspepsia

Getting tested for indigestion, or to find the cause of it, is a key step to feeling better.

Your doctor will ask about your symptoms and past health issues and feel your belly to see if everything feels normal. Keeping track of your symptoms may help. Beyond this, your doctor may choose to do:
  • An X-ray of the stomach and/or small intestine.
  • An ultrasound of the belly.
  • A blood, breath or stool test (to look for bacteria or allergies).
  • An endoscopy (with biopsy).

What to expect during endoscopy

An endoscopy is done to get a small piece of tissue (biopsy) from your esophagus (the tube that
links your mouth and stomach) to see if there is damage.

You will be given medicine to block pain and make you feel relaxed and sleepy, so you won’t feel much during the test.
During the endoscopy, your gastroenterologist will use a long, thin (about the width of your little finger), flexible tube with a tiny camera on the end to look inside.

The tube is passed through the mouth into the small intestine as your gastroenterologist does a
careful exam to check for damage. Learn more about endoscopy and how to prepare.

Treatment for dyspepsia

Your indigestion symptoms are unique to you.

Your gastroenterologist can help you find out the cause of your indigestion, so you can work together to develop the best plan to handle your symptoms. Your choices will depend on the
cause of your indigestion.

Talk to your doctor about which medications or options might be best for you.

Lifestyle changes to treat dyspepsia

  • Don’t smoke or use tobacco.
  • Don’t drink alcohol, caffeine or carbonated drinks.
  • Eat several small, low-fat meals during the day.
  • Eat at a slow pace; chew food with care and fully.
  • Allow enough time for meals (avoid excitement or exercise right after a meal).
  • If possible, avoid taking aspirin or anti-inflammatory drugs (be sure to talk with your health care provider first).
  • Try to track your symptoms to find out which foods cause your symptoms and do your best to cut those out of your diet.
  • Don’t eat right before you go to bed.
  • Sleep with your head raised slightly.
  • Get plenty of rest.
  • Find ways to reduce stress.

Medications

These medications should only be used at the dose and for the length of time showed on the label. Be sure to tell your doctor if you use over the counter (OTC) acid-blocking medications.
Antacids are available OTC and get rid of acid in the stomach. Examples are:
  • Alka-Seltzer®.
  • Maalox®.
  • Mylanta®.
  • Rolaids®.
  • Riopan®.
Side effects may include diarrhea (loose stool) and constipation (hard stool or trouble passing stool).
These medications are available OTC and in prescription strength. They reduce stomach acid and work longer than antacids but not as quickly. Examples are:
  • Pepcid®.
  • Zantac®.
Side effects may include headache, upset belly, throwing up, constipation, diarrhea, and abnormal bleeding or bruising.
PPIs are available OTC and in prescription strength. Examples are:
  • Prilosec®.
  • Prevacid®.
  • Protonix®.
  • Dexilant®.
Side effects may include back pain, aching, cough, headache, dizziness, belly pain, gas, nausea, throwing up, constipation and diarrhea.

These drugs are helpful for people whose stomachs empty too slowly. An example is: Reglan®.

Side effects may include tiredness, sleepiness, depression (low mood), anxiety (feeling worried), jerky movements or spasms.

Your doctor may prescribe antibiotics if tests show bacteria.

Complications

Alarm symptoms

Indigestion (non-ulcer dyspepsia) is pretty common and often treatable. But, there are a few cases where your symptoms could be a sign of a more serious problem, mainly if you are over 50 years old. You could be at risk of having a more serious health issue if:
  • You have lost weight without trying to.
  • You have trouble swallowing.
  • You can’t stop throwing up.
  • You have black, tarry stools.
  • You have chest or belly pain with activity or if chest or belly pain is unrelieved by GI treatment.
Call your health care provider as soon as possible if you are having any of these symptoms.

Reviewed by

Picture of Sanjiv Mahadeva

Sanjiv Mahadeva

MD, MBBS, MRCP, consultant gastroenterologist
Professor of medicine, University of Malaya, Kuala Lumpur

Picture of Sanjiv Mahadeva

Sanjiv Mahadeva

MD, MBBS, MRCP, consultant gastroenterologist
Professor of medicine, University of Malaya, Kuala Lumpur

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