Indigestion can have many different causes.
- Indigestion (dyspepsia) is a functional disease in which the gastrointestinal (GI) organs, primarily the stomach and first part of the small intestine (and occasionally the esophagus), function abnormally. It is a chronic disease in which the symptoms fluctuate in frequency and intensity usually over many months or years. It may occur every day or intermittently for days or weeks at a time followed by days or weeks of relief (a pattern referred to as periodicity).
- Theories of the cause of indigestion include abnormal input from intestinal sensory nerves, abnormal processing of input from the sensory nerves, and abnormal stimulation of the intestines by motor nerves.
- The primary symptoms of indigestion are
- upper abdominal pain or discomfort,
- belching,
- nausea,
- abdominal bloating,
- feeling full after eating only a small amount of food (early satiety),
- abdominal distention (swelling), and
- occasionally, vomiting.
- The symptoms most often are provoked by eating.
- Indigestion frequently occurs during pregnancy, however, most the time, the symptoms are heartburn caused by acid reflux.
- Indigestion is diagnosed on the basis of typical symptoms and the absence of other GI diseases, particularly acid-related diseases (acid indigestion, esophagitis, gastritis, and ulcers), and non-gastrointestinal diseases that might give rise to the symptoms.
- Since the heart sits near the stomach, there often is confusion about what is causing lower chest or upper abdominal pain. Therefore, indigestion should be considered in anyone with lower chest pain, and heart attack should be considered in anyone with upper abdominal pain. Occasionally, the discomfort of indigestion can be felt in the back.
- Testing in indigestion is directed primarily at excluding the presence of other GI diseases and non-GI diseases. Some people may require specific testing of certain GI functions. It is important to exclude other causes for the indigestion since their treatment will be different from indigestion without a clear cause.
- Treatment in indigestion for which there is no other cause found, is primarily with education as well as smooth muscle relaxant and promotility drugs. There also may be a role for anti-depressant drugs and dietary changes. Because acid reflux is so common, a trial of potent stomach acid suppression often is used as the initial treatment.
- Many people are able to identify specific foods that provoke their indigestion. Despite this fact, there are few foods whose avoidance can be universally recommended since not all people with indigestion have trouble with the same foods. There also are no foods or diets that can be recommended for preventing indigestion other than those that eliminated foods that provoke symptoms.
- There is no evidence that home remedies or natural remedies prevent indigestion.
- Future advances in the treatment of indigestion depend on a clearer understanding of its many cause(s)
