Indigestion (Dyspepsia)

What is indigestion?

Indigestion is pain or discomfort after eating, while your stomach is digesting. Healthcare providers also use the term dyspepsia, which means the same thing: impaired digestion. If you get a stomachache or upset tummy after eating, something in your digestive process isn’t going quite right. It’s not always a problem with your body, though. Sometimes it just means you ate the wrong thing or ate too fast.

Almost everyone has experienced occasional indigestion. But for some people, it’s a daily occurrence that diminishes their quality of life. When indigestion becomes a significant problem, you may find yourself seeking healthcare for answers and relief. Sometimes there’s an underlying gastrointestinal (GI) disease that needs treatment. But sometimes there’s no simple explanation for these symptoms.

What does indigestion feel like?

Indigestion may involve several different symptoms, but it always involves some level of abdominal pain or discomfort. Your abdomen is where most of the organs in your digestive system live, so if they’re having difficulties while doing their jobs, that’s where you’ll feel it. Indigestion symptoms always occur after eating, when your stomach is digesting — what healthcare providers call the postprandial period.

Experts generally agree that the symptoms of indigestion include:

• Epigastric pain. Your epigastrium is your central, upper abdominal region. This is where your stomach is.
• Burning sensation. Burning may come from stomach acids and enzymes in your GI tract, or from inflammation.
• Early or late-lasting satiety. Feeling full soon after eating, or long after, suggests your stomach is overwhelmed.

But people who experience indigestion often report other symptoms along with it, such as:

• Bloating.
• Gas.
• Nausea.
• Burping.
• Regurgitation (when swallowed food comes back up).
• Acid reflux.
• Heartburn.

These symptoms can overlap with indigestion, but they can also occur separately from it.

Note: Sometimes a heart attack can masquerade as indigestion. Seek medical attention right away if your indigestion is accompanied by sweating, shortness of breath or a tight, clenching feeling in your upper abdominal area.

How long does indigestion last?

You may have symptoms of indigestion for a few minutes to a few hours after eating. It takes 3-5 hours for your stomach to digest a meal before passing it on to your intestines. During that time, your pancreas and gallbladder send bile and enzymes to your stomach to help with digestion. These are the organs in your epigastric region (upper middle abdomen), where indigestion symptoms occur.

What causes indigestion?

Causes of occasional indigestion can be simple. For example, many people get indigestion after an especially large or rich meal. That’s easy to explain: your digestive system is working harder than usual to accommodate a heavy load. Your stomach is stretching, your gallbladder and pancreas are contracting, and they’re all producing strong digestive juices, which may be irritating your tissues.

But indigestion that lasts longer than one meal, or that comes and goes chronically, is often less simple. There may be a variety of factors involved. Sometimes there’s an organic cause, like a disease. And sometimes there’s no obvious cause. This is called functional dyspepsia. Functional GI disorders occur when the nerves in your GI tract are hypersensitized, which lowers your threshold for discomfort.

In general, causes of indigestion fall into three categories:

1. Your eating habits.
2. How your digestive system is functioning.
3. Your perception of pain and discomfort.

What is the main cause of indigestion?

When there’s an organic cause, it usually has to do with stomach acid. Acid causes the telltale burning sensation often described in indigestion. Your stomach has a strong lining designed to protect it from its own acid, but sometimes the lining is worn down. When this happens, it becomes irritated and inflamed by the acid. Inflammation of your stomach lining has other causes, but they’re less common.

Sometimes gastric juices escape from your stomach into the top part of your small intestine (duodenum). Your duodenum doesn’t have the same protective lining as your stomach, so acid can do more damage there. Acids can also escape from the top of your stomach into the bottom of your esophagus. This is called acid reflux. Your esophagus isn’t designed to tolerate acid, either.

Acid reflux may explain other symptoms that can come with indigestion, such as burping, regurgitation and heartburn. You can have acid reflux and discomfort in your esophagus even if your stomach lining is still intact. When acid eats away at your stomach lining, though, you have peptic ulcer disease, which can cause ulcers in your stomach and duodenum. Peptic ulcers also cause a burning kind of pain.

Peptic ulcer disease may explain other symptoms that can come with indigestion, such as early satiety (fullness), nausea and bloating. In fact, acid and ulcers are so often the organic causes of chronic indigestion that healthcare providers have come to refer to functional dyspepsia as “non-ulcer dyspepsia”. But overall, functional dyspepsia is more common than any organic cause of indigestion.

What are other possible causes?

Diet and lifestyle factors that may contribute to occasional dyspepsia include:

• Eating too much or too fast. Overeating stretches your stomach and makes it more likely for acid to escape through the top.
• Too much fat in your diet. High-fat content triggers more acids and enzymes, which may irritate your tissues.
• Unidentified food intolerances. You may be having difficulties digesting certain foods.
• Smoking and alcohol use. Both of these substances irritate the mucous lining throughout your GI tract. They can cause inflammation.
• Overuse of NSAIDs (like aspirin and ibuprofen). Too many NSAIDs can erode your stomach lining.
• Stress and anxiety. Your GI tract is intimately connected with your brain through nerves, and each can affect the other.

Diseases and conditions that may be involved in chronic dyspepsia include:

• Peptic ulcer disease.
• Gastroesophageal reflux disease.
• Hyperchlorhydria (too much stomach acid).
• Gastritis (inflammation of your stomach lining).
• Gastroparesis (slow stomach emptying).
• Hiatal hernia (your stomach pushes up through your diaphragm).
• Bacterial overgrowth (in your stomach or small intestine).
• Eating disorders.
• Gallstones.
• Gallbladder inflammation (cholecystitis).
• Pancreas inflammation (pancreatitis).
• Irritable bowel syndrome (IBS).
• Celiac disease.
• Small bowel obstruction.
• Stomach cancer.
• Visceral hypersensitivity.

How do I relieve indigestion at home?

Many people find indigestion relief from over-the-counter (OTC) antacid medications, like Tums ®, Rolaids ® and Pepto-Bismol ®. Antacids neutralize the acid in your stomach so it doesn’t irritate your tissues. They work well for occasional indigestion when acid is the cause, but you shouldn’t take them too often. If you have chronic indigestion, or if antacids don’t help, you should see a healthcare provider.

Does drinking water help?

Small sips of water when you’re experiencing indigestion may help a little. If you have acid reflux in your esophagus, the water may help wash the acid back down into your stomach. If your stomach seems slow to digest and release your food, a little water may help move things along while also diluting the acid. But don’t drink so much that it expands your stomach, or it might have the opposite effect.

What medical treatment is available for chronic indigestion?

If you go to a healthcare provider with chronic indigestion, they’ll ask you about your symptoms, your health history and your diet and lifestyle. They’ll physically examine you to look for any obvious signs of disease. Depending on what they learn, they may want to run some other tests to confirm or rule out a specific condition. Or they may start by prescribing acid-blocking medications to see if they help.

Prescription acid blockers include:

• Histamine receptor antagonists (H2 blockers). These medications reduce stomach acid by blocking the chemicals that tell your body to produce it (histamines). You can take them more frequentlythan antacids, but they don’t always work long-term. Your body may adapt to them, making them less effective.
• Proton pump inhibitors (PPIs). These are stronger acid blockers that also promote the healing of the tissues. Your provider may prescribe these if your symptoms are relatively severe or you have signs of ulcers or other tissue damage in your GI tract. They’re very effective against acid, and you can take them long-term.

Other medications for indigestion may include:

• Prokinetic agents — medications that speed up your digestive system if it’s sluggish.
• Antibiotics — if you have bacterial overgrowth in your stomach or small intestine.

What helps indigestion when it’s not acid-related?

If you have a specific disease, you’ll need specific treatment for it. If you have functional dyspepsia, it can take some trial and error to discover the treatment plan that works for you. Since functional disorders are based in your nervous system, typical medications may not work. But medications that target your nerves, combined with mind-body therapies, have a better chance of succeeding.

What can I do to prevent indigestion?

Try not to eat too much at once, and don’t eat dinner too late. Give it time to digest before you lie down. Pay attention to the foods and drinks that trigger your symptoms and reduce them if possible. Some people find that general health measures like getting enough sleep and exercise, managing stress and losing weight helps their indigestion. If you take NSAIDs regularly, consider alternatives.

When should I seek healthcare for indigestion?

See a healthcare provider if you have persistent indigestion that’s not relieved by antacids, or if you’re taking antacids too frequently and need a long-term plan.

Also see a provider if you have any red-flag symptoms along with your indigestion, such as:

• Difficulty swallowing.
• Shortness of breath.
• A tightness in your chest.
• Blood in your poop.
• Nausea and vomiting.
• Unexplained weight loss.

A note from Cleveland Clinic

Indigestion is common, and it’s usually not serious. But if you have it often, it can become a real problem. It can interfere with your eating, sleeping and quality of life. It might be a symptom of a medical condition, and rarely, it might be a serious one. Your digestive system is complex, and many things can affect it. An experienced healthcare provider can help you sort through those factors.