Indigestion is either pain or discomfort in the upper region of the abdomen (Dyspepsia) or a burning pain behind the breast bone (Heartburn).
Heartburn is a discomfort or pain caused by the stomach contents regurgitating from the stomach up into the gullet (oesophagus).
The oesophagus is not made to withstand acid and is thus irritated and inﬂamed when acid from the stomach reﬂuxes into it. This is also known as acid reﬂux. The pain caused by the irritation of the oesophagus is a burning pain, which you feel in the centre of the chest. There is often associated awareness of acid and stomach contents in the back of the throat or mouth. Lying down or bending tends to increase the symptoms.
The symptoms of heartburn are feeling full or heavy, belching, bringing food or fluid back up from the stomach (reflux), bloating, feeling sick (Nausea) and vomiting.
The symptoms of dyspepsia are early satiety, bloating, nausea, abdominal pain, and fullness.
Causes of indigestion
Millions of people suffer with indigestion every year and most people will have indigestion at some point in their lives. Common causes are:
- Eating too rapidly.
- Eating too much.
- Fatty diets.
- Spicy diets.
- Drinking too much alcohol.
- Some medicines (such as aspirin, ibuprofen).
- Hiatus hernia.
There are many types of medication available over the counter for self-treatment.
Since heartburn is caused by acid from the stomach, one of the simplest ways to relieve discomfort is to neutralise the acid with an antacid.
Antacids usually contain a mixture of magnesium and aluminium salts, calcium carbonate or sodium bicarbonate. Those containing high amounts of sodium may not be suitable for pregnant women or those on a sodium restricted diet, such as people with high blood pressure or heart disease.
They are available as tablets that can be sucked or chewed or liquids. Liquids may work faster although tablets may have a longer lasting effect.
Some antacids contain ingredients such as dimethicone that help to get rid of excess gas. These ingredients work by combining all the small bubbles of gas to form one big bubble, which is easier to expel and thus relieve the discomfort.
Some antacid products such as Gaviscon also contain sodium alginate.
This substance forms a ‘raft’ that ﬂoats on top of the stomach contents. The raft prevents stomach acid from passing back into the oesophagus and protects the oesophagus from the acid if regurgitation does occur.
These products are particularly useful for heartburn caused by pressure on the stomach such as during pregnancy.
H2 antagonists work by blocking histamine receptors in the stomach, which prevent the cells in the stomach from producing too much acid. Products include cimetidine, ranitidine and famotidine.
Proton pump inhibitors
Proton Pump inhibitors work by reducing the production of stomach acid. They do this by a system in the stomach called the proton pump. Examples include omeprazole and pantoprazole.
Due to its long duration of action, when taken everyday omeprazole is very effective at providing long-term symptomatic relief. If symptoms persist for more than four weeks please seek advice from your GP.
There are a number of lifestyle and dietary changes that may help prevent or reduce the symptoms of indigestion.
- If you are overweight, losing weight can often help.
- Avoid large fatty meals and try not to eat just before bedtime.
- Try to cut down on tea, coffee and alcohol.
- Avoid smoking.
- Avoid stress.
- If suffering from nightly symptoms, use an extra pillow to prop up the head.