Dyspepsia is the medical term for indigestion, a condition affecting a significant portion of the population, with prevalence estimated between 20% and 40%. It is characterized by symptoms in the upper abdomen, including pain or a burning sensation, feeling full shortly after starting a meal, and uncomfortable bloating. These persistent symptoms are why dyspepsia accounts for a notable percentage of visits to primary care physicians.
Lifestyle and Dietary Adjustments
Modifying daily habits and diet can have a substantial impact on managing indigestion. Certain foods are common triggers, including those high in fat, spicy dishes, and acidic items like tomatoes and citrus. Reducing the intake of caffeine, alcohol, and carbonated beverages can also provide relief for some individuals.
The way meals are consumed is as important as what is eaten. Eating smaller, more frequent meals can prevent the stomach from becoming overly full and bloated. It is also beneficial to remain upright for at least two to three hours after eating. Lying down can allow stomach acid to move back up into the esophagus, causing irritation.
Broader lifestyle changes also play a part in managing dyspepsia. Stress is a known factor that can exacerbate digestive issues, so incorporating stress-management techniques like mindfulness or meditation can be helpful. Quitting smoking can lead to significant improvement, as smoking can weaken the muscle that separates the esophagus from the stomach. Maintaining a healthy weight reduces pressure on the abdomen, which can also alleviate symptoms.
Over-the-Counter Medication Options
For short-term relief from indigestion, several over-the-counter (OTC) medications are available. Antacids are often the first choice for rapid relief, as they work by neutralizing stomach acid. Their effect is quick but does not last long, making them suitable for occasional, mild symptoms.
Another class of OTC medications is H2 blockers, which provide longer-lasting relief than antacids. These drugs, which include famotidine, work by reducing the amount of acid the stomach produces by blocking histamine. The effect of H2 blockers is not immediate but can last for several hours.
Proton pump inhibitors (PPIs) are another option that offers a more potent and prolonged reduction in stomach acid. Available in lower doses over-the-counter, PPIs work by blocking the enzyme in the stomach wall that produces acid. This action provides relief for 24 hours, but it may take a few days for the full effect to be felt.
A different type of medication, bismuth subsalicylate, works by coating the lining of the stomach. This protective layer can help to soothe irritation and discomfort. It is important to note that all OTC treatments for dyspepsia are intended for short-term use.
When to Seek Medical Advice
While many cases of indigestion can be managed at home, certain symptoms warrant a prompt visit to a doctor. Unexplained weight loss is a significant warning sign. Difficulty swallowing, known as dysphagia, or pain while swallowing also requires immediate medical attention as it can indicate a more serious underlying issue.
The appearance of vomit or stool can also signal a problem. If vomit contains blood or has a consistency similar to coffee grounds, it is cause for concern. Similarly, stools that are black and tarry may indicate bleeding in the upper gastrointestinal tract. Persistent and severe abdominal pain that does not resolve with self-care measures should also be evaluated.
Even if symptoms are not severe, their persistence is a reason to seek medical advice. If indigestion occurs regularly for more than two weeks despite lifestyle changes and the use of OTC medications, a doctor’s evaluation is recommended. This is particularly important for individuals over the age of 60. A family history of upper gastrointestinal cancer is another factor that makes a medical consultation advisable.
Professional Medical Treatments
When indigestion is persistent, a doctor will work to identify the underlying cause. An upper endoscopy is a common procedure where a thin, flexible tube with a camera is used to examine the esophagus, stomach, and the first part of the small intestine. During this procedure, small tissue samples, or biopsies, may be taken to test for conditions such as an infection with Helicobacter pylori bacteria.
Based on the diagnosis, a doctor may prescribe medications that are stronger than their OTC counterparts. Prescription-strength PPIs or H2 blockers can provide more effective acid suppression for chronic symptoms. If an H. pylori infection is detected, a course of antibiotics is prescribed to eliminate the bacteria. Prokinetics may be used to help the stomach empty more quickly.
In some cases, an investigation reveals no specific organic cause for the symptoms, a condition known as functional dyspepsia. For these individuals, treatment may involve medications that modulate how the nerves in the gut perceive pain. Low-dose antidepressants can be effective because these medications can help control nerve signals between the gut and the brain.