Indigestion Causes, Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Indigestion, also called dyspepsia or upset stomach, is one’s inability to digest the food properly immaterial of the quality and quantity of food consumed. Indigestion is not a disease. It is a set of symptoms along with discomfort in your upper abdomen that you experience.

When one has indigestion, he or she would feel fullness in the belly with an uncomfortable sensation. This may happen while eating, before or after taking food. Abdominal pain, burning pain or pain in the upper part of your belly may also be accompanied with this condition.

Many times indigestion suggests an underlying problem or may be a symptom of yet another digestive disease which needs to be addressed. They include GERD (gastro-esophageal reflux disease), ulcers in the stomach, disease of gallbladder etc. Treatment of indigestion would depend on the cause of this condition. If indigestion is not caused by any underlying disease it can be cured with lifestyle changes and medication.
Read – 120 Remedies For Indigestion Caused By Specific Foods

Symptoms of indigestion

Unable to digest the food is the chief complaint / symptom of indigestion. Many people present different symptoms in varying magnitudes. Though indigestion comprises a wide array of symptoms, there is no rule that all the symptoms persist in everyone. The symptoms also depend on the disease in the backdrop which is causing it. Below mentioned are the symptoms of indigestion.

Bloating – tightness due to excessive accumulation of gases may give one an uncomfortable sensation in their upper belly
Early satiety and fullness in the abdomen / stomach – is a feeling of early fullness during a meal. One may feel full in spite of not eating much food and also could not finish off with eating food which has been served. This may be uncomfortable and the fullness of the abdomen may last longer than it should.
Fullness in the abdomen / stomach – may also occur before or after a meal
Discomfort and burning sensation in the upper abdomen / stomach – one may feel mild to severe pain or uncomfortable heat in their upper belly.
Gases in the abdomen
Belching – sour or otherwise
Nausea – feeling to puke
Vomiting
Acidic taste in the mouth
Growling stomach
Pain in the abdomen
Heartburn

Factors which worsen indigestion

Being stressed – can increase indigestion and its symptoms and make them worse
Swallowing too much air while taking food increases belching and bloating
Read – Effect of Stress, Anxiety on Stomach And Intestines: Remedies

Who gets indigestion?

Indigestion is a common condition. It can happen to anyone. Both men and women of all ages can get indigestion. We all would have suffered from indigestion at one or the other point of time. Some of us have indigestion frequently. If not addressed, it may lead to many diseases. On the other hand, if indigestion is not promptly treated we might miss out on some disease which is in its backdrop and allow it to grow to great proportions reaching a point of incurability.

Etiological Factors of Indigestion

Below mentioned are the important etiological factors of indigestion –

Taking too much of foods
Overeating
Eating too fast / Eating when in stress
Excessive consumption of fatty, greasy or spicy foods
Consumption of too much of alcohol and too much smoking
Consumption of too much chocolate or carbonated beverages
Stress and anxiety and fatigue
Excessive consumption of medicines such as aspirin, certain painkillers and antibiotics, estrogen, steroids, thyroid medicines, iron supplements etc
Read – A Simple Home Remedy To Cure Indigestion And Improve Appetite

Indigestion caused by other conditions

Having ulcers in the stomach and GERD
Gastritis
Celiac disease
Stomach cancer
Infections of the stomach
Irritable bowel syndrome
Having stomach cancer, thyroid disease and pancreatitis
Gastroparesis (condition wherein there is improper emptying of the stomach)
Gallstones
Constipation
Pancreatitis
Blockage of intestine
Intestinal ischemia

Functional dyspepsia / Non-ulcer dyspepsia

Indigestion of long duration which is not related to any of the above said factors is known as functional or non-ulcer dyspepsia. Many pregnant women develop indigestion during pregnancy. This is hormonal and also due to the pressure imparted on the stomach by the growing fetus. This indigestion will go away after delivery of the child.

Diagnosis of indigestion

Indigestion is diagnosed on the basis of thorough history taken by your doctor. The complaint that you are not able to digest the food properly for a few days in succession itself is a point of diagnosis. History is needed to track down if any underlying pathology / disease is causing indigestion. Blood tests and X-rays of stomach or small intestine may be suggested. Endoscopy too may be suggested.

Below mentioned tests shall be suggested by your doctor if the symptoms of indigestion are severe or if the patient is older than 55 years of age –

Lab tests – to check for presence of anemia or any other metabolic disorders
Breathe and stool tests – to check for H. pylori bacterium which can cause indigestion, this test is useful if peptic ulcers are associated
Endoscopy – helps to find out abnormalities in the upper digestive tract, a tissue biopsy too shall be taken for further analysis
X-ray or CT scan – helps in finding out intestinal obstruction or other causes of indigestion, if present

If one or more of these tests do not provide evidence of any cause of indigestion for which they were done, the indigestion may be diagnosed as functional dyspepsia.
Read – Food habits, Indigestion – Ashtanga Hrudayam Sutrasthana 8th Chapter

Treatment of indigestion

If indigestion is not a chronic issue or if there is no major disease in the backdrop causing indigestion, it might just not need any treatment at all. It might just go away on its own as it had come. But if the symptoms of indigestion become frequent and getting worse you need to see your doctor.

Treatment of indigestion will depend on the cause of indigestion. Many times lifestyle changes may help cure or ease the symptoms of indigestion (mentioned under the self help section below).

Self help to cut down the symptoms of indigestion

Don’t chew the food by keeping your mouth open
Do not talk or get indulged in some other distracting activity while chewing food, focus on your eating (conscious eating)
Do not eat too fast, in a hurry
Avoid foods which trigger indigestion
Avoid large meals – take 5-6 small meals in a day instead of 2-3 large meals
Eat food at proper time and maintain the same time every time
Avoid eating food at odd times, like eating at midnight
Avoid taking unwholesome foods or those which give some untoward reaction every time you eat (allergic foods)
Avoid foods which are too sour and spicy
Respect and enjoy food
Relax after taking food
Avoid alcohol, smoking
Avoid pain relievers like aspirin, ibuprofen and naproxen sodium
Control stress and anxiety
Take beverages after meals and not during meals
Read – Gastritis Causes, Types, Symptoms, Prevention, Home Remedies

Medication

Antacids – if the above said measures don’t work you may try antacids.
PPI (Proton Pump Inhibitors) – helps in reducing stomach acid, also indicated for heartburn associated with indigestion
H-2 receptor antagonists (H2RAs) – reduces acids in the stomach
Prokinetics – helps in emptying your stomach properly
Antibiotics – if the digestion is caused by H. pylori bacteria
Antidepressants / anti-anxiety medications – may ease discomfort associated with indigestion by decreasing pain sensation

Lifestyle changes, Preventive measures

Food diary – It is good to maintain a food diary to note down what foods cause trouble on a regular basis leading to indigestion and its symptoms
Eat smaller quantities of food, more frequently rather than large quantity of food for few times
Chew your food slowly and thoroughly, eat food slowly and not in a hurry  
Avoid foods which are acidic (citrus fruits, tomatoes etc)
Avoid or limit spicy foods, fried, excessively oily / greasy foods
Avoid caffeine, processed foods & carbonated beverages
Manage stress by means of relaxation and biofeedback techniques
Practice meditation and Yoga
Quit smoking and alcohol consumption
Avoid tight clothes while eating food
Avoid doing exercises or playing games immediately after food
Don’t sleep immediately after taking food, have early dinner and sleep 2 ½ to 3 hours after taking dinner
Sleep in a position where in your head and chest are higher than your feet
Maintain healthy body weight
Exercise regularly
Do things which you enjoy
Have good sleep
Read – Fruitful Ayurvedic Remedies For Gastritis

Pathya apathya – Yogaratnkara:

Wholesome diet and habits :
Medicated wick smeared with laxatives
Emesis
Sudation
Lightening therapy
Fasting

Unwholesome diet and habits :
Food and drinks which are opposite in quality
Incompatible food and drink
Constipating food
Heavy to digest food

What is the right time to see the doctor?

Consult doctor if you have any of the below mentioned symptoms and also if discomfort persists for more than 2 weeks time –

Severe / repeated vomiting
Blood vomiting wherein the vomit appears with coffee grounds color
Bloody, tarry or black colored feces
Severe pain in the upper right abdomen
Pain in upper or lower right parts of the belly
Uncomfortable feeling in the abdomen in spite of not having eaten any food
Trouble in swallowing food which gets progressively worse
Fatigue
Unexplained weight loss
Loss of appetite

Seek immediate medical attention if you have –

Shortness of breath
Sweating
Chest pain radiating to your jaw, neck or arm
Chest pain on exertion or with stress

Note – symptoms similar to those of indigestion can also be seen when there is ‘heart attack’. One cannot differentiate between indigestion and heart attack many times and a clinical diagnosis of the later may be missed.

Alternative medicine
Below mentioned alternative treatments may help in easing the symptoms of indigestion but the effects of these have not been studied or researched well. They include –

Using herbs like peppermint and caraway
Meditation
Acupuncture and acupressure
Psychological treatment – behavior modification, hypnotherapy, relaxation techniques, cognitive behavioral therapy etc

Note – it is good to take an opinion from your doctor before trying any of these.
Read – Ajirna – how to know that your digestion system is working fine?

Indigestion in Ayurveda

A condition named as Ajirna in Ayurveda texts can be closely compared to indigestion. Ajirna also means indigestion. It is said to be the root for the origin of many systemic and metabolic disorders. Ayurveda has given a detailed account of indigestion, its types, symptoms and treatments in the related contexts and chapters.
A – no / less / inadequate
Jirna / Jeerna – digestion