Dyspepsia or Indigestion

Introduction

Indigestion (or dyspepsia) refers to pain and discomfort in the centre of the upper abdomen, with a feeling that food is stuck and not passing normally through your food pipe. Sufferers might also experience heartburn together with indigestion.

While it certainly is bothersome, indigestion is not a disease, but rather refers to a group of symptoms due to an underlying cause such as Gastritis, Celiac Disease or stomach ulcer.

Signs & Symptoms

Signs and symptoms of indigestion usually occur after eating. These include:

  • Stomach pain which is not alleviated by passing gas or visiting the toilet
  • Burning sensation
  • Feeling full after eating a small amount of food
  • Bloating, belching
  • Nausea and vomiting

When to Seek Medical Attention

  • If you are above 50 years old and have sudden symptoms of indigestion
  • If you are unable to eat
  • Unintentional weight loss
  • Difficulty in swallowing
  • If your symptoms do not respond to self-medication
  • If you notice blood in your stools or vomit, or if your stools are black and tarry

Causes

The cause for indigestion is not always clear. This condition is known as functional dyspepsia, in which underlying conditions such as gastritis, stomach ulcers and reflux are ruled out.

Some causes for dyspepsia are:

  • H. Pylori, a bacteria that can affect the lining of the stomach and cause stomach ulcer
  • Stress
  • Infections such as stomach flu
  • Gastritis and Heartburn
  • Medications
    • Nonsteroidal Anti-inflammatory Drugs
  • Aspirin
  • Ibuprofen
  • Naproxen
  • Prescription drugs like mefenamic acid and diclofenac:
    • Oral steroids
    • Osteoporosis drugs
    • Antibiotics
  • Underlying conditions
    • Irritable Bowel Disease
    • Gallstones
    • Pancreas swelling
    • Cancers

Lifestyle Modifications

Eat more frequent, smaller meals instead of three big meals. Eat slowly to prevent taking in more air during consumption.

Consider losing weight if you are overweight as this can put more pressure on your stomach area. This can be achieved by living an active lifestyle and watching your caloric intake.

Alcohol and smoking are usual triggers. Try cutting down your alcohol intake, and give up smoking.

Peppermint and chamomile tea are commonly used for digestion and stomach pains. However, they might make heartburn worse, so avoid if you have symptoms such as a burning sensation in the chest or a sour taste in your mouth.

Treatment Options

Treatment options are rather similar for heartburn and indigestion.

Antacids can be use when necessary to neutralise acid in the stomach when necessary. Examples of antacids include sodium bicarbonate, calcium carbonate, magnesium carbonate and aluminium hydroxide. Patients on a sodium-restricted diet, such as those with heart problems, should avoid sodium-containing antacids. Common side effects from antacids include bloating, diarrhoea from calcium and magnesium-containing antacids and constipation from aluminium-containing antacids. Because antacids can interfere with some medications, check with your pharmacist or doctor before starting treatment.

Domperidone is a medication known as a prokinetic. This helps to speed the transit of food along the gut, and could help if nausea and vomiting is experienced. Do tell your pharmacist or doctor if you have any heart conditions, as this medicine might not be suitable for you.

Histamine-2 Receptor Antagonists (H2RA) and Proton-pump inhibitors (PPI) are medications that help to inhibit gastric acid secretion, although PPIs are usually preferred because they are more effective at reducing indigestion symptoms. H2RAs, namely cimetidine, ranitidine and famotidine, are available from the pharmacy. Although PPIs are prescription-only medicines, omeprazole and pantoprazole 20mg are also available in small quantities from your pharmacist. However, if you require H2RAs or PPIs for longer than two weeks, go to a doctor for an evaluation.

 

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