What is indigestion?
Indigestion (dyspepsia) refers to a cluster of upper-abdominal symptoms: pain or burning in the upper abdomen, early fullness, bloating, belching, nausea and sometimes heartburn. It affects about 1 in 4 people at some time. Heartburn alone is usually reflux, whereas dyspepsia includes the wider discomfort in the upper belly. See home remedies for heartburn and why am I so bloated.
Symptoms
- Burning or pain in the upper abdomen or just below the breastbone.
- Feeling uncomfortably full during or soon after a meal.
- Bloating, belching and gas.
- Nausea, sometimes vomiting.
- An acid taste or regurgitation.
- Loss of appetite.
- Symptoms often come and go, and relate to eating.
Common causes
- Eating habits: large, fast or late meals; fatty, fried, spicy or acidic foods.
- Alcohol, coffee, fizzy drinks and smoking.
- Stress and anxiety, which affect gut sensitivity.
- Medicines: NSAIDs (ibuprofen, aspirin, naproxen), steroids, some antibiotics, iron and some blood pressure drugs.
- Acid reflux and GORD. See foods to avoid with acid reflux.
- Gastritis and peptic ulcers, often from Helicobacter pylori or NSAIDs.
- Functional dyspepsia: symptoms without an identifiable cause, the commonest diagnosis.
- Gallstones, pancreatitis, coeliac disease, gastroparesis and, rarely, stomach cancer.
- Pregnancy, due to hormones and pressure.
Quick relief
- Antacids (calcium carbonate, magnesium hydroxide, aluminium hydroxide) neutralise acid within minutes; follow the label.
- Alginates (Gaviscon and similar) form a protective raft over stomach contents.
- H2 blockers (famotidine) reduce acid for several hours.
- Proton pump inhibitors (omeprazole, esomeprazole, lansoprazole) for frequent symptoms, usually a 14-day course over the counter.
- Sip water, walk gently or sit upright.
- Ginger or peppermint tea: may soothe some people; peppermint can worsen reflux.
- Loosen tight clothes and avoid lying down.
- Ask a pharmacist if you take other medicines, are pregnant or have kidney or heart problems.
Foods and eating habits that help
- Eat smaller meals more often, and chew slowly.
- Leave 2–3 hours between your last meal and lying down.
- Choose gentle foods when symptomatic: oatmeal, bananas, rice, toast, skinless chicken, fish, cooked vegetables, yoghurt. See bland diet foods.
- Increase fibre gradually and keep well hydrated. See foods high in fibre.
- Limit fatty, fried, spicy and very acidic foods if they trigger symptoms.
- Moderate coffee, alcohol, chocolate and fizzy drinks.
- Keep a food and symptom diary to identify your own triggers.
Lifestyle changes
- Stop smoking; it weakens the lower oesophageal sphincter and increases acid.
- Reach and keep a healthy weight; abdominal fat pushes on the stomach.
- Raise the head of your bed by 15–20 cm if symptoms occur at night.
- Avoid tight belts and waistbands.
- Manage stress with exercise, relaxation or counselling.
- Review NSAIDs with your doctor; use paracetamol for pain where suitable.
- Be physically active but avoid vigorous exercise right after meals.
Functional dyspepsia
When tests show no ulcer, reflux or other disease, symptoms are called functional dyspepsia. It involves heightened gut sensitivity, slow stomach emptying and stress. Management includes reassurance, dietary adjustments, acid suppression, prokinetics in some cases, low-dose antidepressants for persistent pain, treating H. pylori if present and psychological therapies. Symptoms may fluctuate for years but are not dangerous.
When to see a doctor
- Indigestion lasting more than 2 weeks, or recurring often.
- New indigestion after age 55, or any age with alarm features.
- Unintentional weight loss, loss of appetite or feeling full after small meals.
- Persistent vomiting, vomiting blood or black stools.
- Difficulty or pain swallowing.
- Iron-deficiency anaemia, or a lump in the abdomen.
- Family history of stomach cancer, or taking long-term NSAIDs or blood thinners.
- Chest pain: call emergency services.
Three common situations
Upper abdominal discomfort after a large, fatty dinner: eat smaller portions, avoid late meals and use an antacid if needed.
A person who takes ibuprofen daily and has stomach pain: review the medicine with a doctor; NSAIDs can cause ulcers.
A 60-year-old with new indigestion and weight loss: needs prompt medical assessment and likely an endoscopy.
Indigestion in pregnancy and older age
Indigestion is common in pregnancy because progesterone relaxes the muscle at the top of the stomach and the growing uterus presses on it. Small meals, avoiding trigger foods and not lying down after eating help; ask your midwife or doctor which antacids and alginates are suitable, and avoid products high in sodium or containing aspirin or sodium bicarbonate unless advised. In older adults, new indigestion deserves more attention, because ulcers, medicine side effects (such as NSAIDs and bisphosphonates) and, less often, cancers are more likely. Anyone over 55 with new, persistent symptoms should be assessed rather than treated blindly.
Tests a doctor may suggest
- A breath, stool or blood test for Helicobacter pylori, followed by treatment with antibiotics and acid suppression if positive.
- A blood count and iron studies to look for anaemia.
- Upper endoscopy (gastroscopy) to look at the oesophagus, stomach and duodenum, particularly for alarm features or age over 55.
- Tests for coeliac disease, gallstones (ultrasound) or pancreatic problems when the picture suggests them.
- A trial of acid-lowering treatment for 4–8 weeks, followed by review.
- Reviewing medicines such as NSAIDs, iron, bisphosphonates and some blood pressure drugs.
Key points to remember
Indigestion usually improves with smaller meals, trigger avoidance, lifestyle changes and short-term antacids or alginates. See a doctor for persistent symptoms, alarm features or new indigestion after 55. Our nutrition team can help you plan meals.
This guide is for general information and does not replace an assessment by your own doctor or dietitian.
Questions about indigestion relief
These answers are general information and do not replace an examination or individual medical advice.
What helps indigestion fast?
An antacid or alginate, sitting upright and avoiding trigger foods.
What foods cause indigestion?
Fatty, fried, spicy and acidic foods, large meals, coffee, alcohol and fizzy drinks.
When is indigestion serious?
With weight loss, vomiting, trouble swallowing, black stools, anaemia or onset after age 55.
Can stress cause indigestion?
Yes, stress and anxiety increase gut sensitivity and acid.
Do antacids work long term?
They give short-term relief; frequent use needs medical review.
Could it be a heart problem?
Chest pain with pressure, sweating or breathlessness can be a heart attack; seek emergency help.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.