Also referred to as dyspepsia or upset stomach, indigestion broadly describes discomfort in the upper abdomen. It's also an umbrella term used for many different symptoms -- so that what you or someone else may think of as indigestion can vary widely.
"Indigestion is a very subjective term that people use, and it is actually not really a medical symptom, per se," says Dr. Ketan Shah, a gastroenterologist at MemorialCare Saddleback Medical Center in Laguna Hills, California. "But people use the term to describe various sensations usually after eating -- sensations such as a sour stomach or burning in the upper abdominal area or some nausea, regurgitation, heartburn, belching, bloating."
Other symptoms of indigestion may include gas and a "growling," rumbling or gurgling stomach.
Indigestion is a common problem. And when upset stomach is infrequent -- as is most often the case -- it may be uncomfortable, but it's generally not a cause for concern.
In cases when a person has frequent indigestion, however -- like several times weekly or even daily -- it could be a sign of an underlying medical problem. So it's worth talking with your doctor about frequent upset stomach, or if symptoms persist for more than a couple weeks. Make sure to provide specifics on exactly what you're feeling and the symptoms you're experiencing to help your health provider better understand what's going on.
Also, seek prompt medical attention if you experience any of these symptoms with indigestion:
-- Vomiting frequently or bloody vomiting.
-- Black, tarry stool.
-- Swallowing is difficult or painful.
-- Unexplained weight loss.
-- Belly pain or discomfort even when you haven't eaten.
-- Severe abdomen pain.
-- Shortness of breath.
Causes of Indigestion
A rumbling tummy can often be traced back to what you ate -- or how much you had.
"Fatty, fried, cheesy, processed foods, fast foods -- those are all things that would be common causes of indigestion," says Dr. Leena Khaitan, a gastrointestinal surgeon at University Hospitals Cleveland Medical Center and professor of surgery at Case Western Reserve University School of Medicine. Overeating -- or having a large volume of food, beyond what you would normally eat -- can also cause indigestion, Khaitan says.
In some instances, underlying health conditions may be to blame for an upset stomach. Among those possible causes of indigestion are:
-- Acid reflux, or gastroesophageal acid reflux disease (GERD).
-- Peptic ulcers, or sores that develop in the lining of the stomach or upper part of the small intestine.
-- Bacterial infection with Helicobacter pylori, or H. pylori.
-- Inflammation of the stomach lining called gastritis.
-- Gastroparesis, when food is delayed in leaving your stomach.
-- Stomach cancer.
It's easy to jump to worst-case-scenario conclusions about what might be to blame for frequent indigestion. However, experts point out, serious causes like stomach cancer are rare. Nevertheless, make sure to be medically evaluated for any concerns.
Easing an Upset Stomach
Oftentimes the simplest approach to indigestion is the most effective: Avoid any offending foods. If you experience indigestion each time you have fast food, for instance, skip the drive-through meals -- which is probably a healthier move anyway.
Over-the-counter antacids, such as Tums, Rolaids, Maalox and Mylanta, can help, Shah notes. He adds that "sometimes over-the-counter, anti-reflux medications such as Zantac or Pepcid" can also help with acid reflux symptoms. But these short-term fixes are just that. "If it occurs frequently, then it really should be evaluated," he says.
Lifestyle is still tends to be the initial focus to ease indigestion. "We usually first advise patients to make certain lifestyle modifications. The single most important lifestyle modification for acid reflux is to lose weight and to maintain a healthy weight," Shah says.
Among other suggested changes, he notes patients are also advised to:
-- Eat smaller but more frequent meals.
-- Avoid lying down soon after a meal.
-- Minimize certain foods that precipitate acid reflux, such as chocolate, peppermint, caffeine and alcohol.
-- Avoid smoking.
If lifestyle changes aren't enough to ease symptoms, medications may be prescribed. "If these lifestyle modifications are ineffective, then we often start a daily acid reflux medication, such as a histamine-2 blocker, like Zantac or Pepcid, or a proton pump inhibitor, like Prilosec or Prevacid, Nexium, Protonix," Shah says.
With any medication it's important to consider risks and stop to the medications when they're no longer needed. That's been highlighted in the case of proton pump inhibitors, highly effective medicines that nonetheless have been shown to raise risks for everything from vitamin deficiency to heart and kidney disease with long-term use.
Surgery for GERD
In some cases, a surgical procedure may be recommended to treat GERD. One, called the transoral incisionless fundoplication procedure, is done through a patient's mouth, using an endoscope, a flexible tube with a camera on it. "The top of the stomach is wrapped around the esophagus to lengthen and reconstruct the valve between the esophagus and stomach, which can ease reflux and indigestion and allow many patients to discontinue their daily anti-reflux medications," says Shah, who performs the procedure.
It's done under general anesthesia while the patient is asleep. The approach is similar to more conventional anti-reflux surgeries like the Nissen fundoplication, but the TIF procedure is minimally invasive, so there's less risk. Rarely, the TIF procedure may lead to other more serious issues such as bleeding and infection.
"Though traditional anti-reflux surgeries such as the Nissen fundoplication are very effective, they are also known to have a high rate of long-term side effects, including difficulty swallowing (26%), bloating (36%) and increased flatulence (65%)," Shah says. In contrast, the rate of side effects is low for the TIF procedure (2%).
In other instances, frequent indigestion may be caused by a stomach ulcer. The two most common causes of stomach ulcers are H. pylori bacteria and the long-term use of nonsteroidal, anti-inflammatory medications such ibuprofen, naproxen and aspirin. Respectively, these issues can be addressed by treating the bacteria with antibiotics or by modifying NSAID use. Make sure to always keep your doctor in the loop about medications you're taking, including OTC drugs.
The most important thing is not to ignore indigestion that occurs frequently, experts remind.
"People need to realize that when symptoms persist like that, that's not normal," Khaitan says. So don't resign yourself to frequent indigestion. For those who do have acid reflux, clinicians reiterate that it's important to remember that drugs -- including those taken over the counter to provide immediate relief -- aren't long-term solutions or meant to be taken on an ongoing basis. Instead, talk with a doctor who regularly treats conditions like GERD to discuss other treatment options as needed.