Indigestion explained Indigestion explained

What is indigestion?

Indigestion is one of those words that we all think we understand but which can be rather hard to define. It is best used as a term to describe unpleasant or even painful sensations in the top of the abdomen or perhaps in the lower part of the chest, which usually come on after eating or drinking. Indigestion is a symptom but not a disease as such. It is so common that nearly everyone experiences it from time to time. Doctors sometimes give indigestion the rather grander name of dyspepsia – but the two words actually mean the same thing.

Using rather vague terms means that indigestion can mean different symptoms from one person to another. To some extent, these symptoms vary because they depend on the nature of the underlying problem which is causing indigestion. For example, some people may feel a burning sensation rising up into the chest, called heartburn. After a hot or spicy meal, others experience a more general feeling of fullness and discomfort. Sometimes, a more localised painful sensation just below the tip of the breastbone is felt. Indigestion can occur by itself or may be accompanied by other symptoms, such as nausea, and sometimes by vomiting.

What causes indigestion?

Indigestion is so common that many regard it as a normal part of their lives. Almost all of us are likely to experience indigestion from time to time, often after a heavy, spicy or fatty meal, sometimes when we have rushed our food but quite often when we have simply had too much to eat or drink.

Most of the time indigestion is irritating, unpleasant or even a nuisance – rather than a danger. Even after medical investigations, most people with indigestion don’t turn out to have an ulcer or anything else serious.
Whilst gastric and duodenal ulcers used to be a common cause of indigestion only a few years ago, they occur less frequently nowadays. Part of the reason for this is that most ulcers are caused by an infection with Helicobacter pylori and this bacterium (stomach bug) is becoming less and less common. We know that people who have to take anti-inflammatory drugs for arthritis and similar conditions are at particular risk of getting both indigestion and a peptic ulcer. An increasing number of people get indigestion because the acid in their stomach can reflux back up into their oesophagus (gullet).

Less commonly, indigestion symptoms can be due to gallstones, disease of the pancreas, and rarely are caused by cancer in the stomach or oesophagus. Happily, most people with indigestion don’t have any of these conditions: such patients are said to have ‘non-ulcer dyspepsia’.

Why is this happening to me?

Because the cause of indigestion is often difficult to determine, it is not always easy to say why certain individuals get these symptoms. Over-eating, rushed meals and a lot of spicy and fatty food can cause indigestion for anyone but some people are more prone to underlying conditions such as peptic ulcer disease. This may be partly because ulcers tend to run in families, but ulcers are also more common in people who smoke and those who take one of the many anti-inflammatory drugs for joint and muscle pains. Helicobacter infection usually starts in childhood although indigestion can take many years to develop. Reflux is more
common in people who are overweight. Others who feel under stress can experience indigestion. But for many people, there is no obvious reason why such symptoms occur – they just do.

What symptoms might I expect?

Most indigestion sufferers have their own pattern of symptoms which range from mild discomfort in the upper part of the abdomen to quite severe pain, which sometimes might go through into the back. This can be accompanied by a burning discomfort, rising up from the breastbone into the throat, when reflux of stomach contents into the oesophagus takes place. There may also be nausea and retching or vomiting and others feel very full and bloated after meals. Occasionally, people  with indigestion go on to develop complications from the condition that is giving rise to their symptoms. For example, ulcers can bleed or they can perforate (make a hole). When ulcers bleed, this results in vomiting blood which either looks quite fresh or it may resemble coffee
grounds. Alternatively, the blood may appear at the other end resulting in the passage of black motions that look like tar. A perforated ulcer causes severe abdominal pain.