What is the best treatment for indigestion?

Treating indigestion starts by looking for causes which can easily be remedied: over-eating, excess alcohol, heavy smoking, rushed meals, eating too much fatty or spicy foods and taking medications which cause indigestion.

Most patients with indigestion are able to control their symptoms simply by taking over-the-counter antacid tablets or liquids from the pharmacist. Some of these treatments work by neutralising stomach acid while others reduce the amount of acid your stomach produces.

The Helicobacter test-and-treat approach, which can be organised by your general practitioner, is also often very effective.

Can I help myself?

As indicated above, an inappropriate diet and eating habits, and taking drugs likely to cause stomach irritation, are common causes of indigestion, and present obvious opportunities for you to help yourself. There isn’t much evidence that stress and worry are linked with indigestion but any measures which promote good health – exercise, weight loss, healthy eating and cutting down on smoking and alcohol, are also likely to improve your general sense of well being.

How important is diet?

Some individuals find that particular foods bring on indigestion every time they are eaten – bananas, cucumbers, nuts, tomatoes, citrus fruit, curry – the list is almost endless. Large quantities of spicy and fatty foods, large meals and large amounts of alcohol are likely to bring on indigestion in anyone. Changing your diet is one way of reducing the amount of trouble your indigestion gives you.

How can the doctor help?

Your general practitioner can help in a number of ways. Having listened to your symptoms and examined you, the GP is likely to be able to reassure you that there is no serious underlying cause for your symptoms. Your GP can request a Helicobacter test on a blood sample taken in the surgery, and triple antibiotic therapy can be prescribed in general practice. Your GP can also arrange a follow up breath test to make sure the Helicobacter infection has cleared up. Your doctor will also be able to advice you about whether any other medication that you are taking is likely to be causing indigestion and, should simple medicines obtained from the pharmacist be ineffective, will be able to prescribe longer-term antacid or acid suppressing medication for you.

Will I need treatment forever?

Many patients with indigestion find that their symptoms improve after they have been investigated and treated by their GP. A small number, however, do go on to have longer-term problems, and they may find that they need to take treatment over a prolonged period. Sometimes, treatment need not be continuous. Finding the lowest dose of the medicine that keeps you well is a wise strategy. You may be able to have breaks between courses of tablets, and just take your treatment when you feel worse.

Is indigestion ever serious?

The short answer is rarely. Most people with indigestion don’t have anything seriously wrong. A small proportion will have an ulcer in their stomach or duodenum, and this can usually be easily dealt with.  Only a tiny number of, usually considerably older, patients turn out to have a growth of some kind in their stomach or oesophagus. A small number of patients with reflux symptoms, such as heartburn, may be advised to have regular but infrequent endoscopy tests.

What research is needed?

Medical research has enabled many of the important questions about ulcer disease to be answered. However, we have much to learn about Helicobacter pylori and why it causes important problems for some but not all.  It would be a major breakthrough to find out why there are people with Helicobacter infection who never have symptoms. Indigestion is one of the commonest reasons for people to visit a GP. We must find out why it is so common – prevention is much better than cure.