Definition

Indigestion (dyspepsia) is a mild discomfort in the upper belly or abdomen. It often occurs during or right after eating. It may feel like:

• Heat, burning, or pain in the area between the navel and the lower part of the breastbone
• Unpleasant fullness that starts soon after a meal begins or when the meal is over

Bloating and nausea are less common symptoms.

Indigestion is NOT the same as heartburn.

Alternative Names

Dyspepsia; Uncomfortable fullness after meals

Causes

Most of the time, indigestion is not a sign of a serious health problem unless it occurs with other symptoms. These may include:

• Bleeding
• Trouble swallowing
• Weight loss

Rarely, the discomfort of a heart attack is mistaken for indigestion.

Indigestion may be triggered by:

• Drinking too many caffeinated beverages
• Drinking too much alcohol
• Eating spicy, fatty, or greasy foods
• Eating too much (overeating)
• Eating too fast
• Eating high-fiber foods
• Smoking or chewing tobacco
• Stress or being nervous

Other causes of indigestion are:

• Gallstones
• Gastritis (when the lining of the stomach becomes inflamed or swollen)
• Swelling of the pancreas (pancreatitis)
• Ulcers (stomach or intestinal ulcer)
• Use of certain medicines such as antibiotics, aspirin, and over-the-counter pain medicines (NSAIDs, such as ibuprofen or naproxen)

Home Care

Changing the way you eat may help your symptoms. Steps you can take include:

• Allow enough time for meals.
• Avoid arguments during meals.
• Avoid excitement or exercise right after a meal.
• Chew food carefully and completely.
• Relax and get rest if indigestion is caused by stress.

Avoid aspirin and other NSAIDs. If you must take them, do so on a full stomach.

Antacids may relieve indigestion.

Medicines you can buy without a prescription, such as ranitidine (Zantac) and omeprazole (Prilosec OTC) can relieve symptoms. Your health care provider may also prescribe these medicines in higher doses or for longer periods of time.

When to Contact a Medical Professional

Get medical help right away if your symptoms include jaw pain, chest pain, back pain, heavy sweating, anxiety, or a feeling of impending doom. These are possible heart attack symptoms.

Contact your provider if:

• Your indigestion symptoms change noticeably.
• Your symptoms last longer than a few days.
• You have unexplained weight loss.
• You have sudden, severe abdominal pain.
• You have trouble swallowing.
• You have yellow coloring of the skin and eyes (jaundice).
• You vomit blood or pass blood in the stool (which may appear black).

What to Expect at Your Office Visit

Your provider will do a physical exam of the stomach area and digestive tract. You will be asked questions about your symptoms.

You may have some tests, including:

• Blood tests
• Esophagogastroduodenoscopy (EGD or upper endoscopy)
• Ultrasound test of the abdomen

References

Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, chest pain of presumed esophageal origin, and heartburn. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 128.

Tack J. Dyspepsia. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 14.