Guide To Indigestion, Heartburn, and Upset Stomach

Regardless of whatever your age, gender, current gut health, and/or race, you can experience indigestion. Indigestion is not always easy to define, and is also known as dyspepsia, heartburn, and upset stomach.

Instead, it is believed to be a symptom of certain underlying intestinal disorders such as peptic ulcer disease, gallbladder disease or disorders of brain-gut interaction, like functional dyspepsia.

Sometimes described simply as abdominal discomfort or a painful burning sensation in the upper abdomen, indigestion can often be accompanied by heartburn, abdominal bloating, belching, nausea, and even vomiting.

What Causes Indigestion?

Contrary to the popular belief, indigestion isn’t caused by hyperchlorhydria, otherwise known as excessive stomach acid or an abundance of hydrochloric acid.

Indigestion is often attributable to poor eating habits such as eating while stressed, the consumption of high-fat foods, eating too quickly, or simply overeating.

It can also be caused by various conditions such as gallstones, gastritis, gastroesophageal reflux disorder (GERD), hiatal hernias, an inflamed esophagus (esophagitis), peptic ulcers (gastric or duodenal ulcers), stomach cancer, or pancreatitis.

Other causes of indigestion include:

  • Excessive alcohol consumption
  • Excessive consumption of caffeinated beverages
  • Medications that irritate the stomach lining (primarily NSAIDs)
  • Emotional stress
  • Smoking

These factors can also exacerbate any underlying conditions that may be the cause of indigestion. Note that there is another type of indigestion known as functional, or non-ulcer dyspepsia. Though the cause is unknown, some research suggests the condition is related to how food moves through the digestive tract.

Symptoms of Indigestion

Symptoms of indigestion are not normally present all the time; they tend to come and go, occurring in bouts, usually in relation to meals. During times of stress, symptoms tend to increase. 

Common symptoms of indigestion include a burning sensation in the stomach or upper abdomen, abdominal pain, an acidic taste in the mouth, belching, gas, bloating, fullness, diarrhea, a growling stomach, heartburn, nausea, and vomiting.

Unfortunately, indigestion symptoms are often similar to other more serious illnesses. Some of the symptoms may even resemble those associated with heart attacks.

It is crucial to seek the advice of your health care provider if you have had or experienced any of these symptoms:

  • An appetite loss
  • Black tarry stools
  • Bloody vomit
  • Discomfort, unrelated to eating or that is severe enough to wake you from sleep
  • Indigestion accompanied by pain radiating to the jaw, neck, or arm; shortness of
    breath; or sweating
  • Severe pain in the upper right abdomen
  • Persistent vomiting
  • Weight loss
  • Fever

…Or if your symptoms have lasted for more than a couple of weeks.

Diagnosing Indigestion

In order to make an accurate diagnosis, your health care provider will ask about your symptoms, medical history, and current medications. It will help expedite your diagnosis to describe where, exactly, in your abdomen the discomfort normally occurs.

It is crucial that your physician also be made aware of habits such as alcohol intake, smoking, drug use, and other lifestyle factors that can be associated with indigestion.

Your health care provider will likely recommend a variety of tests in order to rule out certain medical conditions. These may include blood tests, stool tests, imaging (ultrasound, x-ray or CT scan), or an endoscopy to look inside the esophagus and stomach to look for a cause of symptoms.

Treating and Preventing Indigestion

Indigestion treatment may vary depending on the underlying cause. Indigestion treatment and prevention are often tied together as preventing indigestion is also the key to effective treatment. 

The Do’s and Don’ts of Preventing Indigestion

  • Avoid alcoholic beverages
  • Avoid carbonated beverages
  • Avoid all foods that are known triggers
  • Avoid high-acidic foods, such as citrus fruits and tomatoes
  • Avoid late-night eating
  • Avoid situations/stressors that are known triggers
  • Avoid spicy foods
  • Do not chew with your mouth open or talk while chewing
  • Do not eat too quickly
  • Do not exercise on a full stomach
  • Do not lie down soon after eating
  • Do not overindulge in fatty foods
  • Do not wear tight-fitting clothing/waistbands which compresses the stomach
  • Keep a food diary to help identify indigestion triggers
  • Eat several (5-6) small meals a day rather than three large ones
  • Eat slowly and chew thoroughly
  • Exercise regularly
  • Reduce and manage stress
  • Maintain a healthy weight
  • Quit smoking 
  • Reduce or avoid caffeinated beverages
  • Relax after meals
  • Sleep with your head elevated at least six inches above your feet; this discourages
    digestive juices from flowing into the esophagus (regurgitation)
  • Switch from aspirin/NSAIDs to acetaminophen
  • Wait three hours after your last meal before going to bed

Medications

Antacids and proton pump inhibitors (PPIs) are often used to treat indigestion. However, stomach acid doesn’t cause indigestion, so antacids – in many cases – are not effective.

Indigestion caused by acid reflux is sometimes treatable with antacids, histamine 2-blockers (H2 blockers), or proton pump inhibitors (PPIs). 

Medicine that affects stomach motility or anti-depressants in low doses are sometimes prescribed for functional indigestion as they can help with gut motility and modulation of pain.

Indigestion Final Thoughts

Changes to dietary habits are important for managing and treating indigestion. Stress reduction is an essential part of it.

Stress is often best managed by eating well, sleeping well, and regularly making time for physical activity.

While in some cases, persistent indigestion may be an indication of other more serious digestive conditions such as stomach cancer or an ulcer, for the most part indigestion is entirely preventable. And with the implementation of proper dietary care, and other lifestyle changes, sufferers tend to improve rapidly.

Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.