Indigestion – Illnesses & conditions

Treatment for indigestion (dyspepsia) will vary, depending on what is causing it and how severe your symptoms are.

If you have been diagnosed with an underlying health condition, you may want to read our information on:

• treating gastro-oesophageal reflux disease (GORD)
• treating a stomach ulcer

Diet and lifestyle changes

If you only have indigestion occasionally, you may not need to see your pharmacist or GP for treatment. It may be possible to ease your symptoms by making a few simple changes to your diet and lifestyle, summarised below.

Healthy weight

Being overweight puts more pressure on your stomach, making it easier for stomach acid to be pushed back up into your gullet (oesophagus). This is known as acid reflux, and is one of the most common causes of indigestion.

If you are overweight or obese, it is important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet. Read advice on losing weight.

Stop smoking

If you smoke, the chemicals you inhale in cigarette smoke may contribute to your indigestion. These chemicals can cause the ring of muscle that separates your oesophagus from your stomach to relax, causing acid reflux.

Read more about quitting smoking, or speak to your GP or pharmacist. You can also call the Quit Your Way Scotland service on 0800 84 84 84 (8.00am to 10.00pm, every day).

Diet and alcohol

Make a note of any particular food or drink that seems to make your indigestion worse, and avoid these if possible. This may mean:

• eating less rich, spicy and fatty foods
• cutting down on drinks that contain caffeine – such as tea, coffee and cola
• avoiding or cutting down on alcohol

At bedtime

If you tend to experience indigestion symptoms at night, avoid eating for three to four hours before you go to bed. Going to bed with a full stomach means there is an increased risk that acid in your stomach will be forced up into your oesophagus while you are lying down.

When you go to bed, use a couple of pillows to prop your head and shoulders up or, ideally, raise the head of your bed by a few inches by putting something underneath the mattress. The slight slope that is created should help to prevent stomach acid moving up into your oesophagus while you are asleep.

Stress or anxiety

If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion.

Read some relaxation tips to relieve stress.

Changing current medication

Your pharmacist may recommend making changes to your current medication if they think it could be contributing to your indigestion.

As long as it is safe to do so, you may need to stop taking certain medications, such as aspirin or ibuprofen. Where required, your pharmacist may advise you see your GP to prescribe an alternative medication that will not cause indigestion. However, never stop taking any medication without consulting your pharmacist or GP first.

Immediate indigestion relief

If you have indigestion that requires immediate relief, your pharmacist can advise you about the best way to treat this. As well as lifestyle changes and reviewing your current medication, your GP may prescribe or recommend:

• antacid medicines
• alginates

These are described in more detail below.

Antacids

Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion. They work by neutralising the acid in your stomach (making it less acidic), so that it no longer irritates the lining of your digestive system.

Antacids are available in tablet and liquid form. You can buy them over the counter from most pharmacies without a prescription.

The effect of an antacid only lasts for a few hours at a time, so you may need to take more than one dose. Always follow the instructions on the packet to ensure you do not take too much.

It is best to take antacids when you are expecting symptoms of indigestion, or when they start to occur, such as:

• after meals
• at bedtime

This is because antacids stay in your stomach for longer at these times and have more time to work. For example, if you take an antacid at the same time as eating a meal, it can work for up to three hours. In comparison, if you take an antacid on an empty stomach, it may only work for 20 to 60 minutes.

Read more about antacids, including possible interactions with other medicines and side effects.

Alginates

Some antacids also contain a medicine called an alginate. This helps relieve indigestion caused by acid reflux.

Acid reflux occurs when stomach acid leaks back up into your oesophagus and irritates its lining. Alginates form a foam barrier that floats on the surface of your stomach contents, keeping stomach acid in your stomach and away from your oesophagus.

Your pharmacist may suggest that you take an antacid that contains an alginate if you experience symptoms of acid reflux or if you have GORD.

Take antacids containing alginates after eating, because this helps the medicine stay in your stomach for longer. If you take alginates on an empty stomach, they will leave your stomach too quickly to be effective.

Treating persistent indigestion

If you have indigestion that is persistent or recurring, treatment with antacids and alginates may not be effective enough to control your symptoms. Your pharmacist may recommend a different type of medication, which will be prescribed at the lowest possible dose to control your symptoms. Possible medications include:

• proton pump inhibitors (PPIs)
• h3-receptor antagonists

These are described in more detail below. Your pharmacist may advise you to see your GP who may also test you for the Helicobacter pylori (H pylori) bacteria (see Indigestion – diagnosis) and prescribe treatment for this if necessary.

Proton pump inhibitors (PPIs)

PPIs restrict the acid produced in your stomach.

The medication is taken as tablets and if you are over 18, you can buy some types of PPIs over the counter in pharmacies, but these should only be used for short-term treatment. PPIs may enhance the effect of certain medicines. If you are prescribed a PPI, your progress will be monitored if you are also taking other medicines, such as:

• warfarin – a medicine that stops the blood clotting
• phenytoin – a medicine to treat epilepsy

If your ingestion is persistent, your pharmacist might advise you to see your GP.

If your GP refers you for an endoscopy (a procedure that allows a surgeon to see inside your abdomen), you will need to stop taking a PPI at least 14 days before the procedure. This is because PPIs can hide some of the problems that would otherwise be spotted during the endoscopy.

PPIs can sometimes cause side effects. However, they are usually mild and reversible. These side effects may include:

• headaches
• diarrhoea
• constipation
• feeling sick (nausea)
• vomiting
• flatulence
• stomach pain
• dizziness
• skin rashes

h3-receptor antagonists

h3-receptor antagonists are another type of medication that your pharmacist or GP may suggest if antacids, alginates and PPIs have not been effective in controlling your indigestion. There are four h3-receptor antagonists:

• cimetidine 
• famotidine 
• nizatidine 
• ranitidine 

These medicines work by lowering the acidity level in your stomach.

Your GP may prescribe any one of these four h3-receptor antagonists, although ranitidine is available from pharmacies under the Pharmacy First Scotland service. h3-receptor antagonists are usually taken in tablet form.

As with PPIs, you will need to stop taking h3-receptor antagonists at least 14 days before having an endoscopy if this has been arranged through your GP. This is because they can hide some of the problems that could otherwise be spotted during the endoscopy.

Helicobacter pylori (H pylori) infection

If your indigestion symptoms are caused by an infection with H pylori bacteria, you will need to have treatment to clear the infection from your stomach. This should help relieve your indigestion, because the H pylori bacteria will no longer be increasing the amount of acid in your stomach.

H pylori infection is usually treated using triple therapy (treatment with three different medications). Your GP will prescribe a course of treatment containing:

• two different antibiotics (medicines to treat infections that are caused by bacteria)
• a PPI

You will need to take these medicines twice a day for seven days. You must follow the dosage instructions closely to ensure that the triple therapy is effective.

In up to 85% of cases, one course of triple therapy is effective in clearing an H pylori infection. However, you may need to have more than one course of treatment if it does not clear the infection the first time.

Heartburn, Regurgitation, Dyspepsia, and More

Written by Annie Stuart

Medically Reviewed by Poonam Sachdev on April 24, 2023

• What Are the Common Acid Reflux Symptoms?
• When Do Acid Reflux Symptoms Occur?
• What Makes Acid Reflux Symptoms Worse?
• Are There Potential Complications With Acid Reflux Symptoms?
• When Should I Call the Doctor With Acid Reflux Symptoms?
• Acid Reflux vs. GERD
• More

Lots of people are intimately familiar with acid reflux symptoms. More than 60 million Americans experience acid reflux at least once a month. Acid reflux disease, also known as gastroesophageal reflux disease (GERD), can produce a variety of symptoms.

Heartburn, regurgitation, and dyspepsia are a few of the most common acid reflux symptoms.

Heartburn. Also called acid indigestion, heartburn is a burning pain or discomfort that can move up from your stomach to the middle of your abdomen and chest. The pain can also move into your throat. Despite its name, heartburn doesn’t affect your heart.

Regurgitation. Another common symptom of acid reflux is regurgitation — or the sensation of acid backing up into your throat or mouth. Regurgitation can produce a sour or bitter taste, and you may experience “wet burps.” 

Dyspepsia. Many people with acid reflux disease also have a syndrome called dyspepsia. Dyspepsia is a general term for stomach discomfort. Symptoms of dyspepsia include:

• Burping
• Nausea after eating
• Stomach fullness or bloating
• Upper abdominal pain and discomfort

Symptoms of acid reflux may be a sign that stomach acid has inflamed your esophagus. When that happens, stomach acid can damage the lining of your esophagus and cause bleeding. Over time, it can also change the cells of esophagus and cause a condition called Barrett’s esophagus.

Although acid reflux is extremely common and rarely serious, don’t ignore your acid reflux symptoms. Making a few lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.

Acid reflux symptoms most often occur:

• After eating a heavy meal
• When bending over or lifting an object
• When lying down, especially on your back

People who have frequent acid reflux symptoms most often experience them at night. Nighttime GERD also produces the most pain. However, the level of pain does not always indicate the degree of damage to your esophagus.

More than half of all pregnant women experience heartburn during pregnancy. Increased hormones and pressure from a growing fetus can combine to produce this acid reflux symptom. In most cases, heartburn improves or completely goes away after delivery.

Acid reflux disease is also known as gastroesophageal reflux disease (GERD).

Certain foods can make the symptoms of acid reflux worse for some people. To lessen your symptoms, try avoiding:

• Citrus fruits
• Chocolate
• Caffeinated drinks or alcohol
• Spicy, fatty, or fried foods
• Garlic and onions
• Peppermint
• Tomatoes

Usually, acid reflux symptoms cause no complications. In a few cases, continued esophageal damage can lead to scarring, which may cause the esophagus to narrow. The narrowing creates strictures and makes it difficult to swallow. You may have dysphagia, a sensation that food is stuck in your esophagus. In some cases, normal cells in the lining of the esophagus may be replaced by a different type of cell. This is called Barrett’s esophagus, which can sometimes develop into cancer.

Be sure to call your doctor if you don’t get lasting relief from medications. Also call the doctor right away if you have any “alarm” acid reflux symptoms, such as these:

• Unexpected weight loss
• Blood in vomit
• Black, tarry, or maroon-colored stools
• Difficulty or pain with swallowing

Other acid reflux symptoms that should prompt a call to your doctor include:

• Asthma-like symptoms, such as wheezing or dry cough
• Hoarseness, especially in the morning
• Chronic sore throat
• Hiccups that don’t let up
• Nausea that lasts for more than a day or two

Sometimes, people confuse the symptoms of heart attack with symptoms of acid reflux disease. That’s because pain in the chest can feel like heartburn. When in doubt, call your doctor.

Call 911 if you have any of these symptoms of heart attack:

• Chest pain, pressure, or fullness lasting more than a few minutes or that goes away and comes back
• Pain or discomfort in your neck, shoulder, upper back, or jaw
• Shortness of breath, with or without chest pain
• Dizziness, lightheadedness, or nausea
• Sweating along with chest pain

GERD stands for gastroesophageal reflux disease. It’s heartburn (or reflux) that happens two or more times per week. It’s more serious than regular heartburn.

The problem lies at the place where your esophagus (the tube that connects your mouth to your stomach) connects to your stomach. You have a muscular valve there called the lower esophageal sphincter. Its job is to keep stomach acid in your stomach. But if that valve doesn’t work well, the acid can go back up into your esophagus. That’s reflux. 

If stomach acid goes into your esophagus, you may have heartburn and belching. If it goes higher into your throat, you may have hoarseness and sore throat. And if it gets into your mouth, you’ll notice a bitter taste and you may cough. If it happens a lot, it may wear down your tooth enamel or worsen the symptoms of asthma.

Symptoms

The most common one is chronic heartburn. Others include:

• Burping
• Chronic sore throat
• Trouble or pain when swallowing
• Suddenly having too much saliva
• Hoarseness
• Sour or bitter taste in the mouth  
• Bad breath
• Inflammation of the gums
• Erosion of tooth enamel (the surface of the teeth)
• Nausea  
• Chest pain

Sometimes, there are no symptoms and you only find out that you have GERD if it causes other problems. But just like with acid reflux, you should call 911 or go to the nearest emergency room if you have chest pain.

Complications

Over time, untreated GERD may cause:

Esophagitis. This is an irritation and inflammation of the lining of the esophagus caused by stomach acid.

Trouble swallowing. Your doctor may call this dysphagia. It can happen if scarring narrows your esophagus.

Barrett’s esophagus. This means that there are changes in the cells of the esophagus that may be precancerous.

Esophageal cancer. Years of exposure to stomach acid may cause cancer of the esophagus.

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symptoms and diagnosis, prices for the treatment of heartburn in Moscow at the Hadassah clinic

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Heartburn is an unpleasant sensation, up to a burning pain in the upper abdomen. Many people experience discomfort regularly or occasionally, especially after overeating or drinking alcohol. If it happens from time to time, it does no harm. With frequent episodes, we are talking about the development of reflux disease. Heartburn occurs

when the contents of the stomach back up into the esophagus – this backflow is also known as reflux. Thus, heartburn is not an independent disease, but is a consequence.

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Symptoms of heartburn

Heartburn is not a disease, but a manifestation of reflux. Discomfort in the chest and neck is aggravated by leaning forward, physical activity and eating. Patients complain of the presence of sour belching and an unpleasant aftertaste in the oral cavity. Additional symptoms depend on the severity of the reflux disease. Thus, the patient may experience a violation of food intake and a manifestation of indigestion. Sometimes there is no discomfort at all.

Additional symptoms of heartburn that indicate the presence of reflux disease:

• increased salivation;
• nausea and bitterness in the mouth;
• discomfort when swallowing food;
• occurrence of bad breath;
• lump in throat and characteristic burning;
• chronic cough and hoarseness;
• sleep problems;
• poor appetite.

In the chronic form of the disease, there are violations of the respiratory system. Inflammation of the lungs may develop, which occurs due to the reflux of gastric juice into the respiratory tract. Bronchial asthma can be complicated by frequent attacks.

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Causes of heartburn

Heartburn can have several causes. In most cases, they remain unclear. Most often, heartburn develops against the background of an unhealthy lifestyle and diet, which overload the stomach. For example, stress can literally hit the stomach and cause heartburn because it stimulates stomach acid production, delays emptying, and promotes reflux.

Other factors that can cause heartburn include:

• excessive body weight;
• alcohol abuse;
• smoking;
• inclusion in the diet of fatty and fried foods;
• eating hot spices such as garlic, mustard or horseradish;
• meal before going to bed.

Medicines are also among the causes of heartburn. They can both cause heartburn and increase existing discomfort. For some medications, reflux is a possible side effect. Painkillers from the group of so-called non-steroidal anti-inflammatory drugs cause heartburn especially often. Therefore, those who are prone to heartburn should prophylactically take a gastric protector during drug therapy.

In addition, there are some diseases that sometimes cause heartburn, for example:

• functional dyspepsia;
• diaphragmatic hernia;
• gastritis and gastric ulcer;
• stenosis and achalasia of the esophagus.

Delayed gastric emptying can also lead to heartburn and reflux. Usually, solid food stays in the stomach for 1 to 5 hours. Liquids are absorbed much faster – with an empty stomach, they enter the small intestine in an average of 10-20 minutes.

Methods for diagnosing heartburn

If you experience a symptom such as heartburn, you should make an appointment with a gastroenterologist. The doctor will take a history of the disease and conduct an initial examination. Comprehensive diagnostics for heartburn allows you to obtain accurate information about the state of the gastrointestinal tract (gastrointestinal tract) of the patient. To determine the cause of heartburn, the specialist will prescribe the following tests:

Esophagogastroduodenoscopy

examination of the mucous membrane of the esophagus, duodenum and esophagus

X-ray of the esophagus

Diaphragmatic herniation and complications of reflux disease

Electromyography

Examination of the muscles of the esophagus

Treatments for heartburn

Medication is given to reduce stomach acid, relieve symptoms, and address the cause of heartburn. In addition to drugs, the gastroenterologist prescribes a diet that allows you to normalize the activity of the intestines and stomach.

Medicines used to treat heartburn:

• Antacids. Neutralize acid, relieve discomfort and pain from heartburn.
• Proton pump inhibitors and H2-histamine receptor blockers. They inhibit the production of hydrochloric acid and improve the condition.

Medication for heartburn can last from 2-3 weeks to 6 months. Each stage of therapy is additionally controlled by a doctor to adjust dosages and eliminate the likelihood of complications.

Surgical intervention for heartburn is necessary only when another pathology was identified during the diagnosis, leading to dysfunction of the digestive tract.

Heartburn prevention and treatment programs at the Hadassah Clinic

As a preventive measure for heartburn, standard medical recommendations are used to prevent the reflux of stomach contents into the esophagus:

• lose extra pounds;
• avoid spicy, salty and fatty foods;
• give up alcohol and cigarettes;
• do not eat 2-3 hours before bedtime.

The Hadassah clinic in Moscow performs two types of operations to eliminate the cause of heartburn:

• Radiofrequency ablation of the esophagus – normalization of the functions of the esophageal sphincter.
• Endoscopic application – prevents the backflow of acid into the esophagus.

Text reviewed by medical expert

Kanevskaya
Svetlana Sergeevna

Medical director, therapist, doctor of medical sciences, professor

Doctor of medical sciences

Work experience: 22 years

Published: 06/24/2022 90 003

Updated: 06/24/2022

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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