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Types of indigestion: Indigestion (Upset Stomach) Causes, Symptoms, Home Remedy Relief, Heartburn

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Over-The-Counter (OTC) Heartburn Treatment | FDA

What is heartburn?

Heartburn occurs when stomach contents flow back up into the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach. Also called acid indigestion, heartburn is an uncomfortable, burning feeling in the mid-chest, behind the breastbone, or in the upper part of the abdomen—the area between the chest and the hips. This feeling occurs because the stomach’s digestive juices contain acid. Sometimes people with this problem can taste food or acidic fluid in the back of the mouth.

What are my OTC treatment options?

There are three classes of OTC medications for the treatment of heartburn.

Antacids

Antacids relieve heartburn (indigestion). They work by changing the stomach acid that causes heartburn. Common OTC antacids include:

Histamine-2 (h3) blockers

h3 blockers relieve and prevent heartburn and work by reducing the amount of acid produced by the stomach. Typically, they start to work within one to three hours and provide acid-suppression for several hours. Because acid reducers may interact with certain other medicines, ask your doctor or pharmacist before use if you are taking a prescription drug.  Common OTC h3-blockers include:  

  • Tagamet HB (cimetidine)
  • Pepcid Complete or Pepcid AC (famotidine)
  • Axid AR (nizatidine)

Proton pump inhibitors (PPIs)

OTC PPIs treat frequent heartburn (occurs 2 or more days a week) and are not intended for immediate relief of heartburn, as they may take one to four days for full effect. In contrast, prescription PPIs are used to treat conditions like gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. PPIs work by reducing the amount of acid produced by the stomach. Because acid reducers may interact with certain other medicines, ask your doctor or pharmacist before use if you are taking a prescription drug.  OTC PPIs are only intended for a 14-day course of treatment and can be used up to three times per year.

  • Prevacid 24HR (lansoprazole)
  • Nexium 24HR (esomeprazole)
  • Prilosec OTC (omeprazole magnesium)
  • Zegerid OTC (omeprazole and sodium bicarbonate)

How do I use these drugs safely and effectively?

  1. Read the label.
  2. Do not take more than directed or use for longer than directed on the label.
  3. If your heartburn symptoms persist even after taking these drugs, then talk to a health care professional.

More Safety Information

Antacids

Proton Pump Inhibitors (PPIs)

General

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088).

More Consumer Information

Antacids

Proton Pump Inhibitors (PPIs)

h3-Blockers

Regulatory Information

 

  • Content current as of:

Indigestion medicines | Health Information

Types of indigestion medicine

There are three main types of medicine for indigestion. They are:

  • antacids and alginates
  • proton pump inhibitors
  • h3-blockers

These all act in different ways to either neutralise or block production of stomach acid – which is often associated with indigestion.

Antacids and alginates

You can buy these medicines over the counter to treat your indigestion, without a prescription from a doctor. Antacids usually contain aluminium, magnesium, calcium or sodium compounds, which act to neutralise your stomach acid. They’re often combined with an alginate. These form a protective layer over the surface of your stomach contents to prevent acid rising back up your oesophagus (the tube that goes from your mouth to your stomach). Sometimes another medicine (simeticone), which reduces wind, is added too.

Examples include Gaviscon, Maalox, Remegel, Settlers and Tums. Check the patient information leaflet or ask your pharmacist to find out exactly what active ingredients your medicine contains.

Proton pump inhibitors

You can also take a proton pump inhibitor (PPI) if you keep getting heartburn. You can buy a PPI from your pharmacy if it’s just for short-term or occasional use. If you start to need PPIs more often or you’re known to have peptic ulcers or gastro-oesophageal reflux disease (GORD), your GP may prescribe one. They work by reducing the amount of acid produced by your stomach.

Examples include omeprazole (for example, Losec, Mezzopram) and lansoprazole (for example, Zoton).

h3-blockers

You can buy low-dose h3-blockers for short-term use from your pharmacist without a prescription. Your GP may also prescribe h3-blockers in stronger doses and for longer if you have ongoing problems with indigestion. Like PPIs, these medicines stop your stomach from producing so much acid – although they work in a different way.

An example of an h3 blocker is ranitidine (for example, Gavilast, Zantac).

Dyspepsia: What It Is and What to Do About It

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

 

Am Fam Physician.  2010 Dec 15;82(12):1459-1460.

What is dyspepsia?

It is a pain or an uncomfortable feeling in the upper middle part of your stomach area. The pain might come and go, but it’s there most of the time. You might feel too full after a meal or too full to finish a meal. You can get it at any age.

What are the symptoms of dyspepsia?

If you have these signs, or any kind of stomach pain or discomfort, talk to your doctor.

What causes dyspepsia?

Often, doctors can’t find a cause for the irritation to the stomach lining. Stomach ulcers or acid reflux can cause dyspepsia. If you have reflux, stomach acid backs up into your esophagus (the tube leading from your mouth to your stomach). This causes pain in your chest. Your doctor may do some tests to find out if you have an ulcer or reflux disease. Some medicines, like anti-inflammatory pain relievers, can cause dyspepsia.

Is dyspepsia a serious condition?

Not usually, but sometimes the symptoms can be a sign of more serious disease (for example, a deep stomach ulcer). Rarely, stomach cancer can cause dyspepsia. If you have dyspepsia, talk to your doctor. This is especially important if you are older than 50 years, have recently lost weight without trying to, have trouble swallowing, have severe vomiting, have stools that are black and tarry, or if you can feel a lump in your stomach area.

How is dyspepsia treated?

Most often, medicine can take care of this condition. If you have a stomach ulcer, it can be cured. You may need to take an acid-blocking medicine. If you have an infection called H. pylori in your stomach, you may also need to take antibiotics.

If your doctor thinks that a medicine you’re taking causes your dyspepsia, you might need to try another one.

A medicine that cuts down on the amount of acid in your stomach might help your pain. This medicine can also help if you have acid reflux disease.

Your doctor might want you to have a procedure called an endoscopy if:

During an endoscopy, a small tube with a camera inside it is put into your mouth and down into your stomach. Then your doctor can look inside your stomach to try to find a cause for your pain.

Do the medicines for dyspepsia have side effects?

Usually, they have only minor side effects that go away on their own. Some medicines can make your tongue or stools black. Some may cause headaches, nausea, or diarrhea.

If you have side effects that make it hard for you to take the medicine, talk to your doctor. You may need to try a different medicine, or your doctor may suggest ways to make the side effects less bothersome. Be sure to ask your doctor if there are side effects from using these medicines for a long time.

Remember to take medicines just the way your doctor tells you. If you need to take antibiotics, take all of the pills, as instructed, even after you start feeling better.

Can I do anything else to avoid dyspepsia?

Yes, for example:

  • If you smoke, stop smoking.

  • If some foods bother your stomach, try not to eat them.

  • Try to reduce the stress in your life.

  • If you have acid reflux, don’t eat right before bedtime. Raising the head of your bed with blocks under two legs may also help.

  • Unless your doctor tells you otherwise, don’t take a lot of anti-inflammatory medicines like ibuprofen (one brand: Motrin), aspirin, naproxen (brand name: Aleve), and ketoprofen (brand name: Orudis). Acetaminophen (brand name: Tylenol) is a better choice for pain, because it won’t hurt your stomach.

Indigestion | Health Navigator NZ

Indigestion is a word used to describe stomach pain or discomfort after eating. It is not a disease on its own, but a group of symptoms (such as stomach pain, bloating, or a sense of fullness) you feel soon after eating.


Indigestion is common, affecting up to 40% (4 in 10) adults in New Zealand every year. It is often confused with heartburn.

Heartburn is a burning feeling rising from the stomach into the chest and up towards the neck. Frequent heartburn is most commonly a symptom of reflux disease (GORD). 



Could it be heart attack?
Some heart attacks are sudden and intense but most heart attacks start slowly, with mild chest pain or discomfort that can be easily mistaken for indigestion. Read more about signs of heart attack.

What causes indigestion?

The most common type of indigestion is known as functional dyspepsia. The exact cause of functional dyspepsia is unknown but it is often related to lifestyle. It may be triggered by food, drink or medication. For example:

  • eating too much or too quickly
  • fatty, greasy or spicy foods
  • too much caffeine, alcohol, chocolate or carbonated drinks
  • taking over-the-counter medications such as ibuprofen or aspirin
  • stress or anxiety.

Functional dyspepsia accounts for 70% of cases of indigestion. Other causes include:

  • Stomach ulcers (15 to 20%).
  • Acid reflux (5 to 15%).
  • Some people get ulcers in their stomach or intestines from bacteria called Helicobacter pylori. Infection from this bacteria can cause indigestion.
  • Other causes, such as cancer, heart disease, disease of the digestive tract and medication effects are rare.

What are the symptoms of indigestion?

People with indigestion often experience:

  • early fullness during a meal or uncomfortable fullness after eating
  • a gnawing or burning stomach pain
  • nausea and vomiting
  • bloating
  • burping.

When to see your doctor about indigestion

Mild indigestion that happens now and again is common and usually nothing to worry about. However, it is important to see your doctor if the discomfort is severe and ongoing, or if you have indigestion in combination with the following symptoms or risk factors:

  • unintended weight loss
  • difficulty swallowing
  • persistent vomiting
  • blood in dark coloured stools (poos)
  • tightness or discomfort in your chest with exercise
  • family history of cancer.

These symptoms could indicate a more serious underlying medical condition and can be easily confused with heart problems, such as angina. Sometimes indigestion can be a symptom of another digestive disease, such as stomach ulcers or acid reflux.  

How is indigestion diagnosed?

To diagnosis indigestion, your doctor will  take a detailed history and conduct a physical examination to try to identify any possible causes for your indigestion. 

Sometimes your doctor might want you to have an endoscopy. This may be because your symptoms suggest a disease of your digestive track, or it may be because you:

  • have had no improvement in symptoms after making lifestyle changes and
  • still have stomach pain after taking an indigestion medicine for 8 weeks.

Self care for indigestion

In about 8 out of 10 people, indigestion symptoms can settle by making some simple changes such as healthier eating or losing weight. The following tips may help prevent indigestion: 

  • stop taking over-the-counter anti-inflammatory medicines
  • drink less alcohol
  • cut down on coffee and fizzy drinks
  • quit smoking
  • avoid large meals in the evening
  • remove foods from your diet that makes symptoms worse (i.e: fatty or spicy foods)
  • reduce your weight if you are overweight
  • find ways to reduce the amount of stress you are under or explore healthy ways of coping with it. Talk to your doctor if you feel that stress is getting on top of you.

What are the treatment options for indigestion?

For mild indigestion that happens now and again, antacids may be helpful in relieving the symptoms. These work by neutralising stomach acid.

If your symptoms are causing ongoing pain and discomfort, see your doctor for a proper check. Treatment will depend on what is causing your indigestion:

  • If you have discomfort, bloating, feeling full and nausea, you may need to take a medication that helps gut movement (eg, domperidone) 
  • If you have a stomach ulcer or acid reflux, you may need to take an acid-blocking medicine such as ranitidine, famotidine or a proton pump inhibitor.
  • If a bacterial infection is causing your symptoms, antibiotics will be prescribed.
  • If your doctor thinks that a medicine you’re taking may be causing your indigestion, you might need to change medicines.
  • If depression or anxiety is thought to be leading to stomach pain, antidepressant or anti-anxiety medication may be prescribed.

Tell your doctor if your symptoms persist after taking the prescribed medication. Your medicine may need to be changed or further tests arranged. 

Learn more

Indigestion NHS Choices, UK
Indigestion Mayo Clinic Online (US), 2013
Dyspepsia  Best Practice Journal (NZ), 2011

References

Managing dyspepsia and heartburn in general practice – an update Best Practice Journal, Feb 2011
Management of dyspepsia and heartburn New Zealand Guidelines Group, Ministry of Health NZ, 2004



Information for healthcare providers on indigestion 

The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.

Guidelines

Managing dyspepsia and heartburn in general practice – an update Best Practice Journal (NZ), 2011
Management of dyspepsia and heartburn NZ Guidelines Group, 2007
Update on the Evaluation and Management of Functional Dyspepsia  American Family Physician, 2011

Clinical pathways

The Northern Region Dyspepsia Clinical Pathway (2014) recommends:

Dysmotility-type symptoms such as discomfort, bloating, early satiety, nausea rather than pain for these patients,

  • prokinetic agents eg, domperidone 10mg tds is recommended first line,
  • then h3 antagonists such as ranitidine (better response rate than PPIs in this group).

Ulcer-type symptoms (some may be atypical gastro-oesopheageal reflux disease)

  • these respond better to acid-suppression first line (h3 antagonists such as ranitidine or PPI – such as omeprazole).
  • Non-response to one group should prompt trial of the other group of medication.

Continuing professional development

Long term risks of PPIs by Dr Tien Huey

(The Goodfellow Unit, 2018)

Regional HealthPathways NZ

Access to the following regional pathways is localised for each region and access is limited to health providers. If you do not know the login details, contact your DHB or PHO for more information: 

Indigestion – NHS Choices

 

Indigestion (dyspepsia) is a general term for pain or discomfort felt in the stomach and under the ribs. 

Heartburn is when acid moves up from the stomach into the gullet (oesophagus) and causes a burning pain behind your breastbone. 

Indigestion and heartburn can occur together or on their own.

It’s a common problem that affects most people at some point. In most cases it’s mild and only occurs occasionally.

This page covers:

Symptoms of indigestion

What causes indigestion

When to see your GP

Further investigations

Treating indigestion

Complications of indigestion

Symptoms of indigestion

As well as heartburn, other common symptoms of indigestion include:

  • feeling uncomfortably full or bloated
  • feeling sick
  • belching or passing wind (flatulence)
  • bringing up food or fluid from your stomach

These symptoms usually occur soon after eating or drinking, although there can sometimes be a delay between eating and getting indigestion.

What causes indigestion?

Indigestion is usually related to eating. When you eat, your stomach produces acid. The acid can sometimes irritate your stomach lining, the top part of the bowel, or the oesophagus.

This irritation can be painful and cause a burning sensation, particularly if the lining of your digestive system is overly sensitive to acid.

Your stomach can also stretch after eating a big meal, causing acid reflux, where the acid moves up into your oesophagus.

Indigestion can also be triggered or made worse by a number of other factors:

Medication

Some medicines, such as nitrates – taken to widen blood vessels – relax the ring of muscle between the oesophagus and stomach. This allows acid to leak back up.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can also affect your digestive tract and cause indigestion. 

Don’t take NSAIDs if you have stomach problems, such as a stomach ulcer, or you’ve had problems in the past. Children under 16 shouldn’t take aspirin.

Obesity

If you’re overweight or obese, you’re more likely to get indigestion. This is because increased pressure inside your stomach, particularly after a large meal, can cause acid reflux.

Pregnancy

Indigestion in pregnancy is partly caused by hormonal changes, and by the growing womb pressing on your stomach in the later stages of pregnancy.

As many as 8 out of 10 women experience indigestion at some point during their pregnancy.

Smoking and alcohol

The chemicals inhaled in cigarette smoke may contribute to indigestion. They can cause the muscle between the oesophagus and stomach to relax, causing acid reflux.

Drinking excess amounts of alcohol can also increase your risk of getting indigestion. Alcohol causes your stomach to produce more acid than normal, which can irritate your stomach lining.

Read more about the risks of drinking too much alcohol.

Stress or anxiety

Stress or anxiety can sometimes contribute to the symptoms of indigestion. Find out about breathing exercises for stress.

Hiatus hernia

A hernia occurs when an internal part of the body pushes through a weakness in the surrounding muscle or tissue wall.

A hiatus hernia is where part of the stomach pushes up into the diaphragm, the sheet of muscle under your lungs. This can cause acid reflux.

Helicobacter pylori (H. pylori) infection

Helicobacter pylori infections are common. They sometimes lead to stomach ulcers, although in most cases they don’t cause any symptoms at all.

Some people may get episodes of indigestion after having an H. pylori infection. In these cases, treating the infection with antibiotics will help.

Gastro-oesophageal reflux disease (GORD)

Gastro-oesophageal reflux disease (GORD) is a common condition and one of the main causes of recurring indigestion.

It occurs when the muscle between the oesophagus and stomach fails to prevent stomach acid rising into the oesophagus.

A small amount of acid reflux is normal and rarely causes problems. But in GORD a large amount of reflux causes the sensitive lining of your oesophagus to become inflamed.

This is caused by repeated irritation from stomach acid, and can cause heartburn, the sensation of bringing fluid back up, and painful swallowing.

Stomach ulcers

A stomach ulcer is an open sore that develops on the inside lining of your stomach (gastric ulcer) or small intestine (duodenal ulcer). Indigestion may be a symptom if you have a stomach ulcer.

Stomach ulcers form when stomach acid damages the lining in your stomach or duodenum wall. In most cases the lining is damaged as a result of an H. pylori infection.

Stomach cancer

In rare cases, recurring bouts of indigestion can be one of the symptoms of stomach cancer.

Cancerous cells in the stomach break down the protective lining, allowing acid to come into contact with the stomach wall.

When to see your GP

There’s usually no need to seek medical advice for indigestion as it’s often mild and infrequent and specialist treatment isn’t required.

However, you should see your GP if you have recurring indigestion and any of the following apply:

These symptoms may be a sign of a more serious underlying health problem, such as a stomach ulcer or stomach cancer.

Also see your GP if you get indigestion regularly, if it causes you severe pain or discomfort, or if your regular anti-reflux remedies stop working.

Your GP will ask you about your symptoms and:

  • any other symptoms you have that may indicate an underlying health condition
  • any medication you’re taking – as some medications can cause indigestion
  • your lifestyle – some lifestyle factors, such as smoking, drinking alcohol or being overweight, can cause indigestion 

Your GP may also press gently on different areas of your stomach to see if this is painful and whether any of your internal organs are swollen.

Further investigations

Depending on your symptoms, your GP may want to investigate further.

This is because indigestion can sometimes be a symptom of an underlying condition, such as a Helicobacter pylori (H. pylori) bacterial infection, a stomach ulcer, or stomach cancer.

Your GP may refer you for a procedure called an endoscopy to rule out a more serious cause of your indigestion.

During an endoscopy, a thin, flexible tube with a light and camera at one end called an endoscope is used to examine the inside of your body.

Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy.

This means that for at least two weeks before having an endoscopy you’ll need to stop taking proton pump inhibitors (PPIs) and h3-receptor antagonists. 

Your GP may also recommend changing other medications that may be causing your indigestion.

However, you should only stop taking medication if your GP or another healthcare professional in charge of your care advises you to do so. 

Diagnosing H. pylori infection

If your GP thinks your symptoms may be caused by an H. pylori infection, you may need to have a test for it.

This may be a:

  • stool antigen test – where a pea-sized stool sample is tested for H. pylori bacteria
  • breath test
  • blood test – a blood sample will be tested for antibodies to H. pylori bacteria

Antibiotics and PPIs can affect the results of a urea breath test or stool antigen test.

These tests may therefore need to be delayed until two weeks after you last used a PPI, and four weeks after you last used an antibiotic.

Diagnosing other conditions

You may need further tests to rule out other underlying conditions that could be causing your indigestion symptoms.

For example, abdominal pain and discomfort can be caused by conditions that affect the bile ducts in your liver.

Bile ducts are tubes that carry bile from the liver to the gallbladder and bowel. Bile is a digestive fluid that breaks down fats, and the gallbladder holds bile.

Your GP may suggest you have a liver function test, a blood test used to assess how well your liver is working.

You may also need to have an abdominal ultrasound scan, which uses high-frequency sound waves to create an image of the inside of your body.

Treating indigestion

Treatment for indigestion will vary depending on what’s causing it and how severe your symptoms are.

Most people are able to manage their indigestion by making simple diet and lifestyle changes, or taking medication such as antacids.

See treating GORD if you’ve been diagnosed with gastro-oesophageal reflux disease (GORD). See treating a stomach ulcer if you’ve been diagnosed with a stomach ulcer.

Diet and lifestyle changes

It may be possible to ease your indigestion symptoms by making a few simple changes to your diet and lifestyle, such as those discussed below.

Losing weight can help if you’re overweight. It’s important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet.

Avoid foods that seem to make your indigestion worse, such as rich, spicy and fatty foods. You should also cut down on caffeinated drinks, such as tea, coffee and cola, as well as alcohol.

Smoking can also contribute to indigestion, so speak to your GP or pharmacist about giving up smoking if you smoke. You can also call the NHS Stop Smoking Helpline on 0300 123 1044.

If you tend to experience the symptoms of indigestion at night, avoid eating for three to four hours before you go to bed.

Going to bed with a full stomach means there’s an increased risk that acid in your stomach will be forced up into your oesophagus while you’re lying down.

When you go to bed, prop your head and shoulders up with a couple of pillows, or raise the head of your bed by a few inches by putting something underneath the mattress.

The slight slope should help prevent stomach acid moving up into your oesophagus while you’re asleep.

Changing medication

If your GP thinks the medication you’re taking could be contributing to your indigestion, they may recommend changing it.

Where possible, your GP will prescribe an alternative medication that won’t cause indigestion.

Immediate indigestion relief

Antacid medicines and alginates can be recommended or prescribed by your GP for immediate relief.

Antacids

Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion.

They neutralise the acid in your stomach, making it less acidic, so it doesn’t irritate 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 don’t take too much.

It’s best to take antacids when you’re expecting symptoms of indigestion, or when they start to occur, such as after meals or 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 considerations when using 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, when stomach acid leaks back up into the oesophagus, irritating 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 GP may recommend taking an antacid that contains an alginate if you experience symptoms of acid reflux or if you have GORD.

Antacids containing alginates should be taken after eating as this helps the medicine stay in your stomach for longer. Taking alginates on an empty stomach will result in them leaving your stomach too quickly for them to be effective.

Persistent indigestion

If you have persistent or recurring indigestion, treatment with antacids and alginates may not be effective enough to control your symptoms.

Your GP 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) and h3-receptor antagonists.

Proton pump inhibitors (PPIs)

Proton pump inhibitors (PPIs) restrict the acid produced in your stomach. They are taken as tablets and are usually only available on prescription.

If you’re over 18, you can buy some types of PPIs over the counter in pharmacies, but these should only be used for short-term treatment. See your GP if your indigestion is persistent.

PPIs may enhance the effect of certain medicines. If you’re prescribed a PPI, your progress will be closely monitored if you’re also taking other medication, such as:

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

If you’re referred for an endoscopy, you’ll 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, but they’re usually mild and reversible.

Side effects may include:

h3-receptor antagonists

h3-receptor antagonists are another type of medication that your GP may suggest if antacids, alginates and PPIs haven’t been effective at 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 famotidine and ranitidine are available to buy over the counter in pharmacies. h3-receptor antagonists are taken either in tablet or liquid form.

As with PPIs, you’ll need to stop taking h3-receptor antagonists at least 14 days before having an endoscopy. This is because they can hide some of the problems that could otherwise be spotted during the procedure.

Helicobacter pylori (H. pylori) infection

If your indigestion symptoms are caused by an H. pylori infection, you’ll need treatment to clear the infection from your stomach.

This should help relieve your indigestion, as 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, where treatment involves taking three different medications.

Your GP will prescribe a course of treatment consisting of:

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

One course of triple therapy is effective at clearing an H. pylori infection in up to 85% of cases. However, you may need more than one course of treatment if it doesn’t clear the infection the first time.

Complications of indigestion

In some cases, severe indigestion can cause complications.

Oesophageal stricture

If the lining of the oesophagus is severely irritated over time by acid reflux, the oesophagus may become scarred. 

The scarring can eventually lead to your oesophagus becoming narrow and constricted – an oesophageal stricture.

If you have oesophageal stricture, you may have symptoms such as:

  • difficulty swallowing (dysphagia)
  • food becoming lodged in your throat
  • chest pain

Surgery to widen the oesophagus is often needed to treat oesophageal stricture.

Pyloric stenosis

Like oesophageal stricture, pyloric stenosis is caused by long-term irritation of the lining of your digestive system by stomach acid.

Pyloric stenosis occurs when the passage between your stomach and your small intestine – the pylorus – becomes scarred and narrowed. This causes vomiting and prevents any food you eat being properly digested.

In most cases, pyloric stenosis is treated using surgery to return the pylorus to its proper width.

Barrett’s oesophagus

Repeated episodes of gastro-oesophageal reflux disease (GORD) can lead to changes in the cells that line your lower oesophagus. This is a condition known as Barrett’s oesophagus.

It’s estimated 1 in 10 people with GORD will develop Barrett’s oesophagus. Most cases affect people aged 50 to 70 – the average age at diagnosis is 62.

Barrett’s oesophagus doesn’t usually cause noticeable symptoms other than those associated with GORD.

However, it is a pre-cancerous condition. This means that while the cell changes aren’t cancerous, there’s a small risk they could develop into “full blown” cancer in the future, resulting in oesophageal cancer.


 

Page last reviewed: 21/09/2016

Next review due: 21/09/2019

Gastroesophageal Reflux Disease Symptoms, Diagnosis & Treatment

Overview


Gastroesophageal reflux disease (GERD) is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages—from infants to older adults.


People with asthma are at higher risk of developing GERD. Asthma flare-ups can cause the lower esophageal sphincter to relax, allowing stomach contents to flow back, or reflux, into the esophagus. Some asthma medications (especially theophylline) may worsen reflux symptoms.


On the other hand, acid reflux can make asthma symptoms worse by irritating the airways and lungs. This, in turn, can lead to progressively more serious asthma. Also, this irritation can trigger allergic reactions and make the airways more sensitive to environmental conditions such as smoke or cold air.


Symptoms & Diagnosis


Symptoms

Everyone has experienced gastroesophageal reflux. It happens when you burp, have an acid taste in your mouth or have heartburn. However, if these symptoms interfere with your daily life it is time to see your physician.


Other symptoms that occur less frequently but can indicate that you could have GERD are:

•    Acid regurgitation (retasting your food after eating)

•    Difficulty or pain when swallowing

•    Sudden excess of saliva

•    Chronic sore throat

•    Laryngitis or hoarseness

•    Inflammation of the gums

•    Cavities

•    Bad breath

•    A recurrent or chronic cough

•    Chest pain (seek immediate medical help)


Diagnosis

Several tests may be used to diagnose GERD including:

•    X-ray of the upper digestive system

•    Endoscopy (examines the inside of the esophagus)

•    Ambulatory acid (pH) test (monitors the amount of acid in the esophagus)

•    Esophageal impedance test (measures the movement of substances in the esophagus)


Treatment & Management


If you have both GERD and asthma, managing your GERD will help control your asthma symptoms.


Studies have shown that people with asthma and GERD saw a decrease in asthma symptoms (and asthma medication use) after treating their reflux disease.


Lifestyle changes to treat GERD include:

•    Elevate the head of the bed 6-8 inches

•    Lose weight

•    Stop smoking

•    Decrease alcohol intake

•    Limit meal size and avoid heavy evening meals

•    Do not lie down within two to three hours of eating

•    Decrease caffeine intake

•    Avoid theophylline (if possible)


Your physician may also recommend medications to treat reflux or relieve symptoms. Over-the-counter antacids and h3 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid production and also may be effective.


In severe and medication intolerant cases, surgery may be recommended.

Find out more about asthma.