About indigestion (dyspepsia, upset stomach)

What is indigestion (dyspepsia, upset stomach)?

Dyspepsia (indigestion) facts

  • Dyspepsia is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate in frequency and intensity.
  • Theories of the cause of dyspepsia include abnormal input from intestinal sensory nerves, abnormal processing of input from the sensory nerves, and abnormal stimulation of the intestines by motor nerves.
  • The primary symptoms of dyspepsia are upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). The symptoms most often are provoked by eating.
  • Dyspepsia is diagnosed on the basis of typical symptoms and the absence of other gastrointestinal diseases, particularly acid-related diseases and non-gastrointestinal diseases that might give rise to the symptoms.
  • Testing in dyspepsia is directed primarily at excluding the presence of other gastrointestinal diseases and non-gastrointestinal diseases. Some patients may require specific testing of certain gastrointestinal functions.
  • Treatment in dyspepsia is primarily with education as well as smooth muscle relaxant and promotility drugs. There also may be a role for anti-depressant drugs and dietary changes.
  • Future advances in the treatment of dyspepsia depend on a clearer understanding of its cause(s).

What is dyspepsia (indigestion)?

Dyspepsia is one of the most common ailments of the bowel (intestines), affecting an estimated 20% of persons in the United States. Perhaps only 10% of those affected actually seek medical attention for their dyspepsia. Dyspepsia is not a particularly good term for the ailment since it implies that there is "dyspepsia" or abnormal digestion of food, and this most probably is not the case. In fact, another common name for dyspepsia is indigestion, which, for the same reason, is no better than the term dyspepsia! Doctors frequently refer to the condition as non-ulcer dyspepsia.

Dyspepsia (indigestion) is best described as a functional disease. (Sometimes, it is called functional dyspepsia.) The concept of functional disease is particularly useful when discussing diseases of the gastrointestinal tract. The concept applies to the muscular organs of the gastrointestinal tract, the esophagus, stomach, small intestine, gallbladder, and colon. What is meant by the term, functional, is that either the muscles of the organs or the nerves that control the organs are not working normally, and, as a result, the organs do not function normally, and the dysfunction causes the symptoms. The nerves that control the organs include not only the nerves that lie within the muscles of the organs but also the nerves of the spinal cord and brain.

Some gastrointestinal diseases can be seen and diagnosed with the naked eye, such as ulcers of the stomach and can be seen at surgery, on X-rays, and by endoscopy. Other diseases cannot be seen with the naked eye but can be seen and diagnosed under the microscope. For example, gastritis (inflammation of the stomach) can be diagnosed by microscopic examination of biopsies of the stomach. In contrast, gastrointestinal functional diseases cannot be seen with the naked eye or the microscope. In some instances, the abnormal function can be demonstrated by tests (for example, gastric emptying studies or antro-duodenal motility studies). However, the tests often are complex, are not widely available, and do not reliably detect the functional abnormalities. Accordingly, and by default, functional gastrointestinal diseases are those that involve abnormal function of gastrointestinal organs in which the abnormalities cannot be seen in the organs with either the naked eye or the microscope.

Occasionally, diseases that are thought to be functional are ultimately found to be associated with abnormalities that can be seen. Then, the disease moves out of the functional category. An example of this would be Helicobacter pylori (H. pylori) infection of the stomach. Some patients with mild upper gastrointestinal symptoms who were thought to have abnormal function of the stomach or intestines have been found to have stomachs infected with H. pylori. This infection can be diagnosed under the microscope by identifying the bacterium. When patients are treated with antibiotics, the H. pylori and symptoms disappear. Thus, recognition of infections with Helicobacter pylori has removed some patients' symptoms from the functional disease category.

The distinction between functional disease and non-functional disease may, in fact, be blurry. Thus, even functional diseases probably have associated biochemical or molecular abnormalities that ultimately will be able to be measured. For example, functional diseases of the stomach and intestines may be shown ultimately to be associated with reduced or increased levels of normal chemicals within the gastrointestinal organs, the spinal cord, or the brain. Should a disease that is demonstrated to be due to a reduced or increased chemical still be considered a functional disease? In this theoretical situation, we can't see the abnormality with the naked eye or the microscope, but we can measure it. If we can measure an associated or causative abnormality, should the disease no longer be considered functional, even though the disease (symptoms) are being caused by abnormal function? The answer is unclear.

Despite the shortcomings of the term, functional, the concept of a functional abnormality is useful for approaching many of the symptoms originating from the muscular organs of the gastrointestinal tract. To repeat, this concept applies to those symptoms for which there are no associated abnormalities that can be seen with the naked eye or the microscope.

While dyspepsia is a major functional disease(s), it is important to mention several other functional diseases. A second major functional disease is the irritable bowel syndrome, or IBS. The symptoms of IBS are thought to originate primarily from the small intestine and/or colon. The symptoms of IBS include abdominal pain that is accompanied by alterations in bowel movements (defecation), primarily constipation or diarrhea. In fact, dyspepsia and IBS may be overlapping diseases since up to half of patients with IBS also have symptoms of dyspepsia. A third distinct functional disorder is non-cardiac chest pain. This pain may mimic heart pain (angina), but it is unassociated with heart disease. In fact, non-cardiac chest pain is thought to result from a functional abnormality of the esophagus.

Functional disorders of the gastrointestinal tract often are categorized by the organ of involvement. Thus, there are functional disorders of the esophagus, stomach, small intestine, colon, and gallbladder. The amount of research that has been done with functional disorders is greatest in the esophagus and stomach (for example, non-cardiac chest pain, dyspepsia), perhaps because these organs are easiest to reach and study. Research into functional disorders affecting the small intestine and colon (IBS) is more difficult to conduct and there is less agreement among the research studies. This probably is a reflection of the complexity of the activities of the small intestine and colon and the difficulty in studying these activities. Functional diseases of the gallbladder (referred to as biliary dyskinesia), like those of the small intestine and colon, also are more difficult to study, and at present they are less well-defined. Each of the functional diseases is associated with its own set of characteristic symptoms.

What are the symptoms for indigestion (dyspepsia, upset stomach)?

Less frequent signs and symptoms include Vomiting and Belching.

Sometimes people with Indigestion also experience Heartburn. Heartburn is a pain or burning feeling in the center of your chest that may radiate into your neck or back during or after eating.

What are the causes for indigestion (dyspepsia, upset stomach)?

Indigestion has many possible causes. Often, indigestion is related to lifestyle and may be triggered by food, drink or medication. Common causes of indigestion include:

  • Overeating or eating too quickly
  • Fatty, greasy or spicy foods
  • Too much caffeine, alcohol, chocolate or carbonated beverages
  • Smoking
  • Anxiety
  • Certain antibiotics, pain relievers and iron supplements

A condition known as functional or nonulcer dyspepsia, which is related to irritable bowel syndrome, is a very common cause of indigestion.

Sometimes indigestion is caused by other conditions, including:

  • Inflammation of the stomach (gastritis)
  • Peptic ulcers
  • Celiac disease
  • Gallstones
  • Constipation
  • Pancreas inflammation (pancreatitis)
  • Stomach cancer
  • Intestinal blockage
  • Reduced blood flow in the intestine (intestinal ischemia)
  • Diabetes
  • Thyroid disease
  • Pregnancy

What are the treatments for indigestion (dyspepsia, upset stomach)?

We usually think of symptoms of dyspepsia as originating from the upper gastrointestinal tract, primarily the stomach and first part of the small intestine. These symptoms include:

  • upper abdominal pain (above or around the navel),
  • belching,
  • nausea (with or without vomiting),
  • abdominal bloating (the sensation of abdominal fullness without objective distention),
  • early satiety (the sensation of fullness after a very small amount of food), and,
  • abdominal distention (swelling as opposed to bloating).

The symptoms most often are provoked by eating, which is a time when many different gastrointestinal functions are called upon to work in concert. This tendency to occur after meals is what gave rise to the notion that dyspepsia might be caused by an abnormality in the digestion of food.

It is appropriate to discuss belching in detail since it is a commonly misunderstood symptom associated with dyspepsia. The ability to belch is almost universal. Belching, also known as burping or eructating, is the act of expelling gas from the stomach out through the mouth. The usual cause of belching is a distended (inflated) stomach that is caused by swallowed air or gas. The distention of the stomach causes abdominal discomfort, and the belching expels the air and relieves the discomfort. The common reasons for swallowing large amounts of air (aerophagia) or gas are gulping food or drink too rapidly, anxiety, and carbonated beverages. People often are unaware that they are swallowing air. Moreover, if there is not excess air in the stomach, the act of belching actually may cause more air to be swallowed. "Burping" infants during bottle or breastfeeding is important in order to expel air in the stomach that has been swallowed with the formula or milk.

Excessive air in the stomach is not the only cause of belching. For some people, belching becomes a habit and does not reflect the amount of air in their stomachs. For others, belching is a response to any type of abdominal discomfort and not just to discomfort due to increased gas. Everyone knows that when they have mild abdominal discomfort, belching often relieves the problem. This is because excessive air in the stomach often is the cause of mild abdominal discomfort; as a result, people belch whenever mild abdominal discomfort is felt, whatever the cause.

If the problem causing the discomfort is not excessive air in the stomach, then belching does not provide relief. As mentioned previously, it even may make the situation worse by increasing air in the stomach. When belching does not ease the discomfort, the belching should be taken as a sign that something may be wrong within the abdomen and that the cause of the discomfort should be sought. Belching by itself, however, does not help the physician determine what may be wrong because belching can occur in virtually any abdominal disease or condition that causes discomfort.

What are the risk factors for indigestion (dyspepsia, upset stomach)?


You experience indigestion when your body cannot digest food as normal. This may be the result of eating a lot or eating too fast.

Spicy, greasy, and fatty foods also increase the risk of indigestion. Lying down too soon after eating can make it harder to digest food. This increases your risk of abdominal discomfort.

Other common causes of poor digestion include:

  • smoking
  • drinking too much alcohol
  • stress


Indigestion can be a side effectof taking specific medications.

Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen, are one class of medications that can cause indigestion.

Antibiotics, medications that treat or prevent bacterial infections, can also irritate the digestive system and cause indigestion as a side effect.

Medical conditions

Several medical conditions can also cause indigestion. These include:

  • gastroesophageal reflux disease (GERD)
  • gastric cancer
  • pancreatic or bile duct abnormalities
  • peptic ulcers
  • lactose, gluten, and other intolerances
  • irritable bowel syndrome (IBS)
  • gastroparesis

Sometimes you may experience indigestion with no apparent cause. The medical term for this is functional dyspepsia.

Is there a cure/medications for indigestion (dyspepsia, upset stomach)?

The most common symptom of most chronic diseases is Indigestion (dyspepsia, upset stomach). The medical term used for this disease is dyspepsia. Indigestion needs attention if it is not cured from household methods.

It can be diagnosed with the causes and symptoms that occur with it. But doctor's help can be taken if indigestion gets worsens:

  • Stool Test
  • Blood Test
  • Imaging Test
  • Breath Test


Indigestion is so common that it is considered a symptom, not a disease. It can be cured easily at home with the following treatments:

  • Eat Smaller meals
  • Quit Smoking
  • Chew food a lot
  • Intake of low-fat foods
  • Maintain moderate weight
  • Have meals 3 hours before going to bed
  • Drink lots of water
  • Limit caffeine and alcohol
  • Limit heavy foods

If the situation worsens and there is no relief from easy methods, consult a physician and get prescribed medicines as follows:

  • Proton Pump Inhibitors (PPIs): Reduces stomach acid
  • Prokinetics: Helps boost food movement through the stomach
  • Antacids: An OTC medicine that does not needs a prescription is antacids. It helps counter the effect of stomach acids
  • Antibiotics: Necessary if ulcers in the stomach arise
  • Antidepressants: For controlling digestive problems due to problems in the central nervous system.

Gastroesophageal reflux disease (GERD),Ulcers,Gallbladder disease
Iansoprazole , Prilosec OTC, Nexium 24HR
Burping and Gas,Gurgling Sound in stomach,Bloating,Nausea

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