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Dyspepsia

DFeb 19 05

Alternative names
Indigestion; Uncomfortable fullness after meals

Definition
Indigestion is a vague feeling of abdominal discomfort—possibly including a feeling of fullness, belching, bloating, and nausea.

Considerations
Indigestion is rarely a serious health problem, unless it is accompanied by other symptoms.

Indigestion is a common problem. It may be triggered by eating particular foods or after drinking wine or carbonated drinks. It may also be caused by eating too fast or overeating. Some people may find that spicy foods, high-fiber foods, fatty foods, or too much caffeine can all aggravate this problem. Symptoms may be worsened by anxiety and depression.

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

Common Causes


  • Overeating
  • Eating too fast
  • Significant caffeine intake
  • Eating fatty or greasy foods
  • Overindulgence in alcohol
  • Tobacco smoking
  • Eating spicy foods
  • Emotional trauma or nervousness
  • Cholecystitis (inflammation of the gallbladder)
  • Acute or chronic gastritis (inflammation of the stomach)
  • Acute or chronic pancreatitis (inflammation of the pancreas)
  • Duodenal ulcer
  • Gastric ulcer
  • Drugs such as antibiotics, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs)

Home Care
Allow time for leisurely meals. Chew food carefully and thoroughly. Avoid conflicts during meals. Avoid excitement or exercise immediately after a meal. Avoid chewing gum—it may cause air swallowing. A calm environment and rest may help relieve stress-related dyspepsia.

Avoid aspirin and NSAIDs (use acetaminophen instead). If you must take them, do so on a full stomach. Antacids may relieve indigestion. Stronger medications are available over-the-counter, such as ranitidine (Zantac). Your doctor may prescribe similar medications, or more potent ones such as omeprazole (Prilosec).

Call your health care provider if


  • Symptoms last longer than 2 weeks.
  • The pattern of indigestion symptoms changes noticeably.
  • Abdominal pain persists longer than 6 hours.
  • Symptoms include unexplained weight loss.
  • Vomiting of blood or passage of blood in the stool.
  • Jaundice (yellow coloring of the skin and eyes).
  • Symptoms include jaw pain, chest pain, back pain, profuse sweating, anxiety, or a feeling of impending doom (possible heart attack symptoms).

What to expect at your health care provider’s office
The medical history will be obtained, and a physical examination performed.

Medical history questions documenting indigestion in detail may include:


  • Aggravating factors
    o Does it begin (or is it worse) after eating particular foods?
    o Does it begin (or is it worse) after drinking wine or other alcoholic drinks or carbonated drinks?
  • Eating habits
    o Do you eat fast?
    o Have you been overeating?
    o Have you changed your diet? Particularly, have you had any spicy foods, high-fiber foods, or fatty foods? Have you increased your intake of caffeine?
  • Medications
    o What medications are you taking?
    o Have you changed medications recently?
  • Other symptoms
    o What other symptoms are occurring at the same time?
    o Is there abdominal pain?
    o Is there vomiting?

The physical examination will probably include emphasis on the abdominal region and digestive system.

Diagnostic tests that may be performed include:


  • Blood tests (depending on the suspected cause)
  • Endoscopy (EGD)
  • Upper GI and small bowel series (with barium)
  • Abdominal ultrasound

After seeing your health care provider:
You may want to add a diagnosis related to indigestion to your personal medical record.

Johns Hopkins patient information

Last revised: December 8, 2007
by Armen E. Martirosyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
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