Indigestion – Frequently Asked Questions

What are the causes of indigestion?

The commonest causes of indigestion are acid reflux, bile reflux and a type of irritable bowel which mainly affects the stomach. Gallstones and other less common conditions such as peptic ulcer, cancer and problems arising from the pancreas may cause indigestion. Some over-the-counter painkillers and anti-inflammatory tablets can also cause indigestion.

 Should I be worried about my indigestion symptoms?

Most indigestion symptoms are due to benign problems easily manageable with either medications or occasionally by surgery (gallstones). However, if your symptoms have lasted for than a month or more, or are getting worse, it will be best to seek medical advice for them. Other potentially worrying features of indigestion symptoms include:

  • Age over 50 years
  • Unintentional weight loss
  • Difficulty with swallowing
  • Recurrent vomiting
  • Passage of black tarry stools indicating bleeding from the stomach.
  • Presence of jaundice

What can I do to avoid getting indigestion?

Simple lifestyle changes can reap many health rewards and also minimise your chance of developing indigestion. These include:

  • Lose any excess weight
  • Avoid going to bed with full stomach. Allow 3-4 hours after last meal before bedtime
  • Sleep propped up in bed
  • Small and frequent meals are helpful and avoid large fatty meals
  • Stop smoking, moderate alcohol intake.
  • Avoid any food items that make your symptoms worse

How are the different causes of indigestion diagnosed?

Upper GI Endoscopy (Gastroscopy) is the main investigation for the different causes of indigestion. Other tests such as ultrasound or CT scanning and oesophageal pH recording may be necessary in some people.

Is surgery ever necessary for indigestion?

This depends on the cause of the indigestion. Medications and lifestyle changes are generally adequate to control indigestion symptoms in the majority of people.

Anti-reflux surgery may be required to have adequate control of reflux symptoms especially if regurgitation or intolerance of the medications is a major issue.

Symptomatic gallstones often require surgery to remove the gallbladder, usually by keyhole surgery done as a day procedure in majority of patients.

If cancer is the underlying cause then surgery may be necessary also.

Is indigestion curable or is it something I have to live with?

Certain causes of indigestion can be cured while others can be managed by modifying diet, changing lifestyle and medications. Indigestion caused by a stomach infection (H. pylori) can be resolved by a one to two week course of antibiotics and antacid medications. Surgery resolves pain from gallstones and greatly improve symptoms from gastro-oesophageal reflux.