Indigestion
A sensation of pain or discomfort in the upper abdominal region accompanied by a feeling of fullness, bloating, and flatulence is known as indigestion or dyspepsia. Some of the common causes of indigestion include sedentary lifestyle, eating habits, certain medications, and some gastrointestinal illnesses like GERD.
Causes
Many factors can cause Indigestion such as -
Lifestyle and dietary factors
Consuming excess alcohol, caffeinated beverages, and carbonated beverages irritate the stomach and cause indigestion.
Eating larger meals that are fried, spicy, or salty also causes stomach upset.
Eating stale and undercooked food.
Excessive smoking also irritates the stomach and causes indigestion
Leading a sedentary lifestyle
Overeating or eating too quickly
Being stressed or overly anxious most of the time
Gastrointestinal diseases
Many gastrointestinal diseases cause an upset stomach, such as -
GERD (gastroesophageal reflux disease): It causes the contents of the stomach to hurl back into the esophagus and cause symptoms like heartburn and dyspepsia (indigestion).
Gastroparesis: It is a condition in which the stomach is not able to empty itself due to affected motility of the stomach. This leads to the sensation of fullness and bloating.
Irritable bowel syndrome: It is a condition that affects the absorption of food from the intestines and can cause indigestion.
Celiac disease: In this condition, the body abnormally reacts to gluten, a protein found in grains such as wheat and barley.
Malabsorption syndrome: It is a condition in which the small intestine is not able to absorb nutrients from the food and body.
Gastrointestinal infections: It can cause acute inflammation in the gastrointestinal tract, known as gastritis or gastroenteritis. These may be caused by a variety of microorganisms.
Chronic pancreatitis: It can often cause bloating, flatulence, and indigestion.
Gastric cancers: They are a rare condition but could be a probable cause of indigestion.
Medications
Certain medications like NSAID painkillers, antibiotics like fluoroquinolones tetracycline, iron and potassium supplements, cardiovascular drugs like digitalis, etc., can irritate the gastric lining and cause hyperacidity, bloating, or indigestion.
Functional dyspepsia
This type of indigestion with no apparent cause is chronic and can last for more than 6 months. It is not associated with stool irregularities either.
Diagnosis
Laboratory tests
Laboratory tests play a limited role in the evaluation of indigestion. Complete hemogram, Lipid profile plus, and liver function test may give an insight into the general health of the patients. Breath test and stool examination R/M may be performed to check for the presence of Helicobacter pylori (H. pylori), the bacterium associated with peptic ulcers and also to find out any disease association, which can cause indigestion.
Imaging studies
X-Ray abdomen - helps visualize the internal organs of the abdomen and looks for the presence of obstruction or as part barium swallow testing.
USG Abdomen, Dual Phase CT Abdomen - to visualize the internal organs of the abdomen in greater detail and diagnose any abnormalities
Barium Meal Follow Through, Barium Swallow - for this study, the patient is made to swallow a drink that has barium in it, followed by taking x-rays of the digestive tract. This helps identify any abnormalities of the esophagus, stomach, or intestines.
A gastric emptying scan helps check the time taken by food particles to pass from the stomach to the intestines and can help identify reduced gastric motility.
Endoscopy, Colonoscopy - these are invasive tests in which a probe is inserted via the mouth (endoscopy) or the rectum (colonoscopy) to visualize the inner structures of the digestive tract in real-time.
Treatments
Symptomatic relief
Digestive enzymes and probiotics help relieve the symptoms of indigestion and improve the body’s digestive system.
OTC preparations for gas, acidity and indigestion help provide immediate symptom relief.
Treatment of underlying cause
If symptoms of gas are due to an underlying cause, it is necessary to treat the causative condition to provide complete relief.
Mesalazine formulations are used to treat Crohn’s Disease and ulcerative colitis.
Proton pump inhibitors (PPIs) like pantoprazole and omeprazole and H2 receptor blockers like famotidine and ranitidine can reduce stomach acid and may be recommended if you experience heartburn along with indigestion.
Antacids and prokinetic agents are used to treat gastroesophageal disease (GERD) and peptic ulcers.
Tegaserod preparations are useful in constipation and reduced movement of food from the mouth which leads to symptoms of indigestion.
Antibiotics like amoxicillin, clarithromycin & tetracycline are used to treat infections like H. Pylori.
Tricyclic antidepressants are used to treat functional dyspepsia, a condition where the cause of dyspepsia is not apparent.