Indigestion

Indigestion, or dyspepsia, is discomfort or pain in the upper abdomen, often accompanied by fullness, bloating, nausea, or heartburn, that occurs during or soon after meals. Most cases are functional, with no detectable disease. Organic causes include peptic ulcers, gastritis, gastroesophageal reflux disease, biliary or pancreatic disorders, and adverse drug effects (notably NSAIDs, iron, or calcium supplements). Infection with Helicobacter pylori may contribute, especially when ulcers are present.

Symptoms vary but commonly include upper abdominal pain or burning, early satiety, belching, and nausea. Alarm features requiring urgent assessment include unintentional weight loss, vomiting blood, black stools, severe or persistent pain, fever, or a palpable mass.

Diagnosis relies on history and examination. In people without alarm features, tests may not be needed. Noninvasive H. pylori testing (breath, stool) can guide treatment, and positive results lead to eradication therapy. In older individuals or those with persistent symptoms, endoscopy or imaging may be used to exclude ulcers, cancer, or other conditions.

Treatment emphasizes symptom relief and addressing causes. Lifestyle adjustments—smaller meals, reducing fatty foods, caffeine, and alcohol, quitting smoking, and maintaining a healthy weight—are first line. Antacids provide rapid relief; acid suppressants such as H2 blockers or proton pump inhibitors are commonly used for longer control. If H. pylori is detected, a course of antibiotics with acid suppression is prescribed. Review of medications that may worsen symptoms is important. Most cases improve, but chronic functional dyspepsia may require ongoing management. Seek urgent care for severe, persistent pain, vomiting blood, black stools, fever, dehydration, or unintended weight loss.