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September 18, 2000
Prevention and Primary Care - Elizabeth Smoots, M.D.

Indigestion: You Can't Believe You Ate the Whole Thing

The number of television commercials advertising Rolaids, Tums, or Mylanta should clue you in -- there's a big indigestion market, and at least one in four of you will be needing some relief.

Only 20 to 25 percent of indigestion sufferers seek medical help; many others treat themselves with over-the-counter medicines and antacids. Occasionally, however, it may be dangerous to do so, since indigestion can be a symptom of serious illness.

The medical term for indigestion is dyspepsia, and it is defined as any type of upper abdominal pain or discomfort following a meal. Symptoms of the digestive disorder can include burping, bloating, heartburn, nausea, and vomiting.

Indigestion may be triggered by a whole host of factors: eating too much, too fast, or too late at night; indulging in spicy or fatty foods; drinking caffeinated or alcoholic beverages; smoking; swallowing air; being overweight; and exposure to stress or fatigue. While you're digesting that, keep in mind that the symptoms of faulty digestion can also result from several serious health problems.

Common culprits in indigestion

The table below describes the most frequent medical causes of indigestion:

Cause of indigestion



Nonulcer dyspepsia

50-60% of the time

Indigestion for which no cause can be found; may result from faulty coordination of stomach contractions

Peptic ulcer


A sore in the lining of the stomach, esophagus, or intestines; often curable with antibiotics for H. pylori bacteria

Gastroesophageal reflux disease (GERD)


Reflux of stomach contents into the esophagus, causing heartburn or a sour taste in the mouth

Irritable bowel syndrome


Symptoms usually include diarrhea or constipation; may improve after a bowel movement


Less than 2%

Affects the stomach, esophagus, and pancreas, usually after age 50

Hiatal hernia


Protrusion of part of the stomach into the chest, making it easier for stomach acid to flow backward



Worse after eating fatty meals; may cause yellow skin and eyes (jaundice), dark urine, and pale stools



Common agents include aspirin, nonsteroidal anti-inflammatory drugs, iron, potassium, antibiotics, codeine, cortisone, theophylline, acarbose, alendronate, cisapride, metformin, orlistat

Herbal remedies


Herbs include garlic, gingko, saw palmetto, feverfew, chaste tree berry, white willow

Heart disease


Signs include sweating, breathing difficulty, or pain radiating to the neck, jaw, or arms

Warning signs not to ignore

Many diseases and disorders that cause dyspepsia are best treated early. Contact your health care provider promptly if you experience frequent indigestion and are over age 44, or have noticed any of the following signs:

  • Pain or discomfort that is severe, persistent, or recurring
  • Indigestion more than twice a week
  • Discomfort that is unrelated to eating, or is worse when you lie down
  • A sour or bitter taste in your mouth
  • Vomiting, weight loss, or loss of appetite
  • A persistent change in your bowel habits (e.g., diarrhea, constipation, or narrow stools)
  • Blood or dark-colored material (old blood) in your stool or vomit
  • Anemia
  • A lump in your stomach area
  • Difficulty or pain when you swallow
  • Chronic coughing or hoarseness
  • Indigestion along with trouble breathing, sweating, or pain radiating to your jaw, neck, or arm

Elizabeth Smoots, M.D., F.A.A.F.P., is a board-certified family physician in Seattle, Washington. A fellow of the American Academy of Family Physicians, Dr. Smoots specializes in prevention and primary care medicine.