Indigestion.

 

Definition:

Indigestion is also known as dyspepsia, and is used to describe the pain which results in the upper abdomen when acid from the stomach comes into contact with the lining of the digestive system.

 

 

Causes:

Certain triggers can cause or exacerbate indigestion. These include smoking, eating

spicy or heavy meals, alcohol, and certain medication (such as NSAIDs) which can

irritate the lining of the stomach.

 

In some cases, a more serious cause such as a stomach ulcer, hiatus hernia or an

infection called Helicobacter pylori, may be to blame for the indigestion.

 

 

Presentation:

The main symptom is pain in the upper abdomen, which may be accompanied by

belching, nausea and a feeling of fullness. Symptoms will often occur in bouts which

come and go, and are often related to eating.

 

 

Differential Diagnosis:

A condition which presents in a similar way is gastro-oesophageal Reflux Disease (GORD) or heartburn. This presents as a pain rising from the stomach or lower chest towards the neck which is related to meals, lying down, stooping and straining. Acid or bile regurgitation, excess salivation and difficulty swallowing may also occur.

 

If there are recurrent bouts it may be an indication of a more serious condition, and the patient should undertake further tests.

 

If indigestion is accompanied by other symptoms such as heartburn, being sick after meals, difficulty swallowing or weight loss this could be an indication of a peptic ulcer. Ulcers can be defined as duodenal ulcers, or gastric ulcers if they affect the stomach.

 

Black, tar like stools, persistent vomiting or new or recently changed symptoms in a person

over the age of 45 may also indicate a more serious cause of the indigestion, such as

stomach cancer, or severe peptic ulcer.

 

 

Treatment:

Antacids are recommended as they neutralise the acid in the stomach to provide relief

from symptoms. For example Gaviscon, ONE to TWO tablets should be sucked or

chewed as required, max of TEN per day.

 

Alginates may also be used to form a 'raft' which lies on top of the stomach acid to

prevent any acid refluxing back into the oesophagus. For example Gaviscon Advance,

5-10ml should be taken after meals and at bedtime.

 

Other OTC treatments include rantidine (Zantac), omeprazole (Zanprol) and cimetidine /

pantoprazole but both of these are seldom used.

 

 

Self Help Advice:

Certain foods can help- oatmeal, rice and also ginger and peppermint (taken as a tea)

are thought to aid digestion.

 

Eat small, regular meals and chew food thoroughly.

 

Don't eat late at night or just before bed.

 

Avoid rich, fatty or spicy foods.

 

Stop or cut down smoking,

 

If overweight, try to loose some weight.

 

If the symptoms are worse at night, it may help to use an extra pillow to raise the head and neck area.

 

 

Sample Question:

When questioning an adult who is asking for advice about the treatment of indigestion, which of the following factors would indicate that the client should be advised to see their GP as soon as possible? You may select more than one answer if applicable.

 

a) associated unintended weight loss 

b) pain which is aggravated by exercise 

c) symptoms that are precipitated by bending 

 

Answers to all sample questions can be found by following the link under the Test Yourself tab.