Indigestion

Also known as:Functional dyspepsia

Anatomy or system affected:Gastrointestinal system

Definition:Discomfort in the abdomen following meals.

Causes and Symptoms

Indigestion is a nonspecific term used to describe a variety of sensations. Burning, fullness, gaseousness, and a gnawing sensation in the abdomen are all symptoms that patients may describe as indigestion. While some people who complain of indigestion have acid reflux disease or ulcers, these are by no means the only causes. Fullness or bloating following the ingestion of milk, cheese, or other dairy products may be symptoms of lactose intolerance. This is one of the few cases of indigestion that is truly a problem in the digestive process, namely in the breakdown of milk sugars. Abdominal discomfort associated with alternating bouts of diarrhea and constipation may signal irritable bowel syndrome (IBS). More rare causes of similar discomfort include diffuse esophageal spasm, in which the food pipe contracts abnormally, and inflammation in the gallbladder.

Since the term “indigestion” is so vague, care must be taken to distinguish it from cardiac pain (angina). Psychiatric causes of abdominal pain must also be considered, especially when other etiologies have been ruled out.

Treatment and Therapy

Since the causes of indigestion are so varied, it is useful to arrive at a more precise diagnosis before offering treatment. Prior to embarking on a lengthy workup, however, some simple measures should be attempted. If symptoms resolve entirely with these measures, then no further investigation or treatment is usually required. Any particular foods that appear to worsen symptoms should be eliminated from the diet. This is especially true for dairy products and wheat, which are offensive factors in lactose intolerance and celiac sprue, respectively. Patients should also try avoiding spicy foods for a period of time. Eating slowly and having frequent small meals are good habits for people with indigestion. Some people find relief with over-the-counter remedies such as magnesium or bismuth mixtures. Histamine blockers can also be tried, especially if acid reflux is suspected.

If symptoms persist, or if they are accompanied by trouble swallowing, vomiting, weight loss, or a change in bowel movements, then more thorough investigation is needed. This is often done through blood tests, X rays, or endoscopy. Indigestion could be a sign of autoimmune disorders like IBS and it can be a preliminary sign of serious illness such as cancer.

Bibliography

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Voiosu, Theodor Alexandru, et al. "Functional Dyspepsia Today." Maedica 8.1 (2013): 68–74.