Indigestion

Indigestion refers to a sensation of pain or discomfort in the upper abdominal region. It is not a disease in itself but instead presents as a group of symptoms seen in certain gastrointestinal diseases.

You may be suffering from indigestion if you have the following symptoms:

• Feeling full too soon while eating meals
• A sensation of bloating in the abdomen
• Abdominal cramps
• Pain along the sides of the stomach
• Burning sensation in the stomach or upper abdomen
• Hyperacidity
• Nausea and vomiting
• Growling or grinding sounds in the stomach
• Acidic taste in the mouth
• Burping or belching up stomach contents
• Flatulence

Seek medical attention in the following conditions:

• Unintentional weight loss or loss of appetite
• Repeated vomiting or vomiting with blood
• Black, tarry stools
• Trouble swallowing that gets progressively worse
• Fatigue or weakness, which may indicate anemia

Many factors can cause indigestion, including:

• Lifestyle and dietary factors:
• Consuming excess alcohol, caffeinated beverages, and carbonated beverages irritates the stomach and causes indigestion.
• Eating larger meals that are fried, spicy, or salty can also lead to stomach upset.
• Consuming stale and undercooked food.
• Excessive smoking irritates the stomach and contributes to indigestion.
• Leading a sedentary lifestyle.
• Overeating or eating too quickly.
• Experiencing stress or anxiety frequently.

• Gastrointestinal diseases:
• GERD (gastroesophageal reflux disease): Causes the contents of the stomach to flow back into the esophagus, leading to symptoms like heartburn and dyspepsia (indigestion).
• Gastroparesis: A condition where the stomach cannot empty itself due to impaired motility, resulting in feelings of fullness and bloating.
• Irritable bowel syndrome: Affects the absorption of food from the intestines and can lead to indigestion.
• Celiac disease: The body abnormally reacts to gluten, a protein found in grains like wheat and barley.
• Malabsorption syndrome: A condition where the small intestine fails to absorb nutrients from food.
• Gastrointestinal infections: Can cause acute inflammation in the gastrointestinal tract, known as gastritis or gastroenteritis, due to various microorganisms.
• Chronic pancreatitis: Often leads to bloating, flatulence, and indigestion.
• Gastric cancers: Though rare, they may be a possible cause of indigestion.

• Medications:
• Certain medications, such as NSAID painkillers, antibiotics (like fluoroquinolones and tetracycline), iron and potassium supplements, and cardiovascular drugs (like digitalis), can irritate the gastric lining and cause hyperacidity, bloating, or indigestion.

• Functional dyspepsia:
• This type of indigestion has no apparent cause, is chronic, and can last for more than 6 months. It is not associated with stool irregularities.

• Other conditions:
• Gallstones
• Constipation
• Reduced blood flow in the intestine (intestinal ischemia)
• Diabetes
• Thyroid disease
• Pregnancy

• Smokers
• Alcoholics
• Frequent use of NSAIDs or painkillers
• Individuals who have suffered from H. pylori infection

A single episode of indigestion is not a cause for concern and requires no further evaluation. However, if indigestion is recurrent, accompanied by other troublesome symptoms, and interferes with the person’s daily life and activities, lab investigations and imaging studies may be needed to establish the cause of indigestion.

Laboratory Tests

• Laboratory tests play a limited role in the evaluation of indigestion.
• Complete hemogram, lipid profile, and liver function tests may provide insight into the general health of the patient.
• Breath tests and stool examination may be performed to check for the presence of Helicobacter pylori (H. pylori), the bacterium associated with peptic ulcers, and to identify any disease associations that may 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 of barium swallow testing.
• USG Abdomen, Dual Phase CT Abdomen: Visualizes the internal organs of the abdomen in greater detail and diagnoses any abnormalities.
• Barium Meal Follow Through, Barium Swallow: In this study, the patient swallows a drink containing barium, followed by x-rays of the digestive tract to identify any abnormalities of the esophagus, stomach, or intestines.
• Gastric Emptying Scan: Checks the time taken by food particles to pass from the stomach to the intestines and can help identify reduced gastric motility.
• Endoscopy, Colonoscopy: 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.

Although indigestion is a very common occurrence, certain lifestyle modifications can help prevent the condition as follows:

• Eat fresh, home-cooked food that is simple and easy to digest. Avoid fried and spicy foods.
• Consume smaller portions throughout the day instead of large meals at once.
• Limit the intake of aerated and caffeinated beverages.
• Quit smoking and limit alcohol consumption.
• Avoid taking medications, such as NSAID painkillers and antibiotics, for longer than prescribed.
• Engage in light exercises, such as walking, after consuming heavy meals to aid digestion.
• Drink plenty of water and fluids throughout the day.
• Refrain from consuming foods that cause allergies.

Indigestion is often neglected by many people as they consider it a common issue that does not require much attention. While occasional episodes of indigestion are mostly harmless and can be easily addressed with simple home remedies, it is important to be mindful of persistent symptoms.

Here are some Indian remedies to treat indigestion naturally.

The treatment of indigestion aims to provide relief from symptoms and treat the underlying cause.

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, as well as 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 cases of constipation and reduced movement of food from the mouth, which leads to symptoms of indigestion.
• Antibiotics like amoxicillin, clarithromycin, and tetracycline are used to treat infections such as H. pylori.
• Tricyclic antidepressants are used to treat functional dyspepsia, a condition where the cause of dyspepsia is not apparent.

Most often, symptoms of indigestion, such as abdominal pain, flatulence, or bloating, can be managed at home with simple remedies and lifestyle changes. Here is a list of recommendations to reduce indigestion-related problems:

• Take OTC preparations for faster relief of symptoms.
• Perform mild exercise, such as walking, to aid digestion and reduce bloating.
• Gently massage the abdomen to alleviate cramps and bloating.
• Modify your diet by increasing the consumption of fiber-rich foods, such as fresh fruits and vegetables, while reducing the intake of fatty and spicy foods that are primary causes of indigestion.
• Limit the consumption of alcohol, aerated, and caffeinated beverages.
• Modify or reduce the use of medications, such as NSAIDs or painkillers.

• Ulceration and bleeding in the gastrointestinal tract due to worsening of GERD and peptic ulcer disease
• Malnutrition due to the inability of the body to absorb nutrients
• Increased risk of gastrointestinal cancers
• Intestinal obstruction

Apart from prescription medications and OTC preparations, there are alternative therapies that may help provide relief from chronic indigestion, such as:

• Diet Modifications: A diet rich in fresh fruits and vegetables can help relieve the symptoms of indigestion. Limiting the consumption of spicy foods, fatty foods, and allergenic foods improves the overall health of the digestive system. It is advisable to eat smaller portions throughout the day instead of larger meals at once. To prevent indigestion, it is recommended to have a minimum gap of 2 hours between dinner and sleep time. An early dinner followed by a short walk can aid digestion and improve sleep quality.
• Exercise and Yoga: Light exercises can help reduce abdominal discomfort, provide relief from symptoms, and improve digestion. Activities such as walking, simple whole-body movements, light stretching, and yoga asanas are beneficial. Suggested yoga asanas for digestive health include Paschimottanasana, Supta Baddha Konasana, Vajrasana, and Pawanmuktasana.
• Massage Therapy: Gentle abdominal massage may help ease abdominal cramps and relieve constipation. You can massage your abdomen gently in circular movements while lying down. Be careful not to exert heavy pressure, as it may harm the internal organs.
• Ayurveda: Ayurveda suggests that indigestion, or Ajirna Rog, is caused when food is consumed without self-restraint. Bio-cleansing therapies like Shodhana Chikitsa and Shamana Chikitsa help manage indigestion. Natural herbs and spices, such as cinnamon (dalchini), carom (ajwain) seeds, cumin (jeera) seeds, ginger (adrak), asafoetida (hing), and fenugreek (methi), help build a strong digestive system and provide relief from flatulence and belching. These herbs and spices can be used in meal preparations or consumed in small quantities directly. Taking a pinch of asafoetida or carom seeds after a heavy meal or sucking on a piece of ginger candy or cinnamon stick can improve digestion. Medicinal preparations like Lahsunadi Vati and Hingavastaka Churna also help reduce indigestion.

Chronic indigestion may impose several dietary restrictions on a patient. The individual may be unable to enjoy or occasionally indulge in fast foods or snacks. They may need to completely avoid certain food items if they suffer from allergies, such as lactose intolerance. Chronic indigestion may also lead to malnutrition, as the patient may avoid eating meals. An acute episode of indigestion may leave the patient feeling extremely weak and fatigued. If experiencing severe symptoms of indigestion, such as prolonged nausea, excessive vomiting, diarrhea, or severe stomach cramping, medical care should be sought promptly.

Additionally, here are a few tips that can help people with functional dyspepsia:

• Eat slowly and chew your food properly, as a busy schedule may lead to fast eating and inadequate chewing.
• Have dinner at least 3 hours prior to bedtime.
• Take a small walk before going to bed.
• Drink 1-2 liters of water throughout the day to dilute stomach acid and aid digestion.
• Include plenty of fresh fruits and vegetables in your diet.
• Ensure you get adequate sleep, as lack of sleep is a key risk factor for stomach problems such as indigestion.