3 causes of indigestion and how to deal with them

Many of us will experience indigestion at some point in our lives – a burning or bloating feeling in our tummies. But what causes these sensations? Top gastroenterologist Dr Michael Mendall explains:

What causes indigestion?

It’s best to think about indigestion (dyspepsia) as 3 different types:

• acid reflux
• peptic ulcer
• bloating/abdominal pain

The causes of indigestion have been changing quite rapidly over the last 20-30 years. About 20 years ago, peptic ulcers were the most common; now ulcers are really very rare. They may be caused by helicobacter pylori.

One of the most common causes nowadays is acid reflux, which is caused by a weakness in the valve at the lower end of the oesophagus. This can result from obesity, normal aging, or other natural causes.

The other common type is bloating, or general abdominal discomfort – a form of IBS. This is caused by food intolerance, obesity, or not digesting food properly.

Other dangers:

What feels like indigestion can sometimes be another health problem manifesting as abdominal pain or a burning sensation, meaning that sometimes, what you thought was acid reflux could be something more sinister:

• Cancer – sometimes cancer both inside the digestive tract, and elsewhere in the abdomen can cause symptoms resembling dyspepsia.
• Stress can also cause feelings of indigestion – it can make your gut more sensitive.

What can you take for indigestion?

For reflux, the best things are antacids, drugs like ranitidine, or stronger proton pump inhibitors, which can be bought over counter.

For peptic ulcers, which manifest as a burning/boring pain in upper abdomen, drugs for reflux can work, but are often not as effective. Antacids containing bismuth subsalicylate are recommended by some doctors.

For bloating, IBS medications containing mebeverine may help relieve indigestion symptoms. Making changes to your diet can also make a big difference – for example, avoiding wheat helps many people.

There are other treatments, but these need to be prescribed by a doctor.

What do indigestion tablets do?

Many of them, such as ranitidine and proton pump inhibitors act by reducing the amount of acid the stomach makes. Others neutralise the acid already in the stomach.

Antacids containing bismuth subsalicylate protect the stomach lining from damage rather than reduce acid production, and protects against bacteria too – bloating can also be due to an overgrowth of bacteria, particularly in older people.

How can you avoid indigestion?

You can avoid indigestion by losing weight, taking regular exercise and avoiding eating large meals late in the evening. Also, drinking too much alcohol can be a factor, so cutting down on drinking can help prevent indigestion.

If you suddenly start getting persistent indigestion, particularly if you are over 40, you should consult your doctor or a specialist.