Indigestion and Bloating (Dyspepsia)
Dyspepsia, or indigestion, is discomfort or pain in the upper abdomen, often with early fullness, bloating, belching or nausea after eating. In Nigeria almost all of these feelings are called 'ulcer', and many people treat themselves for years with antacids, painkillers, bitters or herbal mixtures without a test. In fact most indigestion has no ulcer behind it. Common causes are H. pylori infection, anti-inflammatory painkillers, reflux, large or late meals, alcohol and smoking, and in many people no cause is found, which is called functional dyspepsia. A test for H. pylori and a short course of acid-reducing medicine help most people. A gastroscopy is needed when there are warning signs or symptoms start later in life.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- Pain or burning in the upper middle abdomen
- Feeling full quickly or uncomfortably full after meals
- Bloating and a swollen feeling in the upper abdomen
- Belching
- Nausea
- Heartburn
When to See a Doctor
See a doctor if indigestion lasts more than a few weeks, keeps returning, or needs antacids most days, so you can be tested for H. pylori and have your medicines reviewed. See a doctor promptly, as a gastroscopy is needed, if you are over about forty-five with new symptoms, or have weight loss, difficulty swallowing, persistent vomiting, anaemia or a family history of stomach cancer. Go to an emergency department for vomiting blood, black tarry stools, or sudden severe abdominal pain, and for upper abdominal or chest pain with sweating or breathlessness, which can be the heart.
Treatment options
- Testing for H. pylori by stool antigen or breath test, and treating it if found
- Stopping or replacing anti-inflammatory painkillers such as diclofenac and ibuprofen
- Smaller, regular meals, and cutting down alcohol and smoking
- A defined course of acid-reducing medicine such as omeprazole
- Gastroscopy for warning signs, new symptoms later in life, or indigestion that does not respond
- Further tests such as an ultrasound when gallstones or other causes are suspected
What it costs on Mezo
Published cash prices for the treatments used for this condition.
Common Questions
Is all upper belly pain ulcer?
No. Most indigestion is not caused by an ulcer. Reflux, H. pylori gastritis, painkillers, gallstones and an irritable gut can all feel similar, and occasionally the heart causes upper abdominal pain. A proper assessment tells them apart.
What causes constant bloating?
Common causes are eating quickly or late, fizzy drinks, some high-fibre foods, constipation and irritable bowel syndrome. Bloating with weight loss, a swelling that does not go down, or bleeding needs a doctor to look further.
Do I need a gastroscopy for indigestion?
Not usually at first. A gastroscopy is advised when there are warning signs such as weight loss, difficulty swallowing, vomiting or anaemia, when symptoms start after about forty-five, or when treatment has not helped.
Are bitters and herbal mixtures good for indigestion?
There is no good evidence that they treat the causes of indigestion, and some can irritate the stomach or affect the liver. It is better to find the cause, such as H. pylori, and treat it.
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