indigestion symptoms, signs and symptoms of indigestion, gerd diet, PPI's & ibs

Indigestion symptoms , signs and symptoms of indigestion and its relationship to ibs or the irritable bowel syndrome is discussed here. Do you suffer from heartburn or stomach pain? I expect the answer is probably yes as it is an extreamly common problem, affecting 10 to 20% of people at least once a week. The condition does seem to be quite common in ibs sufferers so I would like to provide you with comprehensive information on this.

What is it?

Indigestion symptoms, often called dyspepsia by healthcare professionals, it is a single or collection of indigestion symptoms including heartburn (burning in the chest), acid brash (acid taste in the mouth), regurgitation (food/acid coming back up from the stomach), bloating and nausea. Sometimes night time cough and problems with your teeth can occur as a result of this.

Why does it occur?

There are many reasons why reflux can occur. Acid, produced in the stomach, is normally prevented from regurgtating into the oesophagus/esophagus (food pipe or gullet) by a series of mechanisms based at the gastroesophageal junction (the 'doorway' between the these 2 areas). These mechanisms can be upset by various factors such as diet, weight, drugs, anatomical reasons and maybe even genetic influence.

Does it need investigating?

If you are under the age of 55 years, it doesn't usually need investigating unless symptoms are poorly controlled or associated with other symptoms.

Those over 55 years of age with new onset of indigestion symptoms or with poorly controlled symptoms or other symptoms such as unexplained loss of weight, food sticking (dysphagia), pain on swallowing (odynophagia) or new anaemia should be investigated further.

What investigations do I need?

It is probably advisable to have your Helicobacter pylori (h.pylori or campylobacter pylori) status checked. This is a bacteria that can live in the stomach and is associated with ulcers (duodenal 98% and stomach approx. 60%) and rarely a form of stomach cancer called gastric MALTOMA. This can easily be checked by doing an antibody test (blood test), a urea breath test via your doctor, or more unusually a stool test. Please discuss with your doctor as to which test is best for you.

Your doctor may wish to refer you for a hospital investigation. This is usually with an endoscopy test, a flexible camera to look into your stomach, or a less commonly used test called a barium swallow (an x-ray test where you swallow some barium dye to visualise the upper gastrointestinal tract).

How can I help improve my symptoms?

There are some simple measures you can take to improve your indigestion symptoms. You can try a gerd diet or gord diet which includes cutting down on foods such as chocholate, fatty foods, and caffeine containing drinks such as tea, coffee and some carbonated soft drinks (check with the packaging for the caffeine content).

If suffering heartburn at night, try to cut down on eating in the 2 hours before bedtime and propping yourself up in bed which will help reduce reflux by gravity.

Exercising may also help and also, if your symptoms have occured with weight gain, trying to lose that weight may also help.

Drug treatments for indigestion?

Drug therapy is commonly used for this condition, but should only be used when the more simple measures have failed. What drugs can be used?

1) Antacids

Antacids are widely used and available without prescription. They are usually aluminium or magnesium based and work by raising the pH of gastric contents. Please remember that the aluminium containing antacids can cause constipation (so if you have constipation-predominant ibs or irritable bowel syndrome, this should be avoided) and magnesium containing antacids can cause diarrhoea/diarrhea (so if you have diarrhea-predominant ibs or irritable bowel syndrome, then this should be avoided).

2) H2 Antagonists

H2 antagonists work to reduce acid in the stomach by antagonising histamine, a substance that stimulates acid production. The common common ones are ranitidine , cimetidine , famotidine and nizatidine . They work by reducing acid secretion in response to food, gastrin (a hormone that stimulates acid production) and histamine. They are generally well tolerated and more information on these can be found by clicking on the drug.

3) PPI's or Proton-pump inhibitors

PPI's or proton-pump inhibitors are widely prescribed these days as they are so effective in controlling indigestion symptoms. In the UK, the cost to the NHS is around £425 million and £7 billion worldwide (figures based in 2006). This is a lot of money and reflective of the degree of suffering from this condition. There are several PPI's available, including Omeprazole , Lansoprazole , Pantoprazole , Esomeprazole and Rabeprazole . They work by inhibiting the acid producing cells in the stomach (inhibit the so called 'proton pump')and are generally well tolerated. If you wish to have more detail on these drugs, please click on the individual drug. They are normally taken once or twice a day and have a long action in acid inhibition.

4) Prokinetics

Prokintics work by increasing gastric emptying so helping to reduce reflux. They are usually anti-sickness medications (anti-emetics) such as metoclopramide and domperidone .

5) Other drugs

Rarely Misoprostol and Sucralfate are used. Information on these drugs can be obtained by clicking on the drug concerned, but I won't be discussing them any further here.

Indigestion symptoms are common in ibs and irritable bowel syndrome .

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