Discomfort or pain in the upper abdomen is often called indigestion. The medical name is dyspepsia. There are respective Causes, and pressure, being overweight, smoking and specific dietary customs are risk factors.
Causes of Indigestion
Indigestion is very common and progresses in only a fraction of cases to ulceration and on to stomach and duodenal ulcers.
The stomach secretes highly concentrated hydrochloric acid, which begins the process of digestion and sterilizes the food. Thick mucus coats the walls of the stomach, protecting it from this acid. Good as this protection is, it commonly breaks down where there are persistently high levels of acid production. Anything that further irritates the lining of the stomach, like alcohol and acidic foods, adds to this. The gullet has less protection against acid, so any acid there causes heartburn. Similarly, acid in the duodenum irritates its walls.
For many years the organism Helicobacter pylori was thought to be an innocent inhabitant of the stomach and duodenum but it is now recognized as a potent source of gastric irritation, peptic ulcers and possibly even of stomach cancer.
Certain drugs irritate the stomach – most commonly anti-inflammatories such as aspirin and ibuprofen – and vary in how irritant they are. Stress, alcohol and smoking all greatly increase the risks of indigestion and peptic ulcers.
Symptoms of Indigestion
For most individuals it’s a feeling of distress caused by eating too much, too fast or by eating food that is really rich, spicy or greasy.
At its mildest there is a burning, gnawing sensation in the pit of the stomach. There may be heartburn. The sensation may be provoked or relieved by eating.
Symptoms suggesting a peptic ulcer are more persistent pain, especially one that wakes you at night and seems to gnaw into the back. However, it is now known that the symptoms bear a poor relationship to the severity of the condition. The diagnosis requires endoscopy, a breath test to detect H. pylori, which gives off a characteristic gas, or biopsy of an ulcer, which is to exclude malignancy and is one reason why endoscopy has replaced barium studies. Duodenal ulcers are almost certainly benign; a stomach ulcer may be malignant.
If an ulcer erodes through a blood vessel in the lining of the stomach or duodenum, there may be vomiting of blood or the passage of blood in the stools, colouring them jet black. If the bleeding is seen at endoscopy to be slight, treatment with tablets alone will be sufficient. If it is more severe, urgent surgery will be required. Potentially, a peptic ulcer can erode through the stomach or duodenal wall, to become a perforated peptic ulcer. This surgical emergency causes sudden severe upper abdominal pain and peritonitis.
“Nervous” indigestion can be a response to pressure and it can be a symptom of heartburn, gallstones or peptic ulcer.
Treatment of Indigestion
- Eat small meals frequently or at least consistently three times a day.
- Take an antacid when symptoms begin.
- See your physician if your pain lasts longer than several hours or if you must take antacids regularly.
- Indigestion beginning abruptly in middle age should be investigated to exclude stomach cancer.
- Eat small pieces of food at regular times without running or overfilling your belly.
- Avoid eating in the three hours before
going to bed to let your body enough time to digest food.
- Reduce or eliminate your consumption of tea, coffee and alcohol.
- Avoid rich, fatty foods like fried foods and butter.
- Maintain a food diary to help identify foods that cause indigestion.
- Learn to conquer anxiety, which can frequently trigger episodes of indigestion.
- Attempt to lose extra weight and prevent tight fitting clothes.
- If it’s possible to do so avoid medications that irritate the digestive tract, like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
Western herbalism – try peppermint or psyllium. See a nutritional therapist or a naturopath for dietary advice. Chiropractic – mid-upper back pain can come with indigestion; treating the spinal irritation and muscle spasm in the mid-thoracic area with manipulation helps ease pain and settle indigestion. Other therapies to try: homeopathy; tai chi/chi kung; chakra balancing; cymatics; hypnotherapy; Ayurveda; acupuncture; Chinese herbalism; auricular therapy.