Most people with indigestion have one or more of the following symptoms:

• Early fullness during a meal. You haven't eaten much of your meal, but you already feel full and may not be able to finish eating.
• Uncomfortable fullness after a meal. Fullness lasts longer than it should.
• Pain in the upper abdomen. You feel a mild to severe pain in the area between the bottom of your breastbone (sternum) and your navel.
• Burning in the upper abdomen. You feel an uncomfortable heat or burning sensation between the bottom of the breastbone and navel.

Less frequent symptoms may come along with indigestion, including:

• Nausea. You feel like you are about to vomit.
• Bloating. Your stomach feels swollen, tight and uncomfortable.

Sometimes people with indigestion also experience heartburn, but heartburn and indigestion are two separate conditions. Heartburn is a pain or burning feeling in the center of your chest that may radiate into your neck or back after eating.

When to see a doctor
Mild indigestion is usually nothing to worry about. Consult your doctor if discomfort persists for more than two weeks. Contact your doctor right away if pain is severe or accompanied by:

• Weight loss or loss of appetite
• Vomiting
• Black, tarry stools
• Jaundice, or yellow coloring in the skin and eyes

Seek immediate medical attention if you have:

• Shortness of breath, sweating or chest pain radiating to the jaw, neck or arm
• Chest pain on exertion or with stress

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

There are many possible causes of indigestion. Some are related to lifestyle and what you're eating and drinking. Indigestion can also be caused by other digestive conditions.

Common causes include:

• Overeating
• Eating too quickly
• Fatty or greasy foods
• Spicy foods
• Too much caffeine
• Too much alcohol
• Too much chocolate
• Too many carbonated beverages
• Smoking
• Nervousness
• Emotional trauma
• Medications, including antibiotics, aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
• Stomach inflammation (gastritis)
• Pancreas inflammation (pancreatitis)
• Peptic ulcers
• Gallstones
• Stomach cancer

When a cause for indigestion can't be found after a thorough evaluation, a person may have functional dyspepsia. Functional dyspepsia is a type of indigestion that may impair the stomach's ability to accept and digest food and then pass that food to the small intestine.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Although indigestion doesn't usually have serious complications, it can affect your quality of life by making you feel uncomfortable and causing you to eat less. When indigestion is caused by an underlying condition, that condition could come with complications of its own.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

If you have indigestion, you're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred directly to a gastroenterologist.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For indigestion, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Other than the most likely cause, what are other possible causes for my symptoms or condition?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will my insurance cover it?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or intermittent?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• What do you eat and drink in a typical day?
• How have you been feeling emotionally?
• How much alcohol do you drink?
• How much do you smoke?
• Are your symptoms better or worse on an empty stomach?
• Have you vomited blood or black material?
• Have your stools turned black?
• What medications — including over-the-counter medications — are you taking?

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

To investigate your signs and symptoms of indigestion, your doctor will likely review your medical history and perform a physical exam. To rule out other conditions that can cause indigestion, the doctor might order tests, including:

• X rays of your esophagus, stomach and small intestine. Also called an upper gastrointestinal and small bowel series, this exam uses X-rays to make images of the inside of your body.
• Blood, breath or stool tests. These help determine whether peptic ulcer disease is causing symptoms.
• Upper gastrointestinal endoscopy. After you've been sedated, a long, thin tube with an attached camera is placed in your mouth, down your esophagus and into your stomach. The doctor looks for abnormalities and may remove some tissue (biopsy) for later examination.
• Abdominal ultrasound. Using high-frequency sound waves, an ultrasound makes images that show movement, structure and blood flow. A gel is applied to your abdomen, and then a hand-held device that emits sound waves is pressed against your skin.
• Abdominal CT scan. A dye might be injected into your veins in order to get more-detailed pictures of inside your body. Then, you lie on a table and the CT scanner rotates around you, taking X-ray pictures as it moves.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

If lifestyle changes — especially avoiding offending foods — don't help your indigestion, there also are over-the-counter and prescription medications that may help. Most are designed to reduce stomach acid or help move food from the stomach to the small intestine.

Types of indigestion medications include:

• Antacids. Alka-Seltzer, Maalox, Mylanta, Rolaids, Riopan and others are available over-the-counter and work by neutralizing stomach acid. Side effects include diarrhea and constipation. These are often the first medications doctors recommend.
• H-2-receptor antagonists (H2RAs). These include Axid, Tagamet, Pepcid and Zantac, which are available over-the-counter or by prescription. They reduce stomach acid and work longer — but not as quickly — as antacids. Side effects may include headache, nausea, vomiting, constipation, diarrhea, and bruising or bleeding.
• Proton pump inhibitors (PPIs). Aciphex, Nexium, Prevacid, Prilosec, Protonix and Zegerid are most effective for people who also have gastroesophageal reflux disease (GERD). These medications reduce stomach acid and are stronger than H2RAs. They're available by prescription, although Prilosec also comes in over-the-counter strength. Possible side effects include back pain, aching, cough, headache, dizziness, abdominal pain, gas, nausea, vomiting, constipation and diarrhea. Long-term use has, rarely, been associated with bone fractures.
• Prokinetics. Medications such as Reglan can be helpful if your stomach empties slowly. People taking this prescription medication frequently experience side effects, including fatigue, sleepiness, depression, anxiety and involuntary muscle spasms.
• Antibiotics. If the bacteria that causes peptic ulcer disease (Helicobacter pylori) is causing your indigestion, your doctor may prescribe an antibiotic. Side effects include upset stomach, fungal infections and diarrhea.
• Antidepressants. If a thorough evaluation doesn't reveal a cause for your symptoms and the conventional treatments above don't work, your doctor may recommend an antidepressant medication. These prescription medications may improve the discomfort from indigestion by decreasing your sensation of pain. Side effects may include headaches, nausea, night sweats, agitation and constipation.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Healthy lifestyle choices may help prevent mild indigestion.

• Eat smaller, more frequent meals. Chew your food slowly and thoroughly.
• Avoid triggers. Fatty and spicy foods, carbonated beverages, caffeine, alcohol and smoking can trigger indigestion.
• Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
• Exercise regularly. With your doctor's OK, aim for 30 to 60 minutes of physical activity on most days of the week. It can be as simple as a daily walk, though not right after you eat. Exercise helps you keep off extra weight and promotes better digestion.
• Manage stress. Create a calm environment at mealtime. Practice relaxation techniques such as deep breathing, meditation or yoga. Spend time doing things you enjoy. Get plenty of sleep.
• Reconsider your medications. With your doctor's approval, stop or cut back on aspirin or other anti-inflammatory drugs, which can irritate your stomach lining. If that's not an option, be sure to take these medications with food.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Some people may find relief from indigestion through the following methods, although more research is needed to determine their effectiveness:

• Drinking herbal tea with peppermint.
• Psychological methods, including relaxation techniques, cognitive therapy and hypnotherapy.
• Using the herb STW 5, which is made with peppermint and caraway. Remember that there's a risk that comes with taking herbs, as they are not regulated.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.