Indigestion refers to the pain or discomfort in the upper abdomen. Heartburn is burning pain behind the breastbone which occurs when stomach acid back flows into the oesophagus (tube that brings food from the mouth to the stomach) and irritates the lining. Indigestion and heartburn are common problems but in most cases, are mild and only occur occasionally. Such symptoms usually appear soon after eating or drinking. Sometimes, bloating, nausea, burping and early satiety (fullness) may also be experienced.
Indigestion occurs in approximately 25% of adults. Heartburn affects about 15% of the total population. There is a higher prevalence among Indians compared to Chinese and Malays.
- Elderly
- Pregnant
- Overweight
- Smoker
- Eating heavy meals, and eating them within 3 hours of bedtime
- Lying down soon after meals
- Eating certain food (Such as: Spicy food, fatty food, alcohol, coffee, carbonated drinks, chocolate and peppermint)
- Having other medical conditions (Such as: Irritable bowel syndrome, peptic ulcer disease and anxiety)
- Taking certain medications/supplements (Such as: Painkillers, steroids and iron salts)
Simple changes to the diet and lifestyle:
- Avoid eating large meals. Eat small frequent meals instead and eat slowly.
- Avoid food and beverages that are known to trigger your symptoms.
- Avoid eating within 3 hours of bedtime and lying down after meals.
- Elevate the head of the bed by using six to eight inch blocks or foam wedges.
- Avoid tight fitting clothes around the waist.
- For medications/supplements that may trigger symptoms, take them with plenty of liquid.
- Weight loss is encouraged for overweight individuals through exercising and having a healthy diet.
- Stop smoking; otherwise at least refrain from smoking immediately after meals.
- Stress management by engaging in relaxation strategies, such as yoga and deep breathing.
Medications:
Should the above diet and lifestyle changes be insufficient to control the symptoms, medications may be considered. However, speak to a doctor or pharmacist before taking any medications.
These medications include:
- Antacids and alginates which provide fast relieve of mild symptoms. Antacids neutralize stomach acid while alginates form a barrier to protect the gut from gastric acid.
- Histamine-2 receptor antagonists (H2RAs) (famotidine) may be used if symptoms are predictable, such as after eating a large meal. It works by reducing gastric acid production.
- Proton pump inhibitors (omeprazole) are used if symptoms persist despite using antacids and/or alginates and/or H2RAs for two weeks. It is used to inhibit gastric acid secretion and allow healing of the gut.
Visiting the doctor
However, the individual should be referred to the doctor, especially if any of the following condition is met:
- Frequent heartburn for more than three months
- Severe heartburn and indigestion
- Difficulty or pain on swallowing solid food
- Vomiting up blood
- Having black tarry stools
- Having unexplained weight loss
- Chronic hoarseness, wheezing, coughing or choking
- Continuous nausea, vomiting or diarrhea
- Chest pain accompanied by sweating, pain radiating to shoulder, arm, neck or jaw, and shortness of breath
- Persistence of heartburn and indigestion symptoms during or after two weeks of self-treatment
- Elderly above 55 years old
- Pregnancy
- Nursing mothers
- Children younger than 12 years old
By adopting healthful lifestyle and dietary choices, and also simple self-medication, symptoms of heartburn and indigestion can be prevented and/or minimized, allowing for better enjoyment of meals.
You can visit your nearest Unity Pharmacy and approach our pharmacists or staff on duty for more information.
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- Fock, KM, Talley N, Hunt R, et al. Report of the Asia–Pacific consensus on the management of gastroesophageal reflux disease.Journal of Gastroenterology and Hepatology. 2004; 19(4), 357-367.Â
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- Lim SL, Goh WT, Lee JM, et al. Changing prevalence of gastroesophageal reflux with changing time: longitudinal study in an Asian population. J Gastroenterol Hepatol. 2005;20:995–1001
- Marchettl N, Chan L. Pharmacist Guidelines for the Management of GERD in Adults: Opportunities for Practice Change under B.C.’s Protocol for Medication Management. Pharmacy Practice.