Table: Some Causes and Features of Indigestion-Merck Manual Consumer Version

Some Causes and Features of Indigestion

Cause	Common Features*	Tests†
Cancer (such as cancer of the esophagus or stomach cancer)	Chronic, vague discomfort Later, dysphagia with esophageal cancer or early satiety with stomach cancer Weight loss	Upper digestive tract endoscopy (examination of the esophagus, stomach, and duodenum using a flexible viewing tube called an endoscope) CT of the abdomen
Celiac disease	Change in bowel habits, such as diarrhea, bloating, or greasy stools Iron deficiency anemia that has no other cause	Blood tests Endoscopic biopsy of tissue from the small intestine
Coronary ischemia (inadequate blood flow to the coronary arteries)	Sometimes in people who have symptoms when exerting themselves Risk factors for heart disorders (such as high blood pressure, diabetes, and/or high cholesterol levels)	Electrocardiography (ECG) Blood tests Sometimes stress testing
	In people who are taking a drug that can cause indigestion Symptoms occur shortly after taking the drug	A doctor’s examination alone
Esophageal spasm	Sometimes difficulty swallowing liquids and solids	Barium swallow Esophageal manometry
Gastroesophageal reflux disease (GERD)	Heartburn and/or sometimes reflux of acid or stomach contents into mouth Symptoms sometimes triggered by lying down Relief with antacids	A doctor's examination Sometimes trying treatment with drugs to suppress acid production Sometimes endoscopy of the upper digestive tract Sometimes pH testing of the esophagus (pH is a measure of acidity)
Peptic ulcer disease	Burning or gnawing pain occurring before meals that may be relieved by eating food or taking antacids, histamine-2 (H2) blockers, or proton pump inhibitors (PPIs) May awaken people at night	A doctor's examination Sometimes endoscopy of the upper digestive tract Sometimes testing for Helicobacter pylori infection
Poor stomach emptying (gastroparesis)—usually due to other disorders such as diabetes, connective tissue disorders, and/or neurologic disorders	Nausea, abdominal pain, and sometimes vomiting Early satiety Sometimes in people who are known to have a causative disorder	Endoscopy of the upper digestive tract and/or nuclear scanning to evaluate stomach emptying
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. Features overlap between causes.
† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.
CT = computed tomography.

Cause

Common Features*

Tests†

Cancer (such as cancer of the esophagus or stomach cancer)

Chronic, vague discomfort

Later, dysphagia with esophageal cancer or early satiety with stomach cancer

Weight loss

Upper digestive tract endoscopy (examination of the esophagus, stomach, and duodenum using a flexible viewing tube called an endoscope)

CT of the abdomen

Celiac disease

Change in bowel habits, such as diarrhea, bloating, or greasy stools

Iron deficiency anemia that has no other cause

Blood tests

Endoscopic biopsy of tissue from the small intestine

Coronary ischemia (inadequate blood flow to the coronary arteries)

Sometimes in people who have symptoms when exerting themselves

Risk factors for heart disorders (such as high blood pressure, diabetes, and/or high cholesterol levels)

Electrocardiography (ECG)

Blood tests

Sometimes stress testing

In people who are taking a drug that can cause indigestion

Symptoms occur shortly after taking the drug

A doctor’s examination alone

Esophageal spasm

Sometimes difficulty swallowing liquids and solids

Barium swallow

Esophageal manometry

Gastroesophageal reflux disease (GERD)

Heartburn and/or sometimes reflux of acid or stomach contents into mouth

Symptoms sometimes triggered by lying down

Relief with antacids

A doctor's examination

Sometimes trying treatment with drugs to suppress acid production

Sometimes endoscopy of the upper digestive tract

Sometimes pH testing of the esophagus (pH is a measure of acidity)

Peptic ulcer disease

Burning or gnawing pain occurring before meals that may be relieved by eating food or taking antacids, histamine-2 (H2) blockers, or proton pump inhibitors (PPIs)

May awaken people at night

A doctor's examination

Sometimes endoscopy of the upper digestive tract

Sometimes testing for Helicobacter pylori infection

Poor stomach emptying (gastroparesis)—usually due to other disorders such as diabetes, connective tissue disorders, and/or neurologic disorders

Nausea, abdominal pain, and sometimes vomiting

Early satiety

Sometimes in people who are known to have a causative disorder

Endoscopy of the upper digestive tract and/or nuclear scanning to evaluate stomach emptying

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. Features overlap between causes.

† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.

CT = computed tomography.