Merck Manual

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Some Causes and Features of Indigestion

Some Causes and Features of Indigestion


Common Features*


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

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)

Blood tests

Sometimes stress testing

Drugs (such as bisphosphonates, erythromycin and other macrolide antibiotics, estrogens, iron, nonsteroidal anti-inflammatory drugs [NSAIDs], and potassium)

In people who are taking a drug that can cause indigestion

Symptoms occur shortly after taking the drug

A doctor’s examination alone

Sometimes difficulty swallowing liquids and solids

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)

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 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

* 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.