“What causes indigestion and what can I do to find relief?” is a common question we hear weekly from RefluxMD’s visitors.  This condition can play havoc with your life if it is persistent and frequent.  However, providing an answer is not as easy as the question.  It all depends on what is causing your indigestion.

Symptoms of indigestion

Does this sound familiar?  You’ve had some stress recently….well, perhaps more than a little stress.  It was a challenging day and before dinner, you have a cocktail to relax.  Since dinner is one of your favorite meals, you eat your first serving quickly, and then fill your plate with another helping.

Shortly after dinner, you begin to feel full and a bit gassy,  and you notice that your stomach is bloated.  A light feeling of nausea is increasing as you find yourself belching.  Those Symptoms are pretty normal under the circumstances described above, and few adults are immune to feeling like this after that meal.

However, for others, a pain can build up in the stomach and lower chest, similar to heartburn.  This set of symptoms can also evolve into more severe nausea that can then lead to vomiting as well.  If these symptoms are persistent and frequent, then the cause can be something more than overeating, drinking alcohol, and stress.  You may have chronic Indigestion – but what is the cause?

Is something other than GERD causing your symptoms?

There are many underlying conditions, including some related to GERD that might be the real cause of your indigestion symptoms. Healthline lists almost fifty conditions that could result in one of the most common symptoms, Bloating, in an article titled, What causes abdominal bloating? 48 possible conditions. This highlights the fact that your symptoms could be a result of many issues including food allergies, irritable bowel syndrome, ulcers, stomach cancer, and pancreatitis, to name a few.

In another interesting article in US News and World Report, a dietician discusses bloating and highlights several reasons for bloating. According to Ms. Freuman, MS, RD, CDN, there are several possible reasons for these symptoms, including GERD:

Carbohydrate trigger – symptoms often appear sometime after breakfast and before lunch and continue throughout the day. A low-carb diet may help reduce symptoms resulting from carbohydrate trigger.

Constipation – slowly moving digested contents can build up gas in the stomach. For some, adding fiber (slowly) to the diet can improve this type of bloating.

Celiac disease – some people have a gluten (wheat) intolerance, which can result in bloating. Your doctor can order a simple blood test to determine if this condition is the cause of your boating.

Excessive tummy fat – reducing or eliminating excess tummy fat can be difficult. The author suggests working with a dietician or your doctor to target this area for weight reduction.

Many of the potential causes mentioned in these articles may not apply to you, but if indigestion has become a frequent and recurring problem for you, you should work closely with your doctor to determine what causes indigestion in your case.

GERD and indigestion symptoms

Indigestion, including bloating, are commonly reported symptom of GERD.  There are also several conditions that are directly associated with a GERD diagnosis that could cause bloating, including a hiatal hernia.  This type of a hernia is typically found during an endoscopy, a standard diagnostic test performed on most adults with GERD symptoms.

In addition to an endoscopy, other tests may include a blood test to rule out anemia or other conditions, x-rays or other imaging technologies to evaluate your digestive system, or a stool sample to test for the presence of an h pylori infection.  Additional GERD testing may be required as well, including a 24-hour pH test, manometry, or a barium swallow test.

If you have GERD symptoms, including frequent indigestion, and you have not had an endoscopy, we suggest you follow up with your doctor.  If you have a hiatal hernia and you are unable to achieve satisfactory relief with medication or other natural treatments, you should consider speaking with a GERD expert about antireflux surgery to fix this abnormality.

As you ask yourself what causes indigestion, you are not alone.  In fact,  we found an excellent article written by the UNC Center for Functional GI & Motility Disorders titled Abdominal Bloating: A Mysterious Symptom, that you may find interesting. As you will see, you do not suffer alone; as many as 30% of adults have this symptom periodically.

Treatment options if GERD is the cause of your indigestion

As everyone should know, GERD is a progressive disease. Time is the enemy here. The longer your esophagus is bathed in the contents from your stomach by regurgitation, the more likely you are to experience complications.

As you address the question of what causes indigestion, there are several other actions you can consider to reduce your symptoms:

• Consider probiotics. This is something you should discuss with your doctor. Probiotics may assist in the development of “good bacteria” and balance off the “bad bacteria.” When out of balance, the bad bacteria can cause undigested food to ferment, resulting in gas and increased intra-abdominal pressure. (see Natural remedies for acid reflux: Probiotics)
• Reduce your sodium consumption. Be especially wary of processed foods that tend to have unusually high sodium content.
• Avoid carbonated drinks. These carbonated drinks can often increase stomach bloating and increase the pressure in your stomach.
• Increase your intake of high fiber foods. Do this slowly, and be sure to consume adequate amounts of water with the increase in fiber.
• Avoid fatty foods. These foods take longer to digest, require more acid and can result in a bloated feeling.
• Exercise more. You may find some exercise will reduce your symptoms.
• Quit smoking (if you smoke). There is a link between smoking and bloating according to the staff at the Mayo Clinic (see their article titled Gas and Gas Pains).
• Eat slowly and eat smaller meals more frequently. This strategy will allow your stomach to more quickly digest the food you consume and it may reduce your bloating symptoms.
• Maintain a healthy BMI between 19 and 24.
• Try acid reducers such as antacids or H2-blockers.  Although proton pump inhibitors are effective for many, they also come with some potentially serious health risks if used daily for a long-term.
• Schedule exercise before meals rather than after eating.

You should also avoid foods that are known to cause bloating.  In the Mayo Clinic article noted above, they provide an excellent list that I am providing below:

• Beans
• Broccoli
• Brussels sprouts
• Cabbage
• Carbonated drinks
• Cauliflower
• Chewing gum
• Fruits, such as apples, peaches, and pears
• Hard candy
• Lettuce
• Milk and milk products
• Onions
• Sugar alcohols found in sugar-free foods (sorbitol, mannitol, and xylitol)
• Whole-grain foods

Signs that your indigestion need immediate attention

The Cleveland Clinic highlighted these six symptoms as alert symptoms and recommend that you contact your doctor;

1. Vomiting or blood in vomit (the vomit may look like coffee grounds)
2. Weight loss
3. Loss of appetite
4. Black, tarry stools or visible blood in stools
5. Severe pain in the upper right abdomen
6. Discomfort unrelated to eating

Don’t wait until your condition progresses, follow up immediately if you have any of these warning signs.

I hope this helps you understand what causes indigestion and how to treat it

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Medical resources used for this article

• Indigestion and Your Digestive System, reviewed by Jennifer Robinson, MD, WebMD,  https://www.webmd.com/heartburn-gerd/indigestion#1
• What Causes Abdominal Bloating?, reviewed by Michele Cho-Dorado, MD, Healthline,  https://www.healthline.com/symptom/abdominal-bloating
• Stomach Bloating: How to Relieve Your Tight, Round Belly, By Lisa Esposito and Tamara Duker Freuman MS, RD, CDN, US News and World Report,  https://health.usnews.com/health-care/patient-advice/articles/stomach-bloating-how-to-relieve-your-tight-round-belly
• Abdominal bloating: A mysterious symptom, Syed Thiwan, MD, UNC School of Medicine,  https://www.med.unc.edu/ibs/files/2017/10/Abdominal-Bloating.pdf
• Upset Stomach (Indigestion): When to Call the Doctor, reviewed by the doctors at the Cleveland Clinic, The Cleveland Clinic,  https://my.clevelandclinic.org/health/symptoms/7316-upset-stomach-indigestion/when-to-call-the-doctor