Indigestion: When to Seek Medical Help

Indigestion is usually described by patients as a burning sensation in the stomach or upper chest region. The burning sensation may be accompanied by other symptoms such as: heartburn, sour stomach, nausea, vomiting, fullness in the back of the throat or abdomen, frequent belching or rectal gas, and loud gnawing intestinal sounds.

For some people, simple indigestion may be normal, and it will be easily relieved with liquid antacids and over-the-counter histamine-blocking tablets. However, indigestion that lasts over two weeks should prompt you to seek medical treatment from your physician. If you are experiencing increased levels of discomfort and are using over-the-counter medications to bring the pain down to a tolerable level, you may be masking a more serious medical condition.

Here are the most frequent causes for indigestion.

• Stress, anxiety, and depression
• Swallowing air while eating or drinking
• Stomach irritation or gastritis
• Regurgitation of acids from the stomach (called reflux)
• Ulcers of the stomach or duodenal area
• Gallbladder inflammation (called cholecystitis)
• Stomach cancer

If you are experiencing an occasional bout of indigestion from ingesting hot and spicy foods, you probably are doing the best thing for yourself by taking liquid antacid. However, if the discomfort lasts longer than two weeks, or if you notice increased levels of pain, it is time to seek a medical diagnosis from your physician.

Your physician will evaluate your condition by the symptoms you describe and what you have been doing to manage the symptoms. Most often, the physician may suggest a course of histamine blocking agents in tablet form over a few weeks and reevaluate your symptoms. This type of treatment may either be continued for a month or longer depending on the alleviation of symptoms.

Another diagnostic test is in the form of a barium swallow and x-rays. Liquid barium is swallowed (several ounces) and followed by x-rays of your upper chest and abdomen. The barium normally highlights constricted regions of the esophagus and stomach areas. It may also highlight abnormal growths or tumor like structures.

More frequently used today to rule out most of the pathological causes for indigestion is through an endoscopic exam. A small fiberoptic tube is placed into your mouth and down the esophagus into the stomach. The patient is given a topical anesthesia in the form of a spray into the back area of the mouth and throat which numbs and prevents gagging during the procedure. This procedure can be completed within minutes. The advantages of this procedure are: easy visualization of the inner lining tissues for inflamation and disease, swab testing for a common cause of inner tissue lining of the esophagus and abdomen called Helicobacter pylori, and obtaining tissue samples if necessary.

Oral antacids: These are the liquid medications found at your drug and food stores. They contain either calcium carbonate, aluminum, magnesium, or a combination of aluminum/magnesium. Calcium carbonate products are generally in chalk tablet form (Tums, Maalox Caps, Chooz tabs, Alka tabs, to name a few). They are effective in relieving indigestion after a short period of time and provide additional calcium intake to the body. Taking more than a few of these tablets daily may cause your calcium levels to rise abnormally. You should consult your physician if you are taking more than three daily.

Liquid antacids: The liguid antacids contain aluminum, magnesium, or a combo of the two elements. They are effective for indigestion and can provide relief within minutes and be effective from 10 minutes up to 90 minutes. Always follow the specific directions on the bottle. It should be remembered that liguids containing aluminum or magnesium should not be taken if you have hypertension, kidney or heart disease. These antacids may interfere with your daily medications by preventing absorption of the medications. Always consult your physician before using these forms of antacid.

Histamine Blocking Agents: Lastly, the use of histamine blocking agents (pepcid, tagamet, prylosec) can be found over-the-counter in lower dosages than normally prescribed by your physician, but they are also effective. These medications normally can take several hours to a few days before you actually notice relief of indigestion. Always consult your physician before using histamine-blocking agents if you have heart disease.