Tip/Thought of the Day

Could It Be Indigestion?

For decades, I’ve heard patients tell me they have never had indigestion, even get angry and frustrated at such a ridiculous answer to their concerns. But the reality is most of us have experienced it at one time or another and just didn’t know because it can produce a wide variety of symptoms.

When I first started in practice, I regularly saw patients who had seen an ear, nose and throat, or lung specialist, when their cough and sore throat persisted after numerous evaluations and treatments. The majority came back with one diagnosis- GERD (gastoesophageal reflex disease). The acid was coming up from the stomach, through the esophagus, and hitting the throat- especially at night when gravity allowed it to pass easier. That resulted in a chronically dry, scratchy throat that created a constant desire to cough in order to clear what felt like something “stuck in the throat”. Left untreated, GERD can sometimes lead to other problems, including:  ulcers, strictures in the esophagus, hoarseness, Barrett’s esophagitis (a change in the lining of the esophagus that can increase the risk of esophageal cancer), lung disease, among other concerns.

All too often, patients have this issue but don’t address it because they assume it only causes abdominal complaints.

Indigestion, also called dyspepsia, is a general term. Indigestion is not a disease, but rather symptoms. Although indigestion is common, each person may experience it in a slightly different way. That’s why so many patients find it incredulous when told the diagnosis. Symptoms can range from something as simple as:

  • sore throat
  • excessive salivation
  • dry cough
  • nausea
  • vomiting
  • bloating
  • belching
  • a growling stomach
  • bad breath,
  • a sour taste in the mouth

All the way to:

  • fatigue
  • general malaise
  • breathing issues
  • trouble swallowing
  • chest pain
  • abdominal pain
  • bloody stools
  • weight loss

That’s why it’s so important to get a thorough evaluation. All too often, patients have this issue but don’t address it because they assume it only causes abdominal complaints.

Heartburn is a another symptom of indigestion. Its a pain or burning feeling in the center of the chest that can radiate into the neck or back during or after eating. Since it can be impossible to differentiate from a cardiac event,  it’s imperative to seek immediate medical attention.

Indigestion has many causes:


  • Ulcers
  • Gastritis
  • GERD
  • Gastroparesis (when the stomach doesn’t empty properly, often related to diabetes).
  • Stomach infections like H Pylori
  • Irritable bowel syndrome
  • Chronic pancreatitis
  • Gallstones
  • Celiac Disease
  • Hiatal hernia (part of your stomach bulges up into your chest)
  • Thyroid disease
  • Pregnancy
  • Rarely, stomach cancer


  • Aspirin and other painkillers, such as NSAIDs (non-steroidal anti-inflammatories) like ibuprofen (Motrin or Advil) and Aleve (naproxen)
  • Estrogens and oral contraceptives
  • Steroid medications
  • Antibiotics
  • Supplements
  • Thyroid pills


  • Eating too much
  • Eating too fast
  • Eating high-fat foods
  • Eating during stressful situations
  • Drinking too much alcohol, caffeine, citrus juices or carbonated beverages
  • Eating chocolates, tomatoes, spicy foods, onions and garlic can increase risk
  • Using tobacco products
  • Being overweight
  • Stress
  • Anxiety
  • Lack of sleep


  • Eating large portions before bedtime
  • Wearing tight-fitting clothing or belts
  • Lying down or bending over after eating
  • Constipation

Mild indigestion can often be helped by making adjustments to your lifestyle and avoiding the above triggers. When it persists, interferes with your life, or lasts longer than 2 weeks, other interventions may be required. Seek immediate attention if you have bloody stools, black tarry stools, weight loss, persistent nausea or vomiting, chest pain, difficulty or painful swallowing, shortness of breath, sweating, or yellow eyes or skin. You don’t need to suffer. If you have concerns, find help. Early evaluations can make a huge difference in your life and prevent future complications.

dsc_0323    –Dr. Courtney






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