What is the difference between heartburn and indigestion?
Indigestion (also called dyspepsia) is a sense of discomfort or pain in the upper abdomen. People experience different symptoms associated with indigestion which can include bloating, nausea, excess gas (either end) or a burning feeling.
Heartburn is a symptom of indigestion and occurs when the acid from the stomach travels towards the throat and causes a burning sensation in the chest, and can also cause an unpleasant taste in the mouth.
What causes indigestion?
Most people will experience indigestion at some stage, and the most common causes are:
– Eating heavy, spicy or fatty meals
– Eating food too quickly
– Eating or drinking too much
– Being overweight
– Smoking
– Pregnancy
– Stress and anxiety
– Some medications, such as anti-inflammatory painkillers (like ibuprofen)
Given the current coronavirus pandemic, people may be eating differently to how they normally eat. For example, drinking more alcohol or caffeinated drinks, or may be feeling more stressed or anxious. If this results in symptoms of indigestion, it is important to know what you can do.
What can I do to self-manage my indigestion without medication?
If you have identified the cause of your indigestion, the best way to manage it is to avoid your triggers.
FOOD & DRINK TRIGGERS
– Avoid spicy or fatty foods
– Eat smaller meals
– Take your time when eating – avoid rushing meals
– Reduce your alcohol or caffeinated drinks intake
Keeping a diary of what you eat/drink and when you get symptoms can be useful to understand which food/drinks affect you. The use of phone apps can be helpful as they are easily accessible if you are out. Here are some apps that we know people find useful;
Foody – Food & Symptom Tracker
Acid Reflux Diet Helper
Understanding your alcohol intake is important too, so if you drink alcohol it is worth regularly doing the Drink Aware self-assessment to monitor your alcohol intake: www.drinkaware.co.uk/selfassessment
There are handy tools on the website to help you cut down, or speak to your GP for more advice.
Weight
Try to lose weight if you are overweight, as this also reduces the frequency of symptoms. Start by workng out your Body Mass Index (BMI): www.nhs.uk/live-well/healthy-weight/bmi-calculator/
In addition, please measure your waist circumference as weight held around the middle is linked with increased risk of developing certain medical conditions. Regardless of your height or BMI, you should try to lose weight if your waist is 94cm (37 inches) or more for men, or 80cm (31.5 inches) or more for women
The NHS offers a free 12-week diet and exercise plan for weight loss: www.nhs.uk/live-well/healthy-weight/start-the-nhs-weight-loss-plan/
Or speak to your GP/Pharmacist if you want advice on how to safely lose weight and maintain your weight loss.
Smoking
You should also consider stopping smoking. If you would like help with this, visit kick-it.org.uk/ and search for services in Hammersmith & Fulham.
Stress and anxiety
Find ways to relax if stress/anxiety is a cause of your symptoms. Stress and anxiety can impact people if different ways, including acid reflux. The following short questionnaire from NHS Every Mind Matters gives you tailored advice depending on your answers: www.nhs.uk/oneyou/every-mind-matters/your-mind-plan-quiz/
You may find these apps helpful too: www.nhs.uk/apps-library/stress-anxiety-companion/ and www.nhs.uk/apps-library/thrive/
Other advice
– Speak to your pharmacist or GP if you are concerned your medication may be causing your symptoms.
– If heartburn is your main symptom and occurs at night, try using an extra pillow or raising one end of your bed/mattress so your head and chest are above your stomach to reduce acid travelling towards your throat.
What can I do to self-manage my indigestion with medication?
If the above measures do not work, or you cannot avoid your triggers, there are some over the counter medications you can try.
Antacids
These medications act by neutralising acid in the stomach. They are available in liquid and tablet form. They are available to buy in the pharmacy and are taken at the onset of symptoms. Directions for use vary so always read the label first. Brands included in this class of medication include Peptac, Gaviscon, Rennies, Tums
For more information on antacids: patient.info/digestive-health/indigestion-medication/antacids
Proton pump inhibitors and H2 receptor antagonists
These medications act by reducing the amount of acid produced by the stomach. They are available in tablets and capsules. Some are available to buy in the pharmacy and can either be taken when required to relieve symptoms or regularly to prevent symptoms. Always read the patient information leaflet for full details of how to take safely. Brands include Ranitidine, Omeprazole, Lansoprazole, Pantoprazole and Esomeprazole
For more information on proton pump inhibitors and H2 receptor antagonists:
patient.info/digestive-health/indigestion-medication/proton-pump-inhibitors
When should I be worried about my symptoms?
It is important to speak with your GP if:
– You have tried over the counter remedies for 4 weeks or more without success
– Lifestyle changes and over the counter medicines are not helping
– You have heartburn most days for 3 weeks or more
– You are 55 years of age or older
– You have any other symptoms like food getting stuck in your throat, frequently being sick, blood in your vomit or poo, or unintentional weight loss.
Further resources
For more information on heartburn: www.nhs.uk/conditions/heartburn-and-acid-reflux/
For more information on Indigestion: www.nhs.uk/conditions/indigestion/
For general information on gut symptoms and advice: gutscharity.org.uk/advice-and-information/symptoms/
For more information on what food to eat or avoid: patient.info/news-and-features/what-to-eat-and-avoid-for-heartburn