-IBIS-1.5.0-
tx
digestive system
indigestion/heartburn
diagnoses
definition and etiology
definition:
gnawing or burning pain/belching/bloating after eating, felt in the stomach, upper abdomen and/or esophagus
etiology: most common causes of indigestion:
hypochlorhydria: pain, belching, bloating
hyperchlorhydria: heartburn
decreased bile production: worse after fatty meals
decreased pancreatic enzymes: pain, bloating, belching
poor eating habits: not chewing food well, eating too fast
anxiety, tension causing increased sympathetic NS activity
intolerance to ingested foods: allergies, sensitivities
hiatal hernia: pain worse lying down after a meal, bloating, belching
gastritis
esophageal pathology: e.g. reflux
poor food choices: food high in preservatives, chemicals, coffee, refined foods, spices (irritants to the GI tract)
insufficient yin or yang (Easley)
signs and symptoms
signs and symptoms: after eating
belching, upper GI bloating, borborygmi
substernal or epigastric pain, heartburn, regurgitation of the stomach contents into the mouth
feeling of a "stone in the stomach" or that digestion is slow
symptoms are > with antacids and </> eating and < lying down or eating big meals
possible change in bowel habits: tendency to constipation (more often) or diarrhea
reliance on OTC or prescription medications
lab findings:
(+) breath hydrogen test for undigested carbohydrates reaching the colon
stool analysis: for undigested food, stool pH, etc.
urinary indican: toxemia from undigested protein in the colon
Heidelberg Gastric Capsule Analysis: to test stomach pH
food allergy testing
amino acid analysis: HCl is needed to absorb phenylalanine, tryptophan and tyrosine
upper GI barium study
endoscopy
Bernstein acid perfusion test: to replicate the symptoms of heartburn
course and prognosis
Indigestion is usually a functional disorder, and rarely a sign of serious disease, but it should always be fully investigated to rule out ulcers, cancer and other major pathology when the signs and symptoms are chronic, severe, not previously investigated, or unrelenting.
In uncomplicated cases of indigestion, where no severe pathology is uncovered, the prognosis is usually good once the correct diagnosis of cause is made and proper treatment initiated.
see: bowel toxemia
differential diagnosis
cardiac ischemia
diffuse esophageal spasm
gastroesophageal reflux
peptic ulcer disease
cholecystitis
anxiety
aerophagia from excess consumption of carbonated beverages
lactose intolerance
footnotes