Answers
Indigestion and heaviness after meals: what causes it, and when is it serious?
Short answer
Indigestion (dyspepsia) means discomfort in the upper belly: heaviness after meals, feeling full after a few bites, or burning above the navel, often with nausea or burping. In most people no serious cause is found; this is called functional dyspepsia and it is treatable. H. pylori, ulcers and some painkillers are other causes. Weight loss, vomiting, black stools or difficulty swallowing need an endoscopy.
What it feels like
Burning that rises into the chest or throat is reflux (acidity), which often occurs with indigestion but is treated a little differently.
- Heaviness or uncomfortable fullness after a normal-sized meal
- Feeling full after only a few bites
- Burning or pain in the upper belly, above the navel
- Bloating in the upper belly, nausea or frequent burping
Common causes
Gallstones usually cause separate attacks of strong pain under the right ribs, not daily heaviness. Stomach cancer is an uncommon cause, but it is the reason warning signs are never ignored.
- Functional dyspepsia, the commonest cause: the stomach is more sensitive or empties more slowly, often worse with stress, poor sleep and irregular meals
- H. pylori infection of the stomach
- Gastritis or an ulcer, often from regular painkillers (NSAIDs) or alcohol
- Some medicines, such as iron tablets and some antibiotics, and long-standing diabetes, which can slow the stomach
Tests
If you are young and have no warning signs, a test for H. pylori (stool antigen or breath test) is often the first step, and the infection is treated if found. An upper GI endoscopy is advised if you have any warning sign, if the symptoms are new after about 45 to 50 years of age, if there is a family history of stomach cancer, or if symptoms do not settle with treatment. Blood tests and an ultrasound are added when the story suggests another cause.
What helps
When a check-up shows no serious cause, a short course of acid-lowering tablets, a medicine that helps the stomach empty, or a low dose of a gut-calming medicine can help. These should be chosen by your doctor, not started on your own for months.
- Eat smaller meals at regular times, and do not skip breakfast and then eat a heavy dinner
- Eat slowly, and finish dinner 2 to 3 hours before lying down
- Cut down on fried and very rich food, alcohol and smoking
- Avoid painkillers you do not need; ask your doctor for a safer option
- Work on sleep and stress, which affect a sensitive stomach
Warning signs: see a doctor soon
Sudden severe belly pain, or chest pain with sweating or breathlessness, is an emergency: call 112 or go to the nearest emergency department.
- Weight loss without trying, or loss of appetite
- Repeated vomiting, or vomiting blood
- Black, tarry stools, or anaemia
- Difficulty or pain in swallowing
- A lump in the belly, or yellow eyes
Eating for a sensitive stomach
Eat more
- Small, regular meals: breakfast, lunch, an evening snack and an early, light dinner
- Soft, simply cooked food on bad days: khichdi, dalia, idli, curd rice, steamed vegetables
- Enough water through the day, sipped rather than gulped with meals
Cut down
- Fried and very rich food: puri, pakode, samosa, heavy gravies and creamy sweets
- Large late dinners and lying down soon after eating
- Alcohol, smoking, fizzy drinks, and many cups of tea or coffee on an empty stomach
Good to know
- Keep a short food and symptom diary for two weeks; it often shows a personal trigger.
- Cutting out whole food groups rarely helps and can make you weak; change the size and timing of meals first.
Common questions
Is indigestion the same as acidity?
Not exactly. Indigestion is discomfort, heaviness or burning in the upper belly. Acidity or reflux is burning that rises into the chest or throat, or sour water in the mouth. Many people have both.
Do I need an endoscopy for indigestion?
Not always. Young people without warning signs can often start with an H. pylori test and lifestyle changes. An endoscopy is advised for warning signs, new symptoms after about 45 to 50, a family history of stomach cancer, or symptoms that do not settle.
Can stress cause indigestion?
Yes. The stomach and brain are closely linked, and stress, worry and poor sleep can make a sensitive stomach feel worse. This is real, not imagined, and improving sleep and stress helps.
Are digestive powders and churans safe to take every day?
Many contain a lot of salt, and some herbal mixtures can harm the liver. Taking them daily can also delay finding the cause. If you need something most days, see a doctor.