What causes dyspepsia (indigestion)?

From the Guidelines

Dyspepsia, or indigestion, is primarily caused by issues with the two-way communication between the upper gut and the brain, including problems with the nerves supplying the stomach and duodenum, as well as psychological factors such as stress and changes in the micro-organisms living in the upper gut. According to the British Society of Gastroenterology guidelines on the management of functional dyspepsia 1, the symptoms of dyspepsia arise from problems with the stomach or the first part of the small intestine, and can be triggered by various factors, including:

• Problems with the nerves supplying the stomach and duodenum, making them more sensitive to normal function
• A slower stomach emptying, contributing to feelings of early fullness
• Psychological factors, such as stress
• Certain foods or changes in the micro-organisms living in the upper gut

To address dyspepsia, patients can try:

• Regular exercise and lifestyle changes, such as avoiding certain foods that may trigger symptoms
• A stool test or breath test to look for a stomach infection called H. pylori, and antibiotic treatment if the test is positive 1
• Medications that reduce stomach acid or help the stomach empty more quickly, or neuromodulators that help reduce the abnormal sensitivity of the nerves 1
• Psychological or behavioural therapies that use the connection between the brain and upper gut nerves to control sensations from the upper gut 1

It is essential to note that while some patients may learn to manage their symptoms themselves, others may require consultation with a healthcare provider, especially if they are older or have a family history of cancer of the oesophagus or stomach 1.

From the Research

Causes of Dyspepsia (Indigestion)

Dyspepsia, also known as indigestion, can be caused by various factors. While the provided studies focus on gastroesophageal reflux disease (GERD), some of the factors associated with GERD may also contribute to dyspepsia.

• Lifestyle factors:
  • Eating habits:
    • Fast eating 2, 3
    • Eating beyond fullness 2, 3
    • Eating very hot foods 2, 3
    • Irregular meal patterns 4, 3
    • Large volume of meals 4
    • Eating meals just before bedtime 4, 3
  • Other lifestyle factors:
    • Excessive body weight, particularly obesity 4, 5
    • Moderate/high alcohol consumption 4, 3
    • Smoking 2, 4, 3
    • Lack of regular physical activity 4
    • Postprandial and vigorous physical activity 4
• Dietary factors:
  • Fatty, fried, sour, spicy food/products 4
  • Orange and grapefruit juice, tomatoes and tomato preserves, chocolate, coffee/tea, carbonated beverages, alcohol 4
  • Meat and fat consumption 3
  • Citrus fruits consumption between meals 5
• Other factors:
  • Central obesity as determined by waist circumference 5
  • Higher educational level and regular physical activity may be associated with lower odds of GERD 5
  • Mental state, with poor mental state being positively correlated with GERD 3

Note that these factors are associated with GERD, and their relationship to dyspepsia may not be directly equivalent. However, they may still contribute to the development of dyspepsia symptoms.