Indigestion is the term used to describe discomfort in the upper digestive system after eating.

Common symptoms include:

• Heartburn – a painful burning feeling behind the breastbone
• Reflux – a burning sensation or bitter taste caused by food being regurgitated into the oesophagus (food pipe)
• Feeling uncomfortably full and bloated
• Feeling nauseous
• Burping

When we swallow food it travels down a pipe called to the oesophagus to the stomach. At the end of the pipe, there’s a sphincter – a ring of muscle – that opens and closes to allow food into the stomach. Its job is to protect the oesophagus from the acidic contents of the stomach.

Heartburn and reflux occur when this sphincter doesn’t work properly and stomach acid comes into contact with the sensitive lining of the oesophagus. The stomach acid damages the lining, leading to irritation, inflammation and pain.

However, not everyone with indigestion has inflammation in their digestive system. In some people, the symptoms are thought to be caused by an increased sensitivity of the digestive system to the acidity and stretching caused by eating.

Other contributing factors include:

• Medications – regularly using over the counter painkillers such as ibuprofen or aspirin can lead to indigestion and damage to the lining of the digestive system. Some medicines, such as the angina nitrate spray can also relax the oesophageal sphincter allowing acid to leak back up.
• Lifestyle factors – smoking and stress can trigger indigestion.
• Trigger foods – certain foods can cause the oesophageal sphincter to relax more than normal triggering heartburn. Common culprits include alcohol, spicy food, onions and garlic, chocolate and peppermint. Food intolerances can also contribute to reflux
• Obesity – increases in belly fat can increase the pressure in the stomach making it more likely that acid will reflux into the oesophagus.
• Pregnancy – also temporarily increases pressure in the abdomen, commonly triggering heartburn especially in the later stages.
• Hiatus hernia – a hiatus hernia occurs when part of your stomach gets pushes up through your diaphragm (the sheet of muscle under your lungs). This change in structural arrangement stop refluxed stomach acid from clearing from the oesophagus, leading to chronic heartburn. Hiatus hernias can occur as a result of weak connective tissue or after a large strain such as lifting something heavy or childbirth.
• Gut infections – Helicobacter is bacteria that can infect the stomach. It’s linked to the development of stomach ulcers. Some people may get bouts of indigestion from Helicobacter infection. An overgrowth of yeast or bacteria in the intestines can also contribute to indigestion
• Lack of stomach acid – feeling full, meals sitting heavy, burping and bloating can be symptoms of a lack of stomach acid. Even when heartburn is present, it doesn’t automatically mean that there is an excess of stomach acid! It’s simply that the stomach acid has ended up somewhere it shouldn’t!

The key to tackling indigestion is to find and address the underlying cause. Medications for indigestion work by reducing stomach acid. But excess stomach acid is rarely the true cause of the problem! Antacids can relieve some symptoms such as heartburn in the short term but they ultimately compromise digestion and can make the other symptoms such as feeling full and bloated worse.

A functional medicine practitioner can help you get to the bottom of what’s causing your indigestion and support your recovery.

• A full review of your diet, lifestyle and medication can identify potential triggers. A personalised diet plan can then be created to help you manage your indigestion. This will also include lifestyle suggestions around eating to help reduce indigestion symptoms. ¹
• Functional testing can help identify whether a gut infection or food intolerance is responsible for your symptoms. A regimen of herbs and supplements can then be recommended to address the underlying imbalance. ^{2 3 4}
• If you’re struggling with your body weight, a functional medicine practitioner can provide support so you can achieve healthier body weight.
• Where heartburn has been present for some time, natural remedies can also be recommended to help soothe the oesophageal lining. ⁵