Indigestion and its Causes
Indigestion is a nonspecific term that covers a variety of upper abdominal complaints such nausea, vomiting, heartburn, regurgitation, dyspepsia (the presence of symptoms thought to originate in the gastro-duodenal region) etc. which affect patients’ health state in a negative way. Dyspepsia may be reported by some individuals as epigastric burning, gnawing discomfort in abdomen, or abdominal pain. Some individuals with dyspepsia experience a constellation of symptoms such as postprandial fullness (feeling of fullness of stomach for long time after meal), early satiety (an inability to complete a meal due to premature fullness), bloating, eructation or belching and anorexia.
Causes of indigestion:
The most common cause of indigestion are gastro-esophageal acid reflux (severe form is GERD or gastro-esophageal reflux disease) and functional dyspepsia.
Gastro-esophageal acid reflux: Reflux of gastric acid into the esophagus can result from a variety of physiologic defects. Reduced lower esophageal sphincter (LES) tone is an important cause of reflux in pregnancy and also in scleroderma. Many individuals exhibit frequent and transient lower esophageal sphincter relaxations during which acid bathes the esophagus. Overeating and aerophagia (air in the stomach that enters during eating) can overcome the LES barrier. If there is impairment of esophageal body motility and reduced salivary secretion, exposure to acids prolongs.
The role of hiatus hernia is controversial, because most reflux patients have hiatus hernia, but most individuals with hiatus hernia do not have excess heartburn (acid reflux).
Functional dyspepsia: Disturbed gastric sensory function is a pathogenic factor in functional dyspepsia. Patients with dyspepsia experience discomfort with distention of fundus of the stomach to lower pressures than healthy individuals. Some patients with dyspepsia exhibit normal esophageal acid exposure. These individuals with functional heartburn are due to heightened perception of normal esophageal pH.
Other causes of dyspepsia: Among other causes dyspepsia includes disturbed gastric motility, delayed gastric emptying (seen in approximately 25% of dyspepsia patients), infection with Helicobacter pylori etc. Many drugs can cause dyspepsia such as analgesics, nitrates, calcium channel blockers, theophylline, and progesterone and affect dyspepsia patients’ health. Alcohol, tobacco, and caffeine can cause dyspepsia via LES relaxation. Genetic factors may also contribute to development of acid reflux and indigestion.
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