Treatment of Indigestion

For most mild cases of indigestion reassurance that careful examination has revealed no serious problem, is generally all that is required. For mild cases drugs age generally not required and if patient is receiving medication for acid reflux may be stopped. Along with reassurance, the patients of indigestion should be advised to reduce intake of alcohol, caffeine (coffee and tea), tobacco etc. as these substances may relax LES. Many of the cases of indigestion are due to GERD, and non pharmacological advises that are given for GERD patients should be given to patients with indigestion such as intake of fat should be reduced, snacks should not be taken before bedtime, elevation of head part of bed during sleep etc.

The most important aspect of treatment indigestion is to diagnose the cause and treat the cause appropriately by surgical (such as billiary colic) or medical approaches (dietary change for lactase deficiency or celiac disease).

As most of the cases of indigestion are due to GERD (gastroesophageal reflux disease) and functional dyspepsia, the treatment should be directed accordingly, such as reduction or neutralization of gastric acid secretion, stimulate gastric emptying etc.

Reduction of gastric acid secretion:

Drugs commonly used for reduction of gastric acid include, proton pump inhibitors (such as omeprazole, lansoprazole, rabeprazole, pantoprazole, esomeprazole etc.), histamine H2 antagonists (e.g. cimetidine, ranitidine, famotidine etc.). Neutralization gastric acid can be achieved by use of antacids, but they have short duration of action have gastrointestinal side effects such as diarrhea and constipation. These treatments are effective for both GERD and functional dyspepsia.

Eradication of H. pylori:

H. pylori are one of the most important causes of dyspepsia and peptic ulcer. Eradication can be done by use appropriate antibiotics (metronidazole, tinidazole, clarithromycin, amoxicillin etc. are used for eradication). Combination of at least two antibiotics along with proton pump inhibitors is used for 1-2 weeks for eradication of H. pylori.

Use of prokinetic drugs:

Gastrointestinal stimulants or prokinetic agents (such as metoclopramide, domperidone, and tegaserod) are also used for treatment of indigestion. But the usefulness prokinetic agents are doubtful as it has not been proved to be useful to use prokinetic agents in large clinical trials for functional dyspepsia or indigestion.

Image(s): FreeDigitalPhotos.net

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