How to investigate the case of Indigestion or Dyspepsia?

How to investigate the case of Indigestion or Dyspepsia?

Indigestion also called dyspepsia is not a particular disease or disorder but it is a symptom that is caused by many underlying diseases.

It is characterized by vague abdominal discomfort or pain, a sense of fullness especially after eating little food, eructation, nausea, vomiting, and loss of appetite.


It is a symptom caused by a variety of diseases like…

Upper gastrointestinal disorder:

Most common diseases causing it are peptic ulcer, GERD including hiatus hernia, gallstones, acute gastritis, spasm of esophagus, functional or non-ulcer dyspepsia.

Other gastrointestinal diseases:

It includes irritable bowel syndrome, pancreatic diseases like carcinoma of the pancreas and chronic pancreatitis, chronic hepatitis, giardiasis, amoebiasis.

Systemic diseases:

Renal failure, hyperparathyroidism or hypercalcemia, tuberculosis, anemia, Addison’s disease can also cause it.


Many medicines can produce these symptoms such as non-steroidal anti-inflammatory drugs including cyclooxygenase-2-selective NSAIDs, iron and potassium chloride, digoxin, corticosteroids, etc.


Many miscellaneous factors can cause it like alcohol, psychological disorder like anxiety or depression, pregnancy, faulty habits of eating, etc.

Investigating a case of indigestion

Evaluation and investigation of the cases of dyspepsia is aimed towards to find out the causative disease or risk factor of the symptom. So we can do proper treatment of the affected patient.

History taking

Mode of onset:

Sudden onset indicates bereavement or shock.

Symptoms duration:

In malignancy, there is short history while in peptic ulcer there is a long history of dyspepsia with intervals of freedom from the symptoms.


Pain may be associated with it mostly colicky in nature which usually due to increased activity of the gut, uterus, and ureter. Sometimes gut pain may be associated with borborygmi which means rumbling or gurgling sound by gas or fluid movement in the intestine.

Loss of appetite:

It is prominent in cases of cancer and cirrhosis of the liver.


Nervous dyspepsia and chronic gastritis cases have nausea.


It is suggestive of organic disease when vomiting is copious and at an interval of many hours.


It can be associated with blood in vomiting in cases of peptic ulcer, gastritis, cirrhosis of liver, carcinoma, etc.


Indigestion with constipation may be present in duodenal ulcer, pyloric stenosis, carcinoma, chronic appendicitis, chronic cholecystitis, and visceroptosis.


It may be present in a nervous state, pancreatic insufficiency, colitis, etc.

Alternating diarrhea and constipation:

can occur in colon carcinoma, diverticulitis, and stricter of colon.

Color of stool:

Dark-colored stool is suggestive of Malena in absence of treatment with iron or bismuth.

Water brash and heartburn:

It is common in peptic ulcer.


It is common in chronic cholecystitis. In nervous dyspepsia, there may be aerophagia which means excessive air swallowing.

Non-organic or functional dyspepsia:

The patient should be investigated for non-organic also known as functional or non-ulcer dyspepsia when the following features are present.

  • Complaints are disproportionate to clinical fitness.
  • Symptoms changes from time to time and the patient describing it dramatically especially pain.
  • Symptoms are continuous, occurring daily over a long period of time.
  • Nausea in morning
  • Pain before breakfast but there is no disturbance in sleep.
  • Previous psychiatric disturbance history.

Personal history:

The evolution of personal history is also very important. Investigate for environmental factors, occupation of the handling of lead or other toxic products, working hours, regularity of meals, any bad habits such as excessive consumption of alcohol, caffeinated beverages, smoking, etc.

Family history:

Also, ask for any history of carcinoma, cholecystitis, duodenal ulcer, etc. in the family.

Physical Examination

After evaluating proper history physical examination of patients is very important to diagnose the underlying cause.

General appearance:

Nervous dyspeptic is usually thin while fat in gallbladder dyspepsia. Also watched for pallor pernicious anemia.


Dental caries is one of the common cause of indigestion and also examine the condition of the tongue.


Examine whole abdomen thoroughly for distention, peristalsis movement, localized tenderness, palpable mass, enlargement of liver, any sound of bubble or fluid, etc.


Also examine the heart and learn if the patient having a cough or dyspnea.


General debility or wasting is present in anorexia nervosa, tuberculosis, malignancy, Addison’s disease, etc.


It is not a disease but a symptom of causative disease or disorder. Therefore treatment is completely based on the disease causing it.

Effective home remedies and suggestions for indigestion or dyspepsia

We have a separate article on this.

Indigestion FAQs

Can indigestion causes chest pain and shortness of breath?

Indigestion is a symptom of many disorders and common cause includes gastro-oesophageal reflux disorder, esophageal spasm, hiatus hernia, acute gastritis, etc. In all these disorders chest pain may be one of the symptoms. In hiatus hernia and GERD due to reflux of gastric content, there may be shortness of breath due to aspiration into the lungs and irritation of throat and larynx.

How much baking soda should be taken for indigestion?

Baking soda or sodium bicarbonate is easily available in every kitchen and acts as a handy home remedies for indigestion.
You can take half a teaspoon of baking soda into 150 to 200 ml of warm water and drink it. It quickly helps to relieve gaseous abdominal discomfort, bloating, and indigestion.
But you should not use it frequently and in excessive quantity. Don’t repeat it within 24 hours of use. If possible one should not use it more than once in 24 hours. For side effects read more details on this study. In large quantities, it may have unfavorable side effects like diarrhea, irritability, constipation, vomiting, muscle cramps, etc.

Where does indigestion occur?

It is a symptom instead of a full-fledged disorder and is mainly caused by upper digestive system disorders like GERD, gastritis, hiatus hernia, and other abdominal disorders. In all these diseases the common symptom include pain in the epigastric region or behind the sternum, burning in the epigastrium or chest, nausea, vomiting, and heaviness of the abdomen even in a small meal.

Which food cause indigestion?

Food and food habits matter a lot for our body, especially our digestive system. Our digestive system has to work hard to digest foods like heavy and oily foods, spicy foods, chocolates, pastries, frequent caffeinated drinks, alcohol, etc.
Some food habits also affect the system like excessive quantity in a meal, lying down suddenly after a meal, eating many varieties of foods at a time, eating in hurried worried conditions, loss of temper, and other emotions. All these affect the system and later on causing indigestion and other digestive problems also.

Can indigestion cause high blood sugar?

It directly doesn’t cause a high level of blood sugar. But person with high blood sugar or uncontrolled diabetes may have indigestion and other gastric problems.

Does dyspepsia covered in insurance?

It depends on your insurance terms and conditions. Generally, there is some underlying disease that causes dyspepsia or indigestion. In such cases usually, insurance is covered only when you are admitted. When you are admitted for one or more days for any treatment or investigations your insurance company will pay for you. But you must confirm for coverage of your insurance regarding this matter with your agent or company person before taking any action.

Leave a Comment