Treating indigestion

Treatment for indigestion will vary depending on what's causingit and how severe your symptoms are.

Most people are able to manage their indigestion by making simple diet and lifestyle changes, or taking medication such as antacids .

See treating GORD if you've been diagnosed with gastro-oesophageal reflux disease (GORD). See treating astomach ulcer if you've been diagnosed with a stomach ulcer.

Diet and lifestyle changes

It may be possible to ease your indigestion symptoms by making a few simple changes to your diet and lifestyle, such as those discussed below.

Losing weight can helpif you're overweight. It's important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet .

Avoid foods that seem to make your indigestion worse, such as rich, spicy and fatty foods. You should also cut down on caffeinated drinks, such as tea, coffee and cola, as well asalcohol.

Smoking can alsocontribute to indigestion, so speak to your GP or pharmacist about giving up smoking if you smoke. You can also call the NHS Stop Smoking Helpline on 0300 123 1044.

If you tend to experience the symptoms of indigestion at night, avoid eating for three to four hours before you go to bed.

Going to bed with a full stomach means there's an increased risk that acid in your stomach will be forced up into your oesophagus while you're lying down.

When you go to bed, prop your head and shoulders up with a couple of pillows, or raise the head of your bed by a few inches by putting something underneath the mattress.

The slight slope should help prevent stomach acid moving up into your oesophagus while you're asleep.

Changing medication

If your GP thinks the medication you're taking could be contributing to your indigestion, they may recommend changing it.

Where possible, your GP will prescribe an alternative medication that won't cause indigestion.

Immediate indigestion relief

Antacid medicinesand alginates can be recommended or prescribed by your GP for immediate relief.

Antacids

Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion.

They neutralise the acid in your stomach, making it less acidic, so it doesn't irritate the lining of your digestive system.

Antacids are available in tablet and liquid form. You can buy them over the counter from most pharmacies without a prescription.

The effect of an antacid only lasts for a few hours at a time, so you may need to take more than one dose. Always follow the instructions on the packet to ensure you don't take too much.

It's best to take antacids when you're expecting symptoms of indigestion, or when they start to occur, such as after meals or at bedtime. This is because antacids stay in your stomach for longer at these times and have more time to work.

For example, if you take an antacid at the same time as eating a meal, it can work for up to three hours. In comparison, if you take an antacid on an empty stomach, it may only work for 20 to 60 minutes.

Read moreabout considerations when using antacids , including possible interactions with other medicines and side effects.

Alginates

Some antacids also contain a medicinecalled an alginate. This helps relieve indigestion caused by acid reflux, when stomach acid leaks back up into the oesophagus, irritating its lining.

Alginatesform a foam barrier that floats on the surface of your stomach contents, keeping stomach acid in your stomach and away from your oesophagus.

Your GP may recommend taking an antacid that contains an alginate if you experience symptoms of acid reflux or if you have GORD.

Antacids containing alginates should be taken after eatingas this helps the medicine stay in your stomach for longer. Taking alginates on an empty stomach will result in them leaving your stomach too quickly for them to be effective.

Persistent indigestion

If you havepersistent or recurring indigestion, treatment with antacids and alginates may not be effective enough to control your symptoms.

Your GP may recommend a different type of medication, which willbe prescribed at the lowest possible dose to control your symptoms.

Possible medications include proton pump inhibitors (PPIs) and H2-receptor antagonists.

Proton pump inhibitors (PPIs)

Proton pump inhibitors (PPIs) restrict the acid produced in your stomach. They aretaken as tablets and are usually only available on prescription.

If you're over 18, you can buy some types of PPIs over the counter in pharmacies, but these should only be used for short-term treatment. See your GP ifyour indigestion is persistent.

PPIs may enhance the effect of certain medicines. If you're prescribed a PPI, your progress will be closely monitored if you're also taking other medication, such as:

• warfarin a medicine that stops blood clotting
• phenytoin a medicine to treat epilepsy

If you're referred for an endoscopy, you'll need to stop taking a PPI at least 14 days before the procedure. This is because PPIs can hide some of the problems that would otherwise be spotted during the endoscopy.

PPIs can sometimes cause side effects, but they're usually mild and reversible.

Side effects may include:

• headaches
• diarrhoea
• constipation
• feeling sick
• vomiting
• flatulence
• stomach pain
• dizziness
• skin rashes

H2-receptor antagonists

H2-receptor antagonists are another type of medication that your GP may suggest if antacids, alginates and PPIs haven't been effectiveat controlling your indigestion.

There are four H2-receptor antagonists:

• cimetidine
• famotidine
• nizatidine
• ranitidine

These medicines work by lowering the acidity level in your stomach.

Your GP may prescribe any one of these four H2-receptor antagonists, although famotidine and ranitidine are available to buy over the counter in pharmacies. H2-receptor antagonists are taken either in tablet or liquid form.

As with PPIs, you'll need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy. This isbecause they can hide some of the problems that could otherwise be spotted during the procedure.

Helicobacter pylori (H. pylori) infection

If your indigestion symptoms are caused by an H. pylori infection,you'll need treatment to clear the infection from your stomach.

This should help relieve your indigestion, as the H. pylori bacteria will no longer be increasing the amount of acid in your stomach.

H. pylori infection is usually treated using triple therapy, where treatment involves taking three different medications.

Your GP will prescribe a course of treatment consisting of:

• two different antibiotics
• a PPI

You'll need to take these medicines twice a day for seven days. You mustfollow the dosage instructions closely to ensure the triple therapy is effective.

One course of triple therapy is effectiveat clearing an H. pylori infection in up to 85% of cases. However, you may need more than one course of treatment if it doesn't clear the infection the first time.