Treatment for indigestion (dyspepsia) will vary depending on what is causing it and how severe your symptoms are.
If you have been diagnosed with an underlying health condition, see the Health A-Z topics on Gastro-oesophageal reflux disease (GORD) and Peptic ulcer for more information on these conditions.
Diet and lifestyle changes
If you have indigestion only occasionally with mild pain and discomfort, you may not need to see your GP for treatment. It may be possible to ease your symptoms by making a few simple changes to your diet and lifestyle. See Indigestion - self help for more information about how to relieve your indigestion.
Current medication
Your GP may recommend making changes to your current medication if they think it could be contributing to your indigestion.
As long as it is safe to do so, you may need to stop taking certain medications, such as aspirin or ibuprofen. Where possible, your GP will prescribe an alternative medication that will not cause indigestion. However, never stop taking any medication without consulting your GP first.
Immediate indigestion relief
If you have indigestion that requires immediate relief, your GP can advise you about the best way to treat this. As well as lifestyle changes and reviewing your current medication, your GP may prescribe or recommend:
- antacid medicines
- alginates
These are described in more detail below.
Antacids
Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion. They work by neutralising the acid in your stomach (making it less acidic), so that it no longer irritates the lining (mucosa) of your digestive system.
Antacids are available in tablet and liquid form. You can buy them over-the-counter (OTC) from most pharmacies without a prescription. Check with your pharmacist if you are unsure about which type of antacid is suitable for you.
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 that you do not take too much.
It is best to take antacids when you are expecting symptoms of indigestion or when they start to occur, such as:
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.
Do not take antacids at the same time as other medicines because they can prevent other medicines from being properly absorbed by your body. For example, antacids can interfere with iron supplements. Speak to your GP to find out how much time you should allow between taking antacids and other medication. Do not stop taking any other medicines without speaking to your GP.
Antacids may cause mild side effects such as:
- diarrhoea (passing loose, watery stools)
- constipation (an inability to empty your bowels)
These side effects may be relieved by switching to an antacid that contains both magnesium salts and aluminium salts. Your pharmacist can give you advice about which antacid is suitable for you.
See the Health A-Z topic about Antacids for more information about this type of medication.
Alginates
Some antacids also contain a medicine called an alginate. This helps relieve indigestion caused by acid reflux.
Acid reflux occurs when stomach acid leaks back up into your oesophagus (gullet) and irritates its lining (mucosa). Alginates work by forming 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 suggest that you take an antacid that contains an alginate if you experience symptoms of acid reflux or if you have gastro-oesophageal reflux disease (GORD).
Take antacids containing alginates after eating because this helps the medicine stay in your stomach for longer. If you take alginates on an empty stomach, they will leave your stomach too quickly to be effective.
Treating persistent indigestion
If you have indigestion that is persistent or recurring, your GP may prescribe a different type of medication. This will be prescribed at the lowest possible dose to control your symptoms. Possible medications include:
- proton pump inhibitors
- H2-receptor antagonists
- prokinetics
These are described in more detail below. Your GP may also test you for the Helicobacter pylori (H pylori) bacteria (see Indigestion - diagnosis) and prescribe treatment for this if necessary.
Proton pump inhibitors (PPIs)
If you have severe or recurring indigestion, treatment with antacids and alginates may not be effective enough to control your symptoms. If this is the case, your GP may prescribe proton pump inhibitors (PPIs).
Like antacids, PPIs affect the acid in your stomach. However, rather than neutralising the acid, PPIs inhibit the acid production in your stomach.
PPIs are taken as tablets and are generally only available with a prescription. If you are over 18 years of age, you can buy some types of PPIs over-the-counter (OTC) in pharmacies. However, these should only be used for short-term treatment. If your ingestion is persistent, see your GP.
PPIs may enhance the effect of certain medicines. If you are prescribed a PPI your progress will be monitored if you are also taking other medicines such as:
- warfarin, a medicine that stops the blood clotting
- phenytoin, a medicine to treat epilepsy
If your GP thinks that you should have an endoscopy (a procedure that allows a surgeon to see inside your abdomen), you will 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.
See Indigestion - diagnosis for more information about endoscopies.
In some cases, PPIs can cause side effects. However, they are usually mild and reversible. These side effects may include:
- headaches
- diarrhoea
- constipation
- nausea (feeling sick)
- vomiting
- flatulence (wind)
- 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 have not been effective in 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 both famotidine and ranitidine are available to buy over-the-counter (OTC) in pharmacies. H2-receptor antagonists are taken either in tablet or liquid form.
Cimetidine can interact with a number of medications. It may not be suitable if you are taking certain medicines such as:
- erythromycin (an antibiotic that is used to treat infections)
- warfarin
- phenytoin
As with PPIs, you will need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy. This is because they can hide some of the problems that could otherwise be spotted during the endoscopy.
See Indigestion - diagnosis for more information about endoscopies.
Side effects of H2-receptor antagonists are uncommon but can include:
- diarrhoea
- headaches
- dizziness
- skin rashes
- tiredness
Prokinetics
If you are still experiencing symptoms of indigestion after taking antacids, alginates and PPIs, your GP may suggest a medicine known as a prokinetic.
There are two types of prokinetics available:
- domperidone
- metoclopramide
These medicines help food pass through your stomach and the first part of your small intestine (duodenum) more quickly. This means that indigestion is less likely to occur.
You may be prescribed domperidone by your GP, although it is also available over-the-counter (OTC) in pharmacies for people aged 16 or over. Metoclopramide is only available on prescription from your GP. Both medicines can be taken in tablet or liquid form.
If you are prescribed domperidone, you will need to take it 15 to 30 minutes before a meal so that it has time to work before your symptoms of indigestion start.
Helicobacter pylori (H pylori) infection
If your indigestion symptoms are caused by an infection with Helicobacter pylori (H pylori) bacteria, you will need to have treatment to clear the infection from your stomach. This should help relieve your indigestion because 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 (treatment with three different medications). Your GP will prescribe a course of treatment containing:
- two different antibiotics (medicines to treat infections that are caused by bacteria)
- a proton pump inhibitor or PPI (a medication that inhibits acid production in your stomach)
You will need to take these medicines twice a day for seven days. You must follow the dosage instructions closely to ensure that the triple therapy is effective.
In up to 85% of cases, one course of triple therapy is effective in clearing an H pylori infection. However, you may need to have more than one course of treatment if it does not clear the infection the first time.
