Treatment for indigestion varies depending on what is causing your condition and how severe your symptoms are.
Diet and lifestyle changes
If you only have indigestion occasionally, with mild pain and discomfort, you may not need to visit your GP for treatment. You may be able to ease your symptoms by making a few simple changes to your diet and lifestyle. See the 'self help' section for more information about what you can do to relieve your indigestion.
Medication
If your indigestion is more severe, or is due to an infection with Helicobacter pylori (H pylori) bacteria, your GP may suggest or prescribe one of the treatments described below.
Your GP may also 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, you should never stop taking any medication without consulting your GP first.
If you have indigestion that often recurs, you may be able to use some of the treatments listed below as and when your symptoms appear. Your GP will be able to advise you about the best way to treat your indigestion, and will always prescribe the lowest possible dose to control your symptoms.
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 pharmacies. Check with your pharmacist if you are unsure about which type of antacid is appropriate 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. However, you should always follow the instructions on the pack 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 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 20-60 minutes.
You should not take antacids at the same time as other medicines because they can prevent other medicines from being properly absorbed by your body. However, you should not stop taking any other medicines before first speaking to your GP.
You may find that antacids cause mild side effects, such as diarrhoea or constipation. These side effects may be relieved by switching to an antacid that contains both magnesium salts and aluminium salts, such as Mucogel, Maalox or Altacite.
Alginates
Some antacids also contain a medicine called an alginate, which helps to 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 containing an alginate if you experience symptoms of acid reflux, or if you have gastroesophageal reflux disease (GORD). Examples of antacids containing alginates that are available over-the-counter (OTC) from pharmacies are Gaviscon and Rennie Duo.
You should take antacids containing alginates after eating because this helps the medicine to stay in your stomach for longer. If you take alginates on an empty stomach they will leave your stomach too quickly to be effective.
Proton pump inhibitors (PPIs)
If your indigestion is severe or recurring, 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 (PPI).
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 on prescription. However, if you are over 18 years of age, you can buy a type of PPI, called omeprazole, over-the-counter (OTC) in pharmacies.
If you are prescribed a PPI, and you are also taking warfarin, or phenytoin, your progress will be monitored because PPIs may enhance the effects of these medicines.
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 the 'diagnosis' and 'related links' sections for more information about endoscopies.
In some cases, PPIs can cause side effects, but they are usually mild and reversible. These side effects may include:
- Headaches.
- Diarrhoea or constipation.
- Nausea.
- Stomach pain.
- Dizziness.
- Skin rashes.
H2-receptor antagonists
H2-receptor antagonists are another medicine that your GP may suggest if antacids, alginates and proton pump inhibitors (PPIs) have been ineffective in controlling your indigestion. There are four H2-receptor antagonists available:
- Cimetidine.
- Famotidine.
- Nizatidine.
- Ranitidine.
They reduce the amount of acid in your stomach, thus making the stomach less acidic.
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 is not suitable if you are taking certain medicines, such as erythromycin or warfarin because it can interact with these medications.
As with proton pump inhibitors (PPIs) you will need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy because they can hide some of the problems that could otherwise be spotted during the endoscopy. See the 'diagnosis' and 'related links' sections for more information about endoscopies.
Side effects of H2-receptor antagonists are uncommon but can include:
- Diarrhoea.
- Headaches.
- Dizziness.
- Skin rashes.
- Tiredness.
Prokinetics (domperidone or metoclopramide)
If you are still experiencing symptoms of indigestion after taking both antacids and alginates, and proton pump inhibitors (PPIs), your GP may suggest a medicine known as a prokinetic.
There are two types of prokinetics available – domperidone and metoclopramide. They work by helping to make food pass through your stomach and the first part of your small intestine (duodenum) more quickly, so 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 those who are over 16 years of age. 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 15-30 minutes before a meal so that it has time to work before your symptoms of indigestion start.
Treatment for a 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 to 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. Your GP will prescribe a course of treatment containing two different antibiotics and a proton pump inhibitor. 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 most 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.
