Indigestion and Heartburn Differences

Heartburn is one symptom of indigestion

Man having indigestion
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Some people who experience heartburn report to others that they have a case of indigestion. Though they both have similar triggers, and treatment may be the same in many instances, indigestion isn't the same thing as heartburn. Indigestion is the condition, and heartburn occasionally is a symptom of indigestion. The condition is also known as dyspepsia or upset stomach.

Indigestion, Heartburn, and GERD

Indigestion is a vague feeling of discomfort and pain in the upper abdomen and chest, including a feeling of fullness and bloating, accompanied by belching and nausea.

Occasionally, heartburn is one of the symptoms. Heartburn is felt when stomach acid comes up through the lower esophageal sphincter (LES) that links your esophagus to your stomach. This causes a burning sensation in your chest or throat. When you feel the taste in the back of your mouth it may be called acid indigestion.

Heartburn that occurs more than twice a week may be considered gastroesophageal reflux disease (GERD). This disease can eventually lead to more serious health problems.

Causes

Indigestion is a common problem and can be triggered by several things, including what and how you eat and drink, but also more concerning health problems.

Common Causes

  • Overeating
  • Eating too fast
  • Significant caffeine intake
  • Eating fatty or spicy foods
  • Significant alcohol consumption
  • Smoking
  • Cholecystitis (inflammation of the gallbladder)
  • Chronic or acute gastritis (inflammation of the stomach)
  • Chronic or acute pancreatitis (inflammation of the pancreas)

Less Common Causes

  • Helicobacter pylori (H. pylori): This is a bacterium that lives in the mucous layer of the stomach, that can cause irritation (gastritis) and ulcers. If H. pylori is diagnosed, it can be treated.
  • Hiatal hernia: This occurs when part of the stomach slides upward through the diaphragm, and into the chest cavity. Besides indigestion, a hiatal hernia can cause pain and heartburn.

Symptoms

You may experience these symptoms with indigestion:

  • Heartburn: a burning pain that usually starts in the chest, behind the breastbone
  • Pain that occurs in the upper abdomen or the chest. It may or may not be related to overeating or consuming a trigger food or beverage.
  • A feeling of discomfort or that you are full too soon when eating and fullness lasting longer than it should after eating
  • Loss of appetite
  • Nausea
  • Burping
  • Flatulence
  • Bloating

See the Doctor If You Have These Symptoms

Because indigestion can be a sign of a more serious condition, such as an ulcer or occasionally cancer, anyone experiencing the following symptoms in addition to indigestion should consult with their doctor.

  • Heartburn more than twice a week
  • Unplanned weight loss
  • Severe pain
  • If you are over age 45 and have not previously suffered from any indigestion problems
  • Difficulty swallowing
  • Black, tarry stools

Immediate medical attention is needed for anyone who experiences either of the following symptoms:

  • Vomiting with specks of blood or with blood that looks like coffee grounds
  • Vomiting fresh blood
  • Shortness of breath, sweating, chest pain

Treatment

You can make changes to your habits that will help relieve heartburn. There are also over-the-counter and prescription medications that can help.

Lifestyle Changes

Symptoms of indigestion can often be relieved with a few lifestyle changes.

  • Eat smaller, more frequent meals and avoid late-night snacks. Large meals expand your stomach and increase upward pressure against the esophageal sphincter.
  • Limit your intake of foods and beverages that trigger your symptoms. Eat foods that rarely cause heartburn and avoid those foods that will often cause heartburn.
  • Exercise regularly but avoid exercising immediately after you eat. Wait an hour or two to allow digestion.
  • Don't lie down for about two hours after you eat. Gravity helps to keep the stomach juices from backing up into the esophagus and assists the flow of food and digestive juices from the stomach to the intestines.
  • Elevate your head a few inches while you sleep. Lying down flat presses the stomach's contents against the lower esophageal sphincter. With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed. You can also use an extra pillow, or a wedge-shaped pillow, to elevate your head.
  • Don't smoke. Nicotine relaxes the esophageal sphincter. Smoking also stimulates the production of stomach acid. 
  • Don't drink alcohol. If you still want to drink alcoholic beverages, follow tips including diluting alcoholic beverages with water or club soda, limiting the amount you drink at one time, choosing white wine rather than red wine, and avoiding mixers you know may trigger your symptoms.
  • Relax. Follow relaxation tips to alleviate stress, and thus make stress-related indigestion less likely.
  • Don't wear belts or clothes that are tight fitting around the waist. Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the lower esophageal sphincter, and cause food to reflux into the esophagus. Clothing that can cause problems includes tight-fitting belts and slenderizing undergarments.
  • Maintain a healthy weight. Excess fat on your abdomen pushes on your stomach.

Medications

These remedies may help with indigestion.

  • Over-the-counter remediesThere are various over-the-counter treatment options available for acid reflux. For some individuals, they've found relief from their indigestion symptoms by using these methods. These include antacids.
  • Histamine Receptor AntagonistsAn important group of medicines for treating indigestion and heartburn known as H2-receptor antagonists or H2 blockers. These include Tagamet HB, Pepcid AC, and Zantac 75.
  • Proton Pump InhibitorsProton pump inhibitors (PPIs) are a group of prescription medications that prevent the release of acid in the stomach and intestines. These include Nexium, Prevacid, and Prilosec.
  • Prokinetics: These drugs help your stomach empty faster. They include Urecholine and Reglan.
  • Antibiotics: If your doctor believes your indigestion is due to an infection with Helicobacter pylori, she may prescribe an antibiotic such as amoxicillin.

Sources:

Indigestion. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/indigestion/symptoms-causes/syc-20352211.

Indigestion (Dyspepsia). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia.