Dyspepsia - Diagnosing indigestion

For most people, indigestion (dyspepsia) is mild and infrequent, and does not require treatment from a healthcare professional.

However, if you have indigestion regularly, or if it causes you severe pain or discomfort, see your GP. 

They will ask about your indigestion symptoms, as well as:

• any other symptoms you have – which may indicate an underlying health condition
• any medication you are taking – as some medications can cause indigestion
• your lifestyle – as some lifestyle factors, such as smoking, drinking alcohol or being overweight, can cause indigestion 

Your GP may also press gently on different areas of your stomach (abdomen) to establish whether or not this is painful.

Depending on the type of indigestion symptoms you have, your GP may want to investigate your condition further. This is because indigestion can sometimes be a symptom of an underlying condition or health problem, such as a Helicobacter pylori (H pylori) bacterial infection.

Details of some of the further investigations you may have are outlined below.

Further investigations

Endoscopy

You may be referred to hospital to have an endoscopy.

An endoscopy is a procedure used to examine the inside of your body using an endoscope – a thin, flexible tube, about the width of your little finger, with a light and a camera on one end. The camera is used to relay images of the inside of your body to a TV monitor.

An endoscopy is not often needed to diagnose indigestion, but your GP may suggest that you have one if:

• they need to examine the inside of your abdomen in more detail
• you have had treatment for indigestion that has not worked
• you have any serious symptoms of indigestion 

Read more about having an endoscopy.

Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy. Therefore, for at least two weeks before your endoscopy, you will need to stop taking proton pump inhibitors (PPIs) and H2-receptor antagonists. 

Read more about treatments for indigestion.

Your GP may also recommend changing other medications that may be causing your indigestion. However, only stop taking medication if you are advised to do so by your GP or another healthcare professional responsible for your care. 

Diagnosing H pylori infection

If your GP thinks that your symptoms may be due to an infection with H pylori bacteria, you may need to have a test for it, such as:

• a stool antigen test – a pea-sized stool (faeces) sample will be tested for H pylori bacteria
• a breath test
• a blood test – a blood sample will be tested for antibodies to H pylori bacteria (antibodies are proteins produced by the body to fight infection)

Antibiotics and PPIs can affect the results of a urea breath test or a stool antigen test. Therefore, these tests may need to be delayed until two weeks after you last used a PPI, and four weeks after you last used an antibiotic.

Diagnosing other conditions

If your GP thinks that your indigestion symptoms may be caused by another underlying medical condition, you may need to have some further tests to rule this out.

For example, abdominal pain and discomfort can also be caused by conditions affecting the bile ducts in your liver. Your bile ducts are a series of tubes that carry bile (fluid used by the digestive system to break down fats) from the liver to the gallbladder (a pouch that holds bile) and the bowel. If your GP thinks that you may have such a condition, they may suggest you have a liver function test, which is a type of blood test used to assess how well your liver is working.

You may also need to have an abdominal ultrasound. An ultrasound scan uses high-frequency sound waves to create an image of the inside of your body.