Dyspepsia - Treating indigestion

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, you may want to read our information on:

Diet and lifestyle changes

If you only have indigestion occasionally, 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, summarised below.

Healthy weight

Being overweight puts more pressure on your stomach, making it easier for stomach acid to be pushed back up into your gullet (oesophagus). This is known as acid reflux, and is one of the most common causes of indigestion.

If you are overweight or obese, it is important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet. Read advice on losing weight.

Stop smoking

If you smoke, the chemicals you inhale in cigarette smoke may contribute to your indigestion. These chemicals can cause the ring of muscle that separates your oesophagus from your stomach to relax, causing acid reflux.

Read more about quitting smoking, or speak to your GP or pharmacist. You can also call the NHS Stop Smoking Helpline on 0300 123 1044.

Diet and alcohol

Make a note of any particular food or drink that seems to make your indigestion worse, and avoid these if possible. This may mean:

eating less rich, spicy and fatty foods
cutting down on drinks that contain caffeine – such as tea, coffee and cola
avoiding or cutting down on alcohol

At bedtime

If you tend to experience indigestion symptoms at night, avoid eating for three to four hours before you go to bed. Going to bed with a full stomach means there is an increased risk that acid in your stomach will be forced up into your oesophagus while you are lying down.

When you go to bed, use a couple of pillows to prop your head and shoulders up or, ideally, raise the head of your bed by a few inches by putting something underneath the mattress. The slight slope that is created should help to prevent stomach acid moving up into your oesophagus while you are asleep.

Stress or anxiety

If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion.

Read some relaxation tips to relieve stress.

Changing 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 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 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
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 more about antacids, including possible interactions with other medicines and side effects.

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 and irritates its lining. Alginates form 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 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, treatment with antacids and alginates may not be effective enough to control your symptoms. Your GP may prescribe a different type of medication, which will be prescribed at the lowest possible dose to control your symptoms. Possible medications include:

proton pump inhibitors (PPIs)
H2-receptor antagonists

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)

PPIs restrict the acid produced in your stomach.

The medication is taken as tablets and is generally only available with a prescription. If you are over 18, you can buy some types of PPIs over the counter in pharmacies, but 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 refers you for 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.

PPIs can sometimes cause side effects. However, they are usually mild and reversible. These side effects may include:

headaches
diarrhoea
constipation
feeling sick (nausea)
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 have not been effective in controlling your indigestion. There are four H2-receptor antagonists:

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 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.

Helicobacter pylori (H pylori) infection

If your indigestion symptoms are caused by an infection with 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 PPI

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.