In many cases, chronic indigestion is diagnosed as functional dyspepsia, a disorder of gut-brain interaction where no clear structural cause is identified. However, H. pylori infection, peptic ulcers, and certain medications—such as NSAIDs, iron supplements, some antibiotics, or GLP-1 receptor agonists—can also be causes. It is also important to distinguish this from reflux diseases centered on heartburn, as they can feel similar. While food and stress can trigger or worsen individual symptoms, they are not concluded to be the sole causes.
Causes of Indigestion
Order of verification by cause
| Verified Scenario | Possible Interpretation | Next Step |
|---|---|---|
| Recurring epigastric pain or early satiety, with no cause found during tests | Possibility of functional dyspepsia | Explain as a gut-brain interaction disorder and consult on treatment based on symptom patterns |
| Started after taking NSAIDs, iron, antibiotics, or GLP-1 medications | Possibility of medication-related indigestion | Do not stop medication arbitrarily; review dosage or alternatives with your prescriber |
| History of H. pylori or risk of ulcers | Differentiate between infection or peptic ulcers | Consult on the necessity of breath/stool tests or endoscopy |
| Heartburn or acid reflux rising into the throat | Possibility that gastroesophageal reflux symptoms are central | Evaluate by separating the primary symptoms of reflux and indigestion |
| Weight loss, vomiting blood, black stools, or difficulty swallowing | Possibility of a significant structural disease | Promptly proceed with gastrointestinal evaluation and necessary endoscopy |
What the clinic checks first
Causes of indigestion are first categorized into functional indigestion, H. pylori infection and peptic ulcers, and reflux symptoms that may overlap with medications. Reactions to food or stress are not diagnostic tests to confirm the cause; if there is weight loss, bleeding, difficulty swallowing, or repeated vomiting, necessary endoscopy and standard evaluations are prioritized.
In functional indigestion, it is believed that stomach relaxation in response to food, sensation regarding stomach acid or normal gastric motility, and the regulation of signals between the gut and the brain are all involved.
H. pylori infection and peptic ulcers can cause epigastric pain and indigestion; these are confirmed through medical history and tests to provide appropriate treatment.
NSAIDs may increase the risk of mucosal damage, and iron, certain antibiotics, or GLP-1 receptor agonists may be temporally linked to indigestion symptoms.
Past infections, eradication status, ulcer diagnosis, and history of bleeding provide important context for current cause evaluation and the selection of tests.
Check if the onset of symptoms aligns with the start or dose increase of a new medication, but do not stop prescribed medications on your own; coordinate with your prescriber.
Certain foods, lack of sleep, and stress can affect symptoms, but these are not used as the sole cause of onset or as diagnostic criteria.
Even if tests do not identify an explainable cause such as an ulcer or tumor, abnormalities in gastric relaxation, sensation, and gut-brain signaling can lead to persistent epigastric pain, early satiety, or postprandial fullness.
Factors such as the stomach's ability to expand to accommodate food, hypersensitivity to gastric acid, duodenal inflammation, and emotional factors may be involved for some people, but no single item is used to confirm the diagnosis.
Although anxiety, depression, and stress may be linked to the intensity of symptoms, they are not explained away as a lack of will or imagination on the part of the patient. The actual symptoms and the resulting disruption to daily life are treated as the targets of therapy.
H. pylori infection and peptic ulcers can cause chronic indigestion. After checking for past infections, eradication history, and bleeding risk, breath tests, stool tests, or gastroscopy are selected depending on the situation.
NSAIDs, iron, certain antibiotics, osteoporosis medications, and GLP-1 receptor agonists can sometimes cause indigestion. Do not stop necessary medications on your own; instead, inform your prescriber of the date the symptoms began.
Heartburn and acid reflux may overlap with indigestion, but they are representative symptoms of a separate condition. Depending on the location of persistent pain and accompanying signs such as jaundice or vomiting, other causes such as gallbladder or pancreatic issues are also evaluated.
Some people experience increased discomfort after specific foods like greasy meals or caffeine, but the same food does not cause indigestion for everyone. Record the food, amount, and timing of symptoms together.
Cutting out multiple foods simply because they caused discomfort once can affect nutrition and weight. Observe whether the same reaction occurs repeatedly and adjust with a medical professional or nutritionist if necessary.
While stress and sleep can fluctuate symptoms, warning signs such as bleeding, weight loss, or difficulty swallowing are not dismissed as psychological issues. An evaluation for necessary structural causes is performed first.
Consultation on the causes of indigestion at Baekrokdam
If warning signs are present, we prioritize gastroenterology or emergency evaluation rather than assuming the condition is functional or waiting for a herbal medicine consultation.
We review the start date of any new medications, history of infection, eradication therapy, and endoscopy results to ensure that necessary tests and standard treatments have been completed.
If herbal medicine treatment is combined for chronic symptoms after the cause evaluation, we determine whether to continue treatment by recording the number of symptomatic days per week, the extent to which meals were finished, and weight.
If you prepare the location of symptoms, timing relative to meals, recent weight, a list of medications, H. pylori and endoscopy results, and whether you have experienced hematemesis, melena, or dysphagia, we can better distinguish between the scope of standard evaluation and complementary consultation.
When to seek urgent care
No. If characteristic symptoms persist while no other structural causes are identified, it may be diagnosed as functional dyspepsia, which is a disorder of the gut-brain interaction.
While certain foods may trigger symptoms in some people, they are not considered the sole cause of indigestion itself. Please record the types and amounts of food and the timing of your symptoms to identify your individual reactions.
While medications such as NSAIDs can be a cause, stopping them arbitrarily can be dangerous depending on why they were prescribed. Please inform your prescriber of the medication name, dosage, start date, and your symptoms to adjust the treatment.
Although stress can worsen symptoms, you must not delay necessary tests and medical evaluation if you experience bleeding, weight loss, difficulty swallowing, or persistent vomiting.
Content reviewed:
This information supports, but does not replace, diagnosis or treatment by a qualified healthcare professional.
