What causes persistent indigestion?

Other possibilities include an ulcer, a hiatus hernia, gallbladder disease or functional dyspepsia, in which upper digestive symptoms persist without a visible structural cause. Helicobacter pylori infection can inflame the stomach and contribute to ulcers. Stomach cancer and oesophageal cancer can present with persistent indigestion, especially with other warning features, but indigestion alone cannot identify cancer.

Indigestion may feel like upper abdominal discomfort, burning behind the breastbone, early fullness, bloating, nausea or frequent burping. Symptoms after lying down or bending may fit reflux, while pain linked to certain medicines can suggest irritation of the stomach lining. The pattern guides investigation but does not confirm a condition.

A clinician will ask about swallowing, appetite, vomiting, stool colour, weight change and family history, as well as alcohol, smoking and medicine use. Depending on the findings, testing may include a breath or stool test for H. pylori, blood tests, or an endoscopy to inspect the oesophagus and stomach and take samples if needed.

Arrange an appointment if indigestion keeps returning, is getting worse, feels different from your usual symptoms or does not respond to appropriate pharmacy advice. Keep notes on meal timing, specific foods, night symptoms, swallowing and medicines. Bring the packages or names of remedies already tried.

Smaller meals, avoiding late meals, and staying upright after eating may reduce reflux-type discomfort. Limit personal triggers rather than removing many foods without guidance. Do not stop prescribed anti-inflammatory, blood-thinning or other medicine independently; ask whether it could be irritating the digestive tract and whether an alternative is suitable.

Get emergency help for vomiting blood, material that resembles coffee grounds, black sticky stool, fainting, severe chest pain, sudden severe abdominal pain or major breathing difficulty. Heart problems can sometimes feel like indigestion, particularly when discomfort comes with sweating, nausea or pain spreading to the arm, jaw, back or neck.

Seek prompt medical review for food sticking, painful swallowing, repeated vomiting, unexplained weight loss, loss of appetite, persistent upper abdominal pain, a lump, anaemia or increasing tiredness. These features do not establish cancer, but they change how quickly examination and testing may be needed.

Ask whether your symptoms fit reflux, inflammation, an ulcer or another cause; whether H. pylori testing is appropriate; and whether current medicines could contribute. Clarify how long to try treatment, when endoscopy might be needed and which new symptom should prompt urgent contact.