Extreme indigestion pain: what you should know

Indigestion can feel like burning, pressure, fullness, belching, nausea, or discomfort in the upper abdomen. Possible causes include [Acid Reflux](/conditions/acid-reflux/), [Gastritis](/conditions/gastritis/), a [Peptic Ulcer](/conditions/peptic-ulcer/), [Hiatus Hernia](/conditions/hiatus-hernia/), [Gallstones](/conditions/gallstones/), or [Helicobacter Pylori Infection](/conditions/helicobacter-pylori-infection/). These conditions can share symptoms, and severe pain cannot be safely assigned to one cause from symptoms alone. Pain from the heart can also resemble indigestion.

Stop strenuous activity and sit upright. Avoid alcohol, smoking, and a large meal while the pain is being assessed. Note its location, onset, relation to food, and whether it travels to the back, jaw, or arm. Do not take medicines that irritate your stomach unless a clinician has told you to use them. A pharmacist or doctor can advise whether [Acid Reflux Medication](/treatments/medical-management/acid-reflux-medication/) fits your symptoms and other medicines.

Call emergency services for chest pressure, breathlessness, cold sweating, fainting, severe weakness, or pain spreading to the arm, jaw, or back. Seek urgent care for vomiting blood, black stools, repeated vomiting, yellow skin, a rigid or swollen abdomen, or pain that is severe and not settling. Arrange a medical appointment for recurring indigestion, difficulty swallowing, or unexplained weight loss.

Ask whether you need an examination or testing for ulcer, reflux, gallbladder disease, or infection, and which pain or stomach medicines are safe with your health history.