What should you know about heart indigestion?

Indigestion, also called dyspepsia, may cause burning or aching in the upper abdomen, a feeling of fullness, bloating, belching, nausea or an unpleasant taste rising into the throat. Some people feel the discomfort behind the breastbone, which can make it difficult to distinguish from heart-related chest pain.

Digestive causes can include acid reflux, irritation of the stomach lining, a hiatus hernia or an ulcer. Gallstones and Helicobacter pylori infection can also contribute to upper-abdominal symptoms. The pattern, triggers and accompanying symptoms help a clinician work out the likely cause; the sensation alone cannot confirm it.

Notice whether symptoms follow a large meal, spicy or fatty food, alcohol, coffee, lying down or a particular medicine. Try smaller meals, eat slowly, remain upright after eating and avoid the trigger that reliably worsens your symptoms. Do not stop a prescribed medicine without medical advice.

A pharmacist or clinician can explain whether an antacid, an acid-reducing treatment or another option is suitable for you, especially if you are pregnant, have another medical condition or take several medicines. Repeated symptoms deserve a medical review rather than ongoing self-treatment.

Seek emergency help for chest pressure, squeezing or pain that is severe, new, persistent or spreading to the arm, back, neck or jaw. Urgent assessment is also needed with breathlessness, sweating, fainting, marked weakness or vomiting. Do not assume these symptoms are indigestion, even if they start after eating.

Arrange a prompt appointment if indigestion keeps returning, swallowing becomes difficult or painful, vomiting continues, you notice black stools or blood, you lose weight without trying, or the pain is becoming more frequent. A clinician may review your symptoms, medicines and examination findings before deciding whether tests are needed.

Ask: Could this be reflux, stomach irritation, an ulcer or another cause? Which symptoms should send me to emergency care? Are any of my medicines aggravating it? Should I be checked for Helicobacter pylori infection, and how long should I try the recommended treatment before review?