What're the treatments for indigestion?
The treatment of indigestion is based on assessment of symptoms and suspected causative factors. Clinical evaluation is aimed at distinguishing those patients who require immediate diagnostic work-ups from those who can safely benefit from more conservative initial treatment. Some of the latter may require only reassurance, dietary modifications, or antacid use. Medications to block production of stomach acids, prokinate agents, or antibiotic treatment may be considered. Further
diagnostic investigation is indicated if there is severe abdominal pain, pain radiating to the back, unexplained weight loss, difficulty swallowing, a palpable mass, or anemia. Additional work-up is also indicated if a patient does not respond to prescribed medications. Since most cases of indigestion are not caused by serious disorders, many doctors prefer to try medications and other treatment measures before ordering an endoscopy.
Diet and stress management: Dietary fiber often is recommended for patients with IBS, but fiber has not been studied in the treatment of indigestion. Nevertheless, it probably is reasonable to treat patients with indigestion with fiber if they also have constipation. Many patients benefit from the doctor's reassurance that they do not have a serious or fatal disorder. Cutting out alcoholic beverages and drinks containing caffeine often helps. The patient may also be asked to keep a record of food intake, daily schedule, and symptom severity. Food diaries sometimes reveal psychologic or dietary factors that influence indigestion. Intolerance to lactose (the sugar in milk) often is blamed for indigestion. Since indigestion and lactose intolerance both are common, the two conditions may coexist. In this situation, restricting lactose will improve the symptoms of lactose intolerance, but will not affect the symptoms of indigestion.
Medications: A range of indigestion treatments can be bought from the pharmacy without a prescription. Patients with the esophagitis type of indigestion are often treated with H2 antagonists. H2 antagonists are drugs that block the secretion of stomach acid. They include ranitidine (Zantac) and famotidine (Pepcid). Patients with motility disorders may be given prokinetic drugs. Prokinetic medications speed up the emptying of the stomach and increase intestinal motility. They include metoclopramide (Reglan) and cisapride (Propulsid). These drugs relieve symptoms in 60-80% of patients.
Removal of H. pylori: It is not clear that patients with H. pylori infections who have not developed gastric ulcers need to have the bacterium removed. Some studies indicate, however, that these patients may benefit from antibiotic therapy. H. pylori can be treated with "triple therapy" which aims to kill off the bacterial infection. This is usually a one-week course of a proton pump inhibitor combined with two different antibiotics.
Herbal medicine: Practitioners of Chinese traditional herbal medicine might recommend medicines derived from peony (Paeonia lactiflora), hibiscus (Hibiscus sabdariffa), or hare's ear (Bupleurum chinense) to treat indigestion. Western herbalists are likely to prescribe fennel (Foeniculum vulgare), lemon balm (Melissa officinalis), or peppermint (Mentha piperita) to relieve stomach cramps and heartburn.
Homeopathy: Homeopaths tailor their remedies to the patient's overall personality profile as well as the specific symptoms. Depending on the patient's reaction to the indigestion and some of its likely causes, the homeopath might choose Gelsemium (Gelsemium sempervirens), Carbo vegetalis, Nux vomica, or Pulsatilla (Pulsatilla nigricans).
Other treatments: Some alternative treatments are aimed at lowering the patient's stress level or changing attitudes and beliefs that contribute to indigestion. These therapies and practices include Reiki, reflexology, hydrotherapy, therapeutic massage, yoga, and meditation. |
