Diagnosis of Indigestion

How do doctors diagnose the cause of indigestion?

Your doctor may use your symptoms, a medical and family history, a physical exam, and tests to diagnose the cause of indigestion.

Review of your symptoms

Your doctor will ask about your symptoms to diagnose the cause of indigestion. Your doctor may diagnose functional dyspepsia if you have pain, a burning feeling, or discomfort in your upper abdomen, or feeling full too soon while eating a meal, and another cause for your indigestion can’t be found. Your doctor may also ask how long you’ve had symptoms. Your doctor may diagnose functional dyspepsia if3

• you’ve had symptoms at least once a week in the last 3 months, and
• your symptoms first started at least 6 months ago

Your doctor may diagnose functional dyspepsia even if you’ve had symptoms for a shorter length of time. You should talk with your doctor if your symptoms are like the symptoms of functional dyspepsia.

Medical and family history

To help diagnose the cause of indigestion, your doctor will take a medical and family history. Your doctor may ask about

• your medical history, including any past indigestion or Helicobacter pylori (H. pylori) infections
• your symptoms, such as whether symptoms occur with meals
• your history of any mental health conditions, such as depression or anxiety
• medicines you take, especially nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors, and calcium
• your family history of indigestion, H. pylori infection, or cancer in the digestive tract

Your doctor will review your symptoms and medical history.

Physical exam

During a physical exam, your doctor may

• check for bloating
• listen to sounds in your abdomen using a stethoscope
• tap on your abdomen to check for tenderness, pain, and lumps
• look for yellowing of your eyes or skin

What tests do doctors use to diagnose the cause of indigestion?

Doctors may use medical tests to help find the cause of indigestion. If specific causes are not found, your doctor may diagnose functional dyspepsia and recommend treatments.

Upper GI endoscopy

Your doctor may perform an upper gastrointestinal (GI) endoscopy to diagnose diseases and conditions that may be causing your indigestion, such as

• gastritis
• peptic ulcer
• stomach cancer or cancer in another part of the digestive tract

A doctor may recommend an upper GI endoscopy for people with indigestion who have

• a family history of cancer
• current or past heavy alcohol use
• difficulty swallowing
• evidence of bleeding in the digestive tract
• frequent vomiting
• weight loss

During an upper GI endoscopy, a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper GI tract. Your doctor may pass small tweezers through the endoscope to take pieces of tissue from the lining of your stomach and duodenum. This procedure is called an upper GI biopsy. A trained specialist known as a pathologist will review the tissue samples to look for digestive tract diseases and conditions, including H. pylori infection.

Imaging tests

Your doctor may use imaging tests such as x-rays, computed tomography scans (CT), or ultrasound to look for diseases and conditions in your digestive tract that may be causing your indigestion.

H. pylori testing

Your doctor may find an H. pylori infection by performing an upper GI biopsy. Your doctor may also use a

• stool test. Your doctor may use a stool test to look for signs of an H. pylori infection or to see if H. pylori treatment has worked.
• urea breath test. Your doctor may use a urea breath test to check for H. pylori infection. For the test, you will swallow a capsule, liquid, or pudding that contains urea “labeled” with a special carbon atom. After a few minutes, you will breathe into a container, and a health care professional will confirm whether you have an H. pylori infection in your digestive tract.
• blood test. A health care professional may take a blood sample from you and send the sample to a lab to test for signs of H. pylori infection.

Reference

[3] Drossman, DA. Appendix A: Rome IV diagnostic criteria for functional gastrointestinal disorders. In: Rome IV: Functional Gastrointestinal Disorders—Disorders of Gut-Brain Interaction. 4th ed. The Rome Foundation; 2017: appendix A.

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