IBS and indigestion: What is the link?

 Key takeaways

• Indigestion occurs when your body finds it difficult to digest food, causing pain and general discomfort. 
• Stress, anxiety, the type of food you eat, and the substances you take, such as caffeine and some drugs, can trigger or worsen indigestion. Indigestion can also be a symptom of gastrointestinal conditions such as IBS.
• There is no strong scientific evidence that IBS causes indigestion. However, both conditions are linked as they share many symptoms in common.
• Treatment for indigestion depends on the cause. Medications, lifestyle changes, and some home remedies are often helpful for treating it.

Occasionally experiencing symptoms of indigestion, especially after enjoying a favorite, heavy meal, should not be a cause for alarm. However, when it occurs more frequently with no obvious cause, it is necessary to figure out the cause.

Indigestion, medically called dyspepsia, is a gastrointestinal condition consisting of collective digestive symptoms like epigastric pain, nausea, bloating, and acid reflux. It affects 12–30% of the general population. Its symptoms usually occur after a large meal, but other underlying causes of this health condition include medical conditions like IBS. 

Irritable bowel syndrome (IBS) is another gastrointestinal condition with constipation, diarrhea, and changes in bowel habits as its primary symptoms.

Some symptoms of indigestion and IBS often overlap, making you wonder how similar these health conditions are. This article explores the link between IBS and indigestion, the possible causes of indigestion, and how to relieve it.

 What is indigestion?

Indigestion occurs when your body finds it difficult to digest food, causing pain or discomfort in your upper abdomen after eating. Things that can cause or trigger indigestion include:

• Dysfunction in the gastrointestinal tract
• The stomach lining being too sensitive to stomach acid or food stretching
• Lifestyle factors, such as smoking and alcohol consumption
• Dietary factors, such as eating large portions of food at a time or eating too fast
• Medical conditions like IBS and peptic ulcers

Indigestion on its own is not a disease. Rather, it can be an indication that something is not quite right with the digestive system or that you have eaten something you shouldn't have eaten. And sometimes, it may have no explanatory cause.

Although indigestion is a common complaint, the symptoms differ for each person. Some of the symptoms of indigestion are:

• Abdominal pains 
• You may feel uncomfortably satisfied shortly after starting your meal, and this may last longer than it should
• Mild to severe upper abdominal pain or a burning sensation
• Bloating and nausea
• Belching, burping, and farting
• Loud growling or gurgling in your stomach
• Heartburn

 Does IBS cause Indigestion?

IBS affects the digestive system and is one of the gastrointestinal conditions that is associated with indigestion. Yet no clear scientific or medical proof exists to show that IBS directly causes indigestion.  

However, IBS and indigestion share several symptoms in common, including abdominal discomfort, bloating, and flatulence. These overlapping symptoms may be because both IBS and indigestion involve disruptions in the normal functioning of the digestive system. 

Indigestion is usually triggered during or after a meal because your gastrointestinal tract or digestive system is generally put to work during these periods.

 The link between IBS and indigestion

Researchers associate the link between IBS and indigestion with the severity and similarities of their symptoms. 

A 2018 study to determine the overlap of functional dyspepsia and IBS in the clinical setting assessed the symptoms of 1127 outpatients using a questionnaire. Out of the 1127 outpatients, 120 were clinically diagnosed as having a functional gastrointestinal disorder (FGID), which in this study includes functional dyspepsia, IBS, or overlap of both health conditions. 

This study showed that 64% of the patients diagnosed with an FGID had an overlap of functional dyspepsia and IBS, and researchers observed an increase in the likelihood of this overlap in patients with severe symptoms of these health conditions. 

This study concluded by associating the overlap of functional dyspepsia and IBS with the severity of their symptoms, as the severity of symptoms was higher in patients with an overlap of these two health conditions compared to patients with just IBS or functional dyspepsia. 

Another study—an epidemiological review—revealed that two-thirds of people with IBS also experience symptoms of functional dyspepsia (a kind of chronic indigestion).

Additionally, both IBS and indigestion can occur due to increased gut sensitivity caused by disorders of how the brain interacts with the intestine and damage to the mucosa. For instance, symptoms like abdominal pain and bloating, common to both conditions, can occur due to increased gut sensitivity to things like gas or stomach distention.

 Other medical conditions that can cause indigestion

Aside from IBS, other medical conditions can cause indigestion, such as:

 Gastro-esophageal reflux disease (GERD)

GERD is a gastrointestinal disorder that occurs when your lower esophageal sphincter becomes weak, which causes acid to rise (reflux) and irritate your esophagus. GERD is also called chronic acid reflux, and it is associated with symptoms like chest pain, heartburn, and a severe cough.

 Gastric cancer

Also known as stomach cancer, this health condition arises when the cells in your stomach grow out of control. This growth can happen in different locations in your stomach; most times, it starts from the lining of your stomach before penetrating deeper. Indigestion and other gastrointestinal manifestations like heartburn and trouble swallowing are possible symptoms of gastric cancer.

 Peptic ulcer

This occurs when open sores develop in the walls of the stomach or intestines. This can be caused by infection with H. pylori bacteria or overuse of non-steroidal anti-inflammatory drugs. 

Ulceration of the stomach wall is called gastric or stomach ulcer, while ulceration of the upper part of the small intestine is called duodenal ulcer. Dyspepsia is a common symptom that ulcer patients experience.

 Hiatal hernia

This medical condition occurs when the stomach pushes past the diaphragm, a muscular wall separating the chest or thoracic region from the abdominal region. A hiatal hernia can interrupt the normal digestive processes of your body and cause indigestion. 

 Gastroparesis

This is a medical condition where food moves through the gastrointestinal (GI) tract slower than usual, and problems relating to the nerves and muscles of the GI tract may cause this condition. This interruption in the usual flow of food can cause indigestion. Its symptoms include nausea, bloating, abdominal pain, vomiting, and acid reflux. 

 Treatment for indigestion with IBS

Indigestion eventually gets resolved and gets better on its own. However, there are medications you can take to manage the symptoms.

Your doctor may prescribe medications depending on the cause and symptoms you experience. These include:

• Antacids to neutralize the stomach acid, making it less acidic so that it no longer irritates the mucosa. Antacids provide quick relief for mild to moderate symptoms of indigestion. 
• H2 receptor antagonists (H2RAs) like Pepcid, Cimetidine, and Ranitidine H2RAs that help reduce the level of acid in the stomach.
• Proton pump inhibitors (PPIs), like Prilosec, which restrict acid production in the stomach.
• Prokinetics, like the prescription medications Reglan and Motilium, which improve the digestive tract’s muscle action. This may be helpful if your stomach empties slowly.
• Antibiotics such as amoxicillin, metronidazole (Flagyl), and tetracycline can help with indigestion that is caused by bacteria such as H. pylori.
• Antidepressants or anti-anxiety medications may ease the discomfort of indigestion by decreasing the pain sensation.

 Home remedies for indigestion

Medication is not the only way to treat indigestion. You can manage and relieve some of the uncomfortable symptoms of indigestion by changing your diet and lifestyle. Some of the changes that can be helpful are:

• Do not overeat. Instead of one large meal, take smaller meals at a time.
• Eat slowly and chew your food properly.
• Do not lie down immediately after eating. 
• Avoid foods and substances that trigger indigestion. Fatty and spicy foods, carbonated drinks, processed foods, caffeine, alcohol, and smoking may trigger indigestion.
• Try to maintain a healthy weight, as being overweight can cause acid reflux, one of the symptoms of indigestion.
• Exercise regularly. Regular exercise helps you maintain a healthy weight and promotes better digestion.
• Engage in activities like meditation, breathing exercises, and yoga that can help you relax and reduce stress and anxiety.
• Avoid or seek alternatives for medications that may irritate your stomach lining and trigger indigestion. Do these only with your doctor's approval. And when it is not an option, make sure to take the medication with your meal.
• Speak to your doctor about trying herbal remedies. Some herbs you can prepare at home, such as aloe vera, may help treat acid reflux and indigestion symptoms such as nausea and heartburn.

 Foods to avoid if you have indigestion

You can prevent frequent bouts of indigestion by avoiding certain foods. Some of the foods and drinks that may aggravate or trigger indigestion include:

• Coffee and tea: are high in caffeine and may worsen acid reflux.
• Chocolate:  contains caffeine, lots of sugar, and fat.
• Soda: high in sugar, and the bubbles may increase pressure, causing bloating and abdominal pain.
• Citrus fruits such as oranges and lemons: their juices are acidic. This can irritate the stomach lining, causing indigestion.
• Tomatoes and tomato products such as ketchup: may be highly acidic and can cause acid reflux.
• Fried and fatty foods: are high in saturated fats, which can cause bloating, constipation, and indigestion.
• Alcohol: stimulates the production of acid in the stomach.
• Dairy products, such as milk: can cause gas and bloating, especially if you are lactose intolerant.
• Margarine and butter: are high in fat, can slow down gastric emptying, and trigger or worsen the symptoms of indigestion.
• Chewing gum and candy: are high in artificial sweeteners such as sorbitol. They also contain sucrose, which can worsen the symptoms of indigestion by fermenting, which increases the production of air in the stomach. Also, chewing for long periods of time can stimulate the production of acids.

 When to seek medical attention

Mild and infrequent indigestion is nothing to be worried about since, most times, you can manage it with OTC medication, lifestyle changes, and some home remedies. However, there are rare cases where indigestion can be a symptom of stomach cancer or ulcers, so it is advisable to seek immediate medical attention if:

• You are having severe and constant abdominal pain. 
• You unintentionally lost a lot of weight.
• You experience frequent and severe vomiting, especially vomiting with traces of blood.
• You experience a loss of appetite.
• You have difficulty swallowing.
• You are experiencing weakness or tiredness, which may indicate anemia. 
• You pass black or tarry stools.
• The medications you are taking are worsening your symptoms of indigestion.
• You are 55 or older and have never experienced indigestion before.
• You are experiencing shortness of breath and sweating profusely.
• You have chest pain radiating toward the chest, neck, jaw, or arms.
• You feel that the medication you are taking aggravates your indigestion symptoms.

 Final thoughts

People with IBS typically experience gastrointestinal symptoms like indigestion. While both conditions are linked, no concrete scientific evidence exists that IBS causes indigestion. 

Indigestion is usually nothing to worry about, as it occurs mostly occasionally and rarely causes serious complications. However, it becomes a cause for concern when it occurs more often, as it can affect your quality of life and productivity. 

You may want to consider home remedies like peppermint, chamomile, and over-the-counter medications to calm the symptoms of IBS and indigestion. You should see your doctor immediately if these symptoms persist or get intense even after OTC medications.