Heartburn & Indigestion

On Call: Heartburn & Indigestion

Table of Contents

  1. Background
  2. Management

Background

Definitions

  • Indigestion (Dyspepsia) – Uncomfortable Feeling of Fullness, Pain or Burning in the Upper Abdomen
  • Symptoms:
    • Heartburn – Acid Reflux
    • Bloating
    • Nausea
    • Abdominal Pain

Causes

  • Gastroesophageal Reflux Disease (GERD)
  • Stress/Anxiety
  • Diet
    • Caffeine
    • Chocolate
    • Spicy Foods
    • Fatty/Fried Food
    • Carbonation
    • Tobacco
    • Alcohol
  • Over Eating
  • Peptic Ulcer Disease (PUD)
  • Gastroenteritis
  • Celiac Disease
  • Pancreatitis
  • Gastroparesis
  • Pregnancy
  • Cholelithiasis

Management

Bloating Relief

  • Treat Any Underlying Cause
  • Avoid Dietary Triggers – Low FODMAPs Diet Often Recommended
  • Avoid Carbonated Drinks
  • Simethicone (Gas-X) – Antiflatulent
    • Mechanism: Decreases Surface Tension on Gas Bubbles to Better Disperse
    • Dose: 40-125 mg After Meals

Heartburn – Acute Management & Immediate Relief

  • Elevate the Head of the Bed – Prevent Aspiration
  • Avoid Dietary Triggers
  • Antacids to Provide Rapid Relief
    • Tums (Calcium Carbonate)
    • Rolaids (Calcium Carbonate & Magnesium Hydroxide)
    • Maalox (Aluminum Hydroxide, Magnesium Hydroxide & Simethicone)
    • Mylanta (Aluminum Hydroxide, Magnesium Hydroxide & Simethicone)
    • Alka-Seltzer (Aspirin, Sodium Bicarbonate & Anhydrous Citric Acid)
    • *See Anti-Reflux Medication Pharmacology
  • Consider Adding a PPI or H2 Blocker for Sustained Relief if Indicated

Chronic Management & GERD Work Up