Indigestion is mild and infrequent for most people, and does not require treatment from your doctor. However, you would need to see your doctor if it is causing you severe pain or discomfort or if you are experiencing indigestion regularly.

Your doctor will ask you about your symptoms and examine your abdomen (your chest and stomach). They may also press gently on different areas of your abdomen in order to see whether or not it is painful.

Your doctor may also carry out a blood test if you have any symptoms of anaemia (a condition that is caused by a lack of red blood cells). The symptoms of anaemia can include:
1. tiredness,
2. breathlessness, and
3. an irregular heart beat.

The test will indicate your full blood count, highlighting whether or not there is a shortage of red blood cells in your bloodstream. Blood loss may be caused by a gastrointestinal bleed (internal bleeding) which will cause your blood count to go down.

Depending on the type of indigestion symptoms that you have, your doctor may also want to investigate your condition further. This is because indigestion can sometimes be a symptom of an underlying condition or health problem, such as a Helicobacter pylori infection. Details of some of the further investigations you may have are outlined below.

Endoscopy

Although it is not often needed to diagnose indigestion, your doctor may suggest that you have an endoscopy if they need to examine your abdomen in more detail. You may also need to have an endoscopy if you have had treatment for your indigestion which has not been effective.

An endoscopy takes place in hospital, and allows your surgeon to examine the inside of your abdomen.

If you need to have an endoscopy, you will be awake but you may be given a sedative to help relax you. A long thin tube with a light and camera on the end (endoscope) will be gently fed down your throat and into your stomach. This will allow your surgeon to see images of the inside of your abdomen on an external monitor.

Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy. If you are due to have an endoscopy, you will need to stop taking proton pump inhibitors (PPIs), or H2-receptor antagonists, at least 14 days before your procedure.

Tests to diagnose Helicobacter pylori infection

If your doctor thinks that your symptoms may be due to an infection with Helicobacter pylori (H pylori) bacteria, you may need to have several tests.

The tests used to diagnose an H pylori infection are listed below:

a) Urea breath test

- where your breath is tested for H pylori, after you have had a special drink containing a chemical which can be digested by the bacteria,

b) Stool antigen test

- where a pea-sized stool sample (faeces) is tested for H pylori bacteria, or

c) Blood test

- where a sample of your blood is tested for antibodies to H pylori bacteria. Antibodies are proteins that help fight infection and are produced naturally in your blood.

Tests to diagnose other conditions

If your doctor thinks that your indigestion symptoms may be caused by an underlying condition, you may need to have some other tests.
For example, abdominal pain and discomfort can also be caused by biliary conditions, which affect the bile ducts in your liver. If your doctor thinks that you may have a biliary condition, they may suggest that you have a liver function test, which is a kind of blood test that can be used to assess how well your liver is working.

You may also need to have an endoscopic ultrasound, where a long, thin probe is inserted into either your mouth or your rectum (anus), and fed gently through to your abdomen while you are sedated. The probe emits high frequency sound waves which transmit images of the inside of your body to an external monitor.

Testing for GORD

In most cases, gastro-oesophageal reflux disease (GORD) can be diagnosed by your doctor asking you about your symptoms. Further testing is not usually required.

Further testing for GORD, for example by endoscopy, is usually only recommended in the following circumstances:

a) If you are 55 years of age, or over, and you have unexplained and persistent symptoms of heartburn. This is because those over the age of 55 have a slightly higher chance of developing cancers of the digestive system, such as stomach or bowel cancer.
b) If there is evidence of internal bleeding.
c) If you are experiencing persistent weight loss.
d) If you are experiencing persistent difficulties with swallowing.
e) If you are experiencing persistent vomiting.
f) If you are showing symptoms of anaemia (a lack of red, oxygen-carrying blood cells).

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