Indigestion (Dyspepsia, Upset Stomach)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Prilosec and Indigestion

Viewer Question: I have been taking omeprazole (Prilosec) on and off for 3 years. Of late, there seems to be less relief for my unusual dyspepsia. At times I can feel the acid rushing out as it gives a warm sensation inside my stomach. When I get excessive acid, I experience heart palpitations and become weak. I understand there is a procedure whereby a nerve controlling acid secretion can be deaden to reduce acid secretion. Where can I find more information.

Doctor's Response: The nerve that is important in promoting acid secretion by the stomach is the vagus nerve. Operations for treating ulcers in the stomach and duodenum include cutting the vagus nerve (vagotomy) to reduce the secretion of acid by the stomach. (Vagotomy is not used for treating acid reflux.) These operations and vagotomy are performed infrequently now because of the effectiveness of medications like omeprazole (Prilosec) at reducing acid and thereby healing or preventing ulcers.

Thank you for your question.

Dyspepsia (indigestion) facts

  • Dyspepsia is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate in frequency and intensity.
  • Theories of the cause of dyspepsia include abnormal input from intestinal sensory nerves, abnormal processing of input from the sensory nerves, and abnormal stimulation of the intestines by motor nerves.
  • The primary symptoms of dyspepsia are upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). The symptoms most often are provoked by eating.
  • Dyspepsia is diagnosed on the basis of typical symptoms and the absence of other gastrointestinal diseases, particularly acid-related diseases and non-gastrointestinal diseases that might give rise to the symptoms.
  • Testing in dyspepsia is directed primarily at excluding the presence of other gastrointestinal diseases and non-gastrointestinal diseases. Some patients may require specific testing of certain gastrointestinal functions.
  • Treatment in dyspepsia is primarily with education as well as smooth muscle relaxant and promotility drugs. There also may be a role for anti-depressant drugs and dietary changes.
  • Future advances in the treatment of dyspepsia depend on a clearer understanding of its cause(s).
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