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Treatments and drugs
By Mayo Clinic staffIf lifestyle changes — especially avoiding offending foods — don't help your indigestion, there also are over-the-counter and prescription medications that may help. Most are designed to reduce stomach acid or help move food from the stomach to the small intestine.
Types of indigestion medications include:
- Antacids. Alka-Seltzer, Maalox, Mylanta, Rolaids, Riopan and others are available over-the-counter and work by neutralizing stomach acid. Side effects include diarrhea and constipation. These are often the first medications doctors recommend.
- H-2-receptor antagonists (H2RAs). These include Axid, Tagamet, Pepcid and Zantac, which are available over-the-counter or by prescription. They reduce stomach acid and work longer — but not as quickly — as antacids. Side effects may include headache, nausea, vomiting, constipation, diarrhea, and bruising or bleeding.
- Proton pump inhibitors (PPIs). Aciphex, Nexium, Prevacid, Prilosec, Protonix and Zegerid are most effective for people who also have gastroesophageal reflux disease (GERD). These medications reduce stomach acid and are stronger than H2RAs. They're available by prescription, although Prilosec also comes in over-the-counter strength. Possible side effects include back pain, aching, cough, headache, dizziness, abdominal pain, gas, nausea, vomiting, constipation and diarrhea. Long-term use has, rarely, been associated with bone fractures.
- Prokinetics. Medications such as Reglan can be helpful if your stomach empties slowly. People taking this prescription medication frequently experience side effects, including fatigue, sleepiness, depression, anxiety and involuntary muscle spasms.
- Antibiotics. If the bacteria that causes peptic ulcer disease (Helicobacter pylori) is causing your indigestion, your doctor may prescribe an antibiotic. Side effects include upset stomach, fungal infections and diarrhea.
- Antidepressants. If a thorough evaluation doesn't reveal a cause for your symptoms and the conventional treatments above don't work, your doctor may recommend an antidepressant medication. These prescription medications may improve the discomfort from indigestion by decreasing your sensation of pain. Side effects may include headaches, nausea, night sweats, agitation and constipation.
References
- Indigestion. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion. Accessed March 14, 2009.
- Feldman M, et al. Treatment of functional dyspepsia. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/127528571-4/0/1389/50.html?tocnode=51637799&fromURL=50.html#4-u1.0-B1-4160-0245-6..50012-3_220. Accessed March 23, 2009.
- Longstreth GF. Functional dyspepsia. http://www.uptodate.com/home/index.html. Accessed March 14, 2009.
- Longstreth GF. Approach to the patient with dyspepsia. http://www.uptodate.com/home/index.html. Accessed March 14, 2009.
- Geeraerts B, et al. Functional dyspepsia: Past, present and future. Journal of Gastroenterology. 2008;43:251.
- Prescrire editorial staff. Herbal remedies for dyspepsia: Peppermint seems effective. Prescrire International. 2008;17:121.
- Soo S, et al. Psychological interventions for non-ulcer dyspepsia. Cochrane Database of Systematic Reviews. 2009:CD002301.
- von Arnim U, et al. STW 5, a phytopharmacon for patients with functional dyspepsia: Results of a multicenter, placebo-controlled double-blind study. 2007;102:1268.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. March 31, 2009.
- Understanding antidepressant medications. U.S. Food and Drug Administration. http://www.fda.gov/consumer/updates/antidepressants010909.html. Accessed March 31, 2009.
