Why Recurring Indigestion Might Signal Something Bigger

1. Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a chronic condition characterized by the frequent backflow of stomach acid into the esophagus, often resulting in persistent indigestion. Unlike occasional heartburn, which may occur after eating spicy foods or overeating, GERD involves recurrent symptoms that can significantly impact daily life. The recurring acid exposure irritates the lining of the esophagus, leading to discomfort, a burning sensation in the chest, regurgitation, and sometimes even difficulty swallowing.

While most people experience heartburn from time to time, persistent or worsening indigestion—especially if it occurs two or more times per week—should be evaluated for GERD. Chronic symptoms may not only cause discomfort but also increase the risk of developing complications such as esophagitis, strictures, or even Barrett’s esophagus, a precancerous condition. It is important to recognize the distinction between mild, occasional heartburn and ongoing symptoms that disrupt normal activities. If you find yourself relying on antacids regularly or experiencing symptoms at night, it may be time to seek medical advice.

For more information, refer to the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

2. Peptic Ulcers

Peptic ulcers are open sores that develop on the inner lining of the stomach or the upper portion of the small intestine (duodenum). These ulcers disrupt the normal digestive process by causing inflammation and damage to the protective mucosal barrier. This disruption is often experienced as persistent indigestion, burning stomach pain, bloating, or nausea—especially on an empty stomach or at night.

One of the primary causes of peptic ulcers is infection with Helicobacter pylori (H. pylori), a bacterium that weakens the stomach’s defense against acid. Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) can also contribute to ulcer formation. While mild ulcers may cause vague discomfort, more severe cases can lead to sharp pain, vomiting, weight loss, or even gastrointestinal bleeding.

Unexplained or recurrent stomach pain that doesn’t improve or is accompanied by alarming symptoms such as black stools, vomiting blood, or significant weight loss should prompt immediate medical attention. Early diagnosis and treatment are crucial to prevent complications like perforation or obstruction. To learn more, visit the Mayo Clinic’s resource on peptic ulcers and the CDC’s peptic ulcer FAQ.

3. Helicobacter pylori Infection

Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections worldwide, affecting approximately half the global population. This bacterium colonizes the stomach lining and disrupts its protective mucus layer, leading to chronic inflammation and increased stomach acid production. As a result, those infected may experience persistent indigestion, including symptoms such as bloating, nausea, abdominal discomfort, and frequent belching. Unlike occasional digestive upset, H. pylori-related indigestion doesn’t resolve with typical over-the-counter remedies and can persist for months or even years if left untreated.

H. pylori infection is a major risk factor for developing peptic ulcers and has been associated with an increased risk of stomach cancer. Treating this infection requires a targeted approach known as triple therapy or quadruple therapy, which includes a combination of antibiotics and acid-reducing medications. This differs significantly from the use of antacids or proton pump inhibitors alone, which only provide temporary symptom relief and do not eradicate the infection.

If you have ongoing digestive symptoms that aren’t relieved by standard remedies, testing for H. pylori is recommended. For more details, visit the CDC’s guide to H. pylori and the NHS information page on H. pylori.

4. Gallstones

Gallstones are hardened deposits that form within the gallbladder, an organ responsible for storing and releasing bile to aid in fat digestion. When these stones migrate and block the bile ducts, they can disrupt normal bile flow, resulting in symptoms such as upper abdominal pain, nausea, and persistent indigestion. The pain usually occurs in the right upper abdomen and can radiate to the back or right shoulder. This discomfort frequently arises after consuming fatty or greasy meals, as the gallbladder contracts to release bile, only to encounter obstruction from a stone.

Unlike mild or occasional digestive upset, gallstone-related pain tends to be intense, sudden, and may last for several hours. In some cases, it may also be accompanied by jaundice (yellowing of the skin or eyes), fever, or vomiting, which can indicate a more serious complication such as cholecystitis or bile duct infection. If you regularly experience upper abdominal pain or indigestion after eating rich foods, especially if the pain is severe or recurrent, it’s important to seek medical evaluation to rule out gallstones.

For further details, review the Mayo Clinic’s overview on gallstones and the NHS guide to gallstones.

5. Pancreatitis

Pancreatitis is the inflammation of the pancreas, an organ essential for producing enzymes that aid in digestion and hormones that regulate blood sugar. When the pancreas becomes inflamed, its digestive enzymes can begin to attack the very tissue they are meant to help, leading to digestive disturbances and significant abdominal discomfort. This disruption can result in persistent indigestion, bloating, and a general inability to properly digest food, particularly fats.

There are two main types: acute pancreatitis, which occurs suddenly and may resolve with treatment, and chronic pancreatitis, a long-standing condition that can lead to irreversible damage and ongoing digestive problems. Acute pancreatitis often presents with sudden, severe upper abdominal pain that may radiate to the back, nausea, vomiting, and sometimes fever. Chronic pancreatitis, on the other hand, is characterized by ongoing pain, frequent indigestion, unexplained weight loss, and fatty stools due to malabsorption.

Red flags for pancreatitis include severe, persistent upper abdominal pain, particularly if it worsens after eating, as well as symptoms such as jaundice or unexplained weight loss. Prompt medical attention is required to prevent complications. For more information, visit the Mayo Clinic’s resource on pancreatitis and the National Institute of Diabetes and Digestive and Kidney Diseases.

6. Celiac Disease

Celiac disease is an autoimmune disorder in which the ingestion of gluten—a protein found in wheat, barley, and rye—triggers the immune system to attack the lining of the small intestine. This immune response causes inflammation and damage to the intestinal villi, the tiny fingerlike projections responsible for nutrient absorption. In people with celiac disease, this damage leads to persistent indigestion, bloating, and discomfort, but the consequences extend far beyond simple digestive symptoms.

Unlike non-celiac gluten sensitivity, which causes discomfort but does not result in immune-mediated intestinal injury, celiac disease can have serious long-term effects if left untreated. Warning signs that may accompany or even overshadow indigestion include unexplained weight loss, chronic diarrhea or constipation, fatigue, anemia, skin rashes, mouth ulcers, and even neurological symptoms. Children may experience growth delays or developmental issues.

Because symptoms can be subtle or mimic other conditions, celiac disease often goes undiagnosed for years. If you have persistent indigestion along with any of these warning signs—especially if you have a family history of the condition—consult a healthcare provider for testing. For more information, see the Celiac Disease Foundation’s overview and the NHS guide to coeliac disease.

7. Food Intolerances

Food intolerances occur when the digestive system is unable to properly break down certain foods, leading to recurring indigestion, bloating, gas, and abdominal discomfort. Unlike food allergies, which involve the immune system, food intolerances are typically due to enzyme deficiencies or sensitivities to specific food components. Lactose intolerance is one of the most common examples, resulting from a deficiency of lactase—the enzyme needed to digest lactose, the sugar found in dairy products. When lactose is not properly digested, it ferments in the gut, causing symptoms like cramping, flatulence, and diarrhea after consuming milk, cheese, or ice cream.

Other sensitivities may include intolerance to fructose (found in fruits and sweeteners), sorbitol (a sugar alcohol), or certain food additives. The symptoms of food intolerances often overlap with other gastrointestinal disorders, making diagnosis challenging. Testing options include hydrogen breath tests for lactose and fructose intolerance, as well as elimination diets guided by a healthcare provider to systematically identify problematic foods.

If you frequently experience indigestion or discomfort after eating specific foods, consider seeking advice from a healthcare professional. For more on food intolerances, visit the NHS’s guide to food intolerance and the Mayo Clinic’s resource on lactose intolerance.

8. Gastroparesis

Gastroparesis is a condition where the stomach’s ability to empty its contents is significantly delayed, often leading to chronic indigestion, bloating, and a sensation of fullness after eating only a small amount of food. This disorder is most frequently associated with diabetes, as high blood sugar levels can damage the nerves (especially the vagus nerve) that control stomach muscles. In normal digestion, coordinated muscle contractions move food efficiently from the stomach into the small intestine. However, in gastroparesis, these contractions are weakened or irregular, causing food to remain in the stomach much longer than usual.

Symptoms of gastroparesis include persistent bloating, nausea, vomiting undigested food, early satiety, and even weight loss. This condition differs from occasional fullness or bloating after overeating; its symptoms are ongoing and not relieved by simple dietary adjustments. Diabetic individuals are particularly at risk, but gastroparesis can also result from surgery or other nerve disorders.

If you notice prolonged bloating, persistent indigestion, or unexplained fullness—especially if you have diabetes—it’s important to consult a physician. Early evaluation and management can prevent complications such as malnutrition. For more details, visit the National Institute of Diabetes and Digestive and Kidney Diseases resource on gastroparesis and the Mayo Clinic’s overview on gastroparesis.

9. Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder that affects how the gut moves and responds to stimuli, leading to symptoms such as recurring indigestion, abdominal pain, bloating, and changes in bowel habits (diarrhea, constipation, or both). Unlike structural diseases, IBS does not cause visible damage to the digestive tract. Instead, it involves abnormal muscle contractions and heightened sensitivity of the intestines, which can trigger discomfort even in response to ordinary digestion or stress.

IBS is distinct from more serious bowel diseases like Crohn’s disease or ulcerative colitis, which involve chronic inflammation and can cause significant damage to the digestive tract. IBS does not increase the risk of colon cancer or cause bleeding, weight loss, or persistent fever—red flags that warrant evaluation for other conditions. However, IBS can significantly impact quality of life and requires a tailored approach to management.

Tracking your symptoms, dietary triggers, and stress levels is crucial for effective diagnosis and management of IBS. Keeping a symptom diary can help your healthcare provider distinguish IBS from other conditions and identify the best treatment strategies. For more information, see the NIDDK’s resource on IBS and the Mayo Clinic’s guide to IBS.

10. Functional Dyspepsia

Functional dyspepsia is a common condition characterized by chronic or recurrent indigestion without any identifiable structural or biochemical cause. Unlike organic digestive disorders such as peptic ulcers or gallstones, functional dyspepsia does not result from visible abnormalities detected through endoscopy or imaging. Instead, individuals experience persistent symptoms such as upper abdominal discomfort, bloating, early fullness after eating, and sometimes mild nausea, all without an underlying disease that can be directly treated.

The exact cause of functional dyspepsia remains unclear, but factors such as abnormal gut motility, heightened sensitivity to stomach stretching, stress, and certain dietary habits are believed to play roles. This diagnosis is made only after ruling out other potential causes of indigestion. While functional dyspepsia is not dangerous, it can significantly impact quality of life and may be frustrating for those affected due to the lack of a concrete diagnosis.

Lifestyle changes are often the cornerstone of symptom management. Strategies include eating smaller, more frequent meals, avoiding trigger foods (such as fatty or spicy dishes), reducing caffeine and alcohol intake, managing stress, and not lying down immediately after eating. For more information, consult the NIDDK’s guide to functional dyspepsia and the Mayo Clinic’s indigestion overview.

11. Stomach (Gastric) Cancer

Stomach (gastric) cancer is a serious but often elusive disease in its early stages, as its symptoms frequently mimic those of benign digestive issues like simple indigestion or functional dyspepsia. Early gastric cancer may present with vague discomfort, bloating, mild nausea, or a feeling of fullness after eating small amounts. These symptoms can easily be mistaken for harmless digestive disturbances, leading to delays in seeking or receiving a diagnosis.

Unlike benign conditions, however, gastric cancer can progressively worsen and eventually lead to more alarming signs such as unexplained weight loss, persistent vomiting, difficulty swallowing, anemia, or the presence of blood in vomit or stools. The subtlety of initial symptoms makes it challenging to differentiate gastric cancer from less serious causes of indigestion without further investigation.

For individuals with persistent or unexplained indigestion, especially those over 50 or with risk factors such as a family history of stomach cancer or previous H. pylori infection, early endoscopy is a valuable diagnostic tool. It allows direct visualization and biopsy of suspicious lesions, increasing the chances of detecting cancer at a treatable stage. For more information, see the American Cancer Society’s page on stomach cancer symptoms and the NHS stomach cancer guide.

12. Esophageal Cancer

Esophageal cancer is a malignancy that develops in the tissues lining the esophagus, the tube connecting the throat to the stomach. Early on, this cancer may manifest as persistent heartburn, chronic indigestion, or difficulty swallowing (dysphagia)—symptoms that are easily confused with more common conditions like gastroesophageal reflux disease (GERD). However, while GERD typically fluctuates and is often relieved by lifestyle modifications or medication, symptoms from esophageal cancer tend to progressively worsen and become unresponsive to standard treatments.

Key distinctions include a gradual inability to swallow solid foods, a sensation of food getting stuck, unexplained weight loss, persistent chest pain, or coughing up blood. These warning signs point to something more serious than routine reflux or heartburn. Individuals with long-standing GERD, Barrett’s esophagus, smoking history, or heavy alcohol use are at increased risk for esophageal cancer.

It is crucial to seek urgent medical care if you experience difficulty swallowing, persistent pain, unexplained weight loss, or vomiting blood. Early diagnosis through endoscopy can significantly improve outcomes. For additional information, visit the American Cancer Society’s esophageal cancer symptoms page and the NHS guide to esophageal cancer.

13. Pancreatic Cancer

Pancreatic cancer is a particularly aggressive disease that often presents with subtle, nonspecific symptoms in its early stages. Initial signs may include vague indigestion, mild upper abdominal discomfort, unexplained weight loss, and a loss of appetite. These symptoms can easily be mistaken for benign pancreatic disorders such as pancreatitis or functional dyspepsia, often leading to delays in diagnosis. Unlike more acute pancreatic conditions, the discomfort associated with pancreatic cancer is typically persistent, gradual, and does not resolve with standard treatments for indigestion.

As the disease progresses, additional symptoms may appear, such as persistent back pain, new-onset diabetes, jaundice (yellowing of the skin or eyes), and pale or greasy stools. These red flags indicate more advanced disease and can signal obstruction of the bile duct or more extensive pancreatic involvement. Early detection is challenging because the pancreas is located deep within the abdomen and tumors can grow undetected for months.

If you experience ongoing indigestion, unexplained weight loss, or any of the above symptoms without a clear cause, it is crucial to consult a healthcare provider. Diagnostic imaging, such as abdominal ultrasound or CT scans, can help reveal pancreatic abnormalities. For more information, visit the American Cancer Society’s pancreatic cancer symptoms page and the NHS guide to pancreatic cancer.

14. Liver Disease

Liver disease can significantly alter digestive function due to the liver’s central role in producing bile, metabolizing nutrients, and detoxifying harmful substances. When the liver is damaged or inflamed, as in the case of hepatitis, its ability to assist with digestion and nutrient absorption becomes impaired. This may lead to persistent indigestion, nausea, bloating, and discomfort after meals—symptoms that can be subtle or easily mistaken for other gastrointestinal issues.

Hepatitis, which refers to inflammation of the liver caused by viruses (such as hepatitis B or C), alcohol use, or certain medications, often begins with vague digestive complaints. Over time, additional warning signs may emerge, including jaundice (yellowing of the skin and eyes), dark urine, pale stools, swelling in the abdomen or legs, chronic fatigue, and unexplained weight loss. The presence of these symptoms suggests more advanced liver dysfunction and warrants immediate medical evaluation.

If you notice persistent changes in digestion accompanied by any of these red flags, it is important to seek medical attention and undergo appropriate blood tests and imaging studies. For further information, review the CDC’s hepatitis statistics and the NHS guide to liver disease.

15. Heart Disease (Atypical Presentation)

Heart disease, particularly heart attacks, can sometimes present with atypical symptoms that mimic indigestion or heartburn rather than the classic chest pain. This is especially true for older adults, women, and individuals with diabetes. Instead of sharp chest pain, these individuals may experience vague upper abdominal discomfort, a sensation of fullness, pressure, burning, or nausea that is easily mistaken for digestive upset. Unfortunately, this overlap can lead to dangerous delays in seeking appropriate care.

Recognizing cardiac risk factors is critical when evaluating indigestion that does not respond to usual treatments. Risk factors include a history of high blood pressure, high cholesterol, diabetes, smoking, obesity, sedentary lifestyle, and a family history of heart disease. If indigestion is accompanied by symptoms such as shortness of breath, sweating, pain radiating to the jaw or arm, or sudden onset during physical exertion or stress, immediate medical attention is essential.

Being aware of these atypical presentations can save lives, as early intervention greatly increases survival rates. For more information, see the American Heart Association’s guide to heart attack warning signs and the NHS resource on heart attacks.

16. Anxiety and Stress

Anxiety and stress are powerful psychological factors that can significantly disrupt gut function, leading to symptoms of indigestion, bloating, and abdominal discomfort. The gut and brain are closely connected through the gut-brain axis, which means emotional distress can directly impact digestive processes. Stress can stimulate the release of hormones like cortisol and adrenaline, altering gut motility, increasing stomach acid production, and heightening sensitivity to normal digestive activity.

Unlike physical causes of indigestion—such as ulcers or gallstones—stress-induced indigestion often worsens during periods of emotional turmoil and may subside when stress levels decrease. It is not uncommon for individuals with anxiety disorders or high-stress lifestyles to experience chronic or intermittent digestive complaints, even in the absence of any underlying medical disease. However, persistent or severe symptoms should always be evaluated to rule out physical conditions.

Coping strategies for managing stress-related indigestion include practicing relaxation techniques (such as deep breathing, meditation, or yoga), regular exercise, maintaining a healthy sleep schedule, and seeking support from friends, family, or mental health professionals. For further guidance, explore the Mental Health Foundation’s resource on stress and the NHS’s relaxation tips for stress.

17. Medications

Many commonly prescribed and over-the-counter medications can disrupt normal digestion and cause persistent indigestion as a side effect. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are well-known for irritating the stomach lining and increasing the risk of gastritis and peptic ulcers. These drugs can weaken the protective mucosal barrier, leading to symptoms like heartburn, nausea, and stomach pain, especially when taken regularly or on an empty stomach.

Antibiotics are another frequent culprit, as they can disturb the balance of beneficial gut bacteria, resulting in bloating, diarrhea, or abdominal discomfort. Other drugs that may cause digestive issues include certain blood pressure medications, steroids, iron supplements, and some antidepressants. Aspirin, for example, is widely used for pain relief and heart health, but chronic use can lead to significant gastrointestinal side effects if not monitored properly.

If you notice persistent indigestion or new digestive symptoms after starting a medication, it’s important to discuss these side effects with your healthcare provider. Adjustments to the dose, timing, or switching to an alternative medication can often help. For more information, see the NHS’s guide to aspirin and the FDA’s information on NSAIDs.

18. Thyroid Disorders

The thyroid gland plays a crucial role in regulating metabolism and overall bodily functions, including digestion. When the thyroid is underactive (hypothyroidism), the body’s metabolic processes slow down, leading to delayed gastric emptying, constipation, and persistent feelings of fullness or indigestion. Conversely, an overactive thyroid (hyperthyroidism) speeds up metabolism, which can result in rapid digestion, frequent bowel movements, diarrhea, and sometimes abdominal cramping.

These digestive symptoms often occur alongside other hormonal changes. People with hypothyroidism may also experience fatigue, dry skin, weight gain, hair loss, and sensitivity to cold, while those with hyperthyroidism might have unexplained weight loss, irritability, sweating, tremors, and heart palpitations. Because these signs can be subtle or attributed to other causes, thyroid disorders are sometimes overlooked when investigating persistent digestive complaints.

If you have ongoing indigestion accompanied by symptoms such as changes in energy level, unexplained weight fluctuations, or other signs of hormonal imbalance, thyroid screening with a simple blood test (TSH and thyroid hormone levels) may be warranted. Early detection allows for effective management. For more information, visit the NIDDK’s page on hypothyroidism and the NHS guide to hyperthyroidism.

19. Pregnancy

Pregnancy brings about significant hormonal and anatomical changes that frequently cause indigestion, even in women who previously had no digestive issues. Elevated levels of the hormone progesterone relax the muscles of the digestive tract, including the lower esophageal sphincter, which can allow stomach acid to flow back into the esophagus and result in heartburn and indigestion. As pregnancy progresses, the growing uterus places increased pressure on the stomach and intestines, further slowing digestion and contributing to a feeling of fullness, bloating, and discomfort after meals.

These symptoms differ from those in non-pregnant states, where indigestion is more likely to be triggered by dietary factors, stress, or underlying medical conditions. In pregnancy, even small meals or mild physical activity can provoke symptoms due to the physical and hormonal environment.

Safe management of indigestion during pregnancy includes eating smaller, more frequent meals, avoiding spicy or greasy foods, sitting upright after eating, and not lying down immediately after meals. Drinking fluids between meals rather than with food can also help. Most over-the-counter antacids are considered safe, but pregnant women should always consult their healthcare provider before starting any medication. For more information, see the NHS guide to heartburn in pregnancy and the ACOG’s nutrition and symptom management advice.

20. Alcohol Use

Excessive alcohol consumption is a common cause of recurring indigestion, as alcohol directly irritates the stomach lining and increases acid production. This irritation can lead to inflammation (gastritis), resulting in symptoms such as burning pain, nausea, bloating, and discomfort after eating. Binge drinking, which involves consuming large quantities of alcohol in a short period, can dramatically worsen these effects and may even trigger acute episodes of vomiting or stomach pain. Chronic heavy drinking increases the risk of developing ulcers, liver disease, and pancreatitis, all of which further disrupt digestion.

Compared to occasional or moderate alcohol intake, heavy or frequent drinking is much more likely to result in persistent digestive symptoms. Even those who do not drink daily can experience significant indigestion if they engage in periodic binge drinking. These symptoms often improve with reduced alcohol intake, but ongoing use can cause lasting damage to the digestive tract and other organs.

For anyone experiencing persistent indigestion related to alcohol use, moderation or abstinence is strongly advised. Persistent symptoms despite cutting back warrant a medical evaluation. For further information and support, see the NHS alcohol advice resources and the CDC’s facts on alcohol use.

21. Smoking

Smoking tobacco is a significant risk factor for recurring indigestion and various digestive disorders. Nicotine and other chemicals in cigarettes weaken the lower esophageal sphincter, the muscular valve that prevents stomach acid from flowing back into the esophagus. This weakening allows acid reflux to occur more frequently, leading to persistent heartburn, indigestion, and an increased risk of developing gastroesophageal reflux disease (GERD). Smoking also stimulates excess stomach acid production and impairs the stomach’s ability to heal itself, further aggravating digestive symptoms.

Comparative studies show that smokers are much more likely than non-smokers to experience frequent indigestion, ulcers, and complications such as Barrett’s esophagus and stomach cancer. Smoking also slows the healing of existing ulcers and increases the risk of complications from other digestive diseases. Non-smokers, by contrast, have a lower incidence of these issues and generally experience better digestive health overall.

Quitting smoking can significantly reduce the frequency and severity of indigestion and lower the risk of many digestive and systemic diseases. Support resources and cessation programs are widely available to help individuals stop smoking. For more information, visit the NHS Quit Smoking support and the CDC’s guide to quitting smoking.

22. Hiatal Hernia

A hiatal hernia occurs when a portion of the stomach pushes upward through the diaphragm into the chest cavity, disrupting the normal barrier that prevents stomach acid from entering the esophagus. In typical anatomy, the diaphragm helps keep the stomach and the lower esophageal sphincter (LES) in place below the chest, ensuring that acid and digestive contents remain in the stomach. However, with a hiatal hernia, the LES may lose its effectiveness, allowing acid reflux to occur more frequently and leading to chronic indigestion, heartburn, and sometimes chest pain.

Hiatal hernias can range in size, and while small hernias may cause no symptoms, larger ones are often associated with persistent reflux and discomfort—especially after meals or when lying down. Risk factors include obesity, age, pregnancy, and heavy lifting. Non-surgical management includes lifestyle modifications such as eating smaller meals, avoiding trigger foods, elevating the head of the bed, and using medications like antacids or proton pump inhibitors to control acid. In severe cases, particularly when symptoms do not respond to conservative measures or complications arise, surgical repair may be recommended to reposition the stomach and reinforce the diaphragm.

For more information, visit the Mayo Clinic’s hiatal hernia guide and the NHS resource on hiatus hernia.

23. Chronic Kidney Disease

Chronic Kidney Disease (CKD) impairs the kidneys’ ability to filter waste products and excess fluids from the blood. As kidney function declines, toxins such as urea accumulate in the bloodstream—a condition known as uremia. This buildup of toxins can negatively impact multiple organ systems, including the digestive tract. People with CKD often experience persistent indigestion, loss of appetite, nausea, vomiting, and a metallic taste in the mouth. These symptoms are primarily due to the effects of uremic toxins on the stomach’s mucosal lining and gastrointestinal motility.

In contrast, healthy kidneys efficiently remove metabolic waste, maintain electrolyte balance, and support normal digestive function. When the kidneys are compromised, not only do digestive symptoms arise, but other complications such as fluid overload, high blood pressure, and anemia can develop, further worsening overall health. Digestive disturbances in CKD can also contribute to malnutrition and unintentional weight loss.

Regular kidney function monitoring is vital, especially for individuals with risk factors such as diabetes, hypertension, or a family history of kidney disease. Early detection and management can help slow disease progression and alleviate digestive symptoms. For additional information, visit the NIDDK’s page on CKD symptoms and complications and the National Kidney Foundation’s CKD resource.

24. Food Poisoning

Food poisoning occurs when contaminated food or beverages introduce harmful bacteria, viruses, or toxins into the digestive system. Common culprits include Salmonella, E. coli, and norovirus, which can cause a rapid onset of symptoms such as acute indigestion, nausea, vomiting, diarrhea, abdominal cramps, and sometimes fever. These symptoms usually begin within hours to a few days after consuming tainted food and are the result of toxins disrupting normal digestive processes and irritating the stomach and intestines.

Unlike chronic causes of indigestion, food poisoning is typically self-limited and resolves within a few days as the body clears the offending agents. However, symptoms can be severe and lead to dehydration, especially in vulnerable populations such as young children, older adults, and those with weakened immune systems. Signs of dehydration include dry mouth, extreme thirst, decreased urination, dizziness, and confusion.

Medical care should be sought if you experience persistent vomiting, bloody diarrhea, high fever, signs of dehydration, or if symptoms last more than a few days. Prompt attention can prevent serious complications and ensure proper recovery. For more information, see the CDC’s guide to foodborne illness symptoms and the NHS resource on food poisoning.

25. Small Intestinal Bacterial Overgrowth (SIBO)

Small Intestinal Bacterial Overgrowth (SIBO) occurs when excessive amounts of bacteria colonize the small intestine, a section of the digestive tract that normally contains far fewer microbes than the colon. This abnormal bacterial growth disrupts the normal digestion and absorption of nutrients, leading to recurrent indigestion, bloating, excessive gas, and abdominal discomfort. Telltale signs of SIBO also include diarrhea, steatorrhea (fatty stools), and, in severe cases, unintentional weight loss due to malabsorption.

Bloating and gas after meals are hallmark symptoms, often resulting from the fermentation of carbohydrates by these excess bacteria. SIBO can develop as a complication of conditions that affect gut motility, such as diabetes, scleroderma, or previous abdominal surgery. Distinguishing SIBO from other digestive disorders can be challenging, as its symptoms overlap with those of irritable bowel syndrome and other chronic gastrointestinal conditions.

Diagnosis is typically made using a non-invasive breath test, which measures the levels of hydrogen and methane gases produced after ingesting a sugar solution. An abnormal rise in these gases suggests bacterial overgrowth. For further details, see the Mayo Clinic’s overview on SIBO and the Canadian Society of Intestinal Research’s resource on SIBO.

26. Gastritis

Gastritis refers to inflammation of the stomach lining, which can manifest as indigestion, upper abdominal pain, nausea, and a feeling of fullness after eating. The condition can be classified into acute and chronic forms. Acute gastritis develops suddenly, often triggered by irritants such as excessive alcohol consumption, nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, or bacterial infections such as Helicobacter pylori. Symptoms can be intense but are usually short-lived if the underlying cause is addressed.

Chronic gastritis develops gradually and may persist for months or years. It is commonly associated with long-term use of NSAIDs, ongoing alcohol use, chronic stress, or autoimmune conditions. Chronic inflammation can weaken the stomach lining over time, increasing the risk of ulcers and, in rare cases, stomach cancer. The symptoms may be milder but more persistent, making them easy to overlook or attribute to other causes.

Identifying and eliminating triggers is crucial for effective management. Discontinuing offending medications, reducing alcohol intake, and treating underlying infections can help resolve inflammation and prevent complications. For more information, visit the Mayo Clinic’s page on gastritis and the NHS guide to gastritis.

27. Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) is an umbrella term for chronic inflammatory conditions of the digestive tract, primarily including Crohn’s disease and ulcerative colitis. Unlike Irritable Bowel Syndrome (IBS), which is a functional disorder with no visible inflammation or tissue damage, IBD involves ongoing immune-mediated inflammation that can cause lasting damage to the intestinal lining. This inflammation leads to symptoms such as persistent indigestion, abdominal pain, diarrhea, fatigue, and unintended weight loss.

One of the key features distinguishing IBD from IBS is the presence of red-flag symptoms such as blood in the stool, ongoing rectal bleeding, or significant anemia. Crohn’s disease can affect any part of the gastrointestinal tract from mouth to anus, often in patchy segments, while ulcerative colitis is limited to the colon and rectum with continuous areas of inflammation. Both conditions may also be associated with extraintestinal symptoms such as joint pain, skin rashes, and eye inflammation.

The appearance of symptoms like blood in the stool, severe pain, or prolonged diarrhea should prompt immediate medical evaluation, as prompt diagnosis and treatment are essential to reduce complications. For more information, visit the Crohn’s & Colitis Foundation’s overview and the NHS guide to IBD.

28. Stomach Polyps

Stomach polyps are benign growths that form on the lining of the stomach, often discovered incidentally during endoscopic examinations for other digestive complaints. While most stomach polyps are harmless and do not cause symptoms, larger or multiple polyps can lead to subtle indigestion, bloating, nausea, or a feeling of fullness after eating. These symptoms tend to be mild and nonspecific, making them easy to overlook or attribute to other causes.

Unlike stomach cancer, polyps are generally non-cancerous, though certain types—such as adenomatous polyps—carry a small risk of becoming malignant over time. Other varieties, like fundic gland polyps, are usually considered low-risk, especially when small. The risk of cancer is also increased in individuals with a family history of gastrointestinal cancers or genetic syndromes such as familial adenomatous polyposis.

Polyps may need removal if they are large, symptomatic, or show concerning features on biopsy. Endoscopic polypectomy is a minimally invasive procedure that can resolve symptoms and reduce cancer risk. Regular surveillance may be recommended for those with recurrent or high-risk polyps. For more information, consult the Mayo Clinic’s guide to stomach polyps and the NHS resource on stomach polyps.

29. Swallowing Disorders (Dysphagia)

Swallowing disorders, also known as dysphagia, arise when muscle or nerve problems interfere with the normal movement of food and liquids from the mouth to the stomach. This can result from a range of conditions, including neurological diseases (such as stroke, Parkinson’s disease, or ALS), structural abnormalities, or muscular disorders affecting the esophagus. Dysphagia can manifest as a sensation of food getting stuck, coughing or choking during eating, and recurrent episodes of indigestion or chest discomfort after swallowing.

Unlike acid reflux, which typically causes burning pain or regurgitation, dysphagia is characterized by difficulty initiating a swallow or the feeling that food is not progressing down the esophagus. While mild swallowing difficulties may be related to stress or minor throat irritation, persistent or progressive symptoms can signal more serious conditions, such as strictures, tumors, or severe motility disorders.

Difficulty swallowing that is sudden, severe, or accompanied by weight loss, recurrent pneumonia, or inability to swallow liquids should prompt urgent medical evaluation. Early assessment by a gastroenterologist or speech-language pathologist is essential for diagnosis and management. For more information, visit the Mayo Clinic’s dysphagia resource and the NHS guide to swallowing problems.

30. Food Allergies

Food allergies occur when the immune system reacts abnormally to specific proteins found in foods such as nuts, shellfish, eggs, or dairy. Unlike food intolerances, which involve digestive enzyme deficiencies or non-immune sensitivities, food allergies trigger an immune response that can affect multiple organ systems. Symptoms often develop rapidly after exposure and may include indigestion, nausea, vomiting, abdominal pain, and diarrhea, along with skin reactions (hives), swelling, and respiratory difficulties.

While mild allergic reactions may cause only digestive upset, severe reactions—known as anaphylaxis—can be life-threatening. Anaphylaxis is characterized by difficulty breathing, throat tightness, a sudden drop in blood pressure, dizziness, or loss of consciousness. Immediate administration of epinephrine (via an auto-injector) and emergency medical attention are critical in these situations.

It is important to distinguish food allergies from intolerances, as the management and risks differ significantly. Individuals with known or suspected food allergies should carry emergency medications and avoid trigger foods entirely. For more information, see the Food Allergy Research & Education (FARE) Food Allergy 101 and the NHS guide to food allergies.

31. Obesity

Obesity, defined as having a body mass index (BMI) of 30 or higher, is a significant risk factor for recurring indigestion and gastroesophageal reflux. Excess body weight, especially around the abdomen, increases intra-abdominal pressure, which can force stomach contents and acid upward into the esophagus. This mechanism weakens the lower esophageal sphincter, resulting in more frequent episodes of heartburn and acid reflux compared to individuals with a normal BMI.

People with obesity are also more likely to experience related digestive issues such as fatty liver disease, gallstones, and delayed gastric emptying, all of which contribute to ongoing indigestion and discomfort. In contrast, maintaining a healthy weight through a balanced diet and regular exercise is associated with lower rates of reflux and improved digestive health.

Weight management strategies to reduce indigestion include adopting a diet rich in vegetables, fruits, lean proteins, and whole grains, while limiting processed foods, sugary drinks, and high-fat meals. Incorporating regular physical activity, setting realistic weight loss goals, and seeking support from healthcare professionals or weight management programs can make a significant difference. For more information, visit the CDC’s guide to obesity causes and risks and the NHS Weight Loss Plan.

32. Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder that can have widespread effects on the body, including the digestive system. High blood sugar levels over time can damage the nerves that regulate gastrointestinal motility, a condition known as diabetic neuropathy. This nerve damage often affects the vagus nerve, which controls how quickly the stomach empties its contents into the small intestine. When this process is disrupted, it can lead to a condition called gastroparesis, characterized by delayed stomach emptying, persistent indigestion, bloating, nausea, and sometimes vomiting.

Gastroparesis is more common in people with longstanding or poorly controlled diabetes and can significantly impact quality of life by causing unpredictable digestion and difficulty managing blood glucose levels. The symptoms differ from typical indigestion in that they are ongoing and often occur regardless of dietary changes. In addition to gastroparesis, diabetes also increases the risk for other digestive complications, such as infections and reduced absorption of nutrients.

Maintaining optimal blood glucose control is essential to prevent or slow the progression of diabetic neuropathy and associated digestive issues. Regular monitoring, medication adherence, and working closely with healthcare providers are key strategies. For further information, visit the NIDDK’s page on diabetic neuropathy and the CDC’s resource on diabetes complications.

33. Polypharmacy in Older Adults

Polypharmacy refers to the use of multiple medications simultaneously, a scenario particularly common in older adults managing chronic health conditions. While each medication may be necessary for treating specific ailments, the combined effect can increase the likelihood of drug interactions and side effects, including persistent indigestion. Medications such as NSAIDs, certain blood pressure drugs, anticholinergics, and even some supplements can irritate the stomach lining or disrupt normal digestive processes when taken together.

Older adults are especially vulnerable to these adverse effects due to age-related changes in metabolism, reduced kidney and liver function, and increased sensitivity to drugs. Symptoms of indigestion in this population can be subtle and may be attributed to aging rather than medication side effects. The risk of medication-induced indigestion rises with the number of prescribed drugs, highlighting the importance of regular medication reviews.

Routine consultations with a pharmacist or healthcare provider can help identify unnecessary medications, prevent harmful interactions, and optimize dosing schedules. Medication reconciliation, especially during transitions of care, is crucial for minimizing digestive side effects. For more information, see the CDC’s guide to medication safety in older adults and the NHS medicines review resource.

34. Ovarian Cancer

Ovarian cancer is often referred to as a “silent” disease because its early symptoms are subtle and easily mistaken for gastrointestinal issues. One of the earliest signs can be vague indigestion, persistent bloating, or a sensation of abdominal fullness—symptoms commonly attributed to benign digestive conditions. Unlike typical gastrointestinal causes of indigestion, ovarian cancer-related discomfort may be accompanied by other non-specific signs such as pelvic or lower abdominal pain, changes in urinary habits, unexplained weight loss, or early satiety (feeling full quickly).

Because these symptoms overlap with those of common digestive disorders, ovarian cancer frequently remains undiagnosed until it has progressed to a more advanced stage. Women, particularly those over 50 or with a family history of ovarian or breast cancer, should be especially vigilant about persistent or unexplained digestive complaints that do not improve with standard treatments.

Regular gynecologic screenings and prompt reporting of new or unusual symptoms to a healthcare provider are essential for early detection. Transvaginal ultrasound and CA-125 blood testing may be recommended if ovarian cancer is suspected. For more information, visit the American Cancer Society’s ovarian cancer symptoms page and the NHS guide to ovarian cancer.

35. Endometriosis

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often affecting pelvic organs such as the ovaries, fallopian tubes, bladder, and even the bowel. When endometrial tissue involves the digestive tract, it can cause symptoms that mimic indigestion, including bloating, abdominal pain, nausea, constipation, or diarrhea, particularly around the time of menstruation. These digestive complaints can be mistaken for irritable bowel syndrome or other gastrointestinal disorders.

Unlike typical menstrual cramps, which are generally limited to the lower abdomen and occur just before or during a period, endometriosis-related pain can be more severe, persistent, and may radiate to the back or legs. It may also be associated with painful periods, pain during intercourse, and difficulties with fertility. Symptoms related to digestion often fluctuate with the menstrual cycle, which can help distinguish endometriosis from other causes of indigestion.

Women experiencing persistent pelvic pain, digestive symptoms that worsen with the menstrual cycle, or difficulty managing their symptoms should consult a gynecologist or specialist in endometriosis. Early intervention can help manage pain and prevent complications. For more information, visit the Endometriosis UK’s overview of symptoms and the NHS guide to endometriosis.

36. Gastrointestinal Infections (Viral or Parasitic)

Gastrointestinal infections caused by viruses or parasites are common culprits behind acute episodes of indigestion and digestive distress. Viral agents such as norovirus and rotavirus can rapidly inflame the lining of the stomach and intestines, leading to sudden-onset symptoms like nausea, vomiting, diarrhea, abdominal cramps, and bloating. Parasitic infections, including giardiasis or amoebiasis, can cause similar symptoms but may also result in chronic indigestion, prolonged diarrhea, weight loss, and malabsorption, especially if left untreated.

Acute gastrointestinal infections typically present with intense but short-lived symptoms that resolve as the body clears the infection. In contrast, chronic parasitic infections can persist and lead to ongoing digestive complaints, fatigue, and nutritional deficiencies. The risk of infection increases with poor sanitation, contaminated food or water, and inadequate handwashing practices—especially in settings with limited access to clean water.

Prevention focuses on good hygiene, including regular handwashing, safe food handling, and drinking clean, filtered water. Travelers should be cautious about local food and water sources to reduce the risk of parasitic infections. For more information, refer to the CDC’s guide to parasitic diseases and the NHS resource on gastroenteritis.

37. Zollinger-Ellison Syndrome

Zollinger-Ellison Syndrome (ZES) is a rare disorder characterized by the presence of one or more tumors called gastrinomas, typically found in the pancreas or duodenum. These tumors secrete excessive amounts of the hormone gastrin, which stimulates the stomach to produce abnormally high levels of acid. The resulting acid overproduction can cause severe, recurrent indigestion, peptic ulcers, abdominal pain, diarrhea, and sometimes weight loss.

Unlike common reflux or typical peptic ulcers, which are often managed with standard doses of acid-suppressing medications, the symptoms of ZES tend to be more severe, persistent, and resistant to conventional treatment. Patients may develop multiple or difficult-to-heal ulcers in unusual locations, and the condition can lead to significant complications if not identified early.

Diagnosis of Zollinger-Ellison Syndrome involves specialized hormone testing to measure fasting gastrin levels in the blood, as well as imaging studies to locate gastrinomas. If ZES is suspected, referral to an endocrinologist or gastroenterologist is essential for further evaluation and management. For additional information, visit the NIDDK’s resource on Zollinger-Ellison Syndrome and the Mayo Clinic’s guide to ZES.

38. Motility Disorders

Motility disorders are conditions in which the muscles of the gastrointestinal tract fail to contract and relax properly, disrupting the coordinated movement of food from the mouth to the anus. Examples include achalasia, where the esophagus has trouble moving food into the stomach due to failure of the lower esophageal sphincter to relax, as well as conditions like intestinal pseudo-obstruction and chronic intestinal dysmotility. These disorders can lead to symptoms such as persistent indigestion, difficulty swallowing, bloating, abdominal pain, early satiety, and, in severe cases, vomiting or unintentional weight loss.

Unlike functional dyspepsia, which has no identifiable structural or motility abnormality and is often linked to heightened sensitivity of the gut, motility disorders have a measurable physical basis. Their symptoms also tend to be more severe and may not respond to standard dietary or lifestyle changes. Diagnosis often requires specialized motility studies, such as esophageal manometry, gastric emptying studies, or small bowel transit tests, to assess how effectively the gut muscles are working.

Early diagnosis and tailored management are crucial to improve symptoms and prevent complications. For more information, visit the NIDDK’s overview of motility disorders and the Mayo Clinic’s page on achalasia.

39. Bile Acid Malabsorption

Bile acid malabsorption is a digestive disorder in which the normal recycling of bile acids—substances produced by the liver to help digest fats—is disrupted. Normally, bile acids are released into the small intestine during digestion and then reabsorbed in the ileum for reuse. When this process fails, excess bile acids spill into the colon, irritating the lining and causing symptoms such as chronic diarrhea, bloating, and indigestion, particularly after eating fatty meals.

This condition is often confused with other common causes of diarrhea, such as irritable bowel syndrome or infections. However, bile acid malabsorption is specifically related to disorders affecting the ileum (such as Crohn’s disease, surgical resection, or radiation therapy) or changes in the way the liver and intestines process bile. The diarrhea associated with bile acid malabsorption is typically watery and can occur several times a day, often leading to dehydration and nutrient malabsorption.

Treatment options include medications known as bile acid sequestrants (e.g., cholestyramine), which bind excess bile acids in the intestine and prevent their irritating effects. Dietary adjustments and treatment of any underlying conditions are also important. For more details, visit the NHS guide to bile acid malabsorption and the Guts UK resource on bile acid malabsorption.

40. Chronic Constipation

Chronic constipation is a common digestive complaint characterized by infrequent, difficult, or incomplete bowel movements. When stool moves too slowly through the colon, it can lead to excessive water absorption, resulting in hard, dry stools that are difficult to pass. This slow transit not only causes discomfort but can also lead to persistent feelings of fullness, bloating, and indigestion, as waste material accumulates and disrupts normal digestive rhythms.

Normal bowel habits vary between individuals, but most people have bowel movements anywhere from three times a day to three times a week. Chronic constipation is generally defined as having fewer than three bowel movements per week, often accompanied by straining, abdominal pain, or the sensation of incomplete evacuation. Factors contributing to constipation include low fiber intake, inadequate hydration, sedentary lifestyle, certain medications, and underlying medical conditions.

Improving regularity often involves increasing dietary fiber (fruits, vegetables, whole grains), drinking plenty of fluids, and engaging in regular physical activity. Establishing consistent bathroom habits and responding promptly to the urge to defecate can also help. For more guidance, see the NHS guide to constipation and the Mayo Clinic’s constipation resource.

41. Appendicitis

Appendicitis is an inflammation of the appendix that often begins with symptoms easily mistaken for indigestion, such as mild abdominal discomfort, loss of appetite, nausea, or bloating. In its early stages, appendicitis can appear deceptively benign, leading individuals to attribute their symptoms to a minor digestive upset or stomach bug. However, as the condition progresses, the pain typically localizes to the lower right side of the abdomen and becomes more severe and constant—a classic sign that distinguishes it from common indigestion.

Other symptoms may include fever, vomiting, and a marked increase in pain with movement, coughing, or pressing on the abdomen. Unlike ordinary digestive discomfort, appendicitis pain often escalates within a matter of hours and does not improve with rest or over-the-counter remedies. A sudden, sharp pain that migrates to the lower right abdomen is particularly concerning and should not be ignored.

Because a ruptured appendix can lead to life-threatening infection, it is crucial to seek emergency medical evaluation if you experience persistent or worsening abdominal pain, especially if accompanied by fever or vomiting. For further details, see the NHS guide to appendicitis and the Mayo Clinic’s resource on appendicitis.

42. Intestinal Obstruction

Intestinal obstruction occurs when a blockage—caused by tumors, adhesions, hernias, or impacted stool—prevents the normal passage of food, fluids, and gas through the intestines. This disruption halts digestion and can lead to a rapid buildup of pressure, swelling, and pain within the digestive tract. Unlike mild or functional indigestion, which may cause bloating and discomfort that comes and goes, an intestinal obstruction produces severe, persistent symptoms that require urgent attention.

Typical warning signs include crampy abdominal pain that comes in waves, significant bloating, vomiting (which may become fecal in severe cases), and the inability to pass gas or have a bowel movement. The abdomen may become distended and tender to touch. As the obstruction persists, there is a risk of bowel perforation, infection, and life-threatening complications.

Anyone experiencing these symptoms—especially persistent vomiting, abdominal distension, or the inability to pass stool or gas—should seek emergency medical care immediately. Early intervention is critical for preventing serious outcomes. For more information, visit the NHS guide to bowel (intestinal) obstruction and the Mayo Clinic’s intestinal obstruction resource.

43. Hernias (Other than Hiatal)

Hernias occur when an internal organ or tissue, such as the intestine, protrudes through a weak spot in the abdominal wall or groin muscles. Common types include inguinal hernias (in the groin) and abdominal wall hernias (such as umbilical or incisional hernias). While many hernias initially present as a painless bulge, they can interfere with digestion, causing mild discomfort, bloating, or a feeling of heaviness, especially when standing, lifting, or straining.

More concerning are situations where a section of bowel becomes trapped (incarcerated) within the hernia, potentially cutting off its blood supply (strangulation). This can lead to acute digestive symptoms, including severe pain, nausea, vomiting, and an inability to pass gas or have a bowel movement—signs that mimic intestinal obstruction and indicate a surgical emergency. The overlying skin may become red or tender, and the hernia may no longer be reducible (able to be pushed back in).

Anyone with a hernia who develops persistent pain, swelling, or sudden digestive symptoms should seek urgent medical care. Early intervention can prevent serious complications. For more information, see the NHS guide to hernias and the Mayo Clinic’s resource on hernias.

44. Malabsorption Syndromes

Malabsorption syndromes are a group of disorders in which the small intestine fails to absorb nutrients effectively, leading to a range of digestive and systemic symptoms. Conditions such as tropical sprue, cystic fibrosis, and short bowel syndrome can damage or reduce the functioning surface area of the intestines, impairing the digestion and absorption of fats, proteins, carbohydrates, vitamins, and minerals. Unlike isolated indigestion, which involves mild and transient upper abdominal discomfort, malabsorption syndromes cause chronic symptoms that persist regardless of dietary changes.

Common signs include persistent diarrhea, steatorrhea (bulky, pale, foul-smelling stools that float due to excess fat), bloating, and abdominal discomfort. Over time, individuals may develop significant weight loss, fatigue, anemia, and deficiencies in essential nutrients such as iron, vitamin D, or vitamin B12. In children, malabsorption can manifest as poor growth or developmental delays.

Early diagnosis and management are crucial for minimizing complications and improving quality of life. Evaluation often involves stool tests, blood work, and sometimes specialized absorptive studies. For more information, see the NIDDK’s guide to malabsorption and the Cystic Fibrosis Trust’s digestive system overview.

45. Autoimmune Gastritis

Autoimmune gastritis is a chronic condition in which the body’s immune system mistakenly attacks the parietal cells lining the stomach, leading to progressive inflammation and atrophy of the gastric mucosa. This immune-mediated destruction reduces the stomach’s ability to produce acid and intrinsic factor—a protein necessary for vitamin B12 absorption. Unlike gastritis caused by Helicobacter pylori, which results from bacterial infection and can often be resolved with antibiotics, autoimmune gastritis is a lifelong disease driven by the immune system’s persistent activity.

Symptoms of autoimmune gastritis can be subtle and may include indigestion, bloating, a feeling of fullness after eating, and mild abdominal discomfort. Over time, the loss of intrinsic factor leads to vitamin B12 deficiency, which can cause anemia, neurological symptoms (such as numbness, tingling, or balance problems), and fatigue. The risk of developing stomach cancer is also increased with long-standing autoimmune gastritis.

Diagnosis is typically confirmed through blood tests for autoantibodies, vitamin B12 levels, and sometimes gastric biopsy. Lifelong monitoring and vitamin B12 supplementation are often required. For more information, see the NIDDK’s resource on gastritis and the Mayo Clinic’s guide to pernicious anemia.

46. Chronic Infections (e.g., Tuberculosis)

Chronic infections, such as gastrointestinal tuberculosis (TB) or certain fungal and parasitic diseases, can have a profound impact on the digestive tract. Unlike common causes of indigestion, which are usually acute or easily identifiable, chronic infections often present with vague and persistent symptoms such as ongoing indigestion, abdominal pain, bloating, low-grade fever, night sweats, and unintended weight loss. Tuberculosis, for instance, can infect the intestines, peritoneum, or lymph nodes, leading to chronic inflammation, ulceration, and strictures that disrupt normal digestion and nutrient absorption.

These infections are much less common than bacterial or viral gastroenteritis, but they should be considered in individuals with persistent or unexplained digestive symptoms, especially if there is a history of travel to or residence in regions where TB or other chronic infections are prevalent. A detailed history of exposures, including contact with known cases or risk factors such as immunosuppression, is essential for diagnosis.

Specialized tests such as stool cultures, tissue biopsies, and imaging studies are often needed to confirm the diagnosis. Early identification and targeted treatment are crucial to prevent complications and transmission. For more information, see the CDC’s overview of tuberculosis and the NHS guide to tuberculosis.

47. Radiation or Chemotherapy Effects

Radiation therapy and chemotherapy are vital cancer treatments, but both can have significant adverse effects on the digestive system. Unlike common medication side effects that may cause mild indigestion or nausea, these cancer therapies can directly damage the delicate lining of the mouth, esophagus, stomach, and intestines. Radiation, particularly when targeted at the abdomen or pelvis, can cause inflammation (radiation enteritis or gastritis), ulceration, and scarring, disrupting normal digestion and absorption. Chemotherapy agents, by targeting rapidly dividing cells, often lead to symptoms such as nausea, vomiting, diarrhea, mouth sores, and persistent indigestion.

These effects can be acute, occurring during treatment, or chronic, lasting months or even years after therapy has ended. Persistent digestive symptoms may include bloating, pain, malabsorption, and changes in bowel habits. The severity and duration of symptoms depend on the type, dose, and location of treatment, as well as individual susceptibility.

Management strategies include eating small, frequent meals, choosing bland or low-fiber foods, staying hydrated, and using prescribed medications to control nausea or diarrhea. Coordination with oncology and gastroenterology teams is essential. For further guidance, see the American Cancer Society’s guide to managing digestive side effects and the Macmillan Cancer Support’s resource on digestive effects.

48. Post-Surgical Changes

Surgeries that alter the anatomy of the digestive tract, such as gastric bypass, bowel resection, or removal of the gallbladder, can significantly impact how food is processed and absorbed. After procedures like gastric bypass, the stomach is reduced in size and the route of food through the intestines is changed, often resulting in faster gastric emptying (dumping syndrome), indigestion, bloating, and diarrhea. In contrast to pre-surgical function, where the digestive system efficiently regulates food breakdown and nutrient absorption, post-surgical changes may reduce the time available for digestion and lead to malabsorption or nutritional deficiencies.

Other surgeries, such as removal of the gallbladder (cholecystectomy), can alter bile flow and make it harder to digest fatty foods, causing symptoms like cramping, loose stools, or persistent indigestion after meals. The severity and nature of digestive changes depend on the type of surgery and individual response.

Persistent or severe symptoms—including ongoing pain, vomiting, unintentional weight loss, or signs of malnutrition—should always be reported to a healthcare provider, as they may signal complications or the need for dietary adjustments. For more information, see the NHS guide to risks of weight loss surgery and the Mayo Clinic’s overview of gastric bypass surgery.

49. Age-Related Digestive Changes

As people age, natural physiological changes in the digestive system can lead to increased occurrences of indigestion and related symptoms. Aging is associated with slower gastric emptying, decreased production of digestive enzymes, and weakened muscle tone in the esophagus and intestines. These changes can contribute to common complaints such as bloating, a feeling of fullness after small meals, constipation, and mild heartburn. Saliva production may also decrease, making swallowing and the initial stages of digestion less efficient.

Unlike disease processes—such as peptic ulcers, cancers, or inflammatory bowel disease—age-related digestive changes generally develop gradually and are not accompanied by alarming symptoms like bleeding, severe pain, or significant weight loss. However, the presence of coexisting medical conditions, polypharmacy, and decreased mobility can amplify digestive issues in older adults and increase the risk of complications.

Regular check-ups and open communication with healthcare providers are essential for distinguishing benign age-related changes from early signs of more serious disease. Preventive care, medication review, and dietary adjustments can help maintain digestive health and quality of life in older adults. For more information, see the Johns Hopkins Medicine’s resource on aging and digestive health and the NHS guide to symptoms of aging.

50. Rare Genetic Disorders

Rare genetic disorders can significantly impact digestion by causing inherited metabolic or enzyme deficiencies. Conditions such as phenylketonuria, hereditary fructose intolerance, or congenital sucrase-isomaltase deficiency interfere with the body’s ability to break down and absorb specific nutrients. These enzyme or metabolic defects often manifest as chronic indigestion, bloating, diarrhea, and failure to thrive in infancy or childhood, or as unexplained digestive symptoms in adults. Unlike acquired disorders, which develop due to environmental factors, infections, or lifestyle, these inherited conditions are present from birth and may become apparent with the introduction of certain foods.

In contrast to more common or acquired causes of indigestion, rare genetic disorders often have distinct patterns of symptoms triggered by specific dietary components. Early recognition is important because removing or substituting the offending nutrient can lead to dramatic improvement. Genetic testing or enzyme assays are used for diagnosis, and lifelong dietary management is often required to prevent complications.

Genetic counseling may be indicated for affected individuals and their families to understand inheritance patterns, recurrence risks, and management options. For more information, see the NIH’s list of rare digestive diseases and the NHS guide to genetic conditions and counseling.

Conclusion

Persistent indigestion should never be overlooked, as it can signal a wide spectrum of underlying causes—from benign conditions to serious illnesses. Understanding the potential origins of ongoing digestive discomfort empowers individuals to seek timely care and avoid complications. Proactive steps such as scheduling routine checkups, maintaining a detailed symptom diary, and promptly discussing any persistent or unusual symptoms with a healthcare provider are essential for early detection and effective management. Staying informed and vigilant can safeguard both digestive and overall health. For more information on digestive health, visit the NIDDK Digestive Diseases portal and the NHS guide to digestive health.