Visit your GP because there are many different causes of indigestion symptoms and several conditions that can seem like indigestion but aren't. You may have severe indigestion, but it could be a stomach ulcer, hiatus hernia, angina or a tumour. Chronic severe indigestion needs to be thoroughly investigated and properly diagnosed.

Think about what you mean by indigestion: is it pain in your stomach, a feeling of being bloated, rawness and burning in your gullet ('heartburn'), or regurgitation of acidic stomach contents? All of these have different implications.

Simple indigestion

The key to coping with simple indigestion is to try to spot your triggers and deal with them. Common causes include eating too much, eating very rich, spicy or fatty foods, eating too quickly and severe stress ('nervous indigestion').

Being overweight increases the risk of oesophagitis, or inflammation of the lower end of the gullet, especially because it can cause a hiatus hernia. This is a condition in which the top part of the stomach is pushed upwards through the muscular diaphragm from the abdomen into the chest cavity. This stops the top of the stomach from closing properly.

The result is that the acidic stomach contents can spill into the gullet above, damaging and inflaming the delicate mucosa or lining. Smoking can aggravate this process.

Indigestion remedies, which contain what are known as alginates, can help because they form a foamy layer that helps keep your stomach contents down and offers a protective coating on the mucosa. But the answer really is to lose weight, so that the hernia gets better, and stop smoking.

Stomach ulcers

Indigestion pain may be due to ulcers either in the stomach itself (gastric ulcers) or in the first part of the small intestine leading out of the stomach (duodenal ulcers). Surgery is rarely necessary, especially as we now know that an infection with a bacteria called Helicobacter pylori is often to blame in stomach ulcers.

Tests such as a gastroscopy (passing a telescopic tube into the stomach to look around) or a barium meal (a special dye put into the stomach to allow X-rays to be taken) may be needed to make the diagnosis. Treatment, consisting of a simple combination of antibiotics and anti-ulcer medicines, is usually effective.

Angina and heart disease

People often mistake angina and pain from heart disease for indigestion, and these possibilities must be ruled out with a simple ECG recording of your heart.

This article was last medically reviewed by Dr Trisha Macnair in March 2008