Diagnosis and Tests for Indigestion

Many people with mild, short-lived indigestion need no tests. A doctor decides based on age, duration and alarm symptoms.

History and examination

• Questions on pain, meals, weight loss, vomiting, stools, medicines (especially painkillers), alcohol, smoking and family history
• Examination of the abdomen

When tests are advised

• Age over 55 with new symptoms
• Alarm features such as black stools, vomiting blood, difficulty swallowing, weight loss or anaemia
• Symptoms that persist or return despite treatment
• Strong family history of stomach cancer

Common tests

• H. pylori testing: breath test, stool antigen test or blood test, usually at endoscopy. Stop acid-lowering medicines or antibiotics for the period your doctor advises before the test.
• Upper gastrointestinal endoscopy: a thin camera looks at the food pipe, stomach and first part of the intestine. Biopsies may be taken.
• Blood tests: haemoglobin, liver and pancreas tests, and tests for celiac disease if suspected
• Ultrasound of the abdomen: looks for gallstones and other causes
• Heart tests (ECG): if chest symptoms could be cardiac

Preparing for endoscopy

You usually fast for 6 to 8 hours. Tell the doctor about blood thinners and allergies.

Key point

Tests look for treatable causes and rule out serious ones. Do not delay them if you have alarm symptoms.

Before your appointment

Note when symptoms started, how they relate to meals, and what makes them better or worse. List all medicines, especially painkillers, and any herbal products. Mention weight loss, vomiting, black stools, trouble swallowing, family history of stomach problems, smoking and alcohol. Ask about tests such as an H. pylori test or endoscopy, and the warning signs that mean you should call 112 or 102.