Treatment includes the avoidance of problem foods, such as citrus fruits, spicy foods, fatty foods, milk, and beans.
Helpful Vitamins & Supplements
Lipase, a pancreatic enzyme, aids in the digestion of fats and may improve digestion in some people. In a double-blind trial, a timed-release form of pancreatic enzymes was shown to significantly reduce gas, bloating, and fullness after a high-fat meal. Participants in this study took one capsule immediately before the meal and two capsules immediately after the meal. The three capsules together provided 30,000 USP units of lipase, 112,500 USP units of protease, and 99,600 USP units of amylase. However, the amount of pancreatic enzymes needed may vary from person to person, and should be determined with the help of a doctor.
Activated charcoal has the ability to adsorb (attach to) many substances, including gases produced in the intestine. In a small, controlled trial, people were given a meal of gas-producing foods along with capsules containing 584 mg of activated charcoal, followed by another 584 mg of activated charcoal two hours later. Using activated charcoal prevented the five-fold increase in flatulence that occurred in the placebo group. Another, small controlled study found that taking 388 mg of activated charcoal two hours after a gas-producing meal normalized flatulence by the fourth hour. However, a preliminary human study found no effect on flatulence or abdominal symptoms when healthy volunteers took 520 mg of activated charcoal four times per day for one week.
Vitamin B12 supplements may be beneficial for a subset of people suffering from indigestion: those with delayed emptying of the stomach contents in association with Helicobacter pylori infection and low blood levels of vitamin B12. In a double-blind study of people who satisfied those criteria, treatment with vitamin B12 significantly reduced symptoms of dyspepsia and improved stomach-emptying times.
Three major categories of herbs are used to treat indigestion when no cause for the condition is known: bitters (digestive stimulants), carminatives (gas-relieving herbs), and demulcents (soothing herbs).
Bitter Herbs. These herbs are thought to stimulate digestive function by increasing saliva production and promoting both stomach acid and digestive enzyme production. As a result, they are particularly used when there is low stomach acid but not in heartburn (where too much stomach acid could initially exacerbate the situation). These herbs literally taste bitter. Some examples of bitter herbs include greater celandine, wormwood, and gentian. Bitters are generally taken either by mixing 1–3 ml tincture into water and sipping slowly 10–30 minutes before eating, or by making tea, which is also sipped slowly before eating.
Celandine. A double-blind study found that a standardized extract of greater celandine could relieve symptoms of indigestion (such as abdominal cramping, sensation of fullness, and nausea) significantly better than placebo. The study employed an extract standardized to 4 mg of chelidonine per capsule and gave 1–2 tablets three times daily for six weeks. However, recent reports of hepatitis following intake of greater celandine have raised concerns about its safety for treating indigestion.
Bitter Orange. Very little published research is available on the traditional uses of bitter orange as a digestive aid and sedative. The German Commission E has approved the use of bitter orange for loss of appetite and dyspeptic ailments. One test tube study showed bitter orange to potently inhibit rotavirus (a cause of diarrhea in infants and young children). Bitter orange, in an herbal combination formula, reportedly normalized stool function and completely eased intestinal pain in 24 people with non-specific colitis and, again in an herbal combination formula, normalized stool function in another 32 people with constipation.