Indigestion (dyspepsia) produces discomfort in the upper stomach, often accompanied by belching and bloating. It is a symptom many of us are familiar with across the Christmas festive period and as a community pharmacist saw most families purchase products in anticipation. Long standing indigestion may be investigated by endoscopy. Symptoms can involve bringing up food or bitter-tasting fluids into your mouth temporarily.

GORD is reflux of the contents of the stomach into the oesophagus. It can also be associated with gastritis (inflammation of the stomach) or damage to the stomach due to use of NSAIDs such as ibuprofen, diclofenac and naproxen.  It is associated with the term heartburn and can be linked to a cough. Symptoms can be exacerbated by over-eating, obesity or pregnancy.

H. Pylori can be diagnosed by a test done on a sample of stools (faeces), by a breath test, by a blood test, or from a biopsy sample taken during a gastroscopy (endoscopy). It is treated by a variety of combinations of two antibiotics (clarithromycin, metronidazole and amoxycillin) in high dose plus a PPI for a week. The PPI may be continued for 4-8 weeks.

Treatment                                                                                                                 

• Antacids containing calcium and sodium – there are many brands available according to choice.
• Simethicone products to absorb wind
• Alginates which form a viscous foam which floats on the stomach contents preventing the reflux
• H2 receptor antagonists such as Famotidine or nizatidine are preferred as smaller amounts pass into breast milk than cimetidine.
• PPIs (proton pump inhibitors) such as omeprazole, lansoprazole, esomeprazole are largely destroyed by stomach acids so little is available to pass into breastmilk

See also SPS Treating heartburn and dyspepsia during breastfeeding

https://www.sps.nhs.uk/articles/treating-heartburn-and-dyspepsia-during-breastfeeding