Further investigations

Depending on your symptoms, your GP may want to investigate further.

This is because indigestion can sometimes be a symptom of an underlying condition, such as a Helicobacter pylori (H. pylori) bacterial infection, a stomach ulcer, or stomach cancer.

Your GPmay refer you for a procedure called an endoscopy to rule out a more serious cause of your indigestion.

During an endoscopy,a thin, flexible tube with a light and camera at one end calledan endoscopeis used to examine the inside of your body.

Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy.

This means that for at least two weeks before having an endoscopy you'll need to stop taking proton pump inhibitors (PPIs) and H2-receptor antagonists.

Your GP may also recommend changing other medications that may be causing your indigestion.

However, you should only stop taking medication if your GP or another healthcare professional in charge of your care advises you to do so.

Diagnosing H. pylori infection

If your GP thinks your symptoms may be caused by an H. pylori infection, you may need to have a test for it.

This may be a:

• stool antigen test where a pea-sized stool sample is tested for H. pylori bacteria
• breath test
• blood test a blood sample will be tested for antibodies to H. pylori bacteria

Antibiotics and PPIs can affect the results of a urea breath test or stool antigen test.

These tests may thereforeneed to be delayed until two weeks after you last used a PPI, and four weeks after you last used an antibiotic.

Diagnosing other conditions

You may need further tests to rule out other underlying conditions that could be causing your indigestion symptoms.

For example, abdominal pain and discomfort can be caused by conditions that affect the bile ducts in your liver.

Bile ducts are tubes that carry bile from the liver to the gallbladderand bowel. Bile isa digestive fluid that breaks down fats, and the gallbladder holds bile.

Your GP may suggest you have a liver function test, ablood test used to assess how well your liver is working.

You may also need to have an abdominal ultrasound scan , which uses high-frequency sound waves to create an image of the inside of your body.