Indigestion vs. Heartburn: What’s the Difference?
Medically reviewed on December 10, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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After eating a meal, some people can experience discomfort in the form of indigestion or heartburn. While the terms are often used interchangeably, they refer to two separate conditions.
So, what’s the difference between indigestion vs. heartburn?
Heartburn is a type of indigestion that causes a burning sensation in the chest. Indigestion, on the other hand, is a general term that refers to a variety of gastrointestinal issues. But, let’s dig a bit deeper.
What Is Indigestion?
After eating, the food moves into the stomach for digestion. During this time, people with indigestion can feel pain or discomfort in the upper abdomen, where the stomach sits. This is often referred to as epigastric pain. This can cause an upset stomach after eating, or it may manifest as several other reflux symptoms, including [1]:
- Burning sensation – It’s not uncommon to also feel a burning sensation in the upper abdomen or chest. This can arise from inflammation, stomach acids, and/or enzymes in the gastrointestinal tract.[1]
- Early or late satiety – People with indigestion may feel too full immediately after eating or very long after having a meal. This is a sign that the stomach is overworking.[1]
People with indigestion can also experience [1,2]:
- Bloating
- Burping
- Nausea
- Gas
- Regurgitation
- Acid reflux/heartburn
How long does indigestion last? The duration in which ingestion lasts will vary from person to person. Some people may only experience symptoms for a few minutes, while others may experience indigestion for several hours as the food moves through the digestive system.[1]
So, why exactly does the pain arise in the abdomen?
It’s where your stomach is located, but it’s also the home of two other organs that are essential to digestion [1]:
- Pancreas – Your pancreas secretes enzymes, or digestive juices, to break down the food you eat. It also produces hormones that communicate with other parts of the digestive system. These include insulin, which helps your body convert sugar into energy; glucagon, which helps to regulate blood sugar levels after eating; gastrin, which triggers the production of gastric acid; and amylin, which controls appetite and stomach emptying. When the pancreas becomes chronically inflamed, symptoms include indigestion, as well as loss of appetite and lightheadedness.[3]
- Gallbladder – Sitting under the liver, the gallbladder stores bile that the liver makes. This helps the body digest fat in the small intestine. It's possible for gallbladder attacks, like gallstones (hardened deposits), to cause indigestion. These deposits can block the bile ducts, which can cause sudden pain.[4]
While pancreas and gallbladder issues can cause indigestion, more common causes of indigestion aren’t as severe. For instance, it’s very common to experience indigestion after eating a large meal made of rich ingredients.[1]
As the food passes through your digestive system, it has to work overtime to break down the food and move it through the gastrointestinal tract. Accordingly, your gallbladder and pancreas will contract, your stomach will stretch, and digestive juices may irritate some tissues. Other potential causes include [1,2]:
- Eating too quickly
- Eating too much fat
- Experiencing food intolerances
- Smoking
- Consuming alcohol
- Overusing NSAIDs
- Taking certain antibiotics
- Experiencing stress and anxiety
In addition to pancreas and gallbladder issues, medical causes of indigestion can also include [2]:
- Gastritis
- Gastroparesis
- Gastroenteritis
- Irritable bowel syndrome
- Peptic ulcer disease
- Stomach cancer
- Helicobacter pylori (H. pylori) infection
Stomach acid can play a key role in indigestion symptoms. Over time, the lining in your stomach can begin to disappear, which makes the tissue more susceptible to irritation and inflammation. These acids can escape to the small intestine and esophagus, which can lead to acid reflux, a condition that causes burping, regurgitation, and heartburn.[1]
Note: A heart attack has many of the same symptoms as indigestion, such as abdomen and chest pain, nausea, fatigue, and dizziness, among others.[5] Ingestion, itself, can be a symptom of a heart attack on its own. If sweating, shortness of breath, or abdominal tightness accompany your indigestion, it’s critical to seek the help of a healthcare professional immediately since you may be experiencing cardiovascular blockages.[1]
How to Treat Indigestion
Acute indigestion is treatable at home. People often turn to over-the-counter antacid medications that neutralize stomach acid to prevent irritation or inflammation of the digestive tissues. These medications include [1]:
- Tums
- Rolaids
- Pepto-Bismol
Drinking water may also help to ease some of the symptoms of indigestion, particularly if you’re experiencing acid reflux. The water can wash the acid from your throat and return it to your stomach. Water may also support digestion.[1]
For those who experience long-lasting or chronic indigestion, it’s advised to seek medical treatment. After assessing your condition, your healthcare provider may prescribe acid blockers, such as histamine receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs), as well as prokinetic agents to speed digestion and antibiotics to reduce bacterial overgrowth in the stomach or small intestine.[1]
To prevent indigestion altogether, avoid large meals and certain foods that may trigger indigestion symptoms. Getting enough sleep and exercise, managing your stress levels, and maintaining a healthy weight may also help reduce indigestion episodes.[1]
What Is Heartburn?
Heartburn is a type of indigestion that causes a burning sensation in the chest. Its primary cause? Acid reflux.
There are two types of acid reflux that adults can experience. These include [6]:
- GER – Occurs when stomach content makes its way back up into your esophagus.
- GERD – A chronic, long-lasting condition in which stomach acid frequently makes its way up to the esophagus. Complications can include esophagitis, esophageal stricture, Barrett’s esophagus, asthma, chronic cough, hoarseness, laryngitis, and wearing away of the tooth enamel.
As explored, digestive acid can escape the confines of the stomach and travel to either the small intestine or the esophagus. The latter occurs when the lower esophageal sphincter—the junction between the stomach and the esophagus—fails to tighten, allowing stomach acid to flow back into the esophagus. When working normally, the esophageal sphincter will temporarily relax to allow food to travel into the stomach, then tighten again.[5]
Unlike the stomach, the esophagus does not have lining to protect itself from digestive acids. So, when the stomach contents do return to the esophagus, it can irritate the tissues within the esophagus, causing pain and burning.
In addition to heartburn, symptoms of acid reflux can include hiccups, cough, hoarse voice, bad breath, bloating, and a sour taste in your mouth.[7] You may also experience more heartburn when sitting, lying down, or bending over.[7]
Several types of food can trigger heartburn, such as [5]:
- Spicy foods
- Onions
- Citrus
- Tomato products
- Fried and fatty foods
- Peppermint
- Chocolate
- Alcohol
- Carbonated water or soda
- Coffee
- Large, fatty meals
There may be some medical causes, too. For example, people who are pregnant or people taking anti-inflammatory painkillers, birth control, and/or blood pressure medications can experience lower esophageal sphincter issues, as well as people who experience [7,8]:
- High stress levels
- High progesterone and estrogen levels
- Hiatus hernia
- High body mass index (BMI)
Like generalized indigestion, heartburn can last several minutes up to several hours. It will pass once the stomach is fully emptied, meaning there are no more contents to come back up to your esophagus.[8]
If you’re just beginning to experience heartburn, two factors may play a role in its sudden occurrence, such as [8]:
- Age – It’s common for older people to experience heartburn as their muscles, like the lower esophageal sphincter, begin to weaken.
- Weight – For some people, weight gain can cause heartburn.
While acid reflux is the most common cause of heartburn, it’s not the only one. A few medical conditions can also trigger heartburn, including [8]:
- Esophageal ulcers – These are sores that arise when the lining of the gastrointestinal tract becomes eroded, often as a result of chronic acid reflux or overusing NSAIDs.
- Esophagitis – GERD, viruses, fungal infections, and certain medications can cause severe inflammation in the esophagus, called esophagitis. If the inflammation is caused by an allergy or food intolerance, it’s called eosinophilic esophagitis.
- Functional heartburn/reflux hypersensitivity – This disorder disrupts the communication between the brain and the digestive system. Symptoms of heartburn like burning, occur, without the presence of acid reflux, erosion, or inflammation.
How To Treat Heartburn
To evaluate your condition, it’s best to visit your healthcare provider. They’ll assess potential esophagus damage by conducting such tests as [8]:
- Upper endoscopy – This involves passing an endoscope into your upper gastrointestinal tract, from the esophagus to the small intestine, to identify signs of esophagitis, hernia, or Barrett’s esophagus (a precancerous condition).
- Esophageal pH test – This test involves implanting a wireless capsule into the esophagus to measure acid levels in the throat over time.
If heartburn is diagnosed, your healthcare provider will likely prescribe a heartburn medication, like [8]:
- Antacids
- Alginates
- Histamine receptor antagonists (H2 blockers)
- Proton pump inhibitors (PPIs)
- Antibiotics
- Topical steroids
- Low-dose neuromodulators
Extinguish The Burn With Everlywell
Ingestion is a generalized term that refers to a number of gastrointestinal conditions, while heartburn is one of these conditions. That said, all forms of indigestion can cause gastrointestinal discomfort, pain, and burning.
If you’re struggling with discomfort after you eat, take our at-home Food Sensitivity Test, or consult with an Everlywell healthcare provider through a telehealth visit. We’ll discuss your symptoms from the comfort of your own home and plan next steps together based on your unique needs.
Schedule a visit today to get started.
Related Content
How Long Does Indigestion Last?
Burning Sensation In Stomach: Causes & Treatment
What Causes An Upset Stomach After Eating?
References
- Indigestion. Cleveland Clinic. Published December 19, 2022. URL. Accessed November 12, 2023.
- Symptoms & Causes of Indigestion. NIH. Published November 2016. URL. Accessed November 12, 2023.
- The Digestive Process: What Is the Role of Your Pancreas in Digestion? Johns Hopkins Medicine. URL. Accessed November 12, 2023.
- Galled by the Gallbladder?. NIH. Published February 2015. URL. Accessed November 12, 2023.
- Heart Attack. Mayo Clinic. Published October 9, 2023. URL. Accessed November 12, 2023.
- Definition & Facts for GER & GERD. NIH. Published July 2020. URL. Accessed November 12, 2023.
- Heartburn and acid reflux. NHS. Published September 9, 2023. URL. Accessed November 12, 2023.
- Heartburn. Cleveland Clinic. Published January 19, 2023. URL. Accessed November 12, 2023.
Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.