INDIGESTION DIAGNOSIS

Patient history

Because indigestion is a nonspecific set of symptoms, patients who feel sick enough to seek medical attention are likely to go to their primary care doctor. The history does not always point to an obvious diagnosis. The doctor can, however, use the process of history-taking to evaluate the patient's mood or emotional state in order to assess the possibility of a psychiatric disturbance. In addition, asking about the location, intensity, timing, and recurrence of the indigestion can help the doctor weigh the different diagnostic possibilities.

An important part of the history-taking is asking about symptoms that may indicate a serious illness. These warning symptoms include:

• Weight loss
• Persistent vomiting
• Difficulty or pain in swallowing
• Vomiting blood or passing blood in the stools
• Anemia.

Imaging studies

If the doctor thinks that the indigestion should be investigated further, he or she will order an endoscopic examination of the stomach. An endoscope is a slender tube-shaped instrument that allows the doctor to look at the lining of the patient's stomach. If the patient has indigestion of the esophagitis type or nonulcer type, the stomach lining will appear normal. If the patient has PUD, the doctor will be able to see breaks or ulcerated areas in the tissue. He or she may also order ultrasound imaging of the abdomen, or a radionuclide scan to evaluate the motility of the stomach.

Laboratory tests

BLOOD TESTS

If the patient is over 45, the doctor will have the patient's blood analyzed for a complete blood cell count, measurements of liver enzyme levels, electrolyte and serum calcium levels, and thyroid function.

TESTS FOR HELICOBACTER PYLORI

Doctors can now test patients for the presence of H. pylori without having to take a tissue sample from the stomach. One of these noninvasive tests is a blood test and the other is a breath test.