1. Made by: Belal Doudin Alaa Almor To: Dr. Adham Abu taha
Indigestion
Made by: Belal Doudin
Alaa Almor
To: Dr. Adham Abu taha

2. Indigestion
Indigestion and Dyspepsia are terms commonly used to describe a range of somewhat vague symptoms in the upper GIT that
are generally associated
with the ingestion of food.

3. Causes Indigestion has many possible causes like Lifestyle:
Overeating or eating too quickly.
Fatty, greasy or spicy foods.
Too much caffeine, alcohol, chocolate or carbonated beverages.
Smoking.
Anxiety.
Certain antibiotics, pain relievers and iron supplements.

4. Sometimes indigestion is caused by other digestive conditions, including:
Gastritis, Peptic ulcers.
Gallstones, Constipation.
Pancreas inflammation (pancreatitis).
Stomach cancer, Intestinal blockage.
intestinal ischemia .
Indigestion with no obvious cause is known as functional dyspepsia or nonulcer stomach pain.

5. Signs and Symptoms illness during a meal. Bloating Early fullness
Nausea.
Signs and Symptoms
Discomfort
Less frequent symptoms include vomiting and belching
Burning

6. When to see a Doctor?! weight loss or loss of appetite.
Repeated vomiting or vomiting with blood.
Black, tarry stools.
Trouble swallowing that gets progressively worse.
Fatigue or weakness, which may be symptoms of anemia.
Seek immediate medical attention if you have:
Shortness of breath, sweating or chest pain radiating to the jaw, neck or arm.
Chest pain on exertion or with stress.

7. Treatment with OTC med. Lifestyle control. Antacids. Aalginates.
H2-antagonistis.
PPI.
Domperidone.

8. Antacids The compounds used as antacids are:
sodium and potassium bicarbonates
calcium carbonate
aluminium hydroxide
magnesium and bismuth salts
magnesium–aluminium complexes.
MOA: These are weak bases that dissociate to form alkaline salts, thereby neutralizing gastric acidity.

9. Alginates
MOA: Alginates act as reflux suppressants, they form a sponge-like polymer matrix, forming barrier.
They include:
Alginic acid
Magnesium alginate
Sodium alginate.

10. H2-antaginistis Compounds available are : Famotidine, Ranitidine.
H2-antagonists are more effective treatments than antacids for non-ulcer dyspepsia.
H2 receptor antagonists occupies receptor sites on the parietal cells (H+/K+ ATPase) blocking their activity.

11. H2-antaginistis
Famotidine: 10 mg for symptomatic relief or 1 hour before consuming food or drink that causes symptoms; maximum dose 20 mg in 24 hours.
Ranitidine: 75 mg for symptomatic relief, followed by 75mg 1 hour later if symptoms persist; maximum dose 300 mg in 24 hours.

12. Cautions and interactions with H2-antagonistis
H2 antagonists are well tolerated and the incidence of side-effects is low.
They should not be sold to patients taking NSAIDs drugs, these may mask the symptoms of developing peptic ulcer.
H2 antagonists are not licensed for sale to pregnant or breastfeeding women.

13. PPI Omeprazole is a selective proton pump inhibitor.
It directly inhibits the H+/K+ ATPase of the parietal cells of the stomach responsible for gastric acid secretion.
It is indicated primarily for pt’s with chronic, intermittent, relapsing disorder of varying frequency and severity.
Who experience recurrent attacks, including at night, which can be distressing and negatively affect quality of life.

14. PPI
The initial dose is tow 10 mg tablets once daily, swallowed whole before a meal, with plenty of liquid.
Omeprazole is licensed as OTC in adults aged 18 years and over. It should not be used by pregnant or breastfeeding women.
Caution should be taken when using anticoagulants and antiepileptics with them (due to CYP450).

15. Domperidone Domperidone is a D2 receptor antagonist.
Domperidone is licensed for the treatment of dysmotility symptoms of dyspepsia, including sensations of fullness, bloating, ‘heavy stomach’, belching and nausea.
The recommended dose is one 10 mg tablet three times daily and at night, when required. The drug is licensed for use in adults aged 16 years and over.

16. Domperidone Cautions
Not recommended during pregnancy or breastfeeding.
Gastric pathology.
Impaired hepatic or renal function.
With prolactinoma.

17. Other medications
Antispasmodics.
antiflatulents and carminatives.