Indigestion (dyspepsia) is not a fate sealed to evening takeaway or stress; it’s a symptom set that often shows up in otherwise fit people and—if misunderstood—can quietly sabotage training, sleep and recovery. Clinically it presents as pain or discomfort in the upper abdomen and sometimes as burning behind the breastbone (heartburn). Common companions are fullness, belching, bloating, nausea or regurgitation.
How indigestion happens (simple physiology)
There are two broad mechanisms. One is direct irritation: stomach acid contacts the protective lining of the stomach, duodenum or oesophagus—and causes irritation and inflammation. The other, and arguably more relevant in many people who train hard, is heightened sensitivity of the gut lining or altered stomach motility: the same volume or acidity that wouldn’t bother someone else produces pain, a sense of fullness or early satiety. Triggers commonly include meal composition, alcohol, caffeine, smoking, pregnancy, stress, and certain medications such as NSAIDs and nitrates. Obesity increases intra-abdominal pressure and the risk of reflux, which in turn can produce indigestion symptoms.
Why this matters for people who exercise
Exercise changes blood flow, gastric emptying and vagal tone—factors that can tip a sensitive gut into symptoms. High-intensity sessions immediately after a large meal commonly provoke nausea, reflux or cramping. Similarly, regular use of common analgesics (ibuprofen, aspirin) for training aches can irritate the stomach and contribute to dyspepsia. Adjusting timing, meal size and medication habits usually reduces episodes without compromising training.
Recognize the red flags—when indigestion is not “just” indigestion
Most indigestion is benign, but certain signs demand prompt clinical review: new, persistent symptoms in adults aged 55 or older; unexplained weight loss; difficulty swallowing; persistent vomiting; signs of bleeding (blood in vomit or dark/black stools); iron deficiency anaemia; or a palpable mass. These features may indicate an underlying problem—ulceration, significant reflux disease (GORD), or, rarely, cancer—and usually trigger referral for endoscopy or imaging.
How clinicians investigate
Initial assessment is clinical: history, medication review, and a physical exam. If clinicians suspect H. pylori infection they’ll test (breath, stool antigen, or blood antibody tests) and treat if positive. Endoscopy is reserved for persistent symptoms, alarm features, or when tissue diagnosis is needed; doctors often advise stopping PPIs for a period before certain tests because acid-suppressing drugs can affect results. Blood tests, imaging and targeted organ tests (e.g., liver function tests) may be ordered depending on the picture.
Treatment principles a fitness person can act on
Treatment starts with targeted, practical changes rather than immediately escalating drugs. Clinicians and guideline sources consistently recommend: adjust diet (avoid large, fatty, acidic or spicy meals close to training), reduce alcohol and caffeinated/carbonated drinks around workouts, avoid late heavy meals before sleep, stop smoking, and keep a healthy weight; regular exercise and weight control also help reduce reflux-related symptoms. If medications are implicated, review alternatives with a clinician. When H. pylori is present, eradication with antibiotics plus acid suppression helps. If symptoms persist, short-term acid suppression (H2 blockers or proton pump inhibitors) or prokinetics may be used under medical supervision.
Note: some people find symptomatic relief with selected complementary approaches (peppermint/caraway oil combinations, mind–body practices such as yoga or CBT for stress-related symptoms), but these should be discussed with your clinician—especially if you’re on other medications.
Practical, workout-ready tactics
Make these adjustments non-negotiable when symptoms appear: shorten the gap between heavy meals and intense training (aim 2–3 hours after a large meal), reduce meal fat and portion size before sessions, avoid concentrated carbohydrate or acidic sports drinks if they trigger reflux, and reappraise routine NSAID use—use alternatives for pain relief where appropriate. If symptoms are triggered by long-duration workouts, experiment with smaller, staggered feeds and avoid lying down immediately post-exercise. These are not experimental hacks—these are risk-reduction strategies grounded in clinical guidance.
When to see a clinician and what to expect
If symptoms are frequent, worsening, or accompanied by any red-flag sign, see a GP or gastroenterologist. Expect a focused history (diet, training, medications, stressors), possible testing for H. pylori, and stepwise management: lifestyle changes first, then targeted medicines, then investigation (endoscopy or imaging) if symptoms persist or alarms are present. Pharmacologic choices depend on suspected mechanism—antacids for quick relief, H2-blockers or PPIs to reduce acid, prokinetics if motility is an issue, and antibiotics if H. pylori is confirmed.
For professionals juggling training and life: track your symptoms (what you ate, timing relative to training, meds used), be honest about alcohol/tobacco, and don’t self-prescribe long-term PPIs without a clear plan—these drugs are useful but not a substitute for resolving the underlying contributors.
Indigestion is common and often manageable without major disruption to training, but it rewards the same practical discipline you use in the gym: adjust inputs (food, alcohol, timing), audit medication use, respect warning signs, and treat recovery (sleep, stress control) as part of the strategy. When basic steps fail or red flags appear, use the clinical pathway—testing for H. pylori, targeted medicines, and endoscopy when indicated—to move from symptoms to solution. Short-term discomfort needn’t become a chronic limiter if you tackle it with the same rigour you apply to performance: measure, modify, and escalate appropriately.
