Indigestion vs Heartburn vs Acid Reflux: What’s the Difference?
Four words that get used interchangeably — and shouldn’t be. What each one means, how the symptoms differ, and why it changes which treatment works.
Part of the Complete Acid Reflux Guide.
The 30-second answer: Indigestion (dyspepsia) is upper-abdominal discomfort after eating. Heartburn is a burning feeling rising behind the breastbone. Acid reflux is the mechanism — acid escaping upwards — that causes heartburn. GORD is the diagnosis when reflux becomes frequent or damaging.
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Order Treatment →The four terms, properly defined
Indigestion (dyspepsia)
A symptom cluster centred on the upper abdomen: discomfort or pain after eating, feeling full quickly, bloating, nausea, burping. A description of how you feel — not a diagnosis of why.
Heartburn
One specific symptom: a burning sensation rising from the stomach up behind the breastbone, often after meals or on lying down, sometimes with a sour taste.
Acid reflux
The mechanism: stomach contents washing back through the valve into the oesophagus. Reflux is the cause; heartburn is what it usually feels like.
GORD
The diagnosis: gastro-oesophageal reflux disease, made when reflux is frequent (typically 2+ times a week) or has inflamed the oesophagus. The point at which treatment shifts from rescue to prevention.
The chain runs: reflux (mechanism) → heartburn (symptom) → GORD (diagnosis when persistent), while indigestion sits alongside — overlapping, but centred lower and broader. Plenty of indigestion has nothing to do with acid reflux at all, which is exactly why the right remedy differs. For the diagnosis itself, see GORD explained.
Symptom comparison table
| Indigestion (dyspepsia) | Heartburn / reflux | |
|---|---|---|
| Where it’s felt | Upper abdomen, below the ribs | Behind the breastbone, rising towards the throat |
| What it feels like | Ache, fullness, bloating, nausea | Burning, sour taste, regurgitation |
| When | During or soon after meals | After meals, bending, lying down; often at night |
| Classic trigger | Large, rich or rushed meals | Fatty food, alcohol, coffee, late eating |
| First-line remedy | Antacid; smaller, slower meals | Alginate (Gaviscon); lifestyle measures |
| If frequent (2+/week) | Assessment; often a PPI trial | Daily PPI — the GORD pathway |
Why the distinction changes treatment
The pharmacy shelf makes more sense once the terms are straight. Antacids (Rennie, Tums) neutralise acid wherever it is — fine for general indigestion. Alginates (Gaviscon) add a physical raft on top of the stomach contents — specifically anti-reflux, so they suit heartburn better than plain dyspepsia. PPIs (omeprazole and relatives) switch off acid production for 24 hours at a time — the treatment for either symptom once it becomes frequent, and the NICE-recommended route for both GORD and persistent dyspepsia.
The frequency rule is the same on both sides: twice a week or more, week after week, means step up from episode treatment to daily prevention — and if a proper PPI course does not settle things, that is a signal for assessment, not a stronger antacid. For quick-relief tactics in the meantime, see how to get rid of heartburn fast.
When “indigestion” is something else
Because dyspepsia is a description rather than a diagnosis, its red flags matter more than its remedies. NICE guidance singles out new, persistent indigestion in anyone over 55 for direct referral, because stomach and oesophageal problems become more likely with age and early symptoms are indistinguishable from benign ones.
See a GP promptly if indigestion is new and persistent over 55, or at any age with: food sticking or pain when swallowing, unintentional weight loss, persistent vomiting, a lump or mass sensation, vomiting blood, or black tarry stools.
Chest pain caution: indigestion-like discomfort with breathlessness, sweating, nausea, or pain spreading to arm, neck or jaw can be a heart attack — call 999. Our guide to heart attack vs heartburn covers the differences in detail.
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Start Your Consultation →Frequently Asked Questions
Are indigestion and heartburn the same thing?
No — though the words get swapped constantly. Indigestion (dyspepsia) is discomfort centred in the upper abdomen: pain, fullness, bloating or nausea after eating. Heartburn is a specific burning sensation rising behind the breastbone, caused by acid refluxing into the oesophagus. You can have either without the other, or both together.
What is dyspepsia?
Dyspepsia is the medical term for indigestion — a cluster of upper-abdominal symptoms including discomfort or pain after meals, early fullness, bloating and nausea. It is a description rather than a diagnosis: causes range from simple overeating to reflux, ulcers or medication side effects, which is why persistent dyspepsia deserves assessment.
What's the difference between acid reflux and GORD?
Acid reflux is the event — stomach contents washing up into the oesophagus, which happens to almost everyone occasionally. GORD (gastro-oesophageal reflux disease) is the diagnosis given when reflux happens often enough (typically twice a week or more) or does enough damage to affect your life. Occasional reflux is normal; GORD needs treatment.
Which medicine should I take for indigestion?
Match the medicine to the symptom. General indigestion after a big meal: a simple antacid. Burning rising behind the breastbone: an alginate such as Gaviscon, which blocks reflux physically. Either symptom twice a week or more: a daily PPI such as omeprazole treats the cause rather than the episode. Persistent symptoms despite this: see a clinician rather than rotating remedies.
When is indigestion serious?
Most indigestion is benign, but see a GP promptly if you are over 55 with new indigestion that persists, or at any age if food sticks when swallowing, you are losing weight without trying, you keep vomiting, or your stools turn black. These need investigation, not another antacid.
Treatment from Access Doctor
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Acid Reflux · Rx
Omeprazole
The UK’s most prescribed PPI — once-daily, 24-hour acid suppression.
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Lansoprazole
A fast-acting alternative PPI, including an orodispersible option.
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Esomeprazole
A stronger option for severe or persistent reflux symptoms.
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Acid Reflux Treatment
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Start consultation →References
- National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management (CG184). 2019. nice.org.uk
- National Institute for Health and Care Excellence. Clinical Knowledge Summary: Dyspepsia — unidentified cause. 2023. cks.nice.org.uk
- National Institute for Health and Care Excellence. Suspected cancer: recognition and referral (NG12). 2023. nice.org.uk
- NHS. Indigestion. 2023. nhs.uk
- NHS. Heartburn and acid reflux. 2023. nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.