Most of the time indigestion is not a sign of cancer but your father should see his GP for a check up.

Cancers that cause indigestion tend to be rare in young people and commoner in older people. So, the chance that indigestion could be caused by a cancer increases with age.

Guidelines

In England and Wales, the National Institute for Clinical Excellence (NICE) has issued guidance to GPs. This suggests that

'an urgent referral for endoscopy should be made in patients aged 55 years and older with unexplained and persistent indigestion that started recently'.

An urgent appointment usually means you will be seen within two weeks.

They also say that an urgent referral to a specialist team or for endoscopy should be arranged for someone of any age with indigestion and any one of the following symptoms:

• weight loss
• persistent blood loss from the gut (this might show up as a type of anaemia called iron deficiency anaemia)
• more than one episode of vomiting
• difficulty swallowing.

In Scotland, SIGN (the Scottish equivalent of NICE) have produced different guidelines for indigestion. They say that people under 55 years of age with indigestion and no other symptoms should first be tested and treated for H pylori infection. Only if indigestion comes back after treatment should a referral for assessment be considered.

The SIGN guidelines also say that anyone with indigestion and any of the following symptoms should be referred for an urgent assessment or for endoscopy:

• difficulty swallowing
• more than one episode of vomiting
• loss of appetite
• weight loss
• bleeding from the gut (gullet, stomach or bowel).