The festive season is a season of joy, forgiveness and togetherness, when families reunite, and open houses bring people together over generous festive spreads. Across multiple open houses, traditional favourites such as rendang, lemang, kuah kacang and festive kuih are enjoyed over several consecutive days, often in larger portions than usual.

 

While festive feasting is central to the celebration, repeated heavy meals within short intervals can place significant strain on the upper digestive system. Dyspepsia, commonly known as indigestion, affects an estimated 15 to 25 per cent of Malaysians, making it one of the most common gastrointestinal complaints nationwide.

 

Understanding Dyspepsia

Dyspepsia refers to a group of upper gastrointestinal symptoms originating from the stomach or proximal small intestine. It may occur without any structural abnormality, known as functional dyspepsia, or alongside conditions such as gastritis, peptic ulcer disease or gastroesophageal reflux disease. Patients commonly experience upper abdominal bloating, early satiety, acid-related burning or discomfort in the upper abdomen, nausea and excessive belching.

 

According to Sunway Medical Centre Velocity (SMCV) Consultant Gastroenterologist and Hepatologist, Dr Deborah Chew Chia Hsin, these symptoms often stem from changes in how the stomach functions rather than visible structural damage.

 

“The stomach continuously produces acid to digest food. When gastric emptying slows, or when the stomach becomes overly sensitive to normal stretching after a meal, patients may experience discomfort even if scans or endoscopy show no visible abnormality,” she explains.

 

Festive periods frequently coincide with a rise in upper abdominal symptoms. “During festive seasons, we tend to see a noticeable uptick in patients experiencing gastric issues,” she says. “Many people attribute it to simple overeating, but symptoms that persist or recur may indicate an underlying condition that warrants evaluation.”

 

Certain individuals are more vulnerable to experiencing dyspepsia, particularly during festive periods. These include those with existing functional dyspepsia, gastritis or reflux disease. Patients with diabetes are also at higher risk due to delayed gastric emptying, while individuals with underlying anxiety may experience heightened perception of gastric discomfort. “When underlying sensitivity already exists, repeated heavy meals can amplify symptoms significantly,” Dr Deborah adds.

 

Why Festive Foods Trigger Indigestion?

The pattern of repeated heavy meals over a short period places cumulative strain on the stomach, especially when dishes are high in fat.
“Fat is one of the strongest physiological inhibitors of gastric emptying,” Dr Deborah explains. “Coconut milk-based dishes such as rendang prolong the time food remains in the stomach, leading to that bloated and overly full sensation.”

 

Large meal volumes further increase intragastric pressure as the stomach expands to accommodate food. When emptying is delayed, the sensation of fullness lasts longer than usual, resulting in persistent bloating and discomfort. The combination of high-fat intake and repeated portion loading makes it difficult for the stomach to fully recover between meals.

 

Sweet desserts and sugary beverages add to this digestive burden by increasing osmotic load, while carbonated drinks introduce excess gas that worsens distension. These dishes can also intensify discomfort, particularly for individuals with a sensitive stomach. Spicy foods contain compounds such as capsaicin, which activate receptors responsible for sensing heat and pain. In healthy individuals, small amounts of spice may not cause significant issues. However, for those with conditions such as functional dyspepsia, gastritis, acid reflux, or general visceral hypersensitivity, these receptors are more reactive.

 

“This heightened sensitivity means that even normal amounts of acid or stomach stretching may be perceived as pain, burning, or discomfort,” Dr Deborah notes. Importantly, spicy food does not usually damage the stomach lining, but it can amplify symptoms in those already prone to gastric sensitivity. During festive seasons, when spicy foods are combined with large, fatty meals, the overall gastric burden increases, which makes symptoms more noticeable.

 

Another common factor that worsens indigestion is remaining sedentary or lying down immediately after meals. “After a large festive meal, lying down can slow digestion and increase reflux of stomach contents into the oesophagus, which heightens burning, bloating, and discomfort,” Dr Deborah notes. It is recommended to wait at least 2 to 3 hours after eating before lying down or going to bed to allow the stomach to empty sufficiently.

 

“These effects are cumulative,” Dr Deborah adds. “One heavy meal may not cause significant discomfort, but repeated indulgence combined with poor post-meal habits over several days can overwhelm normal gastric function.”

 

 

 

Treatment and Management Methods

Although festive-related indigestion is often temporary, it is important to distinguish it from symptoms that require medical attention. Normal indigestion usually subsides within a few hours after a meal or with simple dietary adjustments. Persistent symptoms that last beyond 2–3 weeks, progressively worsen, or are accompanied by warning signs such as unexplained weight loss, anaemia, black stools, persistent vomiting, or progressive difficulty swallowing, warrant medical evaluation.

 

Dr Deborah explains that assessment begins with a clinical review and may involve blood tests, Helicobacter pylori testing (a type of blood test conducted to detect bacterial infections in the stomach and small intestine that cause ulcers, chronic gastritis, and stomach pain) and upper endoscopy where indicated.

 

In selected cases where symptoms remain unexplained despite routine investigations, doctors may recommend Endoscopic Ultrasound (EUS).

 

“Endoscopic Ultrasound, or EUS, essentially combines two technologies in one instrument,” explains Dr Deborah. “The first is endoscopy, where a flexible camera is passed through the mouth into the stomach and small intestine. The second is ultrasound, which uses sound waves to create detailed internal images. By bringing the ultrasound probe inside the digestive tract, we can obtain much clearer views of structures that lie deeper within or around the stomach.”

 

Because the ultrasound probe sits very close to nearby organs, EUS provides highly detailed imaging of the digestive tract and surrounding structures. This allows doctors to evaluate the layers of the stomach and intestinal wall, the pancreas, the bile ducts, the gallbladder, and the surrounding lymph nodes. The technique is particularly helpful in identifying submucosal or deeper lesions that may not be visible during a standard endoscopy.

 

 

According to Dr Deborah, EUS plays an important role in investigating a variety of conditions. “It is especially useful for evaluating pancreatic masses, assessing bile duct abnormalities, and investigating unexplained thickening in the stomach wall,” she says. “In addition, EUS allows us to perform fine needle biopsies with great precision, because the ultrasound imaging guides the needle directly to the area that needs to be sampled.”

 

Another key advantage of EUS is how it complements other diagnostic tests. Compared with conventional upper endoscopy, which mainly examines the inner lining of the digestive tract, EUS can visualise deeper tissue layers and structures outside the stomach wall. It also overcomes some of the limitations of external abdominal ultrasound, such as interference from abdominal fat, bowel gas, or the distance between the probe and internal organs.

 

“While CT scans and MRI remain important tools for evaluating abdominal conditions, EUS can provide higher-resolution images of small lesions and enables real-time needle biopsy when needed. This makes it particularly valuable for characterising small pancreatic abnormalities and other subtle findings that may require closer examination.” Dr Deborah added.

 

Because of its ability to deliver detailed imaging and guide targeted tissue sampling, EUS is often recommended when symptoms persist but routine investigations remain inconclusive. By providing a clearer view of deeper digestive structures, this advanced diagnostic technique helps doctors detect underlying conditions more accurately and determine the most appropriate next steps for patient care.

 

Once serious conditions are excluded, the treatment focuses on relieving symptoms and improving gastric function. Medications may be prescribed to reduce acid-related irritation or support gastric motility, depending on the patient’s presentation. Where an infection such as Helicobacter pylori is identified, targeted treatment is required. In most cases, however, symptoms improve with appropriate medical guidance and dietary adjustment.

 

Beyond medication, prevention remains the most effective strategy during festive periods. Dr Deborah advises practising portion control, pacing meals and allowing adequate time between heavy dishes. Probiotics may benefit selected individuals, particularly those prone to bloating, by supporting gut balance during sudden dietary changes. She also emphasises that while festive indulgence is part of the celebration, awareness and moderation are what sustain long-term digestive comfort: “Festive season is about connection, not overconsumption. Listen to your body. Moderation allows you to celebrate comfortably and avoid turning joy into discomfort.”

 

For enquiries, please contact +603 9772 9191 or email smcv-enquiry@sunway.com.my.

 

For more information or to learn more about Sunway Medical Centre Velocity, visit their website or Facebook: Sunway Medical Velocity.