Functional Dyspepsia
What are the symptoms of Functional Dyspepsia?
- Upset stomach
- Discomfort or pain in the belly
- Bloating
- Feeling full quickly when eating
- Nausea, vomiting
- Lack of appetite
Sometimes, even weight loss.
When to seek help?
●Vomiting that will not stop or Blood in vomiting
●If you are losing weight or have no appetite
●Bloody or dark-colored, tarry bowel movements
●Pain or difficulty with swallowing
Causes of Dyspepsia
It is usually not clear what causes functional dyspepsia and this can be multifactorial as follows:
Motor or nerve problems — Digestion of food is a process involving the nerves and muscles of the digestive tract. Problems in this system can cause the stomach to empty more slowly than normal, causing nausea and vomiting, feeling full quickly when eating, or bloating. However, not everyone whose stomach empties slowly has functional dyspepsia.
Pain sensitivity — The stomach normally stretches as we eat to hold more food. However, some people may be sensitive to this stretching and feel pain. It is not clear why this happens.
Infection — Helicobacter pylori (H. pylori) is a bacterial infection of the stomach that can lead to inflammation (gastritis) or ulcers. There may be a relationship between infection with H. pylori and functional dyspepsia. However, not all people with H. pylori have functional dyspepsia.
Functional dyspepsia occasionally begins with acute gastroenteritis, usually due to a bacterial or viral infection. Dyspepsia can persist long after the infection subsides, perhaps caused by a change in the bacteria that normally live in the gastrointestinal tract.
Psychological and social factors — People with functional dyspepsia often have mood problems, like anxiety or depression. Treating the underlying depression or anxiety can improve symptoms of abdominal pain.
How to assess a patient with dyspepsia ?
To help determine if you might have a cause of symptoms different from functional dyspepsia, your doctors will ask questions and do a physical examination. Some of the routine of es are as follows :
●Is the pain "gnawing" or worse when you are hungry?
●Is the pain worse when you move in certain ways or press on certain areas of the abdomen?
●Do you take any pain killers ? Do you have a history of stomach ulcers?
●Do you also have heartburn (burning sensation in the area behind breast bone/sternum ?
●Do you have intense pain in the upper right or middle of the tummy? Does the pain shoot into your back or between the shoulder blades? Does this happen periodically, along with vomiting, sweating, or feeling restless?
●Have there been changes in your bowel movements (new constipation or diarrhea)?
●Have you recently unintentionally lost weight, vomited repeatedly, or had difficulty in swallowing?
●Do you have a family history of stomach cancer?
Investigations:
If a patient is 40 years or older or have serious symptoms, such as repeated vomiting, weight loss, or difficulty swallowing, you might need an upper endoscopy procedure. This is a test that allows an endoscopist look at the insides of a patient's esophagus, stomach, and upper intestine. However, most patients are offered medical treatment in the first instance. In Indian scenario where over the counter drugs are rampant it is prudent to recommend the test for serious symptoms earlier rather than later. If the symptoms do not get better within four to eight weeks or if they get worse, the endoscopist or Gastroenterologist might recommend further tests.
What is the treatment of Functional Dyspepsia?
Diagnosis of functional dyspepsia can be a relief to some and frustration to others. It is important to understand that your pain is not in your head and the treatment may involve a multipronged approach. In general dealing with emotional issues can hhelp one feel better, both physically and mentally.
Some people feel less pain after making changes in their diet.
●Avoiding fatty foods
●Eating small, more frequent meals.
●Avoiding foods that make you feel worse.
●Avoiding alcohol and tobacco.
If you have questions about what you should eat, talk to a GI specialist or a dietitian.
Some people feel better after taking a medicine that reduces stomach acid. Examples include:
●Proton pump inhibitors (PPIs) are more likely than other types of acid reducers to improve pain.
●Histamine blockers might help some people.
●Antacids are not usually helpful for people with functional dyspepsia.
If diagnosed with H. pylori (a bacteria that can be present in the stomach, treating the H. pylori may help to reduce symptoms but if there is an ulcer in the stomach or duodenum then the bacteria has to be treated aggressively.
Low doses of an antidepressant medicine might help to reduce symptoms, even if one is not depressed. One of the most commonly used antidepressants is called a tricyclic antidepressant (TCA). It is not clear how TCAs work, but they seem to improve pain when taken at low doses. The dose of TCAs used to treat pain is usually much lower than that used to treat depression.
TCAs commonly used for pain include Amitryptyline and these are generally started in low doses and increased gradually. It can take a few weeks to begin feeling better.
Medicines like Aspirin, Ibuprofen, Naproxen etc. are not helpful and can actually worsen the problem
eg. peppermint oil tablets.
Available at:
(with prior appointment please)