Functional dyspepsia, also known as nonulcer dyspepsia, refers to recurring symptoms of an upset stomach without a clear cause.
It's a common condition characterized by persistent symptoms, though they may not occur all the time. These symptoms are similar to those of an ulcer and may include pain or discomfort in the upper abdomen, bloating, belching, and nausea. Let’s find out all about Functional dyspepsia!
What is Functional Dyspepsia?
Functional dyspepsia is a term for ongoing indigestion that can't be linked to a specific physical cause. People with chronic indigestion often experience stomach pain, bloating, and feeling overly full before or after eating.
They may also have symptoms like acid reflux, heartburn, and excessive burping. While these symptoms resemble those of peptic ulcer disease, only about one-third of people with chronic indigestion have an ulcer. The remaining two-thirds are diagnosed with functional dyspepsia.
A "functional" disorder means a problem with how your body works, but doctors can't find a clear physical reason for it. Even though the symptoms are real and observable, there's no identifiable mechanical issue causing them.
Many gastrointestinal conditions fall into this category. Doctors don't always understand why these conditions happen, but they suspect that the brain and nerves may play a role.
- If you frequently experience indigestion symptoms, healthcare providers will check for any problems in your gastrointestinal tract, such as ulcers or structural issues.
- If they can't find anything wrong, they'll diagnose your condition as functional dyspepsia (FD). Sometimes FD is also called nervous dyspepsia, non-ulcer dyspepsia, or pseudo-ulcer syndrome.
Types Of Functional Dyspepsia
Certain healthcare experts categorize symptoms of functional dyspepsia into two groups:
- Epigastric pain syndrome (EPS): This type includes symptoms related to upper abdominal pain and burning sensation.
- Postprandial distress syndrome (PDS): This type encompasses symptoms that occur after eating, such as early fullness, bloating, and nausea.
While not all individuals experience symptoms that fit neatly into these categories, identifying symptoms within these classifications can aid healthcare specialists in focusing on treating them as a cohesive group.
Symptoms Of Functional Dyspepsia
- Sporadic nature: Symptoms come and go without clear reasons, and it's difficult to identify specific triggers.
- Chronicity: Functional dyspepsia persists over a long period but may disappear temporarily and return unexpectedly.
- Diagnostic criteria: To be diagnosed, symptoms must have occurred within the last three months and persisted for at least six months.
Common symptoms include:
- Epigastric pain: Pain in the upper abdomen beneath the rib cage, where the stomach, small intestine, pancreas, and liver are located.
- Bloated stomach: Feeling of uncomfortable pressure or fullness in the belly, particularly after eating.
- Early satiety or loss of appetite: Feeling full quickly during or after eating.
- Heartburn: Burning pain between the stomach and esophagus, often due to acid reflux.
- Acid reflux: Stomach acid flowing back up through the esophagus, causing a burning sensation and sometimes a sour taste in the mouth.
- Nausea and vomiting: Severe cases may progress from fullness and loss of appetite to actual feelings of nausea or vomiting.
What Causes Functional Dyspepsia?
The term "indigestion" suggests that something isn't quite right with your digestion, but pinpointing the exact cause can be tricky. While doctors don't have all the answers, they have some theories:
1. Impaired stomach function
In some individuals, the stomach may struggle to relax and expand properly to accommodate food, leading to a constant feeling of fullness. Additionally, signals prompting the stomach to empty into the small intestine may be disrupted, causing food to linger too long and allowing gas and bacteria to accumulate.
2. Food allergies
Undiagnosed food allergies could trigger inflammation in the gut, leading to symptoms like nausea, gas, and bloating. Some people with functional dyspepsia report sensitivities to certain foods, particularly wheat, which may exacerbate symptoms.
3. H. pylori infection
This common bacterial infection can cause chronic inflammation in the stomach lining and erode the protective mucous layer. Treating H. pylori infection has been shown to improve symptoms in some individuals with functional dyspepsia.
4. Visceral hypersensitivity
Some individuals have an oversensitive nervous system, which can lead to physical reactions to stress and emotions, such as tightening of the digestive organs. These individuals may also experience visceral hypersensitivity, where the normal movements of the digestive organs feel exaggerated or uncomfortable.
What Risk Factors Contribute to Functional Dyspepsia?
Risk factors for functional dyspepsia:
-Being female.
-Regular use of certain over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others), which can irritate the stomach lining.
-Smoking.
-Anxiety or depression.
-History of childhood physical or sexual abuse.
-Helicobacter pylori infection.
How Is Functional Dyspepsia Treated?
If you've been diagnosed with a bacterial infection, antibiotics will be prescribed as the first line of treatment. However, if functional dyspepsia persists and no other direct cause is identified, treatment focuses on managing symptoms. This process involves some trial and error.
Treatment options may include:
1. Acid reduction
Your healthcare provider may prescribe medications to temporarily suppress or neutralize stomach acid. This helps the stomach lining to heal and reduces symptoms of acid reflux. Commonly prescribed medications include proton pump inhibitors (PPIs) and H2 receptor blockers.
These medications are typically used for a short period and then reevaluated. Over-the-counter antacids may also be used to manage symptoms, but it's important to consult your healthcare provider if you're using them regularly for an extended period.
2. Prokinetic agents
These drugs help improve the movement of food through your digestive system. They encourage the stomach to empty food into the small intestine efficiently, reducing the risk of food or fluids refluxing back into the esophagus.
3. Phytotherapy
Certain herbal preparations, especially combinations of different plant extracts, have shown promise in alleviating symptoms. For example, a combination of peppermint and caraway oil can stimulate motility while calming the digestive system. Another commercial compound called Iberogast® contains nine different ingredients and has shown effectiveness in clinical trials.
4. Low-dose antidepressants
Tricyclic antidepressants (TCAs) given in lower doses than usual for depression treatment can help some individuals manage symptoms related to the nervous system. These medications may help reduce pain perception, discomfort, and psychological triggers, while also promoting relaxation of the stomach during digestion.
It's important to note that while these medications may target specific factors contributing to symptoms, functional dyspepsia is often complex, and medications have only a moderate success rate in treating it.
Other therapies that some people use to manage symptoms include:
- Acupuncture: While results vary, some studies and individuals report improvement after consistent acupuncture treatments over several weeks.
- Behavioral therapy: Mind-body techniques such as relaxation techniques, biofeedback, and psychotherapy may help regulate the nervous system and digestive system.
- Natural Remedies: Using natural ingredients such as turmeric, licorice root, or aloe vera is very beneficial for the stomach and helps alleviate indigestion. These components are combined in Cumargold.
- Diet changes: While diet alone may not be a major factor in functional dyspepsia, identifying and avoiding trigger foods can be beneficial. Keeping a food journal or trying an elimination diet can help identify problem foods. Eating smaller meals and chewing thoroughly can also aid digestion.
- Lifestyle changes: Losing weight, increasing physical activity, ensuring adequate sleep, and reducing stress can improve digestive symptoms for some individuals.
When to See a Doctor
Make an appointment with your healthcare provider if you experience persistent symptoms that concern you.
Seek medical attention immediately if you experience:
- Bloody vomit.
- Dark or tarry stools.
- Shortness of breath.
- Pain in your jaw, neck, or arm.
- Unexplained weight loss.
