Functional dyspepsia is a type of ongoing indigestion characterized by stomach discomfort, fullness, or bloating, particularly during or after meals. It's diagnosed when no clear cause for these symptoms can be identified. Treatment for functional dyspepsia varies, and what works for one person may not work for another. Learn more about Functional dyspepsia.
What is Functional Dyspepsia?
Functional dyspepsia, also known as chronic indigestion, is characterized by recurring stomach discomfort, bloating, and feelings of fullness during and after meals. Symptoms may include acid reflux, heartburn, and excessive burping. While these symptoms resemble those of peptic ulcer disease, only a third of individuals with chronic indigestion have an ulcer; the remaining two-thirds have functional dyspepsia.
A functional disorder refers to ongoing issues with bodily functions that cannot be explained by physical causes. Although symptoms are present and observable, there is no identifiable mechanical reason for them.
Gastrointestinal diseases often fall under the category of "functional" rather than structural, as their underlying causes are not always well understood and may involve the brain and nerves.
If you experience frequent symptoms of indigestion, healthcare providers will typically conduct tests to rule out any structural issues in the gastrointestinal tract, such as ulcers. If no such abnormalities are found, the diagnosis may be functional dyspepsia (FD). Other terms used to describe FD include nervous dyspepsia, non-ulcer dyspepsia, or pseudo-ulcer syndrome.
Symptoms of Functional Dyspepsia
Functional dyspepsia symptoms are unpredictable, coming and going without clear triggers, and it's challenging to identify factors that alleviate or worsen them. Although the condition is chronic, meaning it persists over an extended period, symptoms may temporarily resolve only to reappear later without apparent cause. To receive a diagnosis, you must have experienced symptoms within the last three months consistently for at least six months.
You may also experience more than one of the following symptoms:
Epigastric pain: Discomfort in the upper abdomen beneath the rib cage. This area, known as the epigastrium, houses organs such as the stomach, small intestine, pancreas, and liver.
Bloating: Sensations of uncomfortable pressure or fullness in the abdomen, particularly after eating.
Early satiety or loss of appetite: Feeling full shortly after starting or during a meal.
Heartburn: A burning sensation in the area between the stomach and esophagus, typically caused by acid reflux.
Acid reflux: Stomach acid regurgitates into the esophagus, causing a burning sensation and sometimes a sour taste in the mouth.
Nausea and vomiting: In severe cases, feelings of fullness and loss of appetite may progress to actual nausea or vomiting.
Types of Functional Dyspepsia
Functional dyspepsia symptoms are sometimes categorized into two types by healthcare specialists:
Epigastric pain syndrome (EPS): This refers specifically to symptoms related to upper abdominal pain and burning sensations.
Postprandial distress syndrome (PDS): This category encompasses symptoms that occur after eating, such as early satiety, bloating, and nausea.
While not all individuals experience symptoms that fit neatly into these two categories, organizing symptoms in this way can assist healthcare specialists in targeting treatment strategies for groups of symptoms.
Causes of Functional Dyspepsia
Functional dyspepsia, often referred to as indigestion, occurs when something disrupts the normal functioning of your digestive system.
While the exact causes are not fully understood, healthcare experts have identified several factors that may contribute to this condition:
1. Impaired stomach function
Some individuals may have difficulties with stomach relaxation and expansion to accommodate food, leading to a constant feeling of fullness. Additionally, problems with the signals that prompt the stomach to empty its contents into the small intestine (known as gastroparesis) can cause food to linger too long, resulting in gas buildup and bacterial overgrowth.
2. Food allergies
Undiagnosed food allergies can trigger inflammation in the gut, causing symptoms such as nausea, gas, and bloating. Some people with functional dyspepsia report sensitivities to certain foods, particularly wheat, which may exacerbate their symptoms.
3. H. pylori infection
Helicobacter pylori, a common bacterial infection, can lead to chronic inflammation in the stomach (gastritis) and erosion of the protective mucous lining. Testing for H. pylori is often conducted when gastrointestinal symptoms are unexplained, as treatment for this infection can improve symptoms in some individuals.
4. Visceral hypersensitivity
Certain individuals may have heightened sensitivity in their nervous systems, causing physical responses to stress and emotional factors. This heightened sensitivity may result in excessive or uncomfortable sensations during the normal expansion and contraction of digestive organs.
Risk Factors for Functional Dyspepsia
Several factors may increase your likelihood of developing functional dyspepsia:
1. History of anxiety or depression
Individuals with a history of anxiety or depression may be more prone to experiencing symptoms of functional dyspepsia, as psychological factors can influence digestive health.
2. History of abuse
Past experiences of physical, emotional, or sexual abuse can contribute to the development of functional dyspepsia, possibly due to the lasting impact of trauma on the body and mind.
3. History of H. pylori infection
A previous infection with Helicobacter pylori, a bacterium that can cause stomach inflammation and ulcers, may increase the risk of developing functional dyspepsia.
4. Use of NSAIDs
Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen can irritate the stomach lining, leading to symptoms of dyspepsia.
5. Smoking or tobacco use
Tobacco products can irritate the stomach lining and increase stomach acid production, contributing to digestive discomfort and dyspeptic symptoms.
6. Assigned female at birth
Research suggests that individuals assigned female at birth may be more susceptible to functional dyspepsia, although the reasons for this association are not fully understood.
Source: The nutritional aspects of functional dyspepsia
Treating Functional Dyspepsia
If you've tested positive for a bacterial infection like H. pylori, you'll initially be treated with antibiotics to clear the infection. However, if functional dyspepsia persists without an identifiable cause, treatment focuses on managing symptoms. This process may involve trying different approaches to find what works best for you.
Treatment options include:
1. Acid reduction
Your healthcare provider may prescribe medications to reduce stomach acid levels temporarily. These medications, such as proton pump inhibitors (PPIs) and H2 receptor blockers, can help alleviate symptoms of acid reflux and allow your stomach lining to heal.
2. Prokinetic agents
These medications help improve the movement of food through your digestive system, reducing the likelihood of food lingering in the stomach or refluxing into the esophagus.
3. Phytotherapy
Herbal preparations containing multiple plant extracts, such as peppermint and caraway oil, have shown promise in alleviating symptoms by promoting digestive motility and calming the digestive system.
4. Low-dose antidepressants
Tricyclic antidepressants (TCAs) at lower doses may help manage symptoms by modulating pain perception and relaxing the stomach during digestion.
In addition to medication, other therapies and lifestyle changes may also be beneficial:
Acupuncture: While results vary, some individuals report symptom improvement after consistent acupuncture treatments.
Behavioral therapy: Techniques like relaxation, biofeedback, and psychotherapy can help regulate the nervous system and digestive function.
Diet changes: Identifying and avoiding trigger foods can help alleviate symptoms. Keeping a food journal or trying an elimination diet may be helpful. Eating smaller meals and chewing food thoroughly can also aid digestion.
Lifestyle modifications: Maintaining a healthy weight, engaging in regular exercise, getting enough sleep, and managing stress can contribute to symptom improvement.
Living With Functional Dyspepsia
Functional dyspepsia is complex and involves many factors like your brain, diet, and lifestyle. It's not always easy to manage, but you can play a big part in finding what works for you.
Pay attention to what makes your symptoms better or worse, and talk to your doctor about it. Together, you can try different treatments and lifestyle changes to see what helps.
While there's no one solution, experimenting with different things can help you find ways to live with functional dyspepsia and feel better. Just stay involved in your healthcare and listen to your body.
When to see your healthcare provider
Make an appointment with your healthcare provider if you have persistent worrying symptoms.
Seek immediate medical attention if you experience:
- Bloody vomit.
- Dark or tarry stools.
- Shortness of breath.
- Pain in your jaw, neck, or arm.
- Unexplained weight loss.
