Functional dyspepsia is a disorder characterized by discomfort in the upper part of the abdomen, often chronic and persistent, or with a tendency to subside and then recur. It is a common problem affecting between 7-25% of the population in developed countries.

Causes of Symptom Variability

The variability in symptoms can be attributed to several factors, some of which have been identified and diagnosed. The most significant include:

Dysfunction in the stomach’s mechanical and motility functions, particularly delays in the emptying process.

Disruption in the stomach’s adaptation mechanism to incoming food.

Increased sensitivity of the stomach in relation to the transmission of pain sensations.

Infection and inflammation caused by Helicobacter pylori.

Psychological factors, such as a tendency toward depression or anxiety, can exacerbate symptoms and the perception of illness.

Symptoms of Functional Dyspepsia

There is considerable variability in the presentation of functional dyspepsia symptoms, which may appear simultaneously or as distinct symptoms at different times. Symptoms may range from mild, having minimal impact on daily life, to severe, significantly affecting quality of life and daily functioning. Common symptoms include:

Pain and discomfort.

Bloating.

Early satiety and fullness.

Belching.

Heartburn.

Nausea and vomiting.

Nausea after meals.

Early feeling of fullness when eating.

Abdominal pain, sometimes unrelated to meals or may subside after eating.

Causes and Risk Factors of Functional Dyspepsia

The exact cause of functional dyspepsia remains unclear, as it is considered a functional disorder. This means that routine tests may not reveal any abnormalities, and the diagnosis is primarily based on symptoms. Major risk factors include:

Female gender.

Use of over-the-counter pain medications.

Smoking.

Anxiety or depression.

History of physical or sexual abuse in childhood.

Helicobacter pylori infection.

Complications of Functional Dyspepsia

Potential complications include:

Esophageal Stricture: Chronic acid exposure can lead to scarring in the upper gastrointestinal tract, narrowing the esophagus and causing difficulty swallowing and chest pain.

Peritonitis: Over time, stomach acid can erode the lining of the gastrointestinal tract, potentially leading to an infection known as peritonitis.

Diagnosis of Functional Dyspepsia

Diagnosis involves several approaches:

Blood Tests: These help exclude other conditions that might cause symptoms similar to functional dyspepsia.

Tests for Bacteria: Your doctor may recommend tests for Helicobacter pylori, a bacterium that can cause stomach problems. The test may involve blood, stool, or breath samples.

Endoscopy: A thin, flexible, lighted tube is passed through your throat to allow the doctor to view the esophagus, stomach, and part of the small intestine. This procedure can also help in obtaining tissue samples for inflammation testing.

Treatment of Functional Dyspepsia

Treatment strategies include:

Medications to Reduce Acid Production.

Proton Pump Inhibitors (PPIs): These are effective in reducing stomach acid production.

Antibiotics: If Helicobacter pylori is present, your doctor may prescribe antibiotics along with acid-suppressing medications.

Low-Dose Antidepressants: Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) in low doses may help modulate the nerve activity that controls abdominal pain.

Anti-Nausea Medications: If nausea is present after meals, antiemetics may be prescribed.

Prevention of Functional Dyspepsia

Preventive measures include:

Eating smaller meals to reduce the stomach's workload.

Eating slowly.

Avoiding foods high in acids.

Reducing or avoiding caffeine-containing foods and beverages.

Learning new methods to manage stress.

Quitting smoking, as it can irritate the stomach lining.

Reducing alcohol intake, which can irritate the stomach.

Avoiding tight clothing, as it may pressure the stomach and cause acid reflux.

Not lying down immediately after eating.

Waiting at least three hours after eating before going to bed.

Sleeping with your head elevated, using pillows for support.