Dyspepsia
Dyspepsia is sometimes called indigestion and can have many symptoms, such as discomfort and pain in the upper abdomen (body trunk), a feeling of uncomfortable fullness soon after eating, bloating, flatulence, belching, and regurgitation of food or acid. Dyspepsia is often used to describe these symptoms when the cause is not clear. It is different from gastroesophageal reflux disease (GERD) because heartburn is not a major symptom of dyspepsia and it does not usually involve movement of stomach contents backwards into the swallowing pipe (esophagus).
How do you get Dyspepsia?
Dyspepsia is experienced by up to 1 in 10 people and is quite common. It has many possible causes, some of which are more easily detected than others.
- Persistent pain in the upper abdomen that lasts for more than 4 weeks is a good indication of dyspepsia.
- Dyspepsia may be due to peptic ulcer disease (an ulcer or hole in the stomach or top part of the small bowel near the stomach (duodenum)), when the main symptom is pain. The presence of infection with a bacterium called Helicobacter pylori needs to be ruled out because this is a major cause for peptic ulcer disease. Dyspepsia due to peptic ulcer accounts for up to 25% of cases.
- If bloating or feeling of fullness is the main problem this is probably due to problems with abnormal movement of stomach contents.
- Some people may have symptoms like heartburn when acidic stomach contents move backwards into the swallowing pipe (reflux).
This may or may not be due to dyspepsia and needs f urther investigation to identify the cause. Up to 15% of people with dyspepsia may actually have gastroesophageal reflux disease (GERD). - Cancer of the stomach is extremely rare in people with dyspepsia.
- For most people there is no identifiable cause of their dyspepsia, though for some, the use of medicines like aspirin can cause similar pain, in which case they should be avoided.
How serious is Dyspepsia?
Dyspepsia in most cases is not a serious condition but it does lead to much discomfort and it affects feelings of wellbeing. If it persists, it should be checked out to make sure there are no serious problems, which might need special treatment.
How long does Dyspepsia last?
Persistent pain lasts for 4 weeks or more, but dyspepsia comes and goes for months at a time. Many people therefore don't seek medical advice and tend to use over-the-counter medicines, like antacids, rather than seek the benefit of other medicines from the doctor.
How is Dyspepsia treated?
Some people can help to avoid dyspepsia by identifying and avoiding foods that disagree with them, by not eating too quickly and by avoiding stress where possible.
Other people need medicines to control their condition. If Helicobacter pylori infection is detected, this can be treated with additional antibiotics.
Other people need medicines to control their condition. If Helicobacter pylori infection is detected, this can be treated with additional antibiotics.
Medicines to treat dyspepsia include:
- Antacids, which work by neutralising some of the acid in the stomach.
- Acids suppressants, which reduce the amount of acid produced by the stomach. These include:
- Histamine2- receptor antagonists that block the action of histamine, which is a chemical that acts as a signal for stomach cells to make acid.
- Proton pump inhibitors that work on cells in the stomach wall to switch off the release of acid into the stomach.
- Prokinetic agents, which increase stomach movement to improve emptying.
If one or more medicines are tried and do not work then the doctor may perform an endoscopy. This involves passing a tube, containing a special camera, into the stomach to see if there are any abnormalities.
Helicobacter pylori needs to be ruled out because this is a major cause for peptic ulcer disease. Dyspepsia due to peptic ulcer accounts for up to 25% of cases.
Helicobacter pylori needs to be ruled out because this is a major cause for peptic ulcer disease. Dyspepsia due to peptic ulcer accounts for up to 25% of cases.
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