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Functional Dyspepsia - Symptoms, Diagnosis and Treatment

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Functional Dyspepsia - Symptoms, Diagnosis and Treatment

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Indigestion caused by an unknown reason is called functional dyspepsia. Read the article to get an insight into functional dyspepsia.

Medically reviewed by

Dr. Jagdish Singh

Published At March 7, 2022
Reviewed AtMay 10, 2024

What Does Functional Dyspepsia Mean?

When a person frequently suffers from signs and symptoms of indigestion, such as abdominal pain, bloating, belching, for a month or more, and the doctor cannot determine the exact cause, it is called functional dyspepsia (FD). Dyspepsia means indigestion, and the term functional indicates that there is nothing wrong with the upper digestive system structurally, but still, symptoms appear. The signs and symptoms resemble a stomach ulcer, but there is no ulcer present. Therefore, FD is also called non-ulcer dyspepsia or non-ulcer stomach pain.

It is a common condition, and in most cases, it is long-lasting and affects quality of life. The symptoms caused by FD can be managed with the help of lifestyle modifications, medicines, and various therapies. Women who smoke and those who take non-steroidal anti-inflammatory drugs (NSAIDs) are more at risk of developing functional dyspepsia. An estimated 20 percent of the population worldwide is believed to have FD.

What Is the Prevalence of Functional Dyspepsia?

Functional dyspepsia is among the most prevalent functional disorders. It is estimated that 10 to 20 percent of individuals seeking healthcare for their symptoms may have functional dyspepsia. However, since many people never seek healthcare for their symptoms, the actual number of affected individuals could be much higher than reported.

Are There Distinct Subtypes of Functional Dyspepsia?

Some healthcare specialists categorize symptoms of functional dyspepsia into two main groups:

  • Epigastric Pain Syndrome (EPS): Includes symptoms related to upper abdominal pain and burning.

  • Postprandial Distress Syndrome (PDS): Includes symptoms after eating, such as early fullness, bloating, and nausea.

While not all symptoms fit neatly into these categories, when they do, it helps healthcare specialists focus on treating them more effectively.

What Are the Signs and Symptoms of Functional Dyspepsia?

Functional dyspepsia symptoms can vary from one person to another. The following are the most common symptoms experienced by people suffering from FD:

  1. Pain or burning sensation in the upper digestive tract (near the chest).

  2. Bloating.

  3. Early satiety (feeling full after eating a small meal).

  4. Nausea.

  5. Vomiting.

  6. Increased motility of the upper digestive tract.

  7. Heartburn.

  8. Belching or burping.

  9. Foul, metallic, or sour taste in the mouth.

  10. Unintentional weight loss.

  11. Depression due to prolonged symptoms.

What Causes Functional Dyspepsia?

As it is a functional disorder, no identifiable cause or specific disease results in FD symptoms. However, several factors have been identified that increase the risk of FD. The factors include:

  1. Age.

  2. Allergens (like pollens, mites, dust).

  3. Changes in gut microbiota.

  4. Infection (caused by viruses and bacteria).

  5. H. pylori infection (Helicobacter pylori).

  6. Stress and anxiety.

  7. Depression.

  8. Indiscriminate use of anti-inflammatory drugs (non-steroidal anti-inflammatory drugs).

  9. Increased gastric acid secretion.

  10. History of childhood abuse (physical or sexual).

  11. Inflammation of the upper gastric tract.

  12. Smoking.

  13. Digestion problems.

  14. Poor lifestyle management.

  15. Improper diet.

What Are the Risk Factors of Functional Dyspepsia?

Individuals may have a higher likelihood of experiencing functional dyspepsia if the person:

  • Have a history of anxiety or depression.

  • Have a history of abuse.

  • Have a history of H. pylori infection.

  • Use NSAIDs.

  • Smoke or use tobacco products.

  • Are assigned female at birth.

How Is Functional Dyspepsia Diagnosed?

The doctor will first conduct a physical examination based on the signs and symptoms. To rule out other disorders that can result in similar symptoms, the doctor will suggest to get all or some of the following tests:

  • Blood Tests - These help rule out other diseases that can cause similar signs and symptoms.

  • Helicobacter Pylori Tests - The doctor will perform a blood test, breath test, or stool test to look for the bacterium Helicobacter pylori (H. pylori), which commonly causes stomach problems.

  • Endoscopy - A flexible scope is used to examine the digestive tract. An endoscope, a tube-like lighted instrument, is passed into the esophagus, stomach, and small intestine through the throat. With the help of the camera attached at the end of the endoscope, the doctor will look for inflammation, growth, or ulcer in the digestive tract.

  • Biopsy - While performing an endoscopy, the doctor might collect a small sample of the gastrointestinal lining to examine under the microscope.

If the person has lost a lot of weight, is older than 60 years, has a family history of gastric cancer, or has blood in the vomit or stool, the doctor will run some more tests.

Provisional Diagnosis:

Other conditions that can result in upper gastrointestinal symptoms are:

  1. Gastroesophageal Reflux Disease (GERD) - A condition where food, fluids, and digestive juices flow back into the esophagus from the stomach.

  2. Peptic Ulcer Disease (PUD) - An open sore in the stomach's inner lining.

  3. Irritable Bowel Syndrome (IBS) - A disorder of the large intestine that results in bloating, gas, abdominal cramps, and pain.

  4. Gastrointestinal Cancer - An abnormal and uncontrolled growth of cells anywhere in the digestive tract.

  5. Gastroparesis - A condition where the stomach is unable to empty the food normally.

What Are the Treatment Options for Functional Dyspepsia?

FD can become a chronic condition and affect the quality of life. The treatment options include:

Lifestyle Modifications:

Most symptoms of FD can be controlled by lifestyle modifications, such as:

  1. Acid secretion in an empty stomach can cause FD, so eat smaller and more frequent meals.

  2. Eat a fruit or something healthy when the person feels hungry.

  3. Never skip meals.

  4. Do not overeat or consume a large meal.

  5. Avoid caffeinated beverages, spicy or fatty foods, alcohol, or other food items that can trigger FD.

  6. Make sure the person chews their food properly.

  7. Bloating and flatulence can be reduced with the help of over-the-counter drugs that contain Simethicone.

  8. Sleep with the head elevated.

  9. Manage stress by participating in activities the person likes or doing relaxation therapy and yoga.

  10. If the person is overweight, try to lose weight.

Natural Remedies:

Peppermint tea, chamomile tea, apple cider vinegar, ginger, fennel seeds, lemon water, licorice root, etc., may relieve symptoms. It can interact with any drug the person takes for other diseases or conditions, resulting in unwanted side effects. Always consult the doctor before taking herbal or natural supplements.

Medications:

  • H-2-Receptor Blockers - These medicines reduce the production of acid in the stomach. Examples include Cimetidine and Famotidine.

  • Proton Pump Inhibitors - The drugs in this group block the acid-secreting cells in the stomach. The examples are Omeprazole and Lansoprazole.

  • Prokinetic Agents - They help strengthen the valve between the stomach and the esophagus (esophageal sphincter), reducing the upper abdominal symptoms. They also increase the rate of stomach emptying. The drugs Cisapride and Metoclopramide belong to this group.

  • Antidepressants - Antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), are prescribed for FD in low doses. They control intestinal pain by inhibiting the activity of neurons in the brain.

  • Antibiotics - The doctor will prescribe antibiotics if the tests show that they are infected with the H. pylori bacteria.

Conclusion:

While functional dyspepsia presents a significant challenge in clinical practice, recent advancements in the understanding of its pathophysiology and novel treatment approaches offer hope for improved management of this condition. By targeting symptom relief, addressing underlying physiological abnormalities, and implementing dietary and lifestyle modifications, healthcare providers can work towards alleviating symptoms and improving the quality of life for patients with functional dyspepsia

Frequently Asked Questions

1.

How to Treat Functional Dyspepsia?

The symptoms of functional dyspepsia can be managed with the help of certain medicines, which include the following-
- H2 receptor blockers.
- Proton pump inhibitors.
- Antibiotics.
- Low-dose antidepressants.
- Antiemetics.
- Prokinetics.

2.

Is Functional Dyspepsia a Serious Condition?

Functional dyspepsia is a common and constant condition, but the symptoms do not always occur. Although diagnosing this condition is difficult, the outlook is generally good. There has been no evidence to suggest that this condition progresses into a serious condition.

3.

How Long Does Functional Dyspepsia Last?

Functional dyspepsia is a term used to describe recurrent upset stomach symptoms without any obvious cause. It is a common disorder that usually persists lifelong. Although chronic, the symptoms may disappear for a while and then recur for unknown reasons.

4.

Is Functional Dyspepsia a Mental Illness?

Patients with functional dyspepsia have been found to have associated psychiatric complications. The most common comorbidities include depression, anxiety, and somatoform disorders. The findings of a clinical study showed 87 percent of functional dyspepsia patients had a psychiatric diagnosis.

5.

How Does Functional Dyspepsia Develop?

There is no definite cause of functional dyspepsia. However, it has been considered a functional disorder by healthcare providers. This means a medical condition cannot explain it, so routine testing may not reveal any causes or problems. This results in the diagnosis being done based on symptoms.

6.

Is It Possible to Recover From Functional Dyspepsia?

Unfortunately, functional dyspepsia cannot be cured completely. However, the symptoms can be managed successfully through medications, lifestyle changes, or a combination of the two. Lifestyle changes may include the reduction, management, and removal of any causes of ongoing anxiety and stress. 

7.

What Foods Cause Functional Dyspepsia?

The following food items may trigger functional dyspepsia-
- Onions and peppers.
- Fried and fatty foods.
- Citrus fruits.
- Alcohol.
- Spicy foods.

8.

Which Home Remedy Is Best for Dyspepsia?

Dyspepsia can often be helped with a few lifestyle changes that include-
- Maintaining a healthy weight.
- Eating small and more frequent meals.
- Avoiding any triggers.
- Exercising regularly.
- Changing the medications.
- Managing stress.

9.

Which Food Helps With Dyspepsia?

The following foods can be helpful in managing the symptoms of dyspepsia-
- Chamomile tea.
- Peppermint tea.
- Apple cider vinegar.
- Fennel seed.
- Ginger.
- Lemon water.
- Baking soda.
- Licorice root.

10.

When Is an Endoscopy Required for Dyspepsia?

When diagnosing a dyspeptic patient, an endoscopy is the first test that should be done. In order to determine whether the patient has organic or functional dyspepsia, an endoscopic examination is necessary.

11.

Can Stress and Anxiety Cause Dyspepsia?

Dyspepsia and depression, anxiety, and stress (DAS) have been linked. Non-ulcer dyspepsia, which is defined as dyspepsia in which endoscopy excludes peptic ulcer, oesophagitis, and cancer, is said to be primarily caused by stress. Postprandial distress syndrome and functional dyspepsia have been linked to major anxiety.

12.

What Does Dyspepsia Pain Feel Like?

Dyspepsia is a discomfort in the upper part of the abdomen. It feels like a burning sensation and an early feeling of fullness in the stomach. The feeling of stomach fullness is also called satiety. The other symptoms include bloating, nausea, and excessive belching.
Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology

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