Functional Dyspepsia - Symptoms, Diagnosis and Treatment

What Does Functional Dyspepsia Mean?

When a person frequently suffers from signs and symptoms of indigestion, such as abdominal pain, bloating, belching, etc., 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, it is long-lasting and affects the quality of life. The symptoms caused by FD can be managed with the help of lifestyle modifications, medicines, and various therapies. Women, people who smoke, and those who take non-steroidal anti-inflammatory drugs (NSAIDs) are more at risk of developing functional dyspepsia. An estimated 20% of the population worldwide is believed to have FD.

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.

To be diagnosed with FD, you should have some of these symptoms for a month or more.

When to Consult a Doctor?

Consult a doctor immediately in case you experience:

• Blood in vomit.

• Blood in stools (tarry stools).

• Dyspnea (shortness of breath).

• Unintentional weight loss.

• Chest pain radiating to the jaw, arm, or neck.

What Causes Functional Dyspepsia?

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

1. Older age.

2. Allergens.

3. Changes in the normal gut flora.

4. Infection.

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. Females.

14. Digestion problems.

15. A faulty lifestyle.

16. Diet.

How Is Functional Dyspepsia Diagnosed?

The doctor will first conduct a physical examination based on your signs and symptoms. To rule out other disorders that can result in similar symptoms, the doctor will suggest you 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 your esophagus, stomach, and small intestine through your 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 you have lost a lot of weight, are older than 60 years, have a family history of gastric cancer, or had 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 frequent meals.

2. Eat a fruit or something healthy when you feel 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 you chew your food properly.

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

8. Sleep with your head elevated.

9. Manage stress by participating in activities you like or doing relaxation therapy and yoga.

10. If you are 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 you take for other diseases or conditions and result in unwanted side effects. Always consult your 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 - Your doctor will prescribe antibiotics if your tests show that you are infected with the H. pylori bacteria.

Conclusion:

Lifestyle modifications and medications can cure the symptoms of functional dyspepsia. If you are suffering from functional dyspepsia, consult a gastroenterologist online and get the support you need to manage this condition.