Functional Dyspepsia

Functional dyspepsia is a term that can be classified as a “non-ulcer dyspepsia” or “Indigestion” but possess similar symptoms which are mostly intermittent with ulcer pain.

Functional dyspepsia indicates signs and symptoms associated with the upper digestive tract consisting of the esophagus, small intestine, and stomach. 

Functional dyspepsia can also be called “Pyloro-duodenal Irritability“, “Nervous dyspepsia“, “Pseudo-ulcer syndrome” or “Gastritis“. 

Functional dyspepsia can be categorized into two syndromes are the epigastric pain syndrome that involves stomach pain and discomfort, and postprandial distress syndrome that involves the capacity of the stomach when eating and ingestion.

The meaning of dyspepsia is a pathological disorder involving indigestion that results in pains in the stomach alongside nauseous feeling and possible heartburn. Functional dyspepsia is said to be common and persistent. Therefore, it is said to be functional due to the inability to determine the cause and describe the symptoms involved.

This chronic disorder does not have any specific cause regardless of the fact the signs and symptoms can be mistaken for an ulcer due to the discomfort and stomach ache associated with excess belching and bloating. 

A term described as “Peristalsis” influences functional dyspepsia as it affects the sensibility and mobility in the digestive tract. The peristalsis involves pumping and contracting the upper digestive tract when eating.

The female gender is more susceptible to functional dyspepsia or patients that smoke and take non-steroidal anti-inflammatory drugs (NSAIDs). 

Multiple tests such as the Computed tomography, Upper endoscopy, and gastric emptying study are conducted to diagnose the functional dyspepsia. 

RISK FACTORS OF FUNCTIONAL DYSPEPSIA

According to research, there is no noticeable cause of functional dyspepsia. The physicians only make deductions from the symptoms present in the patient as normal routine tests might not indicate abnormalities. 

FUNCTIONAL DYSPEPSIA DIAGNOSIS

Functional dyspepsia is always the last option considered for diagnosis after exterminating all other possible causes of the current symptoms experienced in the patient. 

Therefore, functional dyspepsia is not initially diagnosed as an indigestion disorder can be mistaken for various gastrointestinal problems. 

Possible gastrointestinal problems that can be mistaken for functional dyspepsia are listed below:

1. Gastroparesis.
2. Abdominal cancer.
3. Peptic Ulcer.
4. Gastroesophageal Reflux Disease (GERD).
5. Irritable Bowel Syndrome (IBS).

To avoid the inaccurate diagnosis, previous health conditions are related to the doctor to guide his study as there are no specific means of determining the functional dyspepsia including tests. The diagnosis is established when the tests for other gastrointestinal conditions come back negative. These tests include:

1. X-ray utilizing barium.
2. Upper endoscopy.
3. Blood tests.
4. Test for bacteria.
5. Monitoring the pH of the esophageal.

FUNCTIONAL DYSPEPSIA TREATMENT

There is no cure available for functional dyspepsia though the symptoms present can be controlled which will be explained below:

• Lifestyle:

Lifestyle might not be directly linked to functional dyspepsia but it can influence the treatment.  

Stress is said to affect functional dyspepsia indirectly therefore, limiting stress to a certain level can influence the control over the chronic disorder. Also, managing anxiety can play an important role in the recovery process of indigestion.

Consuming little quantity of food frequently is preferable to consuming larger amounts of food at once when diagnosed with functional dyspepsia which in turn influences loss of weight if the patient feels overweight. 

Avoiding smoking and drinking alcohol can prove effective in minimizing the disorder. Caffeinated drinks and fatty food should be avoided as it aggravates the symptoms present.

Placing the head above the body when laying down can aid the management of the symptoms. 6 inches elevation of the mattress is adequate. It should be noted that usage of a pillow for this elevation is not advisable as the bed frame can also be used as an alternative as pillows can result in backache and compress the stomach, thereby, worsening the symptoms of functional dyspepsia.

• Diet:

As stated previously, fatty foods should be avoided, therefore, changing the diet of the patient might deem successful in controlling functional dyspepsia. Eating manner too can prompt indigestion. 

Beverages, citrus, mints, tomatoes, caffeine can also trigger functional dyspepsia. Eating meals in small quantities, resisting high-fat foods may be efficient too.

• Psychology:

Controlling the mental state of the patient can be effective in managing the disorder as symptoms such as nausea and pain can affect daily activities.

A therapy known as hypnotherapy can be used to improve symptoms. Also, other behavioral therapy may prove successful in minimizing the symptoms.

• Medication:

The most common method for minimizing functional dyspepsia is through medication. Two methods are involved in this treatment plan:

• Acid Neutralization:

The acid in the upper digestive tract can be neutralized with the aid of a medication known as Gaviscon that prevents the migration of acid into the esophagus.

Over-the-counter drugs like Pepto-Bismol, Maalox, and tums may reduce symptoms’ effect. Also, antacids can result in temporary or partial ease but can not stop heartburns from occurring.

The secretion of acid can be suppressed by two types of medications which are the “Proton Pump Inhibitors (PPIs)” and “Histamine-2 Receptors Antagonists (H2RAs)”.

• Blocking Acid Production:

In this case, the compound responsible for the stimulation of gastric acid secretion is known as histamine. The histamine is triggered by allergic reactions, therefore, the Histamine-2 Receptors Antagonists (H2RAs) are used to create a barrier to null the effect of the histamine. The H2RAs involve medications like Tagamet, axid, pepcid, and zantac, and these prescriptions are accessible.

The Proton Pump Inhibitors (PPI) creates a barrier to prevent the secretion of enzymes and it is more efficient when the medication is taken without eating preferably one hour before the first meal. These medications include esomeprazole, omeprazole, pantoprazole magnesium, pantoprazole sodium, lansoprazole, and rabeprazole.

The PPIs are said to be the most effective for minimizing symptoms, thereby, upgrading the quality of the patient’s life. They also affect the esophagus positively and heal sores present.

Also, medications like the domperidone maleate and metoclopramide proffer solutions by modifying the Lower Esophageal Sphincter (LES) to reduce the reflux while the iberogast aids in the regulation of the motility of the digestive tract thereby, controlling symptoms. A combination of methods can also optimize the control of the symptoms of the reflux in the acid.

FUNCTIONAL DYSPEPSIA RECOVERY

There are no proven recovery rates neither are there are any mortality rates recorded for functional dyspepsia as the disorder can last a lifetime or intermittent as there is no cure for the disorder.

Symptoms

FUNCTIONAL DYSPEPSIA SYMPTOMS

Common symptoms that can be experienced for functional dyspepsia are listed below:

1. Quick satisfaction during a meal.
2. Stomach pain.
3. Burning sensation in the digestive tract.
4. Bloating.
5. Belching excessively and nauseous feeling.

Other symptoms that can be experienced that require the immediate attention of medical personnel include:

1. Weight loss.
2. Vomiting blood.
3. Shortage of breath.
4. Jaw, neck, or arm pain.
5. Tarry and dark stools.

These symptoms need to be persistent lasting for more than a month before the patient can be diagnosed with functional dyspepsia as it is intermittent.

Causes

The possible causes of functional dyspepsia are listed below:

1. Excess secretion of acid in the digestive tract.
2. Allergies.
3. Inflammation.
4. Smoking.
5. Psychological issues.
6. Side effects from medications like non-steroidal anti-inflammatory drugs i.e aspirin, naproxen, or ibuprofen.
7. Infection.
8. Obesity.
9. Diet.
10. Bacteria are known as the helicobacter pylori.
11. Lifestyle.
12. Disorder in food digestion in the stomach.
13. Changes in the microbiome in the intestine.
14. Depression.
15. Childhood sexual abuse.

FAQ

Can children be affected by functional dyspepsia?

Functional dyspepsia is liable to anyone for any age range. Therefore, children can experience symptoms of the disorder and the symptoms are equivalent to that of the adult but children are at a disadvantage as they can not take specific medications required for suppressing the symptoms. In this case, the physician recommends special medications.

Can functional dyspepsia be cured?

Functional dyspepsia has no cause therefore it has no specific treatment but some methods are recommended to minimize the symptoms present such as psychological intervention, altering lifestyle and diet, and medications.

Are there any further health implications to having functional dyspepsia?

No further complications are directly involved for patients with possible functional dyspepsia. Also, functional dyspepsia can not lead to cancer in the stomach.

What is idiopathic dyspepsia?

Idiopathic dyspepsia is another name given for functional dyspepsia.

What is the prognosis for functional dyspepsia?

Functional dyspepsia is a chronic disorder that is intermittent meaning the symptoms can come and go. For some patients, it can be there for a lifetime or come and go while for some patients the symptoms go completely.