This is the second most common functional gastrointestinal disorder (after irritable bowel syndrome). Patients can present with a spectrum of symptoms including upper abdominal pain/discomfort, fullness, early satiety, bloating and nausea.
These patients have no structural abnormality as an explanation for their symptoms.
Types of functional dyspepsia
Two subgroups based on the predominant (or most troublesome) single symptoms are suggested:
Ulcer-like dyspepsia with pain centered in the upper abdomen as the predominant (most troublesome) symptom.
Dysmotility-like dyspepsia with non painful sensation (discomfort) centered in the upper abdomen being the prominent symptom. Upper abdominal fullness, early satiety, bloating and nausea may also be associated with the discomfort.
There is considerable overlap between these two groups.
Diagnosis of Functional dyspepsia
Many young patients (< 50) require no investigation. Older patients or those with alarm symptoms require endoscopy . Gastroscopy often shows gastritis but whether this is the cause of the symptoms is doubtful.
Treatment of Functional dyspepsia
The range of therapies prescribed for functional dyspepsia reflects the uncertain pathogenesis and the lack of satisfactory treatment options. Management is further Confounded by high placebo response rates (20-60%). A proportion of patients will respond satisfactorily to reassurance, explanations and lifestyle changes, but anti secretory or prokinetic agents are used for patients with ulcer-like and dysmotility-like dyspepsia respectively. Reducing intake of fat, coffee, alcohol and cigarette smoking may help. H. pylori eradication therapy is often used in functional dyspepsia empirically with varied success. Most gastroenterologists usually try such therapy if only for its possible long-term benefit.
Psychological ailments are major reason for such type of dyspeptic episodes. If all organic causes are excluded visiting a reputed psychologist near you may be of great help.
These patients have no structural abnormality as an explanation for their symptoms.
Types of functional dyspepsia
Two subgroups based on the predominant (or most troublesome) single symptoms are suggested:
Ulcer-like dyspepsia with pain centered in the upper abdomen as the predominant (most troublesome) symptom.
Dysmotility-like dyspepsia with non painful sensation (discomfort) centered in the upper abdomen being the prominent symptom. Upper abdominal fullness, early satiety, bloating and nausea may also be associated with the discomfort.
There is considerable overlap between these two groups.
Diagnosis of Functional dyspepsia
Many young patients (< 50) require no investigation. Older patients or those with alarm symptoms require endoscopy . Gastroscopy often shows gastritis but whether this is the cause of the symptoms is doubtful.
Treatment of Functional dyspepsia
The range of therapies prescribed for functional dyspepsia reflects the uncertain pathogenesis and the lack of satisfactory treatment options. Management is further Confounded by high placebo response rates (20-60%). A proportion of patients will respond satisfactorily to reassurance, explanations and lifestyle changes, but anti secretory or prokinetic agents are used for patients with ulcer-like and dysmotility-like dyspepsia respectively. Reducing intake of fat, coffee, alcohol and cigarette smoking may help. H. pylori eradication therapy is often used in functional dyspepsia empirically with varied success. Most gastroenterologists usually try such therapy if only for its possible long-term benefit.
Psychological ailments are major reason for such type of dyspeptic episodes. If all organic causes are excluded visiting a reputed psychologist near you may be of great help.
