dyspepsia


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Dyspepsia

 

Definition

Dyspepsia can be defined as painful, difficult, or disturbed digestion, which may be accompanied by symptoms such as nausea and vomiting, heartburn, bloating, and stomach discomfort.

Causes and symptoms

The digestive problems may have an identifiable cause, such as bacterial or viral infection, peptic ulcer, gallbladder, or liver disease. The bacteria Helicobacter pylori is often found in those individuals suffering from duodenal or gastric ulcers. Investigation of recurrent indigestion should rule out these possible causes.
Often, there is no organic cause for the problem, in which case dyspepsia is classified as functional or nonulcer dyspepsia. There is evidence that functional dyspepsia may be related to abnormal motility of the upper gastrointestinal tract (a state known as dysmotility in which the esophagus, stomach, and upper intestine behave abnormally). These patients may respond to a group of drugs called prokinate agents. A review of eating habits (e.g., chewing with the mouth open, gulping food, or talking while chewing) may reveal a tendency to swallow air. This may contribute to feeling bloated, or to excessive belching. Smoking, caffeine, alcohol, or carbonated beverages may contribute to the discomfort. When there is sensitivity or allergy to certain food substances, eating those foods may cause gastrointestinal distress. Some medications are associated with indigestion. Stomach problems may also be a response to stress or emotional unrest.

Diagnosis

A physical examination by a health care professional may reveal mid-abdominal pain. A rectal examination may be done to rule out bleeding. If blood is found on rectal exam, laboratory studies, including a blood count may be ordered. Endoscopy and barium studies may be used to rule out underlying gastrointestinal disease. Upper gastrointestinal x-ray studies using barium may allow for visualization of abnormalities. Endoscopy permits collection of tissue and culture specimens which may be used to further confirm a diagnosis.

Treatment

The treatment of dyspepsia is based on assessment of symptoms and suspected causative factors. Clinical evaluation is aimed at distinguishing those patients who require immediate diagnostic work-ups from those who can safely benefit from more conservative initial treatment. Some of the latter may require only reassurance, dietary modifications, or antacid use. Medications to block production of stomach acids, prokinate agents, or antibiotic treatment may be considered. Further diagnostic investigation is indicated if there is severe abdominal pain, pain radiating to the back, unexplained weight loss, difficulty swallowing, a palpable mass, or anemia. Additional work-up is also indicated if a patient does not respond to prescribed medications.

Prognosis

Statistics show an average of 20% of patients with dyspepsia have duodenalor gastric ulcer disease, 20% have irritable bowel syndrome, fewer than 1% of patients had cancer, and the range for functional, or non-ulcer dyspepsia (gastritis or superficial erosions), was from 5-40%.

Resources

Periodicals

Talley, N. J. "Non-ulcer Dyspepsia: Current Approaches to Diagnosis and Management." American Family Physician May 1993: 1407-1416.

Other

"Clinical Economics: Gastrointestinal Disease in Primary Care." April 23, 1998. 〈http://www.avicenna.com〉.

Key terms

Anemia — Diagnosed through laboratory study of the blood, a deficiency in hemoglobin or red blood cells, often associated with paleness or loss of energy.
Endoscopy — A diagnostic procedure using a lighted instrument to examine a body cavity or internal organ. Endoscopy permits collection of tissue and culture specimens.

dyspepsia

 [dis-pep´se-ah]
impairment of the power or function of digestion; usually applied to epigastric discomfort after meals. adj., adj dyspep´tic.
acid dyspepsia dyspepsia associated with excessive acidity of the stomach.
nonulcer dyspepsia dyspepsia in which the symptoms resemble those of peptic ulcer, although no ulcer can be detected. Because many patients with nonulcer dyspepsia have a Helicobacter pylori infection, H. pylori has been suggested as a cause. This has not been proven, however, and many patients still have dyspepsia after antibiotic treatment.

dys·pep·si·a

(dis-pep'sē-ă),
Impaired gastric function or "upset stomach" due to some disorder of the stomach; characterized by epigastric pain, sometimes burning, nausea, and gaseous eructation.
Synonym(s): gastric indigestion
[dys- + G. pepsis, digestion]

dyspepsia

/dys·pep·sia/ (dis-pep´se-ah) impairment of the power or function of digestion; usually applied to epigastric discomfort after meals.dyspep´tic
nonulcer dyspepsia  dyspepsia with symptoms that resemble those of peptic ulcer, although no ulcer is detectable.

dyspepsia

(dĭs-pĕp′shə, -sē-ə)
n.
Disturbed digestion; indigestion.

dyspepsia

[dispep′sē·ə]
Etymology: Gk, dys + peptein, to digest
a vague feeling of epigastric discomfort after eating. There is an uncomfortable feeling of fullness, heartburn, bloating, and nausea. Dyspepsia is not a distinct condition, but it may be a sign of an underlying intestinal disorder such as peptic ulcer, gallbladder disease, or chronic appendicitis. Symptoms usually increase in times of stress. dyspeptic, adj.

dyspepsia

Gastroenterology
1. Formally, a compromised ability to digest food.
2. Popularly defined as postprandial epigastric discomfort. See Nonulcer dyspepsia.

dys·pep·si·a

(dis-pep'sē-ă)
Impaired gastric function or "upset stomach" due to some stomach disorder; characterized by epigastric pain, burning, nausea, and gaseous eructation.
Synonym(s): gastric indigestion.
[dys- + G. pepsis, digestion]

dyspepsia

Indigestion. Any symptoms of disorder of, or abuse of, the digestive system or any symptoms attributed to digestive upset. The symptoms include discomfort in the upper abdomen, heartburn, a tendency to belching, nausea or a sense of bloated fullness (flatulence). See also PEPTIC ULCER.

dyspepsia,

n digestive disturbance characterized by burping, heartburn, and gas.

dys·pep·si·a

(dis-pep'sē-ă)
Impaired gastric function or "upset stomach" due to some disorder of the stomach.
[dys- + G. pepsis, digestion]

dyspepsia,

n a vague feeling of epigastric discomfort, felt after eating. It is not a distinct condition but may be a sign of underlying intestinal disorder, such as peptic ulcer, gallbladder disease, or chronic appendicitis. The symptoms usually increase during periods of stress.

dyspepsia

specifically, impairment of digestion, but commonly applied to subjective feelings of indigestion in humans.
References in periodicals archive ?
The prevalence of symptoms of dyspepsia in north eastern Nigeria: A random community based survey.
8) In the text and dyspepsia treatment ALGORITHM (5,7-12) that follow, you'll find an evidence-based patient management approach.
In current medical terminology, dyspepsia refers to multiple symptoms located in the upper abdomen, often broadly defined as pain or discomfort centered in the upper abdomen.
The report provides a snapshot of the global therapeutic landscape of Functional (Non Ulcer) Dyspepsia
A comparison between those with and without BE revealed that the patients with BE had longer periods of dyspepsia (P<0.
Conclusions: Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture.
Thirty four (38%) of patients in this study were prescribed PPIs for having epigastric pain or dyspepsia, all of which were uninvestigated at the time PPI was first prescribed.
Main outcome: The primary objective was to test the hypothesis that the antioxidant astaxanthin at two doses regimens compared to placebo should ameliorate gastrointestinal discomfort measured as GSRS in patients with functional dyspepsia, who were either positive or negative for Helicobacter pylori, after 4 weeks of treatment.
Veldhuyzen van Zanten SJO, Flook N, Chiba N, Armstrong D, Barkun A, Bradette M et al, for the Canadian Dyspepsia Working Group.
Non ulcer dyspepsia is supposedly considered due to visceral hypersensitivity, delayed gastric emptying and psychological stress5,6.
Compared with usual care, screening for and the eradication of Helicobacter pylori infection did not significantly improve the risk of dyspepsia or peptic ulcer disease, use of health care services, or quality of life in a large randomized, controlled trial reported in the November issue of Clinical Gastroenterology and Hepatology (doi: 10.
CEO of Biohit Oyj, Semi Korpela, commented: "GastroPanel provides a lot of information for the diagnosis of dyspepsia and H.