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

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

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.

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]
References in periodicals archive ?
Surging prevalence of digestive diseases across the globe is one of the prime reasons for the growth of the global dyspepsia market.
pylori infection in patients of less than 60 years of age with no alarm features on presentation and considering upper GI endoscopic studies for those with either alarm features or refractory dyspepsia i.e; dyspepsia not responding to optimal doses of empirical therapy9.
Most patients referred for treatment of HP usually have dyspepsia (12).
Dyspepsia, an offensive halitosis and nausea are often also present.
Many studies also showed that dyspepsia has negative effect on patients life in terms of low productivity at work, high absence rate, and lesser daily activity which means that it has a considerable financial effect on the life of the patients.
Most common non-alarm symptoms in upper GI included upper abdominal pain (26.3%), dyspepsia (22.6%) and reflux (3.7%) while in the lower GI it constituted diarrhea (13.6%) and constipation (4.1%).
[1] In patients with functional gastroduodenal disorders, it is found that functional dyspepsia is the most common diagnosis.
Efficacy and safety of Xiangsha Liujunzi granules for functional dyspepsia: A multi-center randomized double-blind placebo-controlled clinical study.
pylori eradication on the symptoms of functional dyspepsia. In brief, both male and female patients aged 18 years or more, diagnosed with functional dyspepsia and positive for H.
pylori positivity and endoscopic or histological features of the duodenal mucosa in patients referred for endoscopy to investigate dyspepsia.
Delayed gastric emptying is considered to be a pathophysiological feature of FD that is closely related to dyspepsia symptoms [41].