Symptoms of functional dyspepsia

Functional dyspepsia refers to a digestion disorder that usually manifests itself after a food intake. However, the same symptoms can occur without being related to meals.

What are the symptoms?

Symptoms originate in the upper gastrointestinal tract, specifically in the stomach and small intestine and the most common are usually pain in the epigastrium or upper abdomen, burning, pressure and a feeling of fullness or early satiety. nausea, belching, and bloating may also appear.

How is the diagnosis made?

When there is suspicion of functional dyspepsia, an appropriate clinic history collecting all the data:

• Location and radiation of pain,
• Relationship with intake,
• Identification of all symptoms
• Perceptions and toxic habits such as tobacco and alcohol.
• Taking medications, there are drugs that can produce these annoying symptoms and simply with a change in medication they can be alleviated.

In addition, to aid in the diagnosis and rule out an organic cause, it should be accompanied by a physical examination and laboratory tests to guide if there are alterations in the operation of the thyroid gland or other problems like the.

In some cases it is also necessary to combine with a ultrasound or radiological study barium to rule out a pathology of hepatic, biliary or pancreatic origin.

In other cases, it is necessary to use more selective diagnostic tests that allow the visualization of the digestive tract, such as discharge, which also has the advantage of letting take biopsy, very useful to detect the. If there is suspicion of infection by the former, a non-invasive test (breath test or stool test) can be performed.

Which is the treatment?

Since in this digestive affectation it is difficult to define the cause and since it does not often respond to an organic cause, it is necessary to prove different treatments until clearly finding an improvement in symptoms. For this reason, treatment should always be individualized and based on the severity of the symptoms.

Diet and health measures

• Staying at a healthy weight helps decrease reflux symptoms.
• Avoid very large meals and chew food well. It is important to eat in a relaxed environment without rush or stress. It seems that diets poor in fiber and rich in starches and spices with rapid intake and poor chewing can influence the appearance of symptoms.
• Avoid lying down immediately after eating and exercising.
• Stop smoking and reduce alcohol intake for being two causes of reflux and dyspepsia.

Pharmacotherapy

If with these measures there is no change in the improvement of symptoms, pharmacological treatment is used, the most used being those that decrease the acid secretion and those that help empty the stomach called prokinetics.

If these also do not work, the usefulness of antidepressant medications at low doses to reduce sensitivity to pain and improve tolerance to the discomfort of dyspepsia.

Difference between dyspepsia and functional dyspepsia

In the dyspepsia the symptoms that appear are usually related to organic disorders (gastritis, peptic ulcer, gastroesophageal reflux), infectious (metabolic (hypothyroidism) or induced by drugs or alcohol.

In the functional dyspepsia (DF) it is more difficult to define the cause since the same symptoms can appear without an organic origin, probably due to multiple and still unknown causes.

In addition, for many patients these discomforts can persist over time, making it annoying, but still poorly understood.

Current research seeks to determine the causes and the most effective treatment. There is some evidence that implies certain genetic predisposition, has also been associated in some cases with infection by, but without being able to determine that it is the cause in most cases. In some patients it has been found that psychological factors can influence and in many patients, approximately 40%, it has been possible to detect changes in gastric function, the stomach does not relax in response to a meal producing symptoms such as fullness or pressure. This situation is known as “alteration in gastric accommodation”. It has also been observed that they present alterations in gastric emptying and greater perception of gastric activity, which is known as visceral hypersensitivity.

• Current research seeks to determine the causes and the most effective treatment.
• Treatment should always be individualized and based on the severity of the symptoms.
• Initially some dietary and health measures can help improve symptoms.

Deborah Blasco

Nutritional Nurse