What is dyspepsia (indigestion)?

Author: Gwen Reyes-Amurao, MD

Dyspepsia is a common condition and usually describes a group of symptoms rather than one predominant symptom. These symptoms include:
  • Belly pain or discomfort
  • Bloating
  • Feeling uncomfortably full after eating
  • Nausea
  • Loss of appetite
  • Heartburn
  • Burping up food or liquid (regurgitation)
  • Burping
While dyspepsia is a major functional disease, it is important to mention several other functional diseases. A second major functional disease is the irritable bowel syndrome, or IBS. The symptoms of IBS are thought to originate primarily from the small intestine and/or colon. The symptoms of IBS include abdominal pain that is accompanied by alterations in bowel movements (defecation), primarily constipation or diarrhea. In fact, dyspepsia and IBS may be overlapping diseases since up to half of patients with IBS also have symptoms of dyspepsia.

What is the cause of dyspepsia (indigestion)?

Dyspepsia is a chronic disease that usually lasts years, if not a lifetime. It does, however, display periodicity, which means that the symptoms may be more frequent or severe for days, weeks, or months and then less frequent or severe for days, weeks, or months. The reasons for these fluctuations are unknown. Because of the fluctuations, it is important to judge the effects of treatment over many weeks or months to be certain that any improvement is due to treatment and not simply to a natural fluctuation in the frequency or severity of the disease.
Indigestion may be triggered by:
  • Drinking too much alcohol
  • Eating spicy, fatty, or greasy foods
  • Eating too much (overeating)
  • Eating too fast
  • Stress or being nervous
  • Eating high-fiber foods
  • Smoking tobacco
  • Drinking too much caffeine

How is dyspepsia (indigestion) diagnosed?

Dyspepsia is diagnosed primarily on the basis of typical symptoms and the exclusion of non-functional gastrointestinal diseases (including acid-related diseases), non-gastrointestinal diseases, and psychiatric illness. There are tests for identifying abnormal gastrointestinal function directly, but they are limited in their ability to do so.

How is dyspepsia (indigestion) treated and relieved?

The treatment of dyspepsia is a difficult and unsatisfying topic because very few drugs have been studied and have been found to be effective.
The lack of understanding of the physiologic processes (mechanisms) that cause dyspepsia has meant that treatment usually cannot be directed at the mechanisms. Instead, treatment usually is directed at the symptoms.

What causes dyspepsia?

  • Food intolerance
  • Peptic ulcer disease (PUD)
  • Gastroesophageal reflux (GERD)
  • Gastric or esophageal mass/cancer
  • Gastroparesis (diabetes, postvagotomy, scleroderma, chronic intestinal pseudo-obstruction, postviral, idiopathic)
  • Infiltrative gastric disorders
  • Gastric infections (cytomegalovirus, fungus, tuberculosis, syphilis)
  • Parasites
  • Chronic gastric volvulus
  • Chronic gastric or intestinal ischemia
  • Irritable bowel syndrome
  • Functional dyspepsia

How can dyspepsia be diagnosed?

  • Imaging studies (UTZ, CT scan or MRI)
  • For malignancies, additional tests in the blood may be requested.

What are the different treatment options for dyspepsia?

  • In case of Helicobacter pylori infection, antibiotics are given for 7 to 10 days, or even up to 14 days.
  • Surgery and/or chemotherapy
  • For reflux disease, medicines will be enough for most of the time in addition to lifestyle change.
  • Gallstones
  • Gastritis (when the lining of the stomach becomes inflamed or swollen)
  • Swelling of the pancreas (pancreatitis)
  • Ulcers (stomach or intestinal ulcer)
  • Use of certain medicines such as antibiotics, aspirin, and over-the-counter pain medicines (NSAIDs)
Other causes of indigestion are:
  • Gallstones
  • Gastritis (when the lining of the stomach becomes inflamed or swollen)
  • Swelling of the pancreas (pancreatitis)
  • Ulcers (stomach or intestinal ulcer)
  • Use of certain medicines such as antibiotics, aspirin, and over-the-counter pain medicines (NSAIDs)

Home Care

Changing the way you eat may help your symptoms. Steps you can take include:
  • Allow enough time for meals.
  • Chew food carefully and completely.
  • Avoid arguments during meals.
  • Avoid excitement or exercise right after a meal.
  • Relax and get rest if indigestion is caused by stress.
  • Avoid aspirin and other NSAIDs. If you must take them, do so on a full stomach.
  • Antacids may relieve indigestion.
  • Medicines such as ranitidine and omeprazole can relieve symptoms. Your doctor may prescribe these medicines in higher doses or for longer periods of time.

When to contact a medical professional

Get medical help right away if your symptoms include jaw pain, chest pain, back pain, heavy sweating, anxiety, or a feeling of impending doom. These are possible heart attack symptoms.
Call your health care provider if you experience any of the following:
  • Your indigestion symptoms change noticeably.
  • Your symptoms last longer than a few days.
  • You have unexplained weight loss.
  • You have sudden, severe abdominal pain.
  • You have trouble swallowing.
  • You have yellow coloring of the skin and eyes (jaundice).
  • You vomit blood or pass blood in the stool.

What to expect at your office visit

Your doctor will perform a physical exam on the stomach area and digestive tract. You will be asked questions about your symptoms.
You may have some tests.
  • Ultrasound test of the abdomen
  • Blood tests
  • Upper endoscopy

Sources:

http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm

This material is copyrighted. Printed with permission from Medicomm Pacific, Inc., publisher of Health.Care magazine and www.TheFilipinoDoctor.com.

Did you know?

  • 73% of people will suffer from both heartburn and indigestion. interchangeably
  • 1 in 5 people suffering from heartburn may experience symptoms every week.