Dyspepsia
Dyspepsia refers to a group of symptoms related to discomfort in the upper abdomen, which may include:
- Feeling of fullness after meals (postprandial fullness)
- Early satiety (feeling full after eating only a small amount)
- Pain or burning in the upper central abdomen (epigastric region)
- Bloating in the upper abdomen
- Nausea or vomiting
- Belching (burping)
In many cases, even after thorough medical evaluation, no specific physical cause is found. Such cases are called functional dyspepsia.
Organic Causes of Dyspepsia:
Sometimes, dyspepsia occurs due to identifiable medical conditions, such as:
- Gastroesophageal reflux disease (GERD)
- Peptic ulcer disease
- Stomach cancer
- Tuberculosis or sarcoidosis affecting the stomach
- Menetrier’s disease (a rare stomach lining disorder)
- Parasitic infections
- Diabetes mellitus
- Scleroderma (a connective tissue disease)
- Certain medications (such as painkillers or steroids)
- Chronic pancreatitis or pancreatic cancer
- Thyroid disorders like hypothyroidism
- Hyperparathyroidism
- Heart-related issues, such as myocardial ischemia
Functional Dyspepsia:
Functional dyspepsia is diagnosed when a person experiences post-meal fullness, early satiety, epigastric pain, or burning, but no gastrointestinal, systemic, or metabolic cause can be identified. It’s a common condition often related to digestive motility or heightened gut sensitivity.
Investigations:
The need for investigations depends on the patient’s age and symptoms:
- Young patients, without alarming signs (like difficulty swallowing, unexplained weight loss, anemia, or bleeding) can first be given a trial of medication. If symptoms persist, further evaluation is advised.
- Middle-aged or older patients, or those with new or alarming symptoms, should undergo diagnostic tests immediately.
Common investigations include:
- Upper GI endoscopy (UGIE) and H. pylori testing
- Thyroid function tests
- Ultrasound (USG) of the abdomen
- Additional tests as guided by clinical findings
Treatment:
Treatment is based on the underlying cause and may include:
- Proton pump inhibitors (PPIs) to reduce acid
- Prokinetic agents to improve stomach movement
- Simethicone for bloating and gas
- Antidepressants or SSRIs in cases of functional dyspepsia, where stress or hypersensitivity play a role