Dyspepsia

(Indigestion; Non-ulcer Dyspepsia; Non-ulcer Stomach Pain)

by Rhianon Davies

Definition

Dyspepsia is discomfort in the upper abdomen or chest. It is often linked to nausea, belching, or bloating.

Locations of Dyspepsia Symptoms

© 2009 Nucleus Medical Media, Inc.

Causes

The exact cause is not known. Most often the condition is linked to a number of unhealthy lifestyle factors. These factors can result in poor digestion.

Risk Factors

The following lifestyle factors increase your chances of experiencing dyspepsia:

• Overeating
• Eating too quickly or at irregular intervals
• Eating greasy, high-fat, or spicy foods
• Drinking caffeine, alcohol, or soda pop in excess
• Taking nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen
• Smoking
• Psychological stress

Symptoms

Dyspepsia is characterized by a variety of symptoms, including:

• Pain or burning sensation in the upper abdomen or chest
• Nausea
• Abdominal bloating
• Belching or regurgitation

Diagnosis

Your doctor will ask about your symptoms and medical history. Dyspepsia is diagnosed mainly on the symptoms listed above. If the discomfort becomes worse or more worrisome symptoms develop (eg, severe abdominal pain, persistent nausea or vomiting, or unexpected weight loss) your doctor may order one or more of the following tests:

• Laboratory blood work
• Barium x-ray —a chalky solution is used to highlight the upper digestive tract in an x-ray
• Ultrasound —high-frequency sound waves a used to view and examine the organs of the abdominal cavity
• Endoscopy—a long, thin tube affixed with a light and camera is inserted into the throat to examine the lining of the esophagus, stomach, and upper part of the small intestine
• Gastric emptying study—food containing a small amount of radioactive material is tracked to help determine the rate at which the stomach empties of food

Treatment

Your doctor will suggest a plan based on the severity of your symptoms. Treatment options may include the following:

Your doctor may advise you to:

• Reduce your intake of fatty and spicy foods.
• Reduce your intake of alcohol, caffeine, and/or soda pop.
• Stop smoking.
• Avoid nonsteroidal, anti-inflammatory drugs.
• Find ways to manage your stress. If stress appears to be related to your symptoms.

Medications may include:

• Antacids (eg, Rolaids, Maalox, or Mylanta)—to help neutralize stomach acid
• Acid suppression agents (eg Zantac, Pepcid, or Prilosec)
• Prokinetic agents—to help the stomach empty its contents more quickly
• Antidepressants—to treat the pain associated with dyspepsia
• Antibiotics—if tests confirm the presence of Helicobacter pylori; this treatment appears to benefit only a minority of patients

If the discomfort persists, your doctor may order tests to determine if the symptoms are related to a more serious condition, such as:

• Gastritis
• Peptic ulcer

Prevention

To prevent dyspepsia:

• Avoid overeating
• Eat slowly and regularly
• Avoid greasy, high-fat foods
• Limit spicy foods
• Don’t smoke
• Drink coffee, alcohol, and soda pop in moderation
• Maintain a healthy weight
• Exercise regularly
• Practice relaxation techniques

The American College of Gastroenterology
http://www.acg.gi.org/

American Gastroenterological Association
http://www.gastro.org/

The Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org/

The College of Family Physicians of Canada
http://www.cfpc.ca/

REFERENCES:

Functional dyspepsia. University of North Carolina School of Medicine website. Available at: http://www.med.unc... .

Functional dyspepsia (non-ulcer dyspepsia). The Merck Manual website. Available at: http://www.merck.c... .

Karamanolis G, Caenepeel P, Arts J, Tack J. Association of the predominant symptom with clinical characteristics and pathophysiological mechanisms in functional dyspepsia. Gastroenterology . 2006; 130:296

Mertz H, Fullerton S, Naliboff B, Mayer EA. Symptoms and visceral perception in severe functional organic dyspepsia. Gut. 1998; 42:814.

Non-ulcer stomach pain. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/stomach-pain/DS00524 .

Tack J, Talley NJ, Camilleri M ,et al. Functional gastroduodenal disorders. Gastroenterology . 2006; 130:'466

Last reviewed September 2009 by Daus Mahnke, MD
Last Updated: 9/30/09