Dyspepsia Symptoms

Introduction

Dyspepsia is a common problem that affects about 30% of the population. It is defined as pain or discomfort in the upper abdomen. You may experience nausea, vomiting, bloating and a feeling of fullness of the stomach. Symptoms may appear after the intake of food.

Types of dyspepsia

1. Organic dyspepsia: It is due to erosive oesophagitis, gastritis erosions, acute or chronic gastritis ulcer, duodenal ulcer, duodenitis, and malignancy.
2. Functional or non-ulcer dyspepsia: A chronic condition postprandial distress syndrome or epigastric pain syndrome.
3. Drug-related: Aspirin, NSAIDs, antibiotics, bisphosphonates, oestrogens, steroids, digoxin, chloroquine, iron, and potassium supplements.
4. Extra intestinal systemic disease: Diabetes mellitus hypothyroidism, hyperparathyroidism, Addison’s disease, uraemia.

Symptoms of dyspepsia

• Upper abdominal pain or discomfort
• Burning, pressure, or fullness in the upper abdomen
• Early feeling of fullness – satiety
• Nausea or vomiting
• Belching
• Bloating

In particular, the symptoms of dyspepsia can be classified into three categories:

1. Reflux type: Retro-sternal burning regurgitation.
2. Ulcer type: Epigastric pain on an empty stomach. Relieved with the intake of bland food, antacids, or acid suppression.
3. Dysmotility type: Postprandial fullness, distension, early satiety, nausea.

Causes of dyspepsia

• Dietary factors, smoking, obesity, stress, etc.
• Dyspepsia can be presented in association with other underlying diseases such as GERD, peptic ulcer, H-pylori infection of the stomach, stomach cancer, medications, pancreatitis, gallstones, liver diseases, hiatus hernia, celiac disease, IBS, etc.
• Commonly associated with pregnancy – especially in the first and last trimester due to hormonal changes and foetal press on the stomach.

When to see a doctor?

You may experience mild dyspepsia from time to time, and it can be managed with lifestyle changes or simple medications. Consult a doctor if you have persistent signs and symptoms that may hinder your day-to-day activities.

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Immediate medical attention is needed if you have

• Bloody vomitus
• Dark or tarry stools – black stools
• Anaemia
• Shortness of breath
• Chest pain radiating to the jaw, neck or arm
• Sudden weight loss

Risk factors of dyspepsia

• Female sex
• Smoking
• H-pylori infection
• Use of certain drugs which cause stomach irritation
• Anxiety or depression
• History of childhood sexual or physical abuse

Prevention of dyspepsia

• Following a balanced and healthy diet.
• Avoid acidic foods, carbonated drinks, caffeine, alcohol, etc.

Remedies/treatment of dyspepsia

Depending on the cause and severity, the treatment of dyspepsia varies. Treatment of an underlying condition or changing medication will reduce dyspepsia.

Mild cases of dyspepsia with fewer symptoms can be managed by changing the lifestyle. These include:

• Avoiding or limiting the intake of triggering food items such as fried foods, chocolates, onion-garlic drinks like carbonated beverages, caffeine, alcohol, etc.
• It is better to eat smaller meals than heavy ones.
• Have a gap of at least 3 hrs after dinner and bedtime.
• Raising the head portion of the bed.
• Better to quit smoking.

Medications

• Antacids – counter the effect of gastric juices.
• H-2 receptor antagonists – reduce the stomach acids and is more effective than antacids.
• Proton pump inhibitors (PPI) – also reduce the stomach acid but are more effective than the H-2 receptor antagonists.
• Prokinetics – These can help boost the movement of food through the stomach.
• Antibiotics – it is used to treat H-pylori infections that cause peptic ulcer.
• Antidepressants
• Counselling, Cognitive behavioural therapy

Conclusion

Dyspepsia is a common digestive disorder. It can be mild to severe according to symptoms. Mild ones can be managed with dietary or lifestyle changes. If the symptoms are severe, then consult a doctor immediately.