Functional dyspepsia is a medical term that refers to a condition resulting in stomach upset or pain in the upper abdomen.
Definition and DiagnosisFunctional dyspepsia is defined by one or more of the following:
- Fullness after eating
- Feeling full fast
- Pain in the epigastrium (upper central region of the stomach)
- Burning in the epigastrium
- Lack of structural explanation for these symptoms (for example, symptoms can not be explained by an obstruction, narrowing, anatomical defect, or other such cause).
For a diagnosis of functional dyspepsia, these symptoms should be present for the past three months, with the initial onset at least 6 months prior to diagnosis.
CausesIt is usually not clear what causes functional dyspepsia. There is ongoing research in this area. Some of this research is focused on motor or nerve problems and also pain sensitivity. Motor or nerve problems can result in decreased motility (movement) of the gastrointestinal tract, and thus cause symptoms. For some individuals, there is concern that they are more sensitive to the natural stretching of the stomach that normally occurs with eating.
TestingThere are no specific tests to diagnose functional dyspepsia. Instead, the diagnosis is made by fulfilling the above criteria and eliminating other causes for the symptoms.
TreatmentTreating functional dyspepsia is often difficult. The main goal of therapy is to improve the ability to cope with symptoms.
Medications referred to as NSAIDs (non-steroidal anti-inflammatory drugs) can lead to functional dyspepsia and should be kept to a minimum when this is suspected. Other medications have side effects that result in feelings of dyspepsia.
Acid reducing medications can be tried, but they have varying degrees of success. These medications include histamine-2 receptor antagonists (H2RAs), such as: Zantac (ranitidine), or proton pump inhibitors (PPIs) such as Prevacid (lansoprazole), Prilosec (omeprazole), Aciphex (rabeprazole), Protonix (pantoprazole), Kapidex (dexlansoprazole) or Nexium (esomeprazole). It is important to remember that these medications are not without side effects, such as diarrhea and headache.
Psychosocial issues can also lead to functional dyspepsia. Examples of psychosocial issues include: financial difficulties, lack of social support, unhealthy living situation, stressful work schedule, difficult relationships with co-workers, strained relationships with family, lack of safety, neglect, or other similarly-related issues. Assistance from a trained counselor can be helpful and warranted in these instances.
Diet can also play a role in functional dyspepsia. Often, individuals are able to keep a food journal and then identify foods that are a problem for them. Eating small, frequent meals can be helpful (for example, 5-6 small meals per day). Avoiding high fat foods can also be helpful, since fatty foods empty from the stomach at a slower rate than some other foods. In additional, visiting with a dietitian can be helpful in some instances.
There is a lack of adequate studies on many naturopathic and alternative medicine therapies. Therefore, the safety and use of these treatments is unclear.
Functional dyspepsia often comes back over time. Therefore, treatment may need to be modified or adapted to improve the ability to cope with these ongoing symptoms which can not be entirely eliminated in many cases.