Functional Dyspepsia

Functional dyspepsia (dis-PEP-see-uh) refers to symptoms of indigestion that include bloating, belching, heartburn, nausea, feeling extremely full after eating very little food, and ulcer-like discomfort. Although it can mimic an ulcer, functional dyspepsia doesn’t damage the stomach or esophagus as an ulcer does. Functional dyspepsia is relatively common – about 20 percent of people worldwide suffer from it. The condition is chronic, meaning it persists or frequently recurs.

What Causes Functional Dyspepsia?

Although the cause of functional dyspepsia is uncertain, medical experts have several theories about what triggers it:

• Foods such as watermelon (it tops the list), citrus fruits, chocolate, fried food, fatty food, onions, and wheat products. Foods such as scrambled eggs, soup, oatmeal, lean meats such as turkey, bananas, and salads may calm dyspepsia. You may need to experiment with different foods, especially ones you love, to determine what triggers an attack and what doesn’t.
• Stress, depression, and anxiety.
• Medications including aspirin, ibuprofen, steroids, antibiotics, nitrates, and iron.
• Obesity.
• Abnormal acid secretion.
• Allergens.
• Alcohol.
• Carbonated drinks.
• Cigarettes.
• Helicobacter pylori. This bacteria can trigger an infection in the small intestine or stomach.

What are the Symptoms of Functional Dyspepsia?

The symptoms of functional dyspepsia are different for each person, but common ones are:

• Feeling full after only consuming a few bites of food. This is known as early satiety.
• Vomiting.
• Burning sensation in your stomach.
• Sour taste in your mouth.
• Weight loss.
• Excessive burping.

How is Functional Dyspepsia Diagnosed?

Since the disorder is difficult to interpret or understand (enigmatic), it can be confused with other ailments. Because of this, your doctor will first conduct tests as a process of elimination to rule out other conditions that may be causing your symptoms, such as:

• Stomach ulcer.
• Gastroesophageal Reflux Disease (GERD).
• Irritable Bowel Syndrome (IBS).
• Gastroparesis – a condition that delays the stomach contents from passing into the small intestine.
• Gallstones.

If tests for these conditions come back negative, your physician can explore the possibility that you could be suffering from functional dyspepsia and consider additional tests. These tests may include:

• Ultrasound scan.
• Upper GI endoscopy.
• Renal function tests.
• Thyroid function tests.
• Test for celiac disease.
• Barium X-ray.
• Stool test for parasites or occult blood (blood that can’t be seen with the naked eye).
• Detection of Helicobacter pylori infection via breath, stool tests, or serology (a blood test used to find antibodies that show a previous infection).

How is Functional Dyspepsia Treated?

There is no cure for functional dyspepsia, but its symptoms can be managed with various medications such as:

H-2 Receptor Blockers.
H-2 receptor blockers (histamine blockers) are medications that neutralize the acid already in your stomach. They include over-the-counter treatments such as cimetidine (Tagamet HB) and famotidine (Pepcid AC). If necessary, your doctor can prescribe a more powerful type of histamine blocker.

Protein Pump Inhibitors.
Protein pump inhibitors prevent acid from being secreted into the stomach. These inhibitors include over-the-counter remedies such as Prilosec and Nexium.

Antibiotics.
If the H. pylori bacteria is detected in your stomach, your doctor may prescribe antibiotics and an acid suppresser.

Gas Relievers.
The active ingredient in over-the-counter gas-reduction medications (simethicone) is found in remedies such as Mylanta and Gas-X. It helps break up gas bubbles in your gut to relieve painful or uncomfortable pressure.

Motility Medications.
These medications help food empty from your stomach at a normal pace.

Low-Dose Antidepressants.
Traditionally known for their mood-elevating properties, antidepressants may also positively affect the symptoms of functional dyspepsia. Low doses of tricyclic antidepressants (TCAs — Amitriptyline, Imipramine) ease diarrhea, serotonin reuptake inhibitors (SSRIs — Prozac, Zoloft) relieve constipation, and serotonin-norepinephrine reuptake inhibitors (SNRIs — Cymbalta, Effexor) reduce pain.

Prokinetics.
Prokinetics help food empty from your stomach at a normal pace.

Non-Medicinal Ways to Manage Functional Dyspepsia.

There are several ways you can try managing functional dyspepsia without medication:

Portion Control.
Portion control is crucial to functional dyspepsia management. Also, eat several small meals instead of three big ones, so stomach acid doesn’t accumulate. Chew slowly and thoroughly. Don’t overeat, and don’t skip meals. It’s also advisable to bypass nighttime snacks and go to bed no earlier than two hours after dinner.

Wear Loose Clothing.
Loose clothing is kind to your digestive tract. When you wear tight clothing, it may compress the stomach so that its contents back up into the esophagus.

Prop Your Head Up.
At night, elevate your head approximately six inches. This encourages digestive juices to flow down to your intestines rather than backing up into your esophagus. Raise your head by adjusting your mattress, not by stacking pillows. Elevating your head with pillows causes your body to hunch, which crowds your stomach and may intensify your symptoms.

Maintain Good Posture.
Poor posture is also responsible for compressing the stomach and hampering the proper flow of digestive juices. This is especially detrimental when you are sitting, but it can also cause digestive issues if you slouch when you’re standing.

Reduce Stress.
Just as stress can impact other ailments, it can affect the symptoms of functional dyspepsia. Anxiety, worry, and tension can overburden your digestive tract. If you’re having difficulty coping, counseling may be an option. You can also try stress management practices such as yoga, meditation, deep breathing, mindfulness, progressive muscle relaxation, exercise, or walking in nature.

Try Herbal Supplements.
Herbal supplements are an alternative treatment that may relieve functional dyspepsia. These include:

• A combination of peppermint and caraway oils can effectively relieve gastrointestinal distress. This is an affordable remedy that can be purchased over-the-counter or online.
• Iberogast (STW5) is a time-tested antidote that has been used for approximately 50 years. It contains extracts of nine herbs, including bitter candytuft, angelica root, milk thistle fruit, and celandine herb. Iberogast is available over-the-counter.
• Rikkunshito is a traditional Japanese herbal medicine that has been used for more than 600 years to treat gastrointestinal disorders. It hinders functional dyspepsia by helping the stomach empty more rapidly. It is comprised of eight ingredients, including ginger root, Zizyphi fructus, and Pinelliae tuber. Rikkunshito is available over-the-counter and online.

Lose Weight.
Besides enhancing your overall health, losing weight will relieve the detrimental pressure that extra pounds exert against your stomach and digestive tract.

What Symptoms are Considered Dangerous?

See your doctor as soon as possible if you experience these abnormal symptoms:

• Shortness of breath.
• Tarry bowel movements.
• Unexplained weight loss.
• Intense pain in your arms, jaw, or neck.
• Bloody vomit.
• Jaundice.
• Shortness of breath.
• Iron deficiency or anemia.

Contact Us

Contact us today! The team of professionals at GastroMD looks forward to working with you. We are one of the leading gastroenterology practices in the Tampa Bay area. We perform a host of diagnostic procedures using state-of-the-art equipment in a friendly, comfortable, and inviting atmosphere where patient care is always a top priority!