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

Definition

Dyspepsia is the term used to describe discomfort in the upper abdomen or chest that is often associated with nausea, belching, or bloating.

Causes

The exact cause of dyspepsia is not known. Most commonly, however, the condition is attributed to a number of unhealthy lifestyle factors that can result in poor digestion most commonly affecting the esophagus and stomach.

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

If the discomfort persists despite addressing these factors, your doctor may order tests to determine if the symptoms are related to a more serious condition, such as gastritis or a peptic ulcer . In many cases, your doctor may recommend treating your symptoms with medications first and following up with tests if this proves ineffective.

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 primarily on the basis of typical symptoms, as listed above. However, in the event that you experience persistent or worsening discomfort or develop more worrisome symptoms such as severe abdominal pain, persistent nausea or vomiting, or unexpected weight loss—your doctor may order one or more of the following tests to investigate your symptoms further:

• Laboratory blood work
• A barium x-ray , which involves drinking a chalking solution to highlight the upper digestive tract
• An ultrasound , which involves the use of high-frequency sound waves to view and examine the organs of the abdominal cavity
• An endoscopy, which involves the insertion of a long, thin tube affixed with a light and camera down the throat to examine the lining of the esophagus, stomach, and upper part of the small intestine
• A gastric emptying study, which involves the ingestion of food containing a small amount of radioactive material to help determine the rate at which the stomach empties of food

Treatment

Your doctor will suggest a treatment 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 sodapop
• Stop smoking
• Avoid nonsteroidal, anti-inflammatory drugs
• Find ways to manage your stress, if this appears related to your symptoms

Medications may include:

• Antacids such as over-the-counter Rolaids, Maalox, or Mylanta to help neutralize stomach acid
• Acid suppression agents such as Zantac, Pepcid, or Prilosec
• Prokinetic agents to help the stomach empty its contents more quickly
• Antidepressants—low dose tricyclic antidepressants (eg desipramine, nortriptyline etc.) or SSRI’s (eg Zoloft, Celexa, Lexapro etc.) are used to treat the pain associated with dyspepsia.
• Antibiotics, if your tests confirmed the presence of Helicobacter pylori infection in your stomach, however this treatment appears to benefit only a minority of patients.

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 if under considerable stress