Functional Dyspepsia

What is functional dyspepsia?

Functional dyspepsia, also known as non-ulcer dyspepsia or indigestion, is a term used to describe a group of symptoms affecting the gastrointestinal tract, including stomach pain or discomfort, nausea, bloating and belching.[^1] Functional dyspepsia is diagnosed when no obvious cause can be found for the symptoms. [^2]

It is the most common form of dyspepsia and results in no serious consequences.[^3] The condition can often be long lasting but is manageable through a combination of lifestyle changes and medication.

Symptoms of functional dyspepsia

Functional dyspepsia is characterized by a group of symptoms affecting the gastrointestinal tract, including:[^4]

  • Pain or discomfort in the chest or upper abdomen, usually after eating, eating too quickly or eating a heavy meal
  • Bloating
  • Excessive belching
  • Heartburn
  • Feeling full quickly and easily
  • Feeling extremely full after eating
  • Nausea

Symptoms will typically vary in severity from person to person and can often be vague and unpredictable. Individuals may not experience all of the symptoms, though most will experience more than one.[^5]

Causes of functional dyspepsia

Functional dyspepsia has no known cause. The gut of individuals who have been diagnosed with the disorder will appear healthy.

Despite this, there are certain triggers which may bring on or worsen the symptoms of functional dyspepsia. They include:

  • Smoking and alcohol[^6]
  • Obesity
  • Stress and anxiety
  • Infection with the germ Helicobacter pylori (not all people with functional dyspepsia will have Helicobacter pylori in their stomach, and many people with the germ will experience no symptoms)
  • Impairment of the stomach muscles, leading to slowed emptying of the stomach
  • Roughly one in three people with the disorder also experience irritable bowel syndrome (IBS). The cause of IBS, however, is unknown, meaning that the possible link between the two conditions has not yet been properly established

Diagnosis

To diagnose functional dyspepsia, a doctor should exclude other possible causes for symptoms. This includes assessing the symptoms and clinical examination, as well as a review of any medications that the affected person is taking. This can include blood tests (to test for anemia or inflammation), a breath test for Helicobacter pylori (an ulcer-causing stomach bacteria) and endoscopy (a long camera through the mouth to the stomach). During the endoscopy, the doctors may take a sample of the stomach lining to test for other conditions. The results of all these test should be normal in someone with functional dyspepsia.

Treatment

Treating any Helicobacter pylori bacteria (stomach ulcer causing bacteria) infection is often useful in reducing symptoms, even if there is no sign that these bacteria are causing irritation or ulcers in the stomach. This infection is treated with antibiotics. Other treatment methods involve managing the symptoms of this condition. This include medications which reduce acid in the stomach and changes to the diet to avoid foods which make symptoms worse. Some people find that a low dose of an antidepressant medication called a tricyclic antidepressant (TCA) improves their pain, even if they aren't depressed. Some people also use peppermint or chamomile to settle the stomach, though these are not well studied.

Other names for functional dyspepsia

  • Idiopathic dyspepsia
  • Indigestion
  • Non-ulcer dyspepsia