Functional Dyspepsia

Symptom overlap is common among several functional gastrointestinal (GI) disorders. For instance, care must be taken not to confuse functional dyspepsia with other common disorders that may cause upper gastrointestinal distress, like heartburn, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), functional abdominal bloating, and functional biliary disorders.

Functional dyspepsia is identified based on symptoms. Additional evaluation by your physician will normally include a physical exam to rule out other possible causes. The actual diagnosis is based on a detailed history to identify symptoms.

Symptoms
Functional dyspepsia is characterized by chronic or recurrent pain or discomfort centered in the upper abdomen. Unlike IBS, symptoms are not related to the process of defecation. There is no evidence of organic disease or structural or biochemical abnormality.

Functional dyspepsia can be divided into three categories:

  • Ulcer-like,
  • Dysmotility-like, and
  • Unspecified.

Ulcer-like dyspepsia has upper abdominal pain as its predominant symptom. This pain is accompanied by several other symptoms, including: hunger pain that is sometimes relieved by eating, pain relieved by antacids, night pain, periodic pain, and pain which may be very localized in the upper middle region of the abdomen.

Dysmotility-like dyspepsia has upper abdominal discomfort, not pain, as its predominant symptom. It is accompanied by several other symptoms, including: early feeling of having enough to eat, fullness after a meal, nausea, recurrent retching and/or vomiting, upper abdominal bloating, and upper abdominal discomfort aggravated by food.

Incidence and Treatment
In general, dyspepsia occurs in approximately 1 out of 4 adults. About one-half of that number can be classified as having functional dyspepsia.

Functional dyspepsia may be treated with changes in diet or with medications. Although studies have not proven that dietary changes help, individual dietary experimentation may prove helpful for some.

  • Avoiding spicy and fatty food may reduce symptoms of fullness after eating.
  • Eating six small, low-fat meals per day may reduce early feelings of fullness, bloating after a meal, or nausea.
  • Avoidance of caffeine, alcohol or smoking may also help.

 

Adapted from IFFGD Publication: Functional Dyspepsia and IBS: Incidence and Characteristics by John Kellow, MD, FRACP, Assoc. Professor of Medicine, University of Sydney, Australia.

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