Dyspepsia

Dyspepsia is a stomach condition that’s also sometimes called indigestion. It causes stomach pain and burning, bloating, nausea, and gas. Dyspepsia is common and could be related to a problem with the muscles in the stomach. It might be treated with various medications and changes to diet.

This article discusses the symptoms and potential causes of dyspepsia. It also covers how it might be diagnosed and the potential treatments for symptoms, as well as when to see a healthcare provider. 

Symptoms of Dyspepsia 

There is a set of symptoms used to help diagnose dyspepsia. As many as 20% of adults have dyspepsia symptoms in North America. Many of the symptoms are also common to other conditions, however. To rule out other conditions, it’s important to let your healthcare provider know what you're experiencing.

Symptoms of dyspepsia include:

• Belching (burping)
• Bloating (swelling in the abdomen)
• Feeling uncomfortably full after eating (postprandial fullness)
• Pain or burning in the stomach (heartburn)
• Nausea
• Only being able to eat a little (early satiety) 

Types of Dyspepsia

Functional dyspepsia is diagnosed when no physical reason is found for the symptoms. It may be labeled as either epigastric pain syndrome or postprandial distress syndrome. However, it might not always be necessary or helpful to distinguish between the two.

Epigastric pain syndrome is identified as:

• Bothersome stomach pain or burning one or more days per week over the past three months
• Symptoms that have gone on for at least six months 

Postprandial distress syndrome is identified as:

• Uncomfortable fullness after eating or early satiety (feeling full) so you can't finish a regular-size meal or engage in your usual activities on three or more days a week over the past three months
• Symptoms that have gone on for at least six months 

Causes of Dyspepsia

It’s not clear what causes dyspepsia. It’s called a “functional disorder” because tests don’t show a physical reason for the symptoms.

However, it’s thought that dyspepsia might be caused by a problem with the way the stomach works. The stomach and diaphragm (the muscle that runs between the chest and abdomen) will normally relax after a meal. This allows room for food and is important in the process of digestion.

For people with dyspepsia, normal muscle changes after eating might not happen as they should. This can lead to the symptoms of bloating, heartburn, or feeling full.

How to Treat Symptoms of Dyspepsia

Dyspepsia might be treated with certain types of medications. This includes both over-the-counter (OTC) and prescription medications.

Antidepressants

Drugs known as antidepressants can have effects on the nervous system and the digestive system. They can help relax the muscles involved and relieve symptoms of dyspepsia. For dyspepsia, they are usually given in lower doses than what's needed to treat depression.

H2-Receptor Blockers

This medication is available both over the counter and by prescription. These drugs reduce the amount of acid produced by the stomach:

• Axid AR (nizatidine)
  
• Pepcid AC (famotidine) 
• Tagamet HB (cimetidine)
  

OTC Antacid Remedies

These medications reduce acid and are available in drugstores without a prescription. Antacids usually are a first-line treatment for symptoms. Some brands are:

• Alka-Seltzer
• Maalox
• Mylanta
• Rolaids
• Riopan
  

Prokinetics

Prokinetics might be tried when other types of drugs aren’t helpful. There is not a lot of evidence for their effectiveness. But in some cases, they may help empty the stomach more quickly.

Proton Pump Inhibitors (PPIs)

These are medications that reduce the amount of stomach acid produced. This may help some people who have symptoms of dyspepsia. PPIs, such as the following, are available both over the counter and with a prescription:.

• Prevacid (lansoprazole)
• Prilosec (omeprazole)
• Nexium (esomeprazole)
  

Lifestyle and Dietary Changes

Lifestyle changes and altering the foods you eat may reduce symptoms or prevent them. A healthcare provider or a dietitian may recommend the following changes to your diet:

• Avoiding spicy, greasy, acidic, and fatty foods
• Avoiding or limiting caffeine and alcohol
• Eating a healthful diet with enough fiber, fruits, and vegetables
• Staying hydrated by drinking enough water 

Are There Tests to Diagnose the Cause of Dyspepsia?

In some cases, dyspepsia is diagnosed without doing much testing, especially if the symptoms are mild. Medications may be enough to improve symptoms.

However, testing may be needed for some people, especially if symptoms are severe or there’s reason to rule out other, more serious conditions.

Blood tests: A complete blood count (CBC, to measure red and white blood cells) and other tests might be requested. Results of blood tests alone usually aren’t enough to make a diagnosis. Instead, the results are used along with other tests to rule out more serious conditions.

Breath test: Some people with dyspepsia may also have an infection with a bacterium called Helicobacter pylori (H. pylori). It is a common type of infection that is treated with antibiotics. A test for H. pylori might be done if symptoms don’t get better with a trial use of certain medications.

Endoscopy: In an endoscopy, a tube with a light and a camera on the end is passed through the mouth and down into the stomach. This test can show a healthcare provider if there are any problems with the esophagus (food tube) or stomach, such as an ulcer.

Motility studies: Tests that check the muscles of the stomach and other organs might be used. They’re not readily accessible and may only be used for people with severe symptoms. Tests can include: 

• Gastric barostat study
  
• Scintigraphy
• Single photoemission computed tomography (CT)
• Wireless motility capsule 

When to See a Healthcare Provider

The symptoms of dyspepsia are bothersome and can be painful, but they aren’t usually serious. However, they are similar to symptoms of other, more serious conditions, which will need to be ruled out. Reasons to see a healthcare provider right away include:

• Black, tarry bowel movements
• Blood in the stool
• Blood in the vomit
• Pain that goes beyond the stomach (and especially in the arm)
• Trouble breathing
  
• Unintentional weight loss 

Summary

Dyspepsia is a common problem. Some people may find relief from the symptoms with OTC medications. However, for severe symptoms—especially those interfering with daily life—other treatments might be needed.