What happens to the stomach
Normally, when food arrives, the upper part of the stomach relaxes and becomes a reservoir, while the lower part rhythmically mixes and pushes the contents into the intestines in portions. With functional dyspepsia, this mechanism is disturbed: the stomach stretches worse, so saturation occurs after several spoons, or it empties slowly, and the heaviness lasts for hours. Many patients have increased sensitivity of nerve endings - the usual amount of food is perceived as fullness or pain. The brain-gut connection plays an important role: stress, anxiety and lack of sleep increase symptoms.
- Postprandial distress syndrome - heaviness and fullness after eating, early satiety
- Epigastric pain syndrome - burning or pain in the pit of the stomach, not necessarily related to eating
- Often both options are combined, and are also accompanied by heartburn or bloating.
Causes and risk factors
There is no single cause; usually a combination of factors is at work. Some cases are associated with Helicobacter pylori infection; after treatment, the symptoms in some patients go away. Dyspepsia often begins after an acute intestinal infection. Complaints are aggravated by smoking, alcohol, regular use of NSAID painkillers, irregular meals and overeating at night.
- Chronic stress, anxiety and depression
- Past gastroenteritis or food poisoning
- H. pylori infection
- Smoking and alcohol abuse
- Taking NSAIDs, some antibiotics and iron supplements
Symptoms
Complaints occur in episodes and are repeated several days a week for months. It is characteristic that upon examination the abdomen is soft, and the general condition does not suffer: there is no fever, blood in the stool and weight loss. If such signs appear, we are most likely not talking about a functional disorder.
- Heaviness and feeling of fullness after a regular meal
- Quick satiety, inability to finish eating
- Pain or burning in the epigastrium (in the pit of the stomach)
- Nausea, belching, sometimes bloating in the upper abdomen
- Increased complaints due to stress and lack of sleep
Diagnostics
The purpose of the examination is to make sure that the symptoms are not hiding an ulcer, tumor, cholelithiasis or pancreatitis. The main method is gastroscopy (EGD): with functional dyspepsia, the mucous membrane looks normal or with minimal changes. Be sure to check for the presence of H. pylori - with a breath test, a stool antigen test, or by biopsy during gastroscopy. Blood tests help rule out anemia and inflammation, ultrasound helps to rule out pathology of the gallbladder and pancreas.
- Esophagogastroduodenoscopy with biopsy if necessary
- Test for Helicobacter pylori
- Complete blood count, biochemistry (liver tests, amylase, glucose)
- Ultrasound of the abdominal organs
- According to indications - analysis for celiac disease, thyroid hormones
Treatment and prevention
Treatment begins with an explanation of the nature of the disorder - the understanding that there is no dangerous disease in itself reduces the symptoms. When H. pylori is detected, eradication therapy is carried out. For pain and burning, medications that reduce acidity (proton pump inhibitors) are effective; for heaviness and early saturation, prokinetics are effective. If standard regimens do not help, your doctor may prescribe low doses of neuromodulators and recommend psychotherapy: they act on increased stomach sensitivity. The gastroenterologist selects the medications and duration of the course - independent long-term use of antacids and enzymes usually only masks complaints.
- Eat 4-5 times a day in small portions, do not overeat at night
- Limit fatty and spicy foods, coffee and carbonated drinks if they increase complaints
- Quit smoking, reduce alcohol
- Do not take NSAIDs without a doctor's prescription
- Regular physical activity and normalization of sleep
