Dyspepsia

GROUP
3A

Introduction
Dyspepsia also known asindigestion, is a condition of
impaireddigestion.
It is a medical condition characterized by chronic or
recurrentpainin the upperabdomen, upper abdominal fullness
andfeeling fullearlier than expected when eating.It can be
accompanied bybloating,belching,nausea, orheartburn.
Dyspepsiais a common problem and is frequently caused by
gastroesophageal reflux disease(GERD) orgastritis.In a small
minority it may be the first symptom ofpeptic ulcer disease(an
ulcer of the stomach orduodenum) and occasionallycancer.
Functional dyspepsia (previously called nonulcer dyspepsia) is
dyspepsia "without evidence of an organic disease that is likely to
explain the symptoms.

Causes
Non-ulcer dyspepsia
In about 50-70% of patients with dyspepsia, no definite organic cause can be
determined. In this case, dyspepsia is referred to asnonulcer dyspepsiaand its
diagnosis is established by the presence of epigastralgia for at least 6 months, in the
absence of any other cause explaining the symptoms.
Post-infectious dyspepsia
Gastroenteritis increases the risk of developing chronic dyspepsia. Post infectious
dyspepsia is the term given when dyspepsia occurs after an acute gastroenteritis
infection. It is believed that the underlying causes of post-infectiousIBSand postinfectious dyspepsia may be similar and represent different aspects of the same
pathophysiology.
Functional Dyspepsia
This is the most common cause of chronicdyspepsia. Up to three-fourths of patients
have no obvious organic cause for their symptoms after evaluation. Symptoms may
arise from a complex interaction of increased visceral afferent sensitivity, gastric
delayed emptying or impairedaccommodationto food, or psychosocial stressors.
Although benign, these symptoms may be chronic and difficult to treat.

Pathophysiology
Functional dyspepsia is a symptom complex
characterized by postprandial upper abdominal
discomfort or pain, early satiety, nausea,
vomiting, abdominal distension, bloating, and
anorexia in the absence of organic disease.
Abnormalities of gastric motor function, visceral
hypersensitivity due to central or peripheral
sensitization, low-grade inflammatory states and
genetic predisposition have all been identified as
major pathophysiological mechanisms.

Pathophysiology
Gastric Motor Function
Abnormal motor function, especially delayed
gastric emptying, has for a long time been
considered the main pathophysiological
mechanism underlying functional dyspepsia
symptom generation. The mechanism
underlying delayed gastric emptying is poorly
understood.

Pathophysiology
Visceral Hypersensitivity and Altered Brain
Processing
Visceral hypersensitivity is considered a key
phenomenon underlying unexplained
gastrointestinal symptoms, but the underlying
mechanisms are incompletely elucidated, and both
peripheral (increased permeability, enhanced
excitability of afferent nerves) and central (altered
brain processing) sensitization have been implicated.
A number of studies have focused on central
processing of gastric stimuli in functional dyspepsia.

Pathophysiology
Genetic Susceptibility
Previous studies have linked functional
dyspepsia to a G-protein beta 3 (GN3) subunit
gene polymorphism (C825T).
A number of recent studies investigated this
and other polymorphisms in functional
dyspepsia but the studies were all of small size,
precluding definite association claims.

Signs and Symptoms

Belly pain or discomfort.
Bloating.
Feeling uncomfortably full after eating.
Nausea.
Loss of appetite.
Heartburn.
Burping up food or liquid (regurgitation).
Burping.

Treatment
Treatment for indigestion (dyspepsia) will vary, depending on
what is causingit and how severe your symptoms are.
Diet and lifestyle changes
If you only have indigestion occasionally, you may not need to
see your GP for treatment. It may be possible to ease your
symptoms by making a few simple changes to your diet and
lifestyle.
Healthy weight
Being overweight puts more pressure on your stomach, making it
easier for stomach acid to be pushed back up into your gullet
(esophagus). This is known as Acid Reflux and is one of the most
common causes of indigestion.

Treatment
If you are overweight or obese, it is important to lose weight safely and
steadily through regular exercise and by eating a healthy, balanced
diet. Read advice onlosing weight.
Stop smoking
If you smoke, the chemicals you inhale in cigarette smoke may
contribute to your indigestion. These chemicals can cause the ring of
muscle that separates your esophagus from your stomach to relax,
causing Acid Reflux.
Diet and alcohol
Make a note of any particular food or drink that seems to make your
indigestion worse, and avoid these if possible. This may mean:
eating less rich, spicy and fatty foods
cutting down on drinks that contain caffeinesuch as tea, coffee and
cola
avoiding or cutting down on alcohol

Treatment
At bedtime
If you tend to experience indigestion symptoms at night, avoid
eating for three to four hours before you go to bed. Going to
bed with a full stomach means there is an increased risk that
acid in your stomach will be forced up into your esophagus
while you are lying down.
When you go to bed, use a couple of pillows to prop your head
and shoulders up or, ideally,raise the head of your bed by a
few inches by putting something underneath the mattress. The
slight slope that is created should help to prevent stomach
acid moving up into your esophagus while you are asleep.
Stress or anxiety
If you regularly experience feelings ofstress or anxiety, this
can contribute to symptoms of indigestion.

Treatment
Alginates
Some antacids also contain a medicinecalled an alginate. This
helps relieve indigestion caused byacid reflux.
Acid reflux occurs when stomach acid leaks back up into your
esophagus and irritates its lining. Alginatesform a foam barrier
that floats on the surface of your stomach contents, keeping
stomach acid in your stomach and away from your esophagus.
Your GP may suggest that you take an antacid that contains an
alginate if you experience symptoms of acid reflux or if you
have GORD.
Take antacids containing alginates after eating, because this
helps the medicine stay in your stomach for longer. If you take
alginates on an empty stomach, they will leave your stomach
too quickly to be effective.

Treatment
Antacids
Antacids are a type of medicine that can provide immediate relief for mild
to moderate symptoms of indigestion. They work by neutralizing the acid
in your stomach (making it less acidic), so that it no longer irritates the
lining of your digestive system.
The effect of an antacid only lasts for a few hours at a time, so you may
need to take more than one dose. Always follow the instructions on the
packet to ensure you do not take too much.
It is best to take antacids when you are expecting symptoms of
indigestion, or when they start to occur, such as:
after meals and at bedtime
This is because antacids stay in your stomach for longer at these times
and have more time to work.
For example, if you take an antacid at the same time as eating a meal, it
can work for up to three hours. In comparison, if you take an antacid on
an empty stomach, it may only work for 20 to 60 minutes.

Thank You!