What is Functional Dyspepsia?

Functional dyspepsia is a condition wherein signs or symptoms of indigestion, primarily pain or discomfort in the upper abdomen, recur without a clear organic or identifiable cause. It can be subdivided into two syndromes - epigastric pain syndrome and postprandial distress syndrome.

• Epigastric pain syndrome (EPS) — characterised by recurrent pain or discomfort in the upper abdomen.
• Postprandial distress syndrome (PDS) — characterised by uncomfortable feelings of fullness that interferes with the ingestion of a normal portion of food.

These two types of dyspepsia can often overlap as well.

Functional Dyspepsia vs Acid Reflux

Acid reflux and functional dyspepsia are the two most common upper gastrointestinal disorders. However, acid reflux is different from functional dyspepsia because the primary and dominant symptoms are heartburn and regurgitation.

Symptoms of Functional Dyspepsia

Functional dyspepsia is chronic, and symptoms can come and go. These symptoms include:

• Epigastric (upper abdominal) pain
• Bloated stomach
• Early satiety
• Loss of appetite
• Nausea and vomiting

Dr Benjamin Yip reminds us that it’s important to get checked as symptoms of functional dyspepsia may mimic stomach cancer, which can occur in individuals as young as 30 years old. If in doubt, please see your Gastroenterologist for an assessment!

When should you visit a doctor?

If symptoms occur for a prolonged duration and cause worry, medical attention should be sought. You should also see a Gastroenterologist if any other associated symptoms like weight loss, black tarry stools, or vomiting blood occurs. Functional dyspepsia is generally not serious, even though it can be constant and chronic.

Risk factors for Functional Dyspepsia

Certain factors can increase the risk of functional dyspepsia. These include:

• Female gender
• Overuse of over-the-counter pain relief medication, like aspirin
• Smoking
• Anxiety or depression
• Helicobacter pylori infection
• Gastroesophageal reflux disease (GERD)
• Food allergies

How is Functional Dyspepsia diagnosed?

Your Gastroenterologist will review signs and symptoms and perform physical examinations and tests to rule out other organic or identifiable disorders that could cause these symptoms. Some diagnostic tests will be performed as well, for this purpose. These tests include endoscopies and blood tests to rule out other disorders that cause similar symptoms to that of functional dyspepsia.

• Gastroscopy — to detect any structural abnormalities in the upper GI tract.
• Blood tests — to rule out any infections and diseases that may be causing your symptoms.
• Urea breath test — to detect the presence of Helicobacter pylori in your stomach.
• Gastric emptying studies — to examine how quickly your stomach empties food into your small intestine.

Treatment options

Treatment of functional dyspepsia is done via a combination of medication, behavioural therapy and lifestyle changes.

• Medications that reduce stomach acid production like proton pump inhibitors (PPIs) may be helpful. Antiemetics also help in reducing nausea, and low-dose antidepressants are also shown to be sometimes beneficial in treating the disorder.
• Behaviour therapy can be useful. A therapist can teach relaxation techniques that help you cope with symptoms when they occur, as well as helping to reduce stress that may cause symptoms to flare up.
• Lifestyle changes are also beneficial. A change in diet and eating habits can help- eating smaller and more frequent meals or avoiding trigger foods like spicy or greasy foods can help to alleviate symptoms. Reducing stress in day-to-day life can help to control symptoms as well.

Summary

Functional dyspepsia is a chronic condition, which means it may come and go, depending on many factors. Although it is benign, it can greatly affect your quality of life. Thankfully, with medication and lifestyle changes, it can be managed and treated effectively. It is important, however, to consult your Gastroenterologist as functional dyspepsia may display the same symptoms as other gastrointestinal disorders.

References

1. “Functional Dyspepsia: Symptoms, Diet, Treatment & Living With.” Cleveland Clinic, 10 January 2022, https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia. Accessed 10 January 2023.
2. “The Diagnosis and Treatment of Functional Dyspepsia.” NCBI, 30 March 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938438/. Accessed 10 January 2023.
3. “Peptic ulcer Information.” Mount Sinai, https://www.mountsinai.org/health-library/diseases-conditions/peptic-ulcer. Accessed 10 January 2023.