Jenny Kopanitsanou 

FUNCTIONAL DYSPEPSIA 

Functional dyspepsia is a group of symptoms of the upper digestive system which normally triggered after eating and after stress, has a duration of at least 3 months in the last six months period and tends to relapse over time. Often patients report symptoms outside the digestive system such as muscle pains or migraines. Formerly known as "stomach neurosis" a term no longer used.
We call it functional because a clear cause of the disease or anatomical disorder of the digestive tract is not found (eg. Peptic ulcer or  gastritis, gallstone etc.).


The most common symptoms of functional dyspepsia include:

-Discomfort or pain in the stomach.
-Bloating in the upper abdomen.
-A Feeling of early filling of the stomach with food (early satiety) and delayed digestion.
-Sometimes nausea, belching and rarely vomiting.

What causes functional dyspepsia?

Although not entirely clear the cause of functional dyspepsia, however, the following possible causes have been reported:

-Neurological causes or disorders of gastric motility (causing delay in stomach emptying)
-Sensitivity to pain. The stomach is usually distended as we eat and some people have an increased sensitivity to distension that occurs as pain when filling the stomach with food.
-Infection by Helicobacter pylori.
-Psychogenic causes. People with functional dyspepsia often have psychological disorders, such as anxiety or depression.
-Dietary factors such as coffee, chocolate, alcohol, fats.

How the diagnosis of functional dyspepsia is made?

First we should necessarily make the distinguish  between functional and organic dyspepsia(dyspepsia due to organic disease). You should see a gastroenterologist who will receive a detailed history, examine you clinically and determine the tests that must be done to exclude organic disease, eg: ulcer, esophagitis, gastritis, gallstones, malignancy etc.
You should never delay your visit to the specialist if meanwhile any of the following danger symptoms develops:

-Vomiting that does not stop
-Vomiting with blood admixture
-Weight loss or anorexia
-Bloody or black tarry stools (faeces)
-Pain or difficulty swallowing

Is there a special examination for functional dyspepsia?

Your gastroenterologist may ask you to have:

-Test for Helicobacter pylori, usually breath test.
-Gastroscopy to exclude other disease which may cause the symptoms. 
By gastroscopy the esophagus, stomach and duodenum are checked.
The gastroenterologist is able during gastroscopy to take biopsies from the stomach and see if any type of bacteria Helicobacter pylori are present.
-Abdominal ultrasound.

How is functional dyspepsia treated?

The treatment of functional dyspepsia depends on the cause. 
If there are psychogenic causes, then a psychologist or psychiatrist will help you solve your psychological problems and consequently the symptoms of functional dyspepsia. If you have anxiety or depression, talk to your gastroenterologist.

Diet. You may need to follow one of the following:

-Try to eat in a calm environment, chew well and do not swallow hastily.
-Small and frequent meals. Instead of three big meals, it is recommended to eat five or six small meals.
-Avoid fatty foods which slow down stomach emptying.
-Avoid excessive amounts of coffee, tea, chocolate, alcohol.
-Avoid certain foods that you consider that aggravate your symptoms of functional dyspepsia. Usually spices, garlic, onions, acidic juices, nuts, etc. Talk to your gastroenterologist or consult a clinical dietician.

Medications

-Drugs that reduce acid production in the stomach, such as proton pump inhibitors and histamine receptor blockers.
-Eradication therapy for Helicobacter pylori (in case of finding of this bacterium)
-Antidepressants.
-Avoid aspirin, nonsteroidal antiinflammatory drugs, certain iron compounds and certain antidiabetic.
-Chios Mastic.

                                                                                                                                                      
Jenny Kopanitsanou, 
Gastroenterologist-Hepatologist.
Fellow of the European Board of Gastroenterology and Hepatology.
  • L.Kountourioti 158, Rethymno.  tel: 2831035733
  • Α. Papandreou and Korai 1, Chania Crete.  tel: 2821028000
  • tel .69837108559
mail  jenyjo@me.com

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Summer 2017

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