A common complaint in clinical practice. Term dyspepsia indicate, pain or discomfort in the upper abdomen which can be acute ,chronic or recurrent. Patients with dyspepsia also complain of heartburn, that if present indicate underlying gastroesophageal reflux disease. Patients usually use the term indigestion to describe any problems related to food. It seen in 80% of population.
Characteristic associated symptoms are population.
• Upper abdominal fullness,
• Early satiety
• Burning,
• Bloating,
• Belching,
• Nausea,
• Retching,
Alarm features in dyspepsia.
• Weight loss
• Anaemia
• Persistent Vomiting
• Vomiting of blood ,passage of blood in stool
• Difficulty in swallowing
• Palpable abdominal mass
• Constant or severe pain
If any of the alarming symptoms are present detailed evaluation is required. Detailed evaluation is also needed in people presenting with new onset dyspepsia at the age more than 55 and young people if not responding to treatment.
Causes of indigestion or dyspepsia
Indigestion directly related to food Drug Intolerance.
Sudden self limited indigestion can occur with overeating ,quick eating ,high fat food intake, eating during stressful circumstances, excessive alcohol or coffee intake.
Drug Intolerance - Commn drugs ivolved are aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digoxin, iron, antibiotics (metronidazole, macrolides), diabetes drugs (metformin, alpha-glucosidase inhibitors, , donepezil, rivastigmine, and opioids
Gut Dysfunction
Peptic ulcer disease (5–15% ). Gastroesophageal reflux disease ( 20% ). Gastric cancer ( 1% ). Helicobacter pylori Infection.are seen
Other Conditions
Diabetes, thyroid disease, kidney disease, heart attack, pregnancy, intra-abdominal cancers, Pancreatic Disease, Disease of the gall bladder and bile duct may be seen.
Functional Dyspepsia
Most common cause of chronic indigestion is functional dyspepsia. Upto two third of patients have no significant cause for their indigestion. Tt is difficult to treat although it is benign.
Recent employment changes, physical and sexual abuse, marital disharmony, depression, anxiety, depression, and fear of serious disease all may lead to development of symptoms. Functional dyspepsia is often seen in young people anxiety and depression or on psychiatric drugs .
