Functional dyspepsia - features of symptoms, diagnosis and treatment
Functional dyspepsia is a pathology that manifests itself in various disorders of the digestive system, while there is no real damage to its organs. In modern gastroenterology, there is an opinion that the syndrome is associated with a violation of the regulatory interaction between the brain and the gastrointestinal tract.
Types of dyspepsia
According to the latest scientific data, functional dyspepsia is divided into two clinical syndromes: postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), each of which has its own clinic. The presence of symptoms during the last three months is considered relevant for making a diagnosis.
With PDS, signs of discomfort are manifested by a feeling of a full stomach when taking a normal portion of food. This symptom appears once a week or more often. The second sign is early satiety, that is, the inability to finish the usual portion. It is also possible to experience nausea immediately after eating and episodic strong belching. Sometimes there may be moderate pain in the stomach area.
With SEB, pain in the epigastrium occurs once a week or more often and can be aching or burning. The pain is clearly localized, does not go anywhere and does not shift. The painful zone does not expand. The pain is not related to the passage of food in the digestive system and is not similar to that which occurs when the functions of the biliary tract are disturbed.
Causes of dyspepsia syndrome
First of all, with functional dyspepsia, importance is given to various disorders of a psychological nature. There is an extremely high risk of FD in people prone to anxiety, with a labile psyche, and in those who easily lose control over themselves in stressful conditions. Also, dyspepsia syndrome is often combined with disorders in the sexual sphere, which indicates a serious influence of the psyche on the disease.
There are also external factors that contribute to the development of the syndrome:
- smoking, which disrupts the normal motility of the digestive system;
- consumption of alcohol, which affects the nervous system;
- spicy food that excessively irritates the receptors of the mucous membrane of the gastrointestinal tract;
- regular use of nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, diclofenac, etc.).
Symptoms of dyspepsia and diagnostic studies
First of all, the doctor pays attention to a constant or systematically occurring feeling of heaviness or fullness of the stomach after eating for 3 months or more, nausea, pain or discomfort in the epigastrium, bloating of the upper abdomen. Unfortunately, these signs are characteristic of many other diseases, and additional studies are prescribed to rule them out:
- general blood and urine tests, blood biochemistry;
- coprogram;
- esophagogastroduodenoscopy, which, if necessary, is accompanied by taking a piece of tissue for histological examination;
- testing for the presence of helicobacter infection;
- Ultrasound of abdominal organs (liver, biliary tract/pancreas), etc. d.
The absence of deviations from the norm according to the results of all the conducted studies and examination of the patient makes us think about one of the variants of functional dyspepsia.
However, there are a number of signs in the presence of which the diagnosis of FD is excluded and another disease should be sought:
- loss of body weight for no apparent reason;
- emergence of symptoms mainly at night;
- constant severe pains in the stomach, which become the main symptom of the disorder;
- increased body temperature;
- enlargement of the liver and spleen;
- change in leukoformula, signs of anemia, changes in blood biochemistry.
These are "alarm symptoms" that signal the presence of an undetected organic pathology.
Principles of dyspepsia treatment
Bad news: dyspepsia cannot be cured with medication alone. Doctors consider a change in lifestyle, diet and general improvement of the body to be more important than taking pills.
Exclusion from the diet of too fatty foods, alcohol, coffee, hot spices, as well as quitting smoking lead to a significant reduction in the severity of symptoms. With early satiety, bloating and nausea, experts recommend switching to 4-6 meals.
Drug treatment is prescribed in the absence of success from the transition to a healthy lifestyle, as well as in pronounced symptoms:
- omeprazole or rabeprazole is prescribed to combat epigastric pain syndrome - these are the drugs of choice;
- domperidone (motilium) drugs are recommended for postprandial distress syndrome;
- antidepressants and sedatives make it possible to normalize the regulatory mechanisms of the gastrointestinal tract.
Dyspepsia in children
This concept in pediatrics includes a whole group of disorders associated with similar symptoms:
- gastritis;
- ulcer disease of the stomach and duodenum;
- pancreatitis;
- dyskinesia of biliary tract;
- gastroesophageal reflux disease;
- colitis.
In addition, it is possible to include banal intolerance of certain products and the body's reaction to overeating. Infectious diseases are also included in the group of so-called putrefactive or fermentative dyspepsia.
Unfortunately, this diagnosis is a legacy of the past, when diagnostic methods were not enough, and doctors, apart from blood and urine analysis, had no special opportunities for examination. In fact, dyspepsia is not a disease, but a set of symptoms and a diagnosis, for example, of "fermentative dyspepsia" only indicates that the doctor cannot, does not know how, or does not want to thoroughly examine the child.
Functional dyspepsia is a real syndrome that brings significant discomfort to life. However, sometimes its symptoms accompany a real disease. The website Dobrobut.com recommends a thorough examination, passing all the necessary tests and studies in order not to miss something more serious than just a violation of digestive regulation. Although the latter also needs to be treated.
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