Dyspepsia: what it is, symptoms, diagnosis and treatment
Dyspepsia is an alteration in the digestive functions of the stomach, commonly described as ‘poor digestion’, however, it is still a syndrome that is difficult to pin down and define
Currently, dyspepsia is defined as a set of symptoms, episodic or persistent, felt predominantly in the upper portion of the abdomen and referable to disorders of the proximal portion of the digestive tract, in the absence of an organic, metabolic or psychiatric illness that justifies them.
As the complaints are often vague and non-specific, there are believed to be many causes, e.g., altered gastric acid secretion, stress, psychological factors, altered visceral perception, altered gastrointestinal motility.
Dyspepsia, there is still doubt as to what role Helicobacter pylori actually plays
Since 70 per cent of patients with this disease are infected with Helicobacter pylori, it has been hypothesised that the germ may play a role, but the numerous studies conducted to date have not been unanimous in demonstrating the regression or disappearance of symptoms after eradication of the germ.
HOW IS DYSPEPSIA RECOGNISED?
- Abdominal pain in the upper abdomen (the band from the ribs to the navel line).
- Non-painful discomfort: ill-defined sensation that does not reach painful intensity, postprandial heaviness, early satiety, nausea, vomiting, bloating.
It is useful to remember that these symptoms are non-specific, i.e. they can be attributable to many gastroenterological diseases, but also to diseases of other districts, which is why it is essential to seek the advice of one’s doctor to understand whether they are minor ailments or deserve further investigation or specialist consultation.
Esophagogastroduodenoscopy is the examination of first choice in the presence of dyspepsia: on the one hand, it allows the detection or exclusion of organic diseases underlying the symptoms (e.g. ulcer, cancer), and on the other hand, it determines the degree of chronic gastritis that may be present and the presence of Helicobacter pylori infection by taking biopsies of the gastric mucosa.
In the case of symptoms indicative of delayed gastric emptying (long digestion, postprandial heaviness and bloating), the study of gastric emptying with radioisotopes may be useful.
DYSPEPSIA, WHO GETS SICK?
Almost all individuals have experienced one or more episodes of dyspepsia in the course of their lives, and therefore there is a lack of real epidemiological data because people often resort to self-medication and do not go to the doctor. However, studies have shown that between 10% and 40% of the general population have chronic or recurring symptoms.
HOW IS IT TREATED?
Treatment depends on the specific cause of the underlying disorder.
Not all dyspeptic patients benefit from the same treatment, so various classes of drugs are available: prokinetics, antacids, acid secretion inhibitors, psychotropics.