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What is dyspepsia?

Dyspepsia-often called indigestion-is a common malady that many of us have come to associate with the TV ads featuring those sorry souls who can't believe they ate the whole thing. While dyspeptic symptoms are often caused by overeating or eating the wrong foods, the disorder can be associated with a more serious problem.

Dyspepsia means painful, difficult, or disturbed digestion. The chronic recurrence and persistence of crippling dyspeptic symptoms disrupts the lives of many Americans. People suffering from the most severe symptoms can become disabled enough to miss work. Frequent doctor's visits and expensive diagnostic procedures can create a financial drain. In addition, many unnecessary operations are performed in an attempt to relieve the painful symptoms. Unfortunately, despite the surgery, many patients continue to suffer from the symptoms of dyspepsia.

The causes of dyspepsia are many and some of them are not clearly understood. Too often dyspepsia has been dismissed as a psychosomatic disorder. However, in recent years, doctors have begun to recognize that dyspepsia is often the result of a malfunctioning of either the nervous system or the muscular activity of the stomach or small intestine.

What Is Dyspepsia?

A person is said to have dyspepsia if she/he suffers from several of a group of symptoms which might include nausea, regurgitation (backwash of stomach contents into the esophagus or mouth), vomiting, heartburn, prolonged upper abdominal fullness or bloating after a meal, stomach discomfort or pain, and early fullness. Often people say that they have a "sick feeling in the stomach'" or indigestion." or, maybe, "nervous stomach" when they are suffering from dyspeptic symptoms. Sometimes a person will experience these symptoms after overeating or eating foods that disagree with them. Sometimes the symptoms accompany a disease such as peptic ulcer disease, gallbladder disease, or gastritis. Other people experience the symptoms for no apparent reason. The symptoms can last for 3 to 4 days, sometimes longer. In some people, dyspeptic symptoms can be severe and continuous, disrupting daily routines and causing absences from work.

Who Gets Dyspepsia?

Although dyspepsia can afflict men and women from all walks of life, it is most common in women ranging in age from 16 to 60. A woman is even more likely to experience dyspepsia during her childbearing years. Also, patients in whom irritable bowel syndrome (IBS) has been diagnosed comprise the majority of dyspepsia sufferers.

What Causes Dypepsia?

Dyspepsia can be caused by many different things. Symptoms can accompany gastritis inflammation of the stomach), viral gastroenteritis (stomach flu), stomach ulcer, cancer of the stomach, gallbladder disease, pancreatic diseases, and IBS. Pregnancy and advanced diabetes mellitus can also be accompanied by dyspepsia.

But dyspepsia can also occur without the presence of other digestive disorders. If no disease is apparent, doctors have, in the past, tended to diagnose patients as having a psychosomatic disorder.

In recent years, however, medical research has recognized that the stomach and small intestine are regulated by "pacemakers"-much like the heart-that coordinate the movement of the muscles of the digestive tract. During normal digestion, the muscle wall contracts and relaxes, allowing the upper part of the stomach to serve as a reservoir and the lower part to break down (digest) food. When the breakdown is complete, the stomach empties its contents into the upper part of the intestine (the duodenum).

The delicate motions of the stomach and small intestine are regulated by the brain and by a network of nerves embedded in the muscle wall of the digestive tract. The coordination between these nerve endings that secrete a variety of chemical substances (called neurotransmitters), hormones, and the muscle fibers in the wall of the digestive tract regulate the movement of the tract and thereby promote the digestion, absorption, and elimination of the food we eat. Any disruption in the normal functioning of the nervous system or the muscular activity of the digestive tract can cause dyspepsia.

How Is Dyspepsia Diagnosed?

If your symptoms are severe enough to interfere with your daily routine, you should see your doctor. To rule out diseases of the stomach, pancreas, and gallbladder, your doctor may perform an array of tests including an upper GI series, gallbladder, x-ray, endoscopy, and routine blood and urine tests.

Unfortunately, although these tests are necessary to eliminate serious gastrointestinal disorders, they offer little help in identifying dyspepsia that is caused by disruption in the normal functioning of the nervous system or the muscular activity of the digestive tract. Researchers are developing new procedures to monitor the activity of the stomach and duodenum in much the same way that EKG records the electrical activity of the heart. Also, doctors can measure gastric (stomach) emptying to determine whether there is any abnormality in the phase of the digestive process. Such an abnormality is often found in patients with severe dyspepsia. More research is needed, however, before satisfactory procedures to diagnose dyspepsia are developed.

Is Dyspepsia Caused by Emotional Tension or Distress?

It is well-known that dyspepsia-like symptoms can accompany emotional upsets. However, emotional tension may not be the most common cause or even the precipitating factor. Before emotional tension or distress can be named as the culprit causing dyspepsia, your doctor will conduct a careful medical evaluation to rule out other factors.

How Are Symptoms Controlled?

If your dyspepsia is associated with gastritis, peptic ulcer disease, gallbladder disease, or some other organic disorder, your doctor will begin by treating the specific disorder.

Most of the time, dyspepsia not associated with a specific illness can be controlled by diet. Avoiding greasy foods or solid foods containing meat often helps. And, if you are lactose intolerant, eliminating all dairy products from your diet should provide relief. For more information about lactose intolerance, write the clearinghouse.) If your symptoms are severe, your doctor may recommend that you take only liquids or small amounts of soft foods until the symptoms subside. If these measures do not work, your doctor may prescribe medical therapies to control persistent symptoms.

In Summary

Dyspepsia is a common digestive disorder among Americans which has many causes. These include intestinal diseases, inappropriate diet, or a disturbance in the delicate mechanisms that govern the muscular activities of the stomach and small intestine.

If your doctor has ruled out a specific illness causing your dyspepsia, your symptoms can probably be controlled if you take the following dietary precautions:

* avoid greasy foods or solid foods containing meat;

* if you are lactose intolerant, eliminate milk and milk products; and

* if your symptoms are severe, follow a liquid diet or eat soft foods in small amounts until your symptoms subside.

If your symptoms persist, see your doctor. She/he may be able to prescribe a medication to control symptoms.

National Digestive Diseases Information Clearinghouse


Bethesda, Maryland 20892

(301) 468-6344

The National Digestive Diseases Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health, under the U.S. Public Health Service. The clearinghouse was begun by Congress to focus a national effort on providing information to the public, patients and their families, and doctors and other health care workers. The clearinghouse works with organizations to educate people about digestive health and disease. The clearinghouse answers inquiries; develops, reviews, and sends out publications; and coordinates informational resources about digestive diseases.

Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, appropriateness of content, and readability. Publications produced by sources other than the clearinghouse also are reviewed for scientific accuracy and are used, along with clearinghouse publications, to answer requests.

This publication is not copyrighted. The clearinghouse urges users of this fact sheet to duplicate and distribute as many copies as desired.
COPYRIGHT 1989 National Institute of Diabetes & Digestive & Kidney Diseases
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1989, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Pamphlet by: National Institute of Diabetes & Digestive & Kidney Diseases
Article Type:pamphlet
Date:Aug 1, 1989
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