Dyspepsia

Dyspepsia is abdominal discomfort that usually occurs after eating. Also called indigestion, it generally does not pose a health risk.

Symptoms and Causes

Dyspepsia, also referred to as indigestion or overeating, is a stomach discomfort perceived in the upper abdomen. Its causes are not entirely clear, but it is usually associated with disturbances in the digestive process.

Although it is normal to experience occasional episodes of overeating, it is considered abnormal if it occurs recurrently. If it recurs over a defined period, it is considered a transient condition, whereas if it occurs consistently over the years, it is considered a chronic condition.

Based on the origin of dyspepsia, it is classified into two types:

Functional dyspepsia: has no specific cause, as it is not associated with structural abnormalities of the digestive system. It is often related to the ingestion of certain foods or periods of stress or anxiety (nervous dyspepsia).
Organic dyspepsia: arises as a consequence of structural or metabolic alterations, the intake of certain medications, or other pathologies:

Ulcer-related dyspepsia: associated with gastric or duodenal ulcers.
Non-ulcer dyspepsia: similar to the previous type but without the presence of lesions.
Biliary dyspepsia: related to gallbladder issues, such as gallstones or dysfunction of the sphincter regulating bile flow.
Nervous dyspepsia: originates from stress or anxiety.
Fermentative dyspepsia: occurs when food is not properly digested in the stomach.

Dyspepsia negatively affects patients’ quality of life, but it generally does not pose a health risk. Lifestyle or dietary modifications usually lead to significant improvement, so the prognosis is favorable.

Symptoms

The most common symptoms of dyspepsia are:

Stomach pain or burning after eating.
Abdominal pain unrelated to food intake.
Bloating.
Excess gas, manifested as belching and flatulence.
Early satiety when eating.
Nausea.
Vomiting.

Causes

The causes of dyspepsia are unclear, but it is associated with the following conditions:

Impaired gastric motility during digestion.
Gastric ulcers: lesions in the stomach lining.
Duodenal ulcers: lesions in the duodenal mucosa.
Gastroesophageal reflux: stomach acids ascend the esophagus to the throat.
Gastritis: inflammation of the stomach lining.
Pregnancy: hormonal changes and uterine pressure on the stomach favor indigestion.
Rarely, gastric cancer.

Risk Factors

The risk of dyspepsia is higher in the presence of the following factors:

Sex: more frequent in women.
Certain medications, such as aspirin or ibuprofen, which can damage stomach tissue.
Smoking.
Excessive alcohol consumption.
Anxiety.
Depression.
Pancreatitis: inflammation of the pancreas.
Helicobacter pylori infection: a bacterium naturally present in the stomach that can proliferate excessively and is usually responsible for gastric or duodenal ulcers.

Complications

Functional dyspepsia usually does not cause complications, whereas in cases of organic dyspepsia, complications are typically related to the underlying cause. In these cases, they can be serious, and it is recommended to consult a specialist as soon as possible:

Excessive weight loss.
Persistent vomiting.
Dysphagia: difficulty swallowing.
Vomiting blood.
Blood in the stool.
Iron-deficiency anemia.
Jaundice: yellowing of the skin, eyes, and mucous membranes.
Palpable abdominal mass.

Which Physician Treats Dyspepsia?

Dyspepsia is managed in Family and community medicine and, if necessary, in the Gastroenterology specialty.

Diagnosis

The diagnosis of dyspepsia includes the following procedures:

Medical history: assessment of patient history, lifestyle, and presenting symptoms.
Physical examination: through observation and palpation, determining abdominal tenderness or inflammation, and identifying pain localization.
Breath or stool test: two effective methods for detecting Helicobacter pylori infection.
Endoscopy: a flexible tube with a camera is inserted from the mouth to the stomach to examine the upper digestive tract.