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What is dyspepsia?
Dyspepsia is discomfort or pain in the abdomen above the navel or in the
lower chest and is related to drinking or eating. It is also known as
indigestion and is very common. It may be accompanied by loss of appetite,
nausea, vomiting, flatulence (discomfort relieved by belching or passing
wind) and heartburn.
What causes dyspepsia and who is at risk?
Most people have experienced dyspepsia. It often has no clear cause but
risk factors seem to be:
- Eating too much
- Eating too quickly
- Eating spicy or fatty foods
- Drinking too much alcohol
- Taking certain types of medicines such as aspirin
and ibuprofen for headache and arthritis
- Being stressed and worried
Many abdominal disorders can cause dyspepsia, and
occasionally the initial symptoms of a heart attack are similar to dyspepsia.
The most common known causes of dyspepsia are:
- Back flow (reflux) of stomach contents into the
oesophagus, which is the tube that passes through the chest and links
the mouth with the stomach. Usually a valve between the stomach and
oesophagus prevents reflux but sometimes this valve does not work very
effectively. This may happen if there is a hiatus hernia, a common disorder
associated with increasing age in which part of the stomach rises and
protrudes into the lower chest
- Peptic ulcer, a break in the lining of the stomach
or duodenum, the first part of the intestine (bowel).
What are the common symptoms and complications
Dyspepsia is itself a symptom. It may be accompanied by a variety of other
symptoms, and be associated with a number of complications, depending
on its cause. These include:
- Heartburn due to reflux of stomach contents. Reflux
can also cause ulceration (damage to the inner lining) and narrowing
of the oesophagus, leading to difficulty and pain on swallowing
- Loss of appetite, nausea, flatulence or vomiting
due to a variety of abdominal conditions
- Severe abdominal pain, vomiting and a fever due
to gallstones (see other factsheet)
- Pain in the upper abdomen two or three hours after
going to bed, due to peptic ulcer (see other factsheet)
Dyspepsia of unknown cause has no complications.
How do doctors recognise dyspepsia?
A variety of investigations can be used to find out the cause of dyspepsia
but are only necessary if the symptoms are severe or if the suspected
cause needs to be treated (eg, peptic ulcer, gallstones).
Endoscopy, in which a long flexible tube is passed down the throat, will
show the lining of the oesophagus, stomach and duodenum. If there is reflux
or an ulcer, these can be seen and inspected.
Barium X-rays involve swallowing a solution of barium, and then X-rays
are taken of the chest and abdomen. The barium, which shows up on X-rays,
will reveal any reflux or ulcer.
An ultrasound test can be used to diagnose gallstones and some other causes
What is the treatment for dyspepsia?
Self-care action plan
A self-care action plan to help prevent dyspepsia
- Avoiding large meals
- Eating slowly
- Avoiding spicy and fatty foods
- Reducing alcohol intake
- Checking with the doctor if certain medicines may
be causing dyspepsia
Simple antacid tablets can be bought at chemists and supermarkets and
act to neutralise stomach acid. Other types of tablet, including anti-ulcer
tablets, may also be helpful and these can also be bought at the chemist
or be prescribed by the doctor. It is important to follow any instructions
on the packets. If there are severe symptoms a doctor should be consulted.
If stress and anxiety are severe, anti-anxiety medicines (tranquillisers)
may be prescribed.
A variety of complementary medical treatments is used for dyspepsia. However,
there is no conclusive research evidence to prove that any complementary
medicine is beneficial or does not have harmful effects. Therapies such as the Alexander technique, reflexology, relaxation and
visualisation, yoga and tai chi may help promote a sense of well-being
and reduce stress.
What is the outcome of dyspepsia?
Most dyspepsia can be prevented with good self care, and if it does occur
can be relieved with antacids bought from the chemist. Treatment of causes
of dyspepsia such as peptic ulcer and gallstones will be followed by a
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