Functional dyspepsia: symptoms and treatment

The medical term "dyspepsia" is understood to mean a large number of different external symptoms associated with problems of the gastrointestinal tract, which are caused by a violation of the processes of digestion of food. Hence the name, because dyspepsia in Greek means "problems with digestion."

A separate type of the whole complex of disorders is functional dyspepsia. Its signs: blunt or burning pains in the area of the abdominal cavity (the so-called epigastric triangle). In addition to discomfort, the patient experiences a feeling of heaviness and overflow of the abdomen. Swelling of the intestines, nausea, heartburn and belching can also occur. At the same time, during the diagnostic process, it is not possible to detect any organic pathologies (there is no morphological or biochemical reason).

This is what distinguishes functional dyspepsia, the treatment of which has some peculiarities.

Let's consider these issues in more detail.

Statistics of the disease

Problems with digestion - one of the most common disorders that occur in the gastrointestinal tract. During the various statistical events it was found that of the total number of patients seeking help from the gastroenterologist, the number of people diagnosed with functional dyspepsia of the stomach is about 70%. In European countries, the number of people affected by the described disability reaches 40%, and in the African states - more than 60%.

Despite the fact that functional dyspepsia, the symptoms of which are very unpleasant, gives a tangible discomfort to a person, only a quarter of victims turn to a medical specialist for help. At the same time, in the overwhelming majority of cases, it is the functional and not the organic type of the disease that is diagnosed.

In the female, this condition occurs about 1.5 times more often.

The main age of patients with this problem is from 20 to 45 years. In elderly people, this dysfunction of the gastrointestinal tract is much less common. Instead, more serious diseases of the digestive system occur, which, nevertheless, have similar symptoms.

Types of violation

Functional gastric dyspepsia, as you have already understood, is not the only type of pathology. There is also its organic variety. Let us dwell in more detail on the distinctive features of each of them.

1. Organic . This disorder occurs as a result of ulcers, various diseases of the pancreas, gall bladder, as well as other organic pathologies.
2. Functional . It occurs when the muscle layer of the stomach and duodenum (not caused by diseases) fail, which continue for 3 months throughout the year. At the same time, the connection of the emerging pain with the dysfunction of the gastrointestinal tract should not be diagnosed.

Classification of non-biological pathology

According to the clinical picture of the course of the disorder, functional dyspepsia of the stomach can be divided into three subspecies:

• Yazvenvennopodobnaya - characterized by pain in the epigastric region.
• Dyskinetic - the patient feels discomfort in the abdomen, which is not accompanied by acute pain.
• Nonspecific - the clinical picture of this disorder has many symptoms (there is nausea, heartburn, belching).

The provoking factors

Unlike the biological form, the consideration of which is not the purpose of this material, functional dyspepsia in children and adults is caused by the reasons given below.

1. Problems with the peristaltic function of the muscle fibers of the stomach and duodenum. These include:
   
   - Absence of relaxation of some parts of the stomach after ingestion of food (so-called accommodation);
   - violation of the cycle of muscle contractions of this body;
   - problems with the motor function of the anal part of the large intestine;
   - failures of anthroduodenal coordination.
   
   
2. Increased propensity of the walls of the stomach to stretch during eating.
3. Unhealthy eating, consuming a lot of tea, coffee, alcoholic beverages.
4. Smoking.
5. Treatment with various medications (non-steroidal anti-inflammatory drugs).
6. Psychological stress.

Some medical workers claim that the syndrome of functional dyspepsia is associated with the release of a large amount of hydrochloric acid in the gastrointestinal tract, but at present there is no reliable evidence of this theory.

Forms of pathology

Let's consider external signs and internal sensations at the patient, characteristic for the described infringement.

Ulcerative functional dyspepsia, in particular, is characterized by acute and prolonged pains that appear in the epigastric region. They take a pronounced character at night or when a person experiences a feeling of hunger. Removing the discomfort can be with the help of appropriate drugs - antacids. Painful sensations become more intense, if a patient experiences psychoemotional stress, he may have fears of having some terrible pathology.

The diskinetic form of the disorder (non-ulcer functional dyspepsia) is accompanied by symptoms such as early satiety, a feeling of overflow of the gastrointestinal tract, bloating of the abdominal cavity and nausea.

With regard to nonspecific dyspepsia, it is difficult to classify a person's complaints on one or another of the grounds. This kind of pathology may be accompanied by signs specific to some other diseases associated with the gastrointestinal tract. This pattern makes it difficult to diagnose a condition such as functional dyspepsia of the stomach. Her treatment is symptomatic.

Diagnostics

The first task that faces a medical specialist is to distinguish between biological dyspepsia and functional. As a rule, the latter occurs in the case when its symptoms are manifested in the patient without any apparent external causes.

In order to speak with confidence about the course of the patient's functional disorder, it is necessary to establish the presence of three main criteria:

• There is a constant (relapsing) dyspepsia - this is indicated by epigastric pain, which continues for a total of 3 months during the year.
• No traces of organic disturbance have been detected - ultrasound, endoscopy or other clinical and biochemical procedures help to establish this.
• Observed symptoms do not disappear after a visit to the toilet, the frequency of bowel movements and the consistency of stool do not change - this allows us to distinguish between dyspepsia and irritable bowel syndrome.

Research Methods

Among other things, it is important to exclude other diseases with symptoms similar to those accompanied by functional dyspepsia of the stomach. Treatment of such pathologies can be radically different.

To this end, the following activities are carried out.

1. Collecting anamnesis. At the initial conversation the medical expert should establish, whether the patient suffers from the infringements accompanied by signs of a dyspepsia. It is necessary to establish the character of the course and to know the sensations of the person (whether there is stomach rash, eructation, heartburn or painful sensations). It is important to find out what the person has been eating for the past few days, and whether he was subjected to any treatment.
2. Inspection. During it, it is necessary to exclude the possibility of the occurrence of disorders of the gastrointestinal tract, cardiovascular system, as well as pathology of the respiratory tract.
3. Delivery of analyzes. Usually you need:

• General stool analysis;
• The study of feces for the presence of traces of blood in them;
• blood tests;
• The presence of certain types of infections.

4. Research using various medical instruments:

• Esophagogastroduodenoscopy (a more common name is gastroscopy);
• The study of the stomach by means of an x-ray apparatus;
• Ultrasound examination of organs located in the abdominal cavity;
• Other necessary procedures.

Survey plan

In order for functional dyspepsia in children and adults to be diagnosed with maximum accuracy, the doctor must follow a certain sequence of actions.

It is necessary to start the examination with an ordinary blood test, as well as establishing its traces in the stool. This will reveal latent bleeding in the gastrointestinal tract.

If there are abnormalities in a particular laboratory test, you should confirm or deny a possible diagnosis with the help of tools (for example, endoscopy). If patients who are over 50 years of age have dangerous signs (vomiting with blood, scarlet stains, fever, anemia, severe weight loss), urgent gastroscopy is mandatory.

Otherwise (when no dangerous symptoms are observed), it is recommended that so-called empirical therapy be prescribed using antisecretory and prokinetic drugs. Only after the absence of positive dynamics should be used instrumental research methods.

However, in such an approach there is a hidden danger. The fact is that many pharmacological agents have a positive effect and reduce the symptoms of many other serious pathologies (for example, cancerous tumors). This greatly complicates the timely diagnosis.

Treatment

During the diagnosis, organic or functional dyspepsia can be established. Treatment of the first is aimed at eliminating the causes of the disease. In the case of the latter, the methods of therapy are developed individually, the features of the clinical picture are taken into account.

The main goals of treatment:

• Reduction of discomfort;
• Elimination of symptoms;
• Prevention of relapse.

Non-pharmacological effects

To get rid of the symptoms of dyspepsia, the following methods are used.

1. Diet. In this case, one should not adhere to any strict recommendations, it is enough just to normalize the food. It is better to completely abandon foods that are difficult to digest intestines, as well as rough food. It is advisable to eat more often, but eat less. It is not recommended to smoke, drink alcohol, drink coffee.
2. Refusal to take certain medications. This is mainly about non-steroidal anti-inflammatory drugs that have a strong effect on the proper functioning of the gastrointestinal tract.
3. Psychotherapeutic effect. Strange as it may seem, more than half of the patients get rid of the symptoms that accompany functional dyspepsia if placebo is used in the treatment. Thus, such methods of combating the violation are not only possible, but have repeatedly proved their effectiveness.

Medicinal products

Specific types of pharmacological agents used for a patient who has functional dyspepsia are determined individually, taking into account established symptoms.

Usually empirical therapy is used, calculated for one or two months of admission.

There are no specific methods of combating the disease and its prevention at the present time. The following types of medicinal products are popular:

• Antisecretory medications;
• Antacids;
• Adsorbing agents;
• Prokinetic tablets;
• Antibiotics.

In some cases, antidepressants are indicated, which are also capable of relieving the symptoms of non-biological dyspepsia.

If functional dyspepsia is diagnosed in children, treatment should be performed taking into account the characteristics of the growing organism.

Tactics of struggle

Long-term methods of work with the disease of modern medical science is not developed.

If the disorder is relapsed, it is advisable to use medicines that have already been shown to be effective at the time of getting rid of the symptoms of dyspepsia.

When prolonged intake of any tablets does not relieve the patient's discomfort, it is recommended that alternative pharmacological agents be treated.

Conclusion

Functional (like biological) dyspepsia is one of the most common diseases. Despite the seeming frivolity, in the presence of its symptoms, the quality of human life is significantly reduced. Therefore, it is important to take preventive measures. To do this, you only need to observe the correct diet, exclude stressful effects on the body and fully rest.

Be healthy!