Dyspepsia is a common disorder that affects up to 30% of the general population.
Symptoms of dyspepsia include upper abdominal pain or discomfort and frequently include symptoms of burning, pressure, or fullness often, but not necessarily, related to meals.
Other common symptoms include early feeling of fullness (satiety), nausea, belching, and bloating.
While dyspeptic symptoms may develop due to diseases such as peptic ulcer or gastritis, the vast majority of poeple who see doctors for dyspeptic symptoms are ultimately diagnosed as having functional dyspepsia.
Functional dyspepsia (FD) is a heterogeneous disorder; in other words a variety of causes can lead to similar symptoms. Some studies suggest that FD is a chronic condition for many people, with approximately 50% of patients still experiencing symptoms over a 5-year follow-up period.
While the definition of FD has changed somewhat over the years, the disorder is generally regarded as a group of symptoms thought to originate in the upper digestive tract (stomach and upper small intestine) in the absence of any structural or metabolic disease likely to explain the symptoms. Frustratingly, symptoms of FD do not reliably guide therapy.
Causes of Functional Dyspepsia
The causes of functional dyspepsia are largely unknown and likely multiple. Some evidence exists to implicate a genetic predisposition. Although H. pylori infection may produce dyspeptic symptoms in a small subset of patients, there is little data to support this bacterium as a cause of symptoms in a majority of patients. Psychological factors may influence the symptom experience in some patients with functional dyspepsia.
Changes in gastric function have been identified in many patients with FD. In approximately 40% of patients with dyspepsia, the stomach does not relax normally in response to a meal. This is known as "impaired accommodation" and may be associated with symptoms of fullness and pressure in some patients. Impaired stomach contractions and abnormal stomach emptying may also be seen in a similar percentage of patients.
Impaired stomach emptying has been associated with symptoms of bloating and early feeling of fullness. As many as two-thirds of patients with functional dyspepsia have heightened perception of stomach activity, which is termed visceral hypersensitivity. While frequently seen, visceral hypersensitivity in functional dyspepsia has not been strongly associated with any specific symptoms.
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