What are dyspeptic symptoms? What is a dyspeptic or dyspeptic reaction? Traditional methods of treatment - gallery

Dyspepsia is a combined functional disorder of the digestive system. This is a complex of symptoms characteristic of many diseases, as well as borderline conditions.

The main causes of dyspepsia are a lack of digestive enzymes, causing malabsorption syndrome, or, what happens most often, gross errors in nutrition. Dyspepsia caused by eating disorders is called nutritional dyspepsia.

Symptoms of dyspepsia can be caused by both a lack of eating regimen and an unbalanced diet.

Thus, dysfunction of the gastrointestinal tract organs without organic damage leads to functional dyspepsia (nutritional dyspepsia), and insufficiency of digestive enzymes is a consequence of organic damage to the gastrointestinal tract. In this case, dyspepsia is only a symptom of the underlying disease.

Dyspepsia in children develops due to a discrepancy between the composition or quantity of food and the capabilities of the child’s gastrointestinal tract. Most common cause Dyspepsia in children of the first year of life is caused by overfeeding the child or untimely introduction of new foods into the diet. In addition, newborns and children in the first weeks of life experience physiological dyspepsia due to immaturity of the gastrointestinal tract. Physiological dyspepsia in children does not require treatment and goes away as the gastrointestinal tract matures.

Dyspepsia in older children often occurs during periods of increased growth, for example, in adolescence, and is associated with an imbalance of hormones (the so-called critical periods of development). In this condition, the gastrointestinal tract is especially vulnerable to dietary errors, while adolescents often abuse fast food, sugary carbonated drinks and foods with a large number easily digestible carbohydrates, which leads to dyspepsia.

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Types of dyspepsia

Nutritional or functional dyspepsia is of the following types:

• Fermentative dyspepsia. It is caused by the predominance in the diet of foods high in carbohydrates that cause fermentation (sweet and flour products, honey, fruits, peas, cabbage, legumes, etc.), as well as fermentation products (kvass, mash, pickled vegetables, etc.). At the same time, fermentative microflora develops in the intestines;
• Putrid dyspepsia. Occurs when excessive consumption products of protein origin, especially those requiring a long time to digest. This mainly applies to red meats (lamb, pork, beef) and their derivatives (sausages and other meat products), the abuse of which stimulates the development of putrefactive intestinal microflora;
• Fatty (soapy) dyspepsia. Caused by eating too much refractory fats, such as lamb and lard and their derivatives.

Dyspepsia, which is a consequence of enzyme deficiency, is of the following types:

• Hepatogenic (liver origin);
• Cholecystogenic (caused by impaired bile secretion);
• Pancreatogenic (lack of pancreatic enzymes);
• Gastrogenic (caused by disruption of the secretory function of the stomach);
• Enterogenous (disturbed secretion of intestinal juice);
• Mixed dyspepsia.

Symptoms of dyspepsia may vary depending on the type of disorder, but there are common signs that are common to all types of the disease. TO general symptoms dyspepsia include:

• Unpleasant sensations in the epigastric region (upper abdomen): a feeling of heaviness, fullness, sometimes pain of varying intensity;
• Nausea;
• Belching. Single belchings may not be a sign of a disorder, but constant ones indicate dyspepsia;
• Heartburn. A burning sensation in the epigastric and retrosternal region, which occurs when aggressive gastric contents enter the esophagus, which should not normally occur;
• Flatulence. A feeling of fullness in the abdomen caused by increased gas formation in the intestines, as well as increased gas production;
• Stool disorder. A characteristic symptom of dyspepsia is irregular bowel movements, usually frequent.

Symptoms of dyspepsia caused by a lack of digestive enzymes are the following: unpleasant taste in the mouth, nausea, rumbling and transfusion in the abdomen, flatulence, decreased appetite, frequent loose stool. The general condition suffers, the patient experiences increased fatigue, weakness, malaise, and there may be sleep disturbances and headaches. Feces contain significant amounts of undigested food.

Fermentative dyspepsia is characterized by rumbling in the abdomen, severe flatulence, frequent loose stools with the release of light, foamy feces, with a characteristic sour odor, and possible pain.

Symptoms of putrefactive dyspepsia resemble symptoms of intoxication: general malaise, weakness, nausea, severe headache. The stool is frequent, the stool is liquid, dark, with a pungent putrid odor.

For fatty dyspepsia, diarrhea is less typical than for other types of dyspepsia. Patients complain of a feeling of heaviness and fullness in the abdomen, belching, flatulence and pain, which intensifies half an hour or an hour after eating. The stool is copious, the feces are whitish in color, containing the remains of undigested fat, with a characteristic oily sheen.

Dyspepsia in young children manifests itself as regurgitation, bloating, frequent bowel movements (more than 6 times a day), green stools containing whitish flakes. The baby is capricious, sleep is disturbed, and appetite is reduced.

Diagnosis of dyspepsia

The diagnosis is made on the basis of studying the characteristic symptoms of dyspepsia, with clarifying laboratory tests (general blood test, urine test, stool test for worm eggs, coprogram, study of the secretion of the gastrointestinal tract) and instrumental (fibrogastroduodenoscopy, ultrasound and radiography of the abdominal organs, etc.). ) methods for diagnosing diseases of the gastrointestinal tract.

Nutritional or functional dyspepsia is diagnosed on the basis of the characteristic symptoms of dyspepsia, the establishment of nutritional errors, and stool examinations in the absence of pathological changes in the gastrointestinal tract.

Treatment of dyspepsia

Treatment of dyspepsia of nutritional origin consists of prescribing a fasting pause, lasting from a day to a day and a half, then gradually introducing food. Particular attention is paid to a balanced diet and adherence to food intake. It is necessary to limit the consumption of foods that cause dyspepsia. You also need to monitor your drinking regime; the recommended amount of water should be at least 1.5 liters per day.

Treatment of dyspepsia caused by enzyme deficiency consists of correcting enzyme deficiency, for which replacement therapy with drugs containing the necessary enzymes is used, as well as following a diet that relieves the affected area of ​​the gastrointestinal tract. With this type of dyspepsia, it is necessary to treat the underlying disease.

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Dyspeptic disorders occur in most people. This is a complex pathological condition that accompanies many gastrointestinal diseases, and can also manifest itself due to errors in diet and emotional overload. It is very important to diagnose the disease in time in order to properly approach its treatment.

What is dyspepsia

Dyspepsia is a complex of painful symptoms in the stomach, which is often accompanied by indigestion. This disease is acid-dependent and manifests itself in most people with increased secretory function of the digestive glands. Dyspeptic syndrome may indicate the presence of a certain gastrointestinal pathology or be an independent disease. A sudden release of hydrochloric acid into the stomach occurs for various reasons. Dyspepsia can occur in both adults and children. In the first case, the symptoms are especially acute, while in the second they may be periodic and not appear so clearly.

The structure of the digestive system shows the close proximity of all organs. Dyspepsia is often caused by pathology near the organs located near the stomach.

What is dyspepsia - video

Classification of pathology

Dyspeptic syndrome is divided into functional and organic. The first type is characterized by the presence of certain symptoms in practically healthy people. The second type of disease appears against the background of other gastrointestinal pathologies. Functional dyspepsia has the following classification:

1. Ulcer-like syndrome. In its manifestations, this type is similar to gastric ulcer, but does not have characteristic defects of the mucous membrane.
2. Dyskinetic. Symptoms occur immediately after eating. And they are often accompanied by intestinal manifestations: flatulence,...
3. Non-specific. Has mixed symptoms of the forms listed above. Practically does not occur in children.

There is also the following classification of dyspeptic syndrome:

1. Alimentary species. It develops against the background of errors in the diet and the predominance of one or another product in the diet. This type is divided into:
   • fermentative form - occurs when there is a significant amount of carbohydrate food in the diet;
   • putrefactive - develops when consuming large amounts of protein, especially stale protein;
   • soapy or fatty - occurs when there is a predominance of fats in the menu.
2. Toxic. Occurs against the background of various food poisoning, as well as during intoxication toxic substances. Divided into the following subtypes:
   • intoxication - manifested by both stomach pain and intestinal upset;
   • intestinal toxicosis - develops against the background of suppression of normal microflora and the introduction of pathogenic ones.
3. Neurotic. It manifests itself against a background of increased anxiety and other psychological disorders.
4. Simple. May have mixed symptoms of several types. However, it does not manifest itself too sharply. There are mild symptoms.
5. Biliary. Associated with the release of bile into the stomach. This process causes characteristic symptoms. Accompanied by gallbladder dysfunction.
6. Enzymatic. Develops due to insufficient amounts of digestive enzymes. Divided into:
   • gastrogenic type - occurs when the production of hydrochloric acid and enzymes in the stomach is disrupted;
   • enterogenous - develops as a result of a violation of secretion in the intestine;
   • pancreatogenic - is a consequence of a lack of pancreatic enzymes;
   • hepatogenic - occurs when the production of bile by the liver is impaired.

Causes and development factors

Dyspeptic syndrome may have the following causes:

• infections that enter the stomach when eating poor quality food;
• chronic gastritis with increased secretory function;
• chronic pancreatitis and cholecystitis;
• cholelithiasis;
• chronic enterocolitis and sigmoiditis;
• taking certain medications: antibiotics, non-steroidal anti-inflammatory drugs, hormonal contraceptives and acetylsalicylic acid.

A provoking factor can be foods that increase the acidity of gastric juice and promote hypersecretion, causing heartburn, pain and burning in the epigastrium. These primarily include sour, fatty and fried foods, as well as fast food.

Main symptoms of the disease

The distinctive signs of pathology directly depend on its form. The alimentary species is characterized by:

• flatulence;
• pain in the abdomen;
• belching;
• feeling of fullness in the stomach.

The toxic type has the following symptoms:

• nausea;
• vomiting;
• burning in the epigastrium;
• diarrhea;
• increase in body temperature.

Neurotic dyspepsia manifests itself:

• increased nervousness;
• burning in the stomach;
• nausea;
• lump in throat;
• alternating diarrhea and constipation.

The biliary type is characterized by:

• burning in the epigastrium;
• change in stool color;
• morning sickness;
• pain in the right hypochondrium;
• diarrhea.

Enzymatic dyspepsia manifests itself:

• nausea;
• heaviness in the stomach and a feeling of fullness;
• vomiting;
• diarrhea with the remains of undigested food.

Differences in symptoms of organic and functional dyspepsia - table

Type of disease	Characteristic symptoms
Organic dyspepsia	pain in the epigastrium that is constant; burning in the stomach; heartburn; recurrent diarrhea; general unsatisfactory condition; nausea; vomit; change in stool color; the presence of undigested food residues in the stool; pain on palpation of the abdominal organs; flatulence.
Functional dyspepsia	emotional instability; feeling of a lump in the throat; nausea that occurs during increased anxiety levels; vomiting immediately after eating; ineffective urge to defecate; abdominal pain that worsens after emotional stress; burning in the stomach.

Diagnostic tests

In the presence of dyspeptic manifestations, a whole range of diagnostic studies is prescribed:

1. FGDS. It is a method of examining the gastrointestinal tract using a special endoscope - a thin tube with a camera, which is placed through the oral cavity into the esophagus and stomach to obtain a detailed picture of the mucous membrane. This reveals microscopic changes, as well as ulcers, erosions and polyps.
2. Colonoscopy. This method is similar to the previous one, however, with it, an endoscope is inserted through the rectum and thus any changes in the mucous membrane are diagnosed. In this case, it is possible to differentiate dyspepsia from intestinal cancer and other functional diseases.
3. Biochemical blood test. Using this method, the level of liver parameters is determined, as well as the presence of the Helicobacter pylori bacterium in the blood.
4. Irrigoscopy. Using an X-ray examination of the stomach and intestines, the condition of these organs is determined. The procedure is performed using liquid barium, which the patient must first swallow. It is this substance that is radiopaque and, enveloping the mucous membranes, allows one to obtain a detailed picture of the organs.
5. Ultrasound. Ultrasound examination can detect chronic pancreatitis, liver changes and the condition of the gallbladder.
6. Stool examination. It is carried out to determine hidden blood and microorganisms that can cause dyspeptic disorders.

Drug treatment of dyspeptic disorders and first aid

First aid for acute manifestations of dyspeptic syndrome is to eliminate symptoms. This is especially important if there is an infection. In this case, you should take adsorbents that will help remove the causative agents of toxic dyspepsia from the body, as well as excess amounts of hydrochloric acid. These drugs include Enterosgel and activated carbon. If diarrhea occurs, then you can take Smecta.

Drug treatment of dyspeptic disorders depends on the manifestation of characteristic symptoms. The following groups of drugs are most often used:

1. Intestinal antibiotics and antidiarrheals. Among the antiseptics that are used for toxic dyspepsia, Alpha Normix is ​​distinguished, acting directly in the stomach and intestines. Antidiarrheal drugs are used for prolonged diarrhea. Most often these are Loperamide and Smecta.
2. Antiemetic drugs. Used for persistent nausea and vomiting. These drugs block the vomiting center in the brain and eliminate unpleasant symptoms. These include: Cerucal and Motilium.
3. Remedies for heartburn and burning in the stomach. Antacids help neutralize the aggressive components of hydrochloric acid and have an enveloping effect on the mucous membrane of the esophagus and stomach. The most commonly prescribed are Maalox, Rennie and Gastal.
4. Antispasmodics and motor stimulants. They help eliminate pain in the abdomen and accelerate the movement of food through all parts of the gastrointestinal tract, preventing fermentation processes. These include Trimedat.
5. Prebiotics and probiotics. Stimulate the growth of beneficial microflora and regulate intestinal function. The most popular of this line of products are: Linex and Hilak Forte.
6. Proton pump blockers. Used for hypersecretion of the digestive glands. These medications block the secretion of hydrochloric acid, lowering the acidity of the stomach. Most often prescribed: Omez and Nolpaza.
7. Enzymes. Promotes high-quality digestion of food in case of insufficient pancreas function. Pancreatin, Mezim and Creon are used.

Medicines used for dyspepsia - gallery

Alpha Normix is ​​an intestinal antibiotic
Smecta eliminates diarrhea and dyspeptic symptoms in the stomach. Motilium blocks the vomiting center in the brain.

Gastal envelops the gastric mucosa, relieving burning sensation Trimedat eliminates pain in the stomach and intestines Hilak Forte restores intestinal microflora
Omez blocks the release of hydrochloric acid Mezim improves the quality of digestion

Diet food and list of prohibited foods

Dietary nutrition in the presence of dyspepsia helps regulate digestion and prevents the occurrence of pain and flatulence. To do this, exclude all foods that can cause hypersecretion and fermentation processes in the intestines. These include:

• fresh fruits, especially apples, grapes and citrus fruits;
• fresh vegetables: eggplants, tomatoes, mushrooms, cabbage, legumes and onions;
• spices;
• soda;
• alcohol;
• semi-finished products;
• baking;
• fatty and fried foods;
• fast food;
• ice cream;
• sauces.

List of prohibited products - gallery

Fruits enhance fermentation processes in the intestines Vegetables have a negative effect on the irritated gastric mucosa Spices increase the secretion of hydrochloric acid
Alcohol is harmful to the digestive organs. Convenience foods increase secretion and fermentation. Baking contributes to heartburn and flatulence.
Confectionery products cause a burning sensation in the stomach Fatty dishes increase dyspepsia Fast food negatively affects the functioning of the gastrointestinal tract

Ice cream is not consumed due to its low temperature Sauces provoke increased secretion Lemonades irritate the mucous membranes of the gastrointestinal tract

• dairy and fermented milk products;
• porridge from buckwheat, millet and oats;
• vegetable stew of zucchini and potatoes;
• steamed fish cutlets;
• bananas and persimmons;
• jelly;
• rosehip decoction;
• mashed potatoes;
• vegetarian cabbage soup;
• noodle soups;
• pasta.

Dairy products help eliminate burning and pain in the stomach Cereal porridges improve the functioning of the gastrointestinal tract Vegetable stew is well digested
Steamed cutlets are very healthy Bananas promote bowel function
Persimmon has an astringent effect, eliminating heartburn
Kissel coats the stomach Rosehip decoction reduces inflammation Mashed potatoes are not a secretion stimulant
You can add chicken to cabbage soup. Vermicelli soup can be seasoned with herbs.
Pasta does not have a negative effect on the gastrointestinal tract

Traditional methods of treatment

Traditional medicine methods are often used to treat dyspeptic disorders. The most effective recipes:

1. Anti-inflammatory collection that has an antispasmodic effect. To prepare the decoction you will need the following herbs: chamomile, mint, calamus and licorice. They should be taken in equal quantities and mixed. 1 tbsp. l. The mixture must be poured with 350 ml of boiling water and put on low heat. After boiling for 10 minutes, cool and filter. Then take a quarter glass 3 times a day 20 minutes before meals for 10–14 days.
2. Remedy for stomach pain. To prepare it you will need 1 medium potato. It must be peeled and grated, then squeeze the juice through cheesecloth into a glass. Add 0.5 tsp to it. honey and lemon juice. Mix everything thoroughly and heat slightly. Take 3 times a day 10 minutes before meals warm within a week.
3. A collection that regulates the functioning of the stomach and intestines. To prepare it you will need mint, chamomile and St. John's wort. They should be mixed in equal quantities. Take 1 tbsp. l. mixture and pour 300 ml of boiling water. Cover with a lid and let stand for about 30 minutes. Then filter and take a quarter glass 3 times a day, half an hour before meals, for 10 days.

Chewing flax seeds is very beneficial for the stomach and intestines. During this process, beneficial mucus is formed, which, when swallowed, has a beneficial effect on the condition of the mucous membrane of the digestive organs. Pain, burning and other unpleasant symptoms are eliminated. To do this, you should consume 1 tsp of flax seeds on an empty stomach. within a month. They need to be chewed thoroughly.

Calamus has a mild choleretic effect Lemon reduces nausea

Treatment prognosis and possible complications

When determining the cause and type of dyspeptic disorder, as a rule, the prognosis is favorable if you approach treatment comprehensively and follow all the doctor’s instructions. Consequences can only occur if the cause of the syndrome is a stomach ulcer, which, if not treated in a timely manner, can lead to bleeding. The same applies to pancreatitis and cholecystitis. In the first case, there is a risk of self-digestion of the organ, as a result of which you can end up on the operating table. This condition can be fatal.

Cholecystitis, accompanied by cholelithiasis, is also fraught with danger. This pathological process can cause blockage of the bile duct, as a result of which the organ will have to be removed.

Preventive measures

Prevention of dyspeptic disorders is as follows:

1. In the early diagnosis of gastrointestinal diseases: cholecystitis, pancreatitis, gastritis, ulcers, enterocolitis.
2. Reducing the level of anxiety, stress and emotional overload.
3. A balanced diet excluding foods that increase acidity.
4. I find it helpful in avoiding snacks and quick meals.

Dyspeptic disorders respond well to treatment, especially at the initial stage. An important point is the identification of the provoking factor, after which the patient’s condition improves. Compliance with prevention helps normal operation gastrointestinal tract.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

What is dyspepsia?

Dyspepsia is a collective term denoting various digestive disorders, mainly of a functional nature. It is not an independent symptom, but rather a syndrome.

Dyspepsia syndrome includes a complex of symptoms that reflect disorders of the gastrointestinal tract ( from Greek dys - disturbance, peptein - digest). The duration of symptoms in dyspepsia syndrome ranges from 3 months or more. The clinical picture includes pain or discomfort in the epigastric region, bloating, and sometimes stool disorders. Most often, these symptoms are associated with food intake, but can also be caused by emotional overload.

In recent decades, scientists have noted a close relationship between stress and dyspepsia syndrome. Apparently, it is no coincidence that the term “dyspepsia” was widely used in medicine back in the Middle Ages and meant a disease caused by nervous disorders along with hypochondria and hysteria.

Causes of dyspepsia

There are a wide variety of causes that can cause dyspepsia. Very often, several causes and/or risk factors are simultaneously involved in the development of this syndrome. The modern concept of the causes of dyspepsia was actively developed in recent years. Today scientists are in a row possible reasons A number of factors contributing to the development of dyspepsia are considered, namely hypersecretion of hydrochloric acid, dietary errors, bad habits, long-term use of medications, Helicobacter Pylori infection, neuropsychic and other factors.

The causes of dyspepsia are:

• stress;
• genetic predisposition;
• biliary pathology ( gall) systems;
• pathologies of the gastrointestinal tract ( Gastrointestinal tract).

Helicobacter Pylori and other bacteria in the development of dyspepsia

A microbial factor, namely Helicobacter Pylori, plays an important role in the development of dyspepsia. Many researchers confirm the etiological role of this microorganism in the formation of dyspepsia syndrome. They rely on data from the clinical picture of dyspepsia in patients with Helicobacter Pylori. They also believe that the severity of the syndrome is interconnected with the degree of contamination of the gastric mucosa. Proof of this theory is the fact that after antibacterial therapy ( against Helicobacter) manifestations of dyspepsia are significantly reduced.

Confirmation that the state of the nervous system plays an important role in the development of dyspepsia is the fact that stressful situations often provoke a deterioration in the condition of patients with this disease.

Genetic predisposition to dyspepsia

In recent years, research has been actively conducted to identify genetic predisposition to dyspepsia. As a result of these studies, a gene was identified that is associated with the functioning of the digestive organs. Disturbance in its expression may explain this pathology.

Pathology of the biliary system

In the hepatobiliary system of the body, bile formation occurs continuously. The gallbladder serves as a reservoir for it. Bile accumulates in it until it enters the duodenum. From the gallbladder during digestion, bile enters the intestines, where it participates in the digestion process. Bile demulsifies ( breaks down into small particles) fats, facilitating their absorption. Thus, the biliary system plays a vital role in digestion, and therefore the slightest dysfunction can trigger the development of dyspepsia.

The most common functional disorders of the biliary system are various dyskinesias ( motor disorders). The prevalence of these disorders ranges from 12.5 to 58.2 percent. In people over 60 years of age, functional disorders of the biliary system are observed in 25–30 percent of cases. It is important to note that dyskinesia affects predominantly women. Functional disorders of the biliary system include functional gallbladder disorder, functional disorder of the sphincter of Oddi, and functional pancreatic disorder.

The flow of bile into the digestive tract is ensured by the storage function of the gallbladder and its rhythmic contractions. With each meal, the gallbladder contracts two to three times. If this does not happen, then bile begins to be released in insufficient quantities. Insufficient participation of bile in the digestion process provokes symptoms such as heaviness in the epigastrium, nausea and others. This is explained by the fact that a lack of bile leads to the fact that food fats are not absorbed by the body, which explains the symptoms of dyspepsia.

Pathology of the gastrointestinal tract with dyspepsia

Various diseases of the gastrointestinal tract can also cause dyspeptic syndrome. This may be gastritis, peptic ulcer or pancreatitis. In this case, we are not talking about functional, but about organic dyspepsia.

The most common disease that manifests itself with symptoms of dyspepsia is gastritis. Chronic gastritis is a disease that affects more than 40–50 percent of the adult population. According to various sources, the frequency of this disease is approximately 50 percent of all diseases of the digestive system and 85 percent of all diseases of the stomach.

Despite this prevalence, chronic gastritis does not have a specific picture and is often asymptomatic. Clinical manifestations are extremely variable and nonspecific. Some patients may experience symptoms of a “sluggish stomach,” while others may experience symptoms of an “irritable stomach.” However, most often, patients exhibit symptoms of intestinal dyspepsia, namely flatulence, rumbling and transfusion in the abdomen, diarrhea, constipation, and unstable stools. This symptomatology can be supplemented by astheno-neurotic syndrome ( weakness, increased fatigue).

The second most common disease is gastric ulcer. This is a chronic disease that occurs with periods of exacerbation and remission. The main morphological sign of this disease is the presence of a defect ( ulcers) in the wall of the stomach. The leading symptom of peptic ulcer disease is pain. This takes into account its frequency, rhythm and seasonality. Unlike functional dyspepsia, in this case there is a clear relationship between food intake and the occurrence of pain. According to the time of appearance, they can be divided into early, ( 30 minutes after eating), late ( two hours after eating) and “hungry”, appearing 7 hours after the last meal. In addition to pain symptoms, the clinical picture is manifested by various dyspeptic symptoms - heartburn, nausea, belching. All these and other symptoms indicate a violation of the evacuation of food from the stomach. Appetite, as a rule, does not decrease, and sometimes even increases.

Types of dyspepsia

Before proceeding to the existing types of dyspepsia, it is necessary to divide dyspepsia into organic and functional. Organic dyspepsia is one that is caused by certain diseases. For example, this may be peptic ulcer disease, reflux disease, malignant tumors, cholelithiasis and chronic pancreatitis. Based on this, organic dyspepsia is divided into gastric, intestinal and other types of dyspepsia. If, after a thorough examination, no diseases can be identified, then we are talking about functional ( non-ulcer) dyspepsia.

Depending on the causes, there are several types of dyspepsia. As a rule, all of them are characterized by the same symptoms. The difference between them is the reason for their development and the peculiarity of pathogenesis ( emergence).

Types of dyspepsia are:

• gastric dyspepsia;
• fermentative dyspepsia;
• putrefactive dyspepsia;
• intestinal dyspepsia;
• neurotic dyspepsia.

Gastric dyspepsia

In most cases, the presence of dyspepsia symptoms is associated with pathology of the stomach and duodenum ( upper intestine). Gastric dyspepsia is based on such common diseases as gastritis, reflux, and gastric ulcer. This pathology is widespread among the population, accounting for about one third of all clinical cases. Gastric dyspepsia is characterized by polymorphic ( diverse) clinical picture, but the severity of its symptoms does not correlate ( not connected) with the severity of damage to the mucous membrane.
Gastric dyspepsia syndrome is manifested by pain in the epigastric region, which is not associated with intestinal dysfunction. The duration of symptoms is at least 12 weeks.

Many experts assign the main role in the development of gastric dyspepsia to a microbial factor, namely Helicobacter Pylori. Proof of this are studies that have shown that eliminating this factor leads to a decrease or complete disappearance of the symptoms of gastric dyspepsia. Thus, against the background of antibacterial treatment, there is a positive dynamics of morphological changes ( these changes are visible on fibrogastroduodenoscopy). Other scientists and clinicians deny the etiological role of this microbe in the development of gastric dyspepsia syndrome. One way or another, the use of antibacterial drugs to remove this microbe from the body is not a mandatory point in the treatment of gastric dyspepsia.

Fermentative dyspepsia

Fermentation dyspepsia is a type of dyspepsia, which is based on excessive gas formation caused by fermentation. Fermentation is the process of breaking down products under oxygen-free conditions. The result of fermentation is intermediate metabolic products and gases. The reason for fermentation is the intake of large amounts of carbohydrates into the body. Instead of carbohydrates, insufficiently fermented products such as kvass and beer can be used.

Normally, carbohydrates are utilized ( are absorbed) in the small intestine. However, when a lot of carbohydrates are supplied, they do not have time to be metabolized and begin to “ferment.” The result of this is excessive gas formation. Gases begin to accumulate in the intestinal loops, causing bloating, rumbling and colicky pain. After passing gas or taking antiflatulents ( espumisan) the above symptoms subside.

Symptoms of fermentative dyspepsia include:

• bloating;
• colicky pain;
• stool 2 to 4 times a day.

With fermentative dyspepsia, the consistency of stool becomes soft and the color becomes light yellow. Sometimes there are gas bubbles in the stool, which gives it a sour smell.

Putrid dyspepsia

Putrefactive dyspepsia is a type of dyspepsia, which is based on intense decay processes. Rotting processes are caused by protein foods, as well as some inflammatory processes in the intestines. Protein food in this case becomes a substrate for pyogenic flora, which triggers putrefactive mechanisms. Clinical manifestations of putrefactive dyspepsia are symptoms such as bloating, frequent diarrhea ( stool up to 10 - 14 times a day). The feces become dark in color and acquire a foul odor.
In the diagnosis of putrefactive dyspepsia great value acquires microscopic examination of stool. Microscopy reveals many undigested muscle fibers.

Intestinal dyspepsia

Intestinal dyspepsia is a symptom complex combining digestive disorders and enteral syndrome. Clinically, it is expressed in flatulence, stool disturbances ( polyfecal), pain syndrome. With intestinal dyspepsia, stool becomes very frequent, 5 times a day or more. The pain is bursting in nature and is localized mainly in the mesogastrium.

At the same time, enteric syndrome is manifested by metabolic disorders, in particular disturbances of protein and lipid metabolism. Disorders of mineral metabolism are also present. Since vitamins are absorbed in the intestines, when it is dysfunctional, hypovitaminosis is detected ( hypovitaminosis A, E, D). This can lead to dystrophic changes in other organs.

Biliary dyspepsia

The basis of biliary dyspepsia is the pathology of the biliary tract. Most often these are functional disorders ( that is, dyskinesia), in the development of which stress becomes of great importance. Since the nervous system plays a leading role in regulating the contractile function of the gallbladder and bile ducts, any stressful situation can lead to the development of gallbladder dyskinesia. The pathogenesis of biliary dyspepsia can be very variable, but always comes down to dysregulation of biliary tract motility. This means that under the influence of trigger factors ( stress, nutritional disorder) there is a change in the motility of the biliary tract, which can be expressed either in its strengthening or weakening. Both lead to the development of symptoms of dyspepsia.

When the motility of the biliary tract changes, the volume and composition of released bile changes. Since bile plays a vital role in the digestion process, any changes in its composition lead to dyspeptic manifestations. In addition to psychogenic factors, the development of functional biliary pathology is influenced by hormonal imbalance. Thus, an imbalance between the production of cholecystokinin and secretin provokes an inhibitory effect on the contractile function of the gallbladder.

The cause of biliary dyspepsia can also be diseases such as hepatitis, cholangitis, cholecystitis. In this case, the development of dyspepsia is associated with inflammatory changes in the biliary tract.

Symptoms of biliary dyspepsia
The clinical picture of biliary dyspepsia is determined by the degree of motor dysfunction of the gallbladder. Pain symptoms dominate. In this case, pain can be localized both in the epigastrium and in the right upper quadrant of the abdomen. The duration of pain varies from 20 – 30 minutes or more. As with functional dyspepsia, pain in this case does not regress after defecation or after taking antacids. In biliary dyspepsia, pain is associated with nausea or vomiting.

Dyspepsia syndrome in psychiatry or neurotic depression

Dyspepsia syndrome occurs not only in the practice of a gastroenterologist, but also in a psychiatrist. Somatic symptoms that persistently haunt the patient for 2 years, without the presence of any organic lesions, are part of the structure of various psychosomatic disorders. Dyspepsia syndrome can mask diseases such as depression, anxiety and panic disorders. Most often, dyspepsia syndrome is observed with depression. So, there is a type of depression called masked. He is not characterized by such classic complaints as depression, low mood, and labile emotional background. Instead, somatic, that is, bodily complaints, come first. Most often these are complaints from the cardiovascular or gastrointestinal system. The first category includes symptoms such as heart pain, shortness of breath, and tingling in the chest. Gastrointestinal symptoms include epigastric pain, nausea, and discomfort after eating. Thus, dyspepsia syndrome can remain the main symptom of depression for a long time.

Symptoms of neurotic dyspepsia are:

• nausea;
• belching;
• heartburn;
• pain in the epigastric region;
• difficulty swallowing;
• discomfort in the stomach and intestines;
• intestinal disorders;

Often, dyspepsia can be accompanied by other complaints. Most often, these may be complaints from the cardiovascular system, namely rapid heartbeat, interruptions and pain in the heart area, sensations of pressure, compression, burning, tingling in the chest.

To date, more than 250 bodily complaints that occur with depression have been described. In general, the variety of complaints can be so great that it makes diagnosis difficult. To make a diagnosis, at least four bodily symptoms must be present in men and six in women. The difficulty of diagnosis lies in the fact that patients do not complain of depressed mood or any other emotional states. However, long-term observation can reveal irritability, fatigue, poor sleep, internal tension, anxiety, and depressed mood.

Functional dyspepsia

According to the new classification, functional dyspepsia is a complex of symptoms that occurs in adults and children over one year of age. Functional dyspepsia includes pain, nausea, a feeling of fullness in the stomach, as well as bloating and regurgitation. Also, patients with functional dyspepsia are characterized by intolerance to fatty foods. The duration of symptoms must be at least 3 months over the past six months. The term “functional” means that during the examination it is not possible to identify an organic disease.

The prevalence of functional dyspepsia, like many other functional digestive disorders, is very high throughout the world. Thus, among Europeans, every fifth suffers from functional dyspepsia, and in the USA - every third. Moreover, the percentage of women suffering from dyspepsia significantly exceeds the percentage of men with a similar disease. Functional dyspepsia is observed among all age groups, but as people get older, its incidence increases.

Prevalence of functional dyspepsia among different age groups

Reasons for the development of functional dyspepsia

Pathogenesis ( set of mechanisms) the development of functional dyspepsia has not been sufficiently studied to date. It is believed that functional dyspepsia is a disease based on impaired regulation of motility of the digestive tract, namely the stomach and duodenum. Motor disturbances themselves include a decrease in the accommodation of the stomach to the food entering it and a delay in gastric emptying due to reduced motility. Thus, there is a disorder in the coordination of those links that regulate the contractility of the gastrointestinal tract, which leads to the development of dyskinesia.

Visceral hypersensitivity also plays a key role ( increased sensitivity of internal organs). It is this that causes disturbances in the adaptation of the stomach to incoming food and difficult evacuation from it. Impaired accommodation of the stomach to incoming food is observed in more than 40 percent of patients. The consequence of this is symptoms such as rapid satiety, a feeling of fullness in the stomach and pain after eating. Gastric secretion in functional dyspepsia is usually not impaired.

Also, most patients with functional dyspepsia have duodenal dysfunction. It is expressed in increased sensitivity to acid coming from the stomach. The consequence of this is a slowdown in organ motility and a delay in the evacuation of contents from it. As noted above, patients with functional dyspepsia are characterized by intolerance to fatty foods. This intolerance is due to hypersensitivity to fats.

Recent research suggests that a substance called ghrelin plays an important role in the development of functional dyspepsia. Ghrelin is a peptide synthesized by endocrine cells of the stomach. With functional dyspepsia, there is a violation of the secretion of this peptide, which normally regulates the digestive organs. Active secretion of ghrelin in healthy individuals occurs on an empty stomach, which stimulates gastric motor activity and gastric secretion. Studies have shown that the level of ghrelin in the blood on an empty stomach in patients with functional dyspepsia is much lower than in healthy people. This causes the development of symptoms such as a feeling of rapid satiety and fullness of the stomach. It was also found that in patients suffering from dyspepsia, the level of ghrelin in the blood plasma does not change after eating, while in healthy individuals it decreases.

Symptoms of functional dyspepsia

Functional dyspepsia is characterized by repeated pain attacks in the upper abdomen. Unlike irritable bowel syndrome, with functional dyspepsia, the pain and feeling of fullness do not go away after defecation. Also, symptoms are not associated with changes in stool frequency. The main distinguishing feature of this pathology is the absence of signs of inflammation or other structural changes.

According to the Rome diagnostic criteria, several variants of functional dyspepsia are distinguished.

The options for functional dyspepsia are as follows:

• Ulcer-like functional dyspepsia characterized by epigastric pain on an empty stomach ( such “hungry” pains are very characteristic of stomach ulcers, hence the name). The pain goes away after eating and antacids.
• Dyskinetic functional dyspepsia accompanied by discomfort in the upper abdomen. Discomfort increases after eating.
• Nonspecific functional dyspepsia. The complaints present in this variant of dyspepsia do not relate to any specific type of dyspepsia.

According to the Rome Diagnostic Criteria, functional dyspepsia is also classified into postprandial distress syndrome and epigastric pain syndrome. The first syndrome involves discomfort and a feeling of fullness that occurs after eating a normal amount of food. Patients with this type of dyspepsia are characterized by rapid satiety. The pain syndrome is characterized by periodic pain in the epigastric region, which is not associated with food intake.
It should be noted that this classification is typical only for adults. Since it is difficult to obtain an accurate description of complaints in children, functional dyspepsia is not classified in pediatric practice.

In patients with functional dyspepsia, the quality of life is significantly reduced. This is due to the above symptoms ( pain and nausea), as well as the fact that there is a need to limit yourself in certain foods and drinks. Diet and constant pain provoke social problems. Despite the fact that dyspepsia is functional in nature, the degree of reduction in quality of life in such patients is comparable to organic pathology.

An important feature of functional dyspepsia is its systematic nature. All digestive organs are affected to varying degrees. Thus, more than 33 percent of patients also experience symptoms of gastroesophageal reflux, while the frequency of signs of irritable bowel syndrome is almost 50 percent.

Dyspepsia in children

Dyspepsia is typical not only for adults, but also for children. Their course of dyspepsia is usually characterized by a favorable prognosis. Manifestations of dyspepsia in children are very variable and extremely unstable.

Doctors assign the main role in the development of dyspepsia syndrome in children to Helicobacter Pylori and the phenomenon of dyskinesia. This is confirmed by studies showing an increase in the prevalence of infection with this microorganism in children with dyspepsia syndrome. While in children who do not suffer from dyspepsia, the incidence of infection is much lower. Also, children show positive dynamics when using antibacterial agents aimed at destroying the microbe.

Motor disorders of the stomach play an important role in the development of dyspepsia in children. It has been established that only 30 percent of children have normal gastric evacuation function. In children who do not suffer from dyspepsia, this percentage reaches 60–70 percent. Also, in such children, dilatation of the antrum of the stomach is often detected on an empty stomach and after eating. The degree of expansion correlates ( interconnected) with the severity of dyspeptic syndrome. In addition to the bacterial factor and dyskinesia, cerebral pathology is considered as an etiological factor ( birth injuries), age-related features of the functioning of the neuroendocrine system.
Children and adolescents with dyspepsia are characterized by appetite disorders such as bulimia and anorexia.

Diagnosis of dyspepsia in children
In the diagnosis of dyspepsia syndrome in children, research plays an important role
gastroduodenal pathology. For this purpose, fibrogastroduodenoscopy is performed ( FGDS), direct and indirect detection of Helicobacter Pylori. Also in the diagnosis, a significant role is played by the history of the disease, namely the presence of symptoms such as hungry night pain, discomfort in the upper abdomen, belching of sour contents, and heartburn.

Diagnosis of dyspepsia

Dyspepsia syndrome is one of the most common manifestations of gastrointestinal pathology. More than 5 percent of initial visits to doctors are caused by dyspepsia. In gastroenterology, dyspepsia syndrome is one of the most common complaints. As already noted, there are two types of dyspepsia - organic and functional ( non-ulcer). The first is characterized by the presence of pathology, for example, ulcers, gastritis, duodenitis. Functional is characterized by the absence of any gastrointestinal lesions.

The diagnostic criteria for dyspepsia are as follows:

• Feeling pain or discomfort, localized in the epigastric region. Pain is subjectively assessed by the patient as an unpleasant sensation or a feeling of “tissue damage.”
• Feeling of fullness and stagnation of food in the stomach. These sensations may or may not be associated with food intake.
• Fast saturation is perceived by the patient as a feeling of fullness in the stomach immediately after starting a meal. This symptom does not depend on the amount of food taken.
• Bloating is perceived as a feeling of fullness in the epigastric region.
• Nausea.

Diagnostic criteria for organic dyspepsia

Dyspepsia according to ICD

According to the International Classification of Diseases, Tenth Revision ( ICD-10) dyspepsia is coded K10. However, this type of dyspepsia excludes neurotic or nervous dyspepsia. These two types of dyspeptic syndrome refer to somatoform dysfunction of the autonomic nervous system and therefore are not included in the section of gastrointestinal pathology.

The diagnosis of dyspepsia is based on the patient having persistent symptoms of dyspepsia for at least 12 weeks over a year. With functional dyspepsia, organic diseases should not be detected, and irritable bowel syndrome should be excluded.

Differential diagnosis of dyspepsia
Symptoms of dyspepsia occur in patients with irritable bowel syndrome, enteritis, and stomach cancer. This must be taken into account when making a differential diagnosis. To exclude the above diseases, instrumental and laboratory tests are performed. These include general and biochemical blood tests, coprogram and stool analysis for occult blood, ultrasound examination ( Ultrasound), endoscopic and x-ray examination ( x-ray).

Instrumental and laboratory tests for dyspepsia

Method	What is it done for?
Fibrogastroduodenoscopy(FGDS)	Excludes ulcers, gastritis, pancreatitis or other organic pathology of the gastrointestinal tract.
Ultrasound examination(Ultrasound)	Detects or excludes cholelithiasis, chronic pancreatitis. The method is informative for biliary dyspepsia.
Scintigraphy with technetium isotopes	Determines the rate of gastric emptying.
Electrogastrography	Registers the electrical activity of the stomach and the contraction of its walls. In a healthy person, the frequency of gastric contractions is about 3 waves per minute.
Gastroduodenal manometry

Dyspeptic phenomena is a collective term that combines various signs of damage to the digestive canal. They develop as a result of disturbances in the processes of absorption and digestion of food. They are the initial symptoms of gastrointestinal pathology.

How does dyspepsia manifest?

Dyspeptic symptoms are signs of damage to the digestive canal. The most significant include:

What is important is not only the fact that the above symptoms appear, but also the regularity of their occurrence, the relationship with food intake, as well as the combination of symptoms.

You should consult a doctor if any signs (2 or more) appear constantly and do not disappear with dietary correction.

It is advisable to talk about extraintestinal manifestations of dyspepsia if the patient develops a chronic pathology of the digestive canal. Progressive metabolic disorders lead to the following changes:

The systemic phenomena described above are typical only for advanced and untreated disease of the digestive canal.

Reasons

Dyspeptic manifestations can be functional and morphological in nature. The reasons for their occurrence, as well as the mechanism of their development, differ.

Non-pathological causes

Functional dyspeptic manifestations are disorders that are not associated with pathological reactions in the organs and tissues of the digestive canal, but are caused by a temporary change in motor-evacuation function. Among the possible reasons are known:

Functional disorders are short-lived and do not require long-term treatment - symptomatic therapy is sufficient. They can occur at any age, even in a small child, and do not depend on gender.

Pathological causes

Dyspeptic manifestations of a morphological nature are a consequence of inflammatory and dystrophic processes in the organs of the digestive canal. Deep disturbances in absorption and subsequent digestion of all nutrients. As the pathological process progresses, all types of metabolism change irreversibly. Among the possible causes of organic dyspepsia, the following diseases are considered:

Only a doctor can determine the exact cause of dyspeptic symptoms. Attempts at self-diagnosis and self-medication only lead to a worsening of the condition.

Possible consequences

Functional dyspeptic manifestations do not pose any threat to the patient’s life. It is enough to adjust the water and food regimes to feel healthy again.

Ignoring constant signs of dyspepsia leads to the fact that the disease of the digestive canal is diagnosed late and difficult to treat. In some cases (peptic ulcer), complications develop that can lead to the death of the patient.

Prevention

Preventive measures are aimed at maintaining the health of the digestive canal and its functional abilities. These recommendations include:

• balanced diet;
• correct drinking regime in accordance with climate and physical activity;
• refusal or restriction junk food(fast food, processed foods, quickly digesting carbohydrates).

If a person watches his diet, then there are no signs of dyspepsia.

Dyspepsia is a digestive disorder caused by organic and functional reasons. Symptoms include pain in the upper abdomen of unclear localization, nausea, heartburn, a feeling of fullness in the stomach, rapid satiety after eating, etc. The diagnosis is established only if other gastrointestinal pathology is excluded; endoscopic examination of the upper digestive tract is of fundamental importance. Treatment is symptomatic: enzyme preparations, means to improve gastrointestinal motility, etc. Psychotherapy is of great importance - after sessions with a psychologist, most patients note a decrease in the intensity of complaints.

ICD-10

General information

Dyspepsia is one of the main problems of modern gastroenterology, since up to 40% of the population of developed countries makes vague complaints of digestive discomfort, while only every fifth person consults doctors. Digestive disorders can have an organic or functional basis.

Organic dyspepsia occurs against the background of various pathologies of the digestive organs (gastritis, peptic ulcers, inflammatory diseases of the hepatobiliary system, pancreas and various parts of the intestine, gastrointestinal tumors, etc.). Functional dyspepsia is spoken of when, in the presence of symptoms of disturbances in the functioning of the stomach, no organic pathology is detected that could cause these complaints. Women suffer from functional dyspepsia 1.5 times more often than men; The main age group in which this disease is detected are persons 17-35 years old.

Causes of dyspepsia

The pathology is considered to be a psychosocial disease, in which, as a result of various stress factors, the regulation of the functions of the stomach and initial parts of the intestine is disrupted. In addition to emotional stress, the causes of the development of functional dyspepsia may be nutritional disorders, taking certain medications, increased secretion of hydrochloric acid, Helicobacter contamination of the gastric mucosa, dyskinesia of the initial parts of the digestive tract, impaired digestion of complex sugars, etc. It is known that hypovitaminosis (vitamin C deficiency) and group B) can also contribute to the development of dyspepsia.

Dyspeptic syndrome also includes diseases such as food allergies, gastroesophageal reflux disease, diaphragmatic hernia with displacement of the abdominal esophagus into the chest cavity, gastritis, achlorhydria, peptic ulcer of the stomach and duodenum, cholelithiasis, cholecystitis, condition after cholecystectomy, pancreatitis, pyloric stenosis , gastrointestinal tumors, various infections of the digestive tract.

The most common cause of dyspepsia in children is foodborne diseases, in this case, along with dyspeptic syndrome, toxic-exicosis syndrome comes to the fore. Since the signs of organic dyspepsia are discussed in the sections on relevant gastrointestinal diseases, this article will focus primarily on functional dyspepsia.

Pathogenesis

As a result of the influence of these factors on the stomach wall, the sensitivity of visceral receptors increases, discoordination of the motility of the stomach and small intestine occurs, and the normal secretion of digestive juices is disrupted. Manifestations of these disorders are gastroparesis (accompanied by heaviness in the epigastrium, nausea and vomiting), increased visceral susceptibility to stretching (feeling of fullness in the stomach, hungry pain in the epigastric region), incomplete relaxation of the muscular layer of the organ (feeling of early satiety), slowdown in the movement of food masses from the stomach into the intestines.

Classification of dyspepsia

Based on the pathogenetic principle, functional and organic dyspepsia are distinguished. Organic pathology accompanies various diseases of the digestive tract, and functional pathology occurs against the background of the absence of organic damage to the gastrointestinal tract. Based on the causative factor, the following variants of dyspepsia are distinguished:

• Nutritional– usually associated with a violation of the ratio of essential nutrients in the diet. Fermentative dyspepsia develops when carbohydrates predominate in the menu, putrefactive dyspepsia develops when proteins and stale meat predominate, and soap dyspepsia develops when there is an excess of refractory fats.
• Enzymatic– associated with insufficient production of digestive enzymes. Depending on which organ the enzyme deficiency has developed, gastrogenic, pancreatogenic, hepatogenic and enterogenic dyspepsia are distinguished.
• Dyspepsia with malabsorption syndrome- associated with impaired absorption of nutrients in the intestines.
• Infectious- develops with various intestinal infections, most often with dysentery and salmonellosis.
• Intoxication– occurs in acute poisoning, severe general infections, and extensive injuries.

There are also four clinical forms of functional dyspepsia: ulcer-like, dyskinetic, reflux-like and indeterminate.

Symptoms of dyspepsia

The diagnosis of a functional disorder is established if three mandatory criteria are met. The first of these is complaints of pain and discomfort in the upper abdomen along the midline for one week every month, or 12 weeks a year. The second is the absence of organic changes in the gastrointestinal tract during physical, endoscopic and ultrasound examination of the upper digestive tract. The third criterion is the absence of signs of irritable bowel syndrome (relief of symptoms after bowel movements or changes in the nature and frequency of stool).

There are a number of signs in the presence of which the diagnosis is excluded: dysphagia, increased body temperature, the appearance of blood in the stool, inflammatory changes in clinical tests, causeless weight loss, anemia. If these symptoms are present, a more in-depth examination of the patient is required to make a correct diagnosis.

There are four variants of the course of functional dyspepsia, each of which has its own clinical and physical signs. The ulcer-like variant is manifested by fairly severe night or hunger pain in the epigastric region, often occurring after emotional stress. The pain syndrome is relieved by eating and administering antacids. A characteristic symptom is a feeling of fear during an attack, obsessive thoughts about the presence of an incurable disease.

The dyskinetic variant is expressed by a feeling of fullness in the stomach after eating, heaviness in the epigastrium, nausea, and bloating. Vomiting is possible, which brings relief. Patients note that after eating they feel quickly full. Reflux-like dyspepsia is manifested by heartburn, a feeling of burning pain behind the sternum, belching and regurgitation of acid. The last form of the disease - vague, or nonspecific - is characterized by a polymorphism of symptoms, and it is not possible to single out one leading one. Functional dyspepsia is characterized by a long course and lack of progression of symptoms.

Diagnostics

A consultation with a gastroenterologist will help identify the leading complaints and determine the required scope of research. The diagnosis of functional dyspepsia is established only after a complete examination of the patient and exclusion of other gastrointestinal pathologies. The following studies are mandatory: consultation with an endoscopist to conduct esophagogastroduodenoscopy, ultrasound of the abdominal organs, blood tests (general clinical and biochemical blood tests), stool examination to assess digestive activity, and detect occult blood.

With functional dyspepsia, changes in the mucous membrane are not visualized during endoscopy. An ultrasound of the abdominal organs may reveal chronic pancreatitis and cholelithiasis. There are usually no deviations in tests for this diagnosis. Additional studies may be required for differential diagnosis with other gastrointestinal diseases. X-rays of the stomach may reveal expansion of the organ cavity and slower evacuation of food. Electrogastrography shows a disturbance in gastric motility (most often a decrease in its rhythm).

To determine acidity, a study of gastric juice and intragastric pH-metry is carried out (both an increase and a decrease in pH are possible). To assess the degree of relaxation of the stomach, antroduodenal manometry is used, during which a special sensor is inserted into the organ cavity, transmitting pressure readings. With functional dyspepsia, manometry may indicate insufficient relaxation or, conversely, relaxation of the stomach walls.

In a situation where symptoms progress or do not sufficiently regress with treatment, two different tests are required to identify Helicobacter pylori infection. The use of methods with different diagnostic mechanisms (determination of Helicobacter in feces by ELISA, PCR diagnostics of Helicobacter, determination of antibodies to Helicobacter in the blood by ELISA, breath test for Helicobacter) will avoid errors.

A repeated consultation with a gastroenterologist after receiving the results of all studies makes it possible to exclude organic pathology, establish a diagnosis of functional dyspepsia and prescribe the correct treatment. It is known that organic reasons disorders are found in 40% of patients with complaints characteristic of this disease, so the diagnostic search should first of all be aimed at identifying these diseases. Functional dyspepsia should be differentiated from irritable bowel syndrome, functional vomiting, and aerophagia.

Treatment of dyspepsia

The main goals pursued by the doctor when prescribing treatment for functional pathology are to reduce the intensity of symptoms and prevent relapses of the disease. Hospitalization to the gastroenterology department is usually indicated only for complex studies when differential diagnosis is difficult. The main directions of treatment for functional dyspepsia: lifestyle and nutrition correction, medication and psychotherapeutic measures.

To normalize the daily routine, you should exclude situations that provoke stress and anxiety, physical and emotional overload. It is recommended to stop drinking alcohol and smoking. It is necessary to allocate time for daily physical exercise - they improve both the general condition of the patient and the function of the digestive organs. It is also necessary to pay great attention to diet. Fried, extractive and spicy foods, carbonated drinks, and coffee are excluded from the diet.

You need to eat in small portions, chew food thoroughly, and avoid overeating and long breaks between meals. After eating, you need to move actively, you should not lie down to rest. If there are signs of dyspepsia, it is recommended not to use non-steroidal anti-inflammatory drugs, as they negatively affect the condition of the gastric mucosa. These measures are leading in the treatment of functional dyspepsia.

If the patient is unable to normalize his diet on his own, he may need the help of a nutritionist. The specialist will explain the need to observe the frequency and volume of each meal, the dangers of overeating and long breaks in nutrition. The nutritionist will also monitor the quality of food - the presence of sufficient amounts of protein, vitamins, and dietary fiber.

Cure from functional dyspepsia is impossible without deep psycho-emotional restructuring. To do this, it is necessary not only to reduce the amount of stress to a minimum, but also to change the patient’s attitude towards negative situations. This can be facilitated by sports, water treatments, and yoga. The attending physician must maintain a trusting relationship with the patient, explain in detail the causes and mechanisms of development of the disease - only in this case is it possible to obtain the desired effect from treatment. Greater effectiveness of therapy can be achieved by prescribing sedatives (valerian herb, motherwort), antidepressants (fluvoxamine, fluoxetine).

Drug treatment is prescribed depending on the form of dyspepsia. For the ulcer-like variant, the main group of drugs are antacids and antisecretory agents: aluminum hydroxide in combination with magnesium hydroxide, proton pump inhibitors, H2 receptor blockers and others. For the dyskinetic form of dyspepsia, prokinetics are used: domperidone or metoclopramide. Other variants of functional dyspepsia involve the use of various combinations of antacids and prokinetics.

If the symptoms of dyspepsia do not regress during treatment, you should use other drugs from these groups, or change the combination medicines. It is also recommended to conduct a test for H. pylori (if it has not yet been carried out); if the result is positive, eradicate the microorganism with antibacterial agents. Anti-Helicobacter therapy significantly alleviates the course of dyspepsia in 25% of cases.

We should not forget about the alarming symptoms that may appear in a patient with dyspepsia: dysphagia, bleeding from different parts of the gastrointestinal tract, unmotivated weight loss. If the patient presents the listed complaints, it is necessary to repeat endoscopic and other studies for timely detection dangerous pathology Gastrointestinal tract (stomach cancer, small intestine cancer, etc.).

Prognosis and prevention

Functional dyspepsia worsens the patient's life, but the prognosis for this disease is favorable. In the absence of the alarming symptoms listed above, the presence of a serious gastrointestinal pathology is unlikely. However, dyspepsia is characterized by an undulating course, so after a course of therapy there remains a high probability of relapse of symptoms. Specific measures for the prevention of dyspepsia have not been developed, but maintaining a healthy lifestyle, rational nutrition and the exclusion of stressful situations significantly reduce the likelihood of developing this disease.

Throughout life, any person has experienced some unpleasant sensations associated with the gastrointestinal tract. Such changes can be caused by errors in nutrition and excessive overeating.

Such violations can occur from time to time or be regular. The most important reason for such conditions is dyspeptic symptoms or disorders.

In order to correctly establish the line between the natural function of digestion and identify the first symptoms of the resulting dyspepsia syndrome, we recommend reading this article.

What are dyspeptic symptoms

A number of symptomatic manifestations that occur in the human body as a result of digestive dysfunction are called dyspeptic syndrome in medicine.

Accompanied this process various functional disorders of the gastrointestinal tract. Usually the patient complains strongly about inadequate digestion of food, and slow bowel movements are observed.

Patients also complain of severe abdominal pain and flatulence, a feeling of heaviness after eating.

Dyspeptic symptoms are classified as pathologies that are dependent on stomach acid. The mechanism of development of the disease is often due to damage to gastric secretion and impaired motility.

Due to the aggressive influence of gastric secretions on the gastrointestinal tract, the patient experiences a specific reaction.

When patients are diagnosed, they wonder what it is?

If we characterize dyspepsia in other words, then this is a phenomenon that develops not only as a result of gastrointestinal diseases. This means that the process may be caused by specific disorders in the functionality of other organs and systems.

Accordingly, dyspeptic symptoms are a disease that affects most of the population. It applies not only to adult patients, but also to children.

Causes

There are many conditions leading to the development of dyspeptic symptoms:

• Reflux disease, when the contents of the intestines are thrown up into the esophagus.
• Chronic gastritis, which worsens and subsides from time to time.
• Pathologies of the gallbladder and biliary system.
• Gallstones.
• Ulcers.
• Formations of any nature, both malignant and benign.
• Diseases of the pancreas.
• Endocrine disorders.
• Changes in stomach acidity to the low side.
• Intoxication, viruses, purulent pathologies.
• Intestinal obstruction.
• Infections and liver diseases.
• Regular use of antibiotics or antiviral agents, for example ergoferon, arbidol.

Considering the initial cause of stomach disease, it can be infectious or non-infectious.

There are also provoking factors that will sooner or later lead to the development of dyspeptic symptoms:

• Errors in nutrition. Abuse of low-quality products, incorrectly selected diet.
• Excessive production of gastric juice or increased secretion.
• Taking medications. Antibiotics, contraceptives, and hormonal agents can contribute to disruption of the digestion process.
• Nervousness, irritability and stress are also of great importance.
• Alcohol abuse, smoking habit.
• Love for coffee and black tea.

Symptoms and types of dyspeptic phenomena

Such disorders make themselves felt very often. Symptoms appear depending on the cause that led to this dyspeptic phenomenon.

However, there are certain signs that may cause dyspepsia:

• The patient is worried about the state of internal heaviness; he regularly complains of severe pain in the gastrointestinal tract. intestinal tract. In addition, there may be severe belching, after which a temporary improvement occurs.
• A strong burning sensation in the upper abdomen and behind the sternum may make itself felt. After a meal, heartburn bothers me. In addition, gas formation and flatulence are observed.
• Patients experience loss of appetite, indigestion is manifested by a rapid feeling of fullness. Diarrhea also makes itself felt.
• Nausea and vomiting are also a concern. There is rumbling in the stomach, and an unpleasant taste appears in the mouth.
• The stool may be very frequent and of a liquid consistency. It contains parts of undigested food.
• The patient complains of a general deterioration in his own health, is worried about weakness, loss of strength, and has problems sleeping.

ABOUT putrid dyspeptic symptoms are said in cases of symptoms of poisoning. This makes itself felt by belching, heartburn, vomiting, and abdominal pain. With this diagnosis, the stool is characterized by a darkish color.

In case fermentation In dyspeptic conditions, gases and flatulence are often observed in the intestines. In this case, the pain may not bother you at all. The stool has a foamy consistency, and the excrement is light in color.

This condition is used when antibiotics and antivirals are taken incorrectly. For example, in case of an overdose of ergoferon.

Diagnostics

In order to determine the cause and treatment of dyspeptic symptoms, it is necessary to carry out certain comprehensive diagnostic measures.

Along this path, the patient will have to go through several specialists, starting with the therapist. This doctor decides where the patient should go next: a gastroenterologist, an infectious disease specialist, etc.

Taking into account the clinical features of the disease, the following manipulations may be prescribed:

Before starting treatment for dyspeptic symptoms, the patient must adjust his diet, because without this, all therapeutic measures will be in vain.

If you are diagnosed with dyspeptic symptoms, then you need to rebuild your life and introduce the following habits into it:

• Do not be in a horizontal position after a meal for about an hour.
• Don't eat too much before going to bed. The last meal should occur no earlier than three hours before bedtime.
• You need to sleep with your head elevated.
• It is necessary to avoid wearing tight clothing that restricts the body, and also to abandon such accessories.
• Follow a therapeutic diet. Remember that the number of meals should be about five times. These are three main meals with two snacks.
• All smoked and fried foods should be completely removed from the menu. You should also give up irritating drinks: tea and coffee, soda.

Dyspeptic symptoms are treated according to the following plan:

• Compliance with the principles of diet.
• Taking pharmacological drugs.
• Unconventional methods.

Therapeutic nutrition consists of excluding certain foods from the menu. Everything hot, spicy, sweet and the like is strictly prohibited. Steam all food. Ideally, you should give preference to cereals, as well as dairy products. Don’t forget that, despite eating 5 meals a day, you should never overeat.

Therapy for dyspeptic symptoms also involves taking medications. The following treatments are used:

• Painkillers to relieve pain.
• Blockers of gastric juice production.
• Preparations to reduce acidity.
• Antibiotics for toxic damage.
• Sorbents, if there is a fermentation process.
• Enzymes for better digestion of food.
• Medicines to restore motor function.
• Antacids for ulcers.

Preventive measures

Any illness can be prevented. To prevent the development of dyspeptic symptoms in you, you must adhere to the following principles:

• Maintain a balanced diet, meals should happen at the same time.
• Avoid stress and strong emotional turmoil.
• Eliminate bad habits.
• Play sports and monitor your health.

If you have a tendency to develop dyspeptic syndrome, you should forget about fast food, weight loss diets, your diet should be filled with various healthy foods.

Of course, the balance between all consumed substances is important: proteins, carbohydrates, fats. It is important to drink plenty of clean water throughout the day.

The presence of dyspeptic symptoms may be indicated by upset stool, abdominal discomfort, and nausea. Don't put off going to medical institution. The sooner you do this, the better it will be for you.

A cup of coffee instead of breakfast, snacks on the go instead of a full lunch, and finally, a hearty hearty dinner at home instead of...