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Irritable bowel syndrome
Inflammatory bowel disease
Having a gastroscopy
Having a colonoscopy
What is dyspepsia?
Dysepsia is a description of a collection of symptoms that are likely to
have origin in the upper gastrointestinal tract (particularly the stomach).
Symptoms include upper abdominal pain and discomfort, upper
abdominal bloating, nausea and feeling full quickly during a meal.
What causes dyspepsia?
Dyspepsia symptoms can have a number of causes. In some cases it is
due to so-called peptic ulcers, where a portion of the lining of the
stomach (gastric or stomach ulcer) or duodenum (duodenal ulcer) is
eroded away. The most frequent cause of stomach ulcer are medications (particularly non-steroidal anti-inflammatory medications such as ibuprofen and diclofenac) and a stomach bacteria called Helicobacter pylori. Stomach and duodenal ulcers are important to treat as they can bleed, or sometimes perforate (‘burst’).
Even in the absence of ulceration, these can also cause inflammation of the stomach (gastritis) that may be a cause of symptoms.
In other people, problems such as gallstones can cause dyspepsia, and in others there may be problems with the efficiency of the stomach in processing and emptying food. In fact, there are many reasons why people can have dyspepsia symptoms. In some cases it may be because the stomach has become particularly sensitive to stretch and the nerves are overactive.
In a small minority of people, dyspepsia can be caused by a stomach cancer. This is why it is important to seek a medical opinion if you have new dyspepsia symptoms, particularly if you are middle-aged or older.
What tests are needed?
In some cases, after the doctor has taken a careful medical history, no tests are needed. In other cases a simple breath or stool test to look for Helicobacter pylori will suffice, with antibiotics given if it is found.
Frequently the tests will involve a gastroscopy and an ultrasound test of the abdomen. The gastroscopy is to look for inflammation and ulcers. It is the best test to rule out a stomach cancer. The ultrasound is to look for problems such as gallstones.
On occasion other tests are also useful. These can include a test to study whether stomach emptying is slow (usually done by eating a meal and doing a series of breath tests over several hours).
How is it treated?
This depends on the cause. Helicobacter pylori can be treated with a short course of antibiotics and anti-acid medication (proton pump inhibitors, PPIs). Ulcers need a more prolonged treatment with PPIs.
Gallstones that are causing symptoms can be effectively treated with a keyhole operation.
Some people find that altering their diet can help with dyspepsia symptoms. The trigger foods can vary from person to person. If necessary discussion with a dietitian can be very helpful.
On occasion medications to speed up stomach emptying or reduce over sensitivity of nerves can help.