Summary about Disease
Non-ulcer dyspepsia (NUD), also known as functional dyspepsia, is a chronic (long-term) condition characterized by persistent or recurrent symptoms of indigestion (dyspepsia) in the absence of any identifiable structural or biochemical abnormalities (such as ulcers or inflammation) in the upper digestive tract. It's a functional gastrointestinal disorder, meaning there's a problem with how the digestive system works, not a visible problem with the organs themselves.
Symptoms
Common symptoms include:
Burning sensation in the upper abdomen
Bloating
Nausea
Feeling full quickly after eating (early satiety)
Upper abdominal pain or discomfort
Belching
Vomiting (less common)
Causes
The exact cause of NUD is not fully understood, but several factors are believed to contribute:
Gastric motility issues: Problems with the muscles in the stomach that move food along.
Visceral hypersensitivity: Increased sensitivity to sensations in the stomach.
Psychological factors: Stress, anxiety, and depression can worsen symptoms.
Helicobacter pylori (H. pylori) infection: Although NUD is defined by the absence of ulcers, some patients with NUD test positive for this bacteria, and its role is still being investigated.
Dietary factors: Certain foods can trigger symptoms in some individuals.
Genetics Family history of functional gastrointestinal disorders
Medicine Used
Medications used to manage NUD symptoms include:
Proton pump inhibitors (PPIs): Reduce stomach acid production (e.g., omeprazole, lansoprazole).
H2 receptor antagonists: Also reduce stomach acid (e.g., ranitidine, famotidine).
Prokinetics: Help speed up gastric emptying (e.g., metoclopramide, domperidone) – use is often limited due to side effects.
Antidepressants: Low doses of tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) can help manage pain and anxiety.
Antacids: Neutralize stomach acid for quick relief.
Eradication therapy for H. pylori: If H. pylori is present, antibiotics are used to eliminate the infection.
Anti-emetics Suppress nausea.
Is Communicable
No, non-ulcer dyspepsia is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Precautions focus on managing symptoms and identifying triggers:
Dietary modifications: Avoid foods that trigger symptoms (e.g., spicy foods, fatty foods, caffeine, alcohol).
Smaller, more frequent meals: This can help reduce bloating and fullness.
Stress management: Practice relaxation techniques (e.g., meditation, yoga).
Avoid smoking: Smoking can worsen symptoms.
Limit alcohol consumption: Alcohol can irritate the stomach lining.
Elevate head while sleeping: Can help if acid reflux contributes to symptoms.
Over-the-counter medications: Use antacids as needed for symptom relief.
How long does an outbreak last?
NUD is a chronic condition, not an outbreak. Symptoms can be persistent or recurrent over a long period (months or years). The intensity of symptoms can vary, with periods of exacerbation (worsening) and remission (improvement).
How is it diagnosed?
Diagnosis involves:
Medical history and physical exam: The doctor will ask about your symptoms and medical history.
Upper endoscopy: A thin, flexible tube with a camera is inserted into the esophagus, stomach, and duodenum to rule out ulcers, inflammation, or other structural abnormalities.
H. pylori testing: Breath test, stool test, or biopsy during endoscopy.
Blood tests: To rule out other conditions.
Gastric emptying study: To assess how quickly the stomach empties. (less common)
Diagnosis of Exclusion Ruling out other possible diseases and conditions. The Rome IV criteria are often used for diagnosis, focusing on symptom-based criteria in the absence of structural disease.
Timeline of Symptoms
Symptoms are chronic or recurrent, meaning they persist over a period of at least 3 months, with symptom onset at least 6 months prior to diagnosis. The timeline can vary greatly between individuals. Some may experience near-constant symptoms, while others have periods of remission followed by flare-ups. There isn't a predictable progression; symptoms can fluctuate in intensity and frequency over time.
Important Considerations
NUD can significantly impact quality of life.
Psychological factors play a significant role in symptom perception and management.
Treatment is focused on managing symptoms rather than curing the underlying condition.
It's important to have realistic expectations about treatment outcomes.
A multidisciplinary approach involving a gastroenterologist, psychologist, and registered dietitian may be beneficial.
Always consult with a healthcare professional for diagnosis and treatment.