Dyspepsia

Dyspepsia (indigestion)

Definition: dysphagia is chronic or recurrent pain or discomfort centered in the upper abdomen.

Discomfort means:

•         Bloating.

•         Abdominal fullness.

•         Early satiety, acidity, heartburn.

•         Or nausea.

In dyspepsia :

•         Detect symptoms suggest specific disorders like peptic ulcer.

•         Detect “alarm features” (weight loss, anaemia, vomiting, haematemesis, dysphagia and palpable abdominal mass) which need urgent endoscopy.

•         Detect atypical symptoms more suggestive of other disorders like ischemic heart disease.

Dyspepsia is an extremely common disorder in an otherwise healthy population. It has been estimated that as many as 25% to 40% of adults will experience dyspepsia in a given year. Although most individuals who experience dyspepsia symptoms do not seek medical attention, approximately 25% do seek treatment, making the condition responsible for 4% to 5% of all primary care physician visits.

 

 Due to the prevalence of the condition and the significant direct and indirect costs with which it is associated, dyspepsia is a major healthcare concern all over the world.

Causes of dyspepsia

A.   Common causes:                                                                                                

                                                                                                                               1. Functional dyspepsia about 60% of cases.                

2. Organic:                                                                           

                 peptic ulcer diseases:             15-25%                        

                .GERD:                                    5-15%                       

                .Gastric or oesophageal cancer: 1-2%

 B. Rare causes:

Pancreatic and hepato-biliary, colonic diseases, systemic diseases                                                                like renal failure, hypercalcaemia, drugs (like NSAIDs, iron, digoxin) and alcohol

                                                                                              

                               

Investigation

1. Early endoscopy

If patient is above 55 years

Or alarm features are present

Or if patient (at any age) is not

responding to empiric therapy

 for H. pylori

2. Test for H. pylori and Anti-

H. pylori (age below 55).

If it is positive

Or Symptomatic treatment if

Negative.