Affects: Stomach2–4 h
Functional dyspepsia
Persistent upper abdominal discomfort with no lesion to explain it. The stomach is not damaged, but it functions and perceives abnormally.
What happens
In functional dyspepsia, endoscopy and blood tests are normal, and yet the discomfort is real and constant. Identified mechanisms include altered gastric emptying, poor relaxation of the stomach as it fills, visceral hypersensitivity and disturbed gut-brain axis signalling.
Two common forms
Postprandial distress syndrome, with fullness and early satiety after meals, and epigastric pain syndrome, with burning or pain not necessarily related to eating. They can coexist.
Functional does not mean imaginary
It is a positive diagnosis based on established clinical criteria, not a leftover from finding nothing. It significantly affects quality of life and deserves serious treatment.
What helps
- Smaller, more frequent meals, eaten slowly
- Reducing fat, alcohol, coffee and heavily spiced food if you notice they affect you
- Testing for and treating H. pylori, which improves a subset of patients
- Not lying down right after eating
- Working on stress and sleep, which directly modulate visceral sensitivity
- Treatments targeting motility or hypersensitivity exist, depending on the symptom profile
When something goes wrong
- GastritisInflammation of the stomach lining. It can be acute and short-lived or chronic, and in many cases the bacterium Helicobacter pylori is behind it.
- Peptic ulcerAn open sore in the wall of the stomach or the first part of the small intestine, where acid has eroded the tissue.
- H. pyloriA bacterium able to survive in stomach acid. It colonises the gastric lining and is the main cause of chronic gastritis and peptic ulcer.
