Dyspeptic Disorders

What are Dyspepsia and indigestion

The terms dyspepsia and indigestion are used in everyday vocabulary to describe common symptoms arising from a number of conditions of the upper gastrointestinal tract. The symptoms include epigastric pain, chest pain, heartburn, fullness, bloating, flatulence, nausea and vomiting. Up to 40% of the adult population experience these types of symptoms in one year, but only 10% seek medical advice.

Causes of dyspepsia

• peptic ulcer
• helicobacter infection
• stomach or oesophagus cancer
• gastritis and duodenitis
• gastro-oesophageal reflux Disease and hiatus hernia
• drugs

A number of commonly used drugs cause dyspepsia, gastritis and duodenitis (inflammation of the stomach and duodenum respectively) and peptic ulcers. These include:

• Pain relieving non-steroidal anti-inflammatory drugs (NSAID) e.g. aspirin, ibuprofen, naproxen, diclofenac.
• antibiotics e.g. erythromycin, metronidazole
• Corticosteroids e.g. prednisolone, prednisone.

Drug induced dyspepsia is treated by avoiding the offending medication or substituting alternative drug regimes.

In the majority of cases of dyspepsia appropriate investigation and treatment leads to resolution of symptoms. People are unlikely to experience significant or persistent functional restrictions or have any need for help with self-care or difficulty in walking.

What it is a Peptic Ulcer?

Peptic ulcer is a discrete lesion breaching the lining of the upper part of the gastrointestinal tract. Characteristically, peptic ulcer causes the symptoms described as indigestion or dyspepsia. Most peptic ulcers occur in the stomach or duodenum (the first part of the intestine arising from the stomach).They develop when the normal defense and repair mechanisms of the lining of the stomach or duodenum are weakened, making the lining more likely to be damaged by stomach acid.

Peptic ulceration is a common condition, four times more common in men than women and with a peak incidence between 30 to 50 years. Overall duodenal ulcers are much more common than gastric (stomach) ulcers.

Causes

• 80% of peptic ulcers are associated with an infection in the stomach caused by the bacterium Helicobacter pylori.
• Pain relieving non-steroidal anti-inflammatory drugs (NSAID) e.g. aspirin, ibuprofen, naproxen, that are used as analgesics and to treat arthritis, cause peptic ulceration. This side effect is more common with increasing age and in women.
• Stomach cancer (a rare cause).

Predisposing factors

A number of factors predispose to peptic ulceration including -:

• Male sex
• Smoking
• Hereditary/familial
• Drugs (in addition to NSAID) – steroids, colchicine
• Renal failure and severely ill people with multiple organ failure
• Raised blood calcium
• Crohn’s disease
• Zollinger Ellison syndrome (a condition in which stomach produces excessive amounts of acid).

Click on the link for details of:

• Helicobacter Pylori Infection
• Gastritis and Duodenitis
• Gastro-Oesophageal Reflux Disease and Hiatus Hernia
• Diagram of the Stomach

Amended April 2008