Functional dyspepsia (FD) is a condition where the signs of indigestion are recurring with no obvious cause.
Functional dyspepsia is also known as non-ulcer stomach pain or non-ulcer dyspepsia as the signs and symptoms resemble those of an ulcer such as discomfort or pain in the upper abdomen with belching (burping, expelling excess air from your stomach and esophagus through your mouth), bloating, and nausea. Stomach ulcers are painful sores that are present in the lining of your stomach.
The signs and symptoms of functional dyspepsia are intermittent (not happening regularly or continuously), however, the condition is common and lasts long.
Indigestion, also called dyspepsia or an upset stomach, is a disorder that is characterized by discomfort in your upper abdomen. Indigestion is accompanied by a group of symptoms that usually occur together, which include pain, a burning feeling, or discomfort in your upper abdomen; feeling full too soon while eating, and feeling uncomfortably full after eating.
Read on to understand the causes, symptoms, and tips to manage and prevent indigestion.
Causes
It's not clear what causes functional dyspepsia. It is considered a functional disorder, which means that on routine testing no obvious findings are seen. Hence, it is diagnosed based on symptoms. However, factors that can increase the risk of functional dyspepsia include:
Female gender: Being a female increase your risk of having indigestion
Use of certain over-the-counter pain relievers like NSAIDs (Non-steroidal anti inflammatory drugs) which can cause stomach problems
Smoking
Anxiety or depression
History of childhood physical or sexual abuse
Helicobacter pylori infection: It is a type of bacteria that can infect your stomach and your bowels. H.pylori infection causes inflammation (redness, warmth, swelling, and pain around the tissue, that occurs as your body’s response to injury/illness) of the mucosal lining of the stomach and duodenum (first part of your small intestine), leading to dyspepsia. Stomach wall is lined by a membrane which is called the mucosa. This contains cells and glands that produce hydrochloric acid and digestive enzymes to help digest the food. Enzymes are substances that act as a catalyst in your body, helping in regulating the rate at which chemical reactions occur without themselves being altered in this process.
Symptoms
Signs and symptoms of functional dyspepsia may include:
Pain or burning in your stomach, bloating, excessive belching, or nausea after meals.
An early feeling of fullness (satiety) when eating i.e., you feel very full after eating only a very small amount of food.
Pain in your stomach that may sometimes occur and is unrelated to meals or maybe relieved with meals.
As the cause of FD is unknown, there is a wide range of treatment options available for symptomatic relief. The type of treatment varies from person to person depending on your symptoms.
Treatment
The severity of your symptoms will help your doctor decide what treatment is best for you. Often, you may be able to treat the condition without the use of any medication. Or you may need a short-term or long-term medication to manage symptoms.
- Medications. Your doctor may recommend acid-neutralizing or acid-blocking medications to help with stomach discomfort and acidity. Gas-relieving medication may be prescribed for belching or bloating, etc., and antibiotics (bacteria-killing drugs), if your FD is due to H.pylori bacterial infection. The duration of these medications will be prescribed by your doctor.
- Natural remedies/diet. Changing your diet may be one of the most important factors in managing FD. It may be that what or how you eat impacts your symptoms. There are no specific foods that are linked to FD, but you may find that certain eating behaviors or foods can trigger FD.
Tips to Treat or Prevent Functional Dyspepsia at Home
1. Eat smaller and lighter meals. Avoiding large meals is one of the easiest ways to lower the chances of experiencing acid reflux and heartburn. Eating 5-6 small meals a day is less work for your digestive system and easy and convenient for you as well.
2. Eat foods rich in healthy fats, fiber, magnesium, and probiotics to fight various symptoms of indigestion.
Eating healthy fats is important to help to fight acid reflux symptoms. Healthy fats include avocados, flax seeds, olive oil, and sesame oil.
Fiber aids digestion and high-fiber foods such as fruits, vegetables, and grains reduce acid reflux (known as heartburn). It occurs when your stomach acid flows back into your food pipe). Fiber, among other things, absorbs liquid in your digestive system, which prevents the displacement of stomach acid.
Magnesium combined with hydroxide or carbonate ions may help neutralize the acid in your stomach. Your stomach contains gastric juices that are made up of water, electrolytes, hydrochloric acid, enzymes, mucus, and intrinsic factor. Include nuts, fish, legumes, bananas, and leafy greens in your daily diet.
Your stomach contains healthy bacteria which help in regulating digestion, your immune system, and your overall health. Probiotics or “friendly” bacteria may help maintain a balance between good and harmful bacteria. Probiotic-rich foods are yogurt, kimchi (a Korean dish which is a combination of vegetables, garlic, ginger, chili peppers, salt, and fish sauce), raw fermented pickles and vegetables, kefir (fermented drink, traditionally made using cow's milk or goat's milk) and kombucha (fermented, lightly effervescent, sweetened black or green tea drink).
3. Exercise daily for at least 30 minutes. Studies show that moderate and low impact exercises are quite beneficial if you have indigestion. Activities like walking, light jogging, yoga, riding a stationary bike, or swimming are great to alleviate symptoms associated with acid reflux.
4. Stay hydrated. Drinking water regularly can make your digestion process better and curb acid reflux and indigestion.
5. Manage or reduce stress and anxiety. Stress and anxiety are known to have both short-term and long-term effects on your digestive system. Stress increases the amount of acid in your stomach, which leads to indigestion and heartburn.
7. Control your weight. Being overweight or obese (excessive body fat) increases your risk of acid reflux disease which can lead to indigestion. Due to excessive accumulation of body fat, there is extra pressure on your stomach which can cause the backflow of stomach acid into your esophagus and cause acid reflux disease.
Reducing your weight through regular physical activity and eating the right foods can help manage indigestion.
8. Stop or avoid painkillers. NSAIDs (Non-steroidal anti inflammatory drugs) are known to cause mild stomach-related side effects such as indigestion, heartburn, nausea, loss of appetite, stomach pain, and diarrhoea (watery stools). It is advisable to avoid painkillers as much as possible or stop them as soon as the need dies.
Also remember, taking pain relief medication on an empty stomach can result in a stomach ache or upset. To avoid this, try to take them with food and a glass of water for stomach pain relief.
9. Avoid spicy food and processed foods. Too much intake of spicy, salty, and processed foods can affect your esophagus (food pipe) and lead to inflammation. This can further cause indigestion and discomfort. Avoid eating these foods on a regular basis and watch your portion sizes while gorging on these foods.
10. Do not drink excessive amounts of alcohol, caffeine, and carbonated beverages.
Alcohol can cause inflammation in your stomach mucosa (the lining that protects the walls of your stomach). Heavy drinking can cause heartburn, nausea, and vomiting.
Caffeinated food and beverages can increase the production of your stomach acid, resulting in acid reflux disease and heartburn, the most common symptoms of indigestion.
Carbonated drinks and sodas are high in acid content and can irritate your esophagus. If you have recurrent indigestion, it is best to avoid excessive amounts of alcohol, caffeine, and carbonated beverages. You can opt for fresh fruit juices, herbal or green teas, and detox water (water that has been infused with the flavors of fresh fruits, vegetables, or herbs to get rid of toxins) instead of tea, coffee, and aerated drinks.
11. Avoid eating food late at night or just before bedtime. Your body slows down its functions at night to prepare for sleep, but consuming foods, especially those high in carbohydrates, can make it harder to digest and result in indigestion. It is advised to eat your dinner 2 hours before bedtime to avoid indigestion symptoms.
When to See a Doctor
Bloody vomit
Dark, tarry stools
Shortness of breath
Pain that radiates to your jaw, neck, or arm
Unexplained weight loss
FD occurs in each person differently. Symptoms can vary, and it can take time to be diagnosed while your doctor rules out other conditions. Get the support you need to help manage your condition. You may find that modifications to your lifestyle and certain medications can relieve your symptoms and improve your quality of life.
References:
1. Gastrointestinal Society. 2021. Functional Dyspepsia. [online] Available at: <https://badgut.org/information-centre/a-z-digestive-topics/functional-dyspepsia/#:~:text=Functional%20dyspepsia%20is%20a%20chronic,intestine%2C%20which%20begins%20after%20swallowing.> [Accessed 8 March 2021].
2. The Institute for Functional Medicine. 2021. Understanding & Diagnosing Functional Dyspepsia | The IFM. [online] Available at: <https://www.ifm.org/news-insights/gut-understanding-diagnosing-functional-dyspepsia/> [Accessed 8 March 2021].
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