Acidity and Reflux (Dyspepsia)

Dyspepsia also known as indigestion, includes pain in the upper abdomen. The main symptoms seen in this condition are:

• Post prandial fullness (feeling of prolonged food existence in the stomach)
• Early satiety (Fullness after eating small portions of meal)
• Epigastric pain (Pain just below the rib cage)
• Epigastric burning
• Bloating in upper abdomen
• Nausea and vomiting
• Belching (Burping)

In absence of any organic reason, dyspepsia is referred as functional dyspepsia.

Organic reasons for dyspepsia include:

• Gastroesophageal reflux disease
• Peptic ulcer
• Stomach malignancy
• Diabetes mellitus
• Scleroderma
• Tuberculosis/sarcoidosis
• Parasitic infections
• Hypothyroidism
• Hyperparathyroidism
• Medications
• Chronic pancreatitis and pancreatic malignancy
• Myocardial ischemia

Functional dyspepsia

Functional dyspepsia includes a wide spectrum of symptoms such as early satiety, post prandial fullness, burning, and epigastric pain in the absence of any specific systemic, gastrointestinal and metabolic cause.

Investigations

Patients with dyspepsia who do not have any severe complications (weight loss, dysphagia, bleeding etc) should be started with trial of medications.
The severity of symptoms should be assessed.

Patients require immediate investigation if they present with alarming symptoms, and are elderly patients.

Investigation for dyspepsia

• UGIE and H pylori testing
• Thyroid function test
• USG abdomen
• CBC/LFT/LFT
• Other investigation based on patient’s clinical situation

Treatment

Dyspepsia can be treated with the following drugs:

• Prokinetic drugs
• Proton pump inhibitors
• Simethicone
• Antidepressant
• SSRI