Dyspepsia

Gastroenterology (12%) Core Clinical Conditions

1A: Able to diagnose and manage

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

The medical term or condition called Dyspepsia, also known as indigestion, refers to a set of symptoms that manifest as pain or discomfort, bloating, and a sensation of fullness following a meal. These symptoms come from the upper abdomen ( stomach, oesophagus or duodenum).

• Gastroesophageal Reflux Disease (GERD).

• Peptic ulcer disease.

• Gallstones, gastritis (inflammation of the stomach lining), use of certain medications such as NSAIDs.

• Consuming fatty or spicy foods.

• Excessive alcohol intake.

• Smoking.

Stomach acid and digestive enzymes break down food and facilitate nutrient absorption. In individuals with dyspepsia, this balance is disrupted, causing impaired digestion. The symptoms are worse if there is Inflammation and/or irritation of the stomach lining.

• Excessive stress and anxiety. Constant stress or dealing with overwhelming anxiety, it can disrupt the normal functioning of our digestive system, leading to symptoms of dyspepsia.

• Older individuals are also more prone to dyspepsia. The ageing process causes the digestive system to undergo natural changes that can affect its efficiency. 

• Women are more susceptible to dyspepsia compared to men. 

• Obesity or being overweight is another risk factor for dyspepsia. Excess weight puts added pressure on the stomach and other organs involved in digestion, which can lead to discomfort and indigestion. 

• A history of smoking is known to be associated with an increased risk of dyspepsia. Smoking can negatively impact the digestive system by weakening the lower esophageal sphincter and reducing blood flow to the stomach lining.

• Nausea, vomiting, and a sensation of acid reflux or heartburn.

• Discomfort or pain in the upper abdomen. 

• Bloating and a constant feeling of fullness, after small meals.

• Good medical history and physical examination. 

• Endoscopy + biopsy to review the presence of H. pylori or malignancy. 

• Urea breath test. 

• Stool test to rule out H. pylori. 

• Blood tests: FBC to rule out anaemia. 

• Lifestyle changes: dietary changes, regular exercise, and stress reduction techniques. 

• Antacids. 

• Proton pump inhibitors (PPI). 

• Treating the underlying causes, such as addressing H pylori infection or gastritis.

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