By 
Dyspepsia or indigestion is a feeling of discomfort in the upper abdomen that almost always occurs during or after a meal. Identify what causes it so you can control it.
Dyspepsia is a concept somewhat heterogeneous but generally includes the following signs or symptoms referable to the upper gastrointestinal tract: pain or discomfort centered in the upper abdomen, burning in the epigastric area, postprandial fullness, and early satiety. It is what is popularly called indigestion or heavy digestion. Who has not ever felt that discomfort in the upper part of the abdomen after a copious meal?
It is a fairly common problem. Up to half of the adults suffer indigestion at some point in their life. Most people who suffer from dyspepsia in a timely manner do not consult the doctor and self-medicate. One in three adults has some kind of discomfort of this type at least once a year, but of these, less than half goes to the doctor and take a gastric protector independently.
Although dyspepsia can have causes that require specific treatment, such as gastroduodenal ulcer, Helicobacter pylori infection, or other more serious ones, in up to half of the cases, no cause is found even with the most important diagnostic test. For the study, upper digestive endoscopy.
What should be taken into account is that there are a series of alarm symptoms (such as weight loss or vomiting with blood) that, in case of appearing together with dyspepsia, make it necessary to consult a doctor.
Dyspepsia can go away forever with treatment, as in the cases mentioned with ulcer or Helicobacter. In all other cases, when dyspepsia is considered functional and therefore benign, it can be chronic and have an intermittent course throughout life, with various trial treatments without improving or completely disappearing.
Causes of dyspepsia
Dyspepsia is not a disease. It is a symptom that can be due to different causes and appear in benign situations and other diseases. Indigestion or dyspepsia can be classified into different types based on its causes:
- Dyspepsia not investigated: no study has been done to find out its cause, or it is the first time it appears.
- Organic dyspepsia: through various diagnostic tests, an organic cause that justifies the symptoms is identified.
- Functional dyspepsia: diagnostic tests have been performed without finding a justifying cause. It is a diagnosis of exclusion. This means that dyspepsia can be classified as functional only when sure that no disease is causing it.
Digestive diseases and causes that cause dyspepsia
The organic causes of dyspepsia, that is, the diseases that can cause this symptom, can, in turn, be classified into those that have their origin in the digestive system and those that are of another source.
The most frequent digestive causes of dyspepsia are gastric or duodenal ulcers (due to anti-inflammatory drugs or Helicobacter pylori) and gastroesophageal reflux disease. In gastroesophageal reflux cases, there are usually other symptoms, such as heartburn (burning in the chest due to gastric acid that rises into the esophagus) and even regurgitation.
Other digestive causes of indigestion include SIBO, chronic pancreatitis, biliary colic, stomach, pancreas or liver tumors, celiac disease or non-celiac gluten sensitivity, lactose or casein intolerance, chronic intestinal ischemia (with lack of blood supply to the intestine), inflammatory bowel disease, some parasitosis and other rarer diseases (Ménétrier’s disease, eosinophilic gastroenteritis, sarcoidosis, amyloidosis).
Some diseases are not of the digestive system, and that can also cause a sensation of heavy digestion or dyspepsia. Dyspepsia can occur in advanced diabetes mellitus with damage to the autonomic nervous system that controls the gastric part of digestion, thyroid diseases, some autoimmune diseases (such as lupus or rheumatoid arthritis ), advanced chronic kidney failure (due to uremic gastropathy ), various drugs (in addition to the mentioned non-steroidal anti-inflammatory drugs, some antibiotics, opiates, colchicine, estrogens, some mineral supplements, iron, digoxin).
The acute myocardial infarction can sometimes present with pain that can be mistaken for a digestive origin. Tobacco and alcohol frequently cause dyspepsia. Finally, pregnancy is not a disease, but it can cause dyspepsia.
Functional dyspepsia is, as mentioned, a diagnosis of exclusion, so you have to be sure that there is no organic cause that is producing. To rule out the reasons above, a complete medical history and physical examination must be performed, as well as an upper gastrointestinal endoscopy. This includes ruling out two underdiagnosed entities: celiac disease, which can be the cause of dyspepsia or irritable bowel syndrome; and non-celiac gluten sensitivity, which is a newly described entity, the diagnosis of which is based on ruling out celiac disease and taking a gluten-free trial diet to see if there is an improvement.
Comments