Dyspepsia

• Dyspepsia


  An umbrella term generally used by healthcare professionals to refer to a group of upper abdominal symptoms
• Conditions categorised under dyspepsia

  • Functional dyspepsia, non-ulcer dyspepsia (indigestion)
  • Gastro-oesophageal reflux disease GORD, heartburn)
  • Gastritis
  • Duodenal ulcers
  • Gastric ulcers
• Dyspepsia


  • General pain/discomfort in the upper abdomen, which is the oesophagus, stomach and duodenum
  • Occurs in bouts (comes and goes)
  • Related to eating
• The exact prevalence of dyspepsia is unknown, largely because of the number of people who self-medicate or don't report mild symptoms to their doctor
• Even so, dyspepsia is extremely common: between 25% and 40% of the general population in the west are reported to suffer from dyspepsia symptoms each year
• Prevalence of dyspepsia increases with age and has been reported to be higher in women than men
• Only 5% of dyspepsia sufferers will consult the GP each year
• Aetiology of dyspepsia


  1. Decreased muscle tone leads to lower oesophageal sphincter incompetence

  2. Increased acid production results in inflammation of the stomach (gastritis)

  3. Helicobacter pylori infection

  4. Functional dyspepsia is thought to be multifactorial, with motility, acid secretion and infection all contributing to symptoms
• Triggers for dyspepsia


  • Smoking
  • Pregnancy
  • Heavy drinking
  • Overweight
• Lifestyle factors that can cause dyspepsia

  • Fast food
  • Alcohol
  • Stress
  • Age-related
• Psychological factors that can cause dyspepsia

  • Anxiety
  • Depression
  • Stress
• Posture factors that can cause dyspepsia

  • Bending over
  • Sitting hunched up
  • Lying down
• Hiatus hernia


  Top of stomach pushes through defect in diaphragm, increases pressure in stomach, reduces pressure of diaphragm on oesophagus
• Drugs and foods that can cause dyspepsia

  • NSAIDs
  • Steroids
  • Spicy foods
  • Alcohol
  • Coffee
  • Chocolate
  • Acidic foods
• Symptoms of dyspepsia


  • Vague abdominal discomfort (aching) above the umbilicus associated with belching
  • Bloating
  • Flatulence
  • A feeling of fullness
  • Nausea and/or vomiting
  • Heartburn
• Retrosternal heartburn is the classic symptom of GORD
• Management/treatment of dyspepsia


  1. Test for H. pylori if uncertain

  2. Lifestyle measures: avoid precipitating factors, eat smaller meals, don't eat before bedtime, weight reduction, reduce stress, eat slowly, avoid tight belts and smoking, sleep with head raised

  3. OTC treatments (short-term): alginates, antacids, H2 antagonists, PPIs, simeticone

  4. Referral: ALARM symptoms, severe/debilitating pain, persistent vomiting, referred pain