Generally, the symptoms are poorly defined abdominal discomfort, indigestion, bloating, gas, abdominal pain, early satiety, nausea and retrosternal burning.
Classification
• If there is a demonstrable organic cause of dyspepsia, organic dyspepsia is mentioned, if not, functional dyspepsia is mentioned.
• About 70% of dyspepsia is functional dyspepsia.
• The most common causes of organic dyspepsia are peptic ulcer and GERD.
Diagnosis of functional dyspepsia
Functional dyspepsia is a diagnosis of exclusion, that is, it is made by excluding other organic and systemic causes.
• For this, the patient is evaluated clinically and if necessary; endoscopy, abdominal ultrasonography, and other advanced tests may be performed.
Patients for whom no other cause can be demonstrated clinically or as a result of these tests are considered functional dyspepsia if they also meet the following criteria.
• Rome IV criteria for the diagnosis of functional dyspepsia;
Beginning at least 6 months ago and continuing for at least 3 months
Presence of at least one of the symptoms of postprandial bloating, early satiety, epigastric pain, epigastric burning, and exclusion of organic cause(s) to explain the symptoms (including endoscopy)
Approach to the dyspeptic patient
• Patients over the age of 45 who have one of the warning signs listed below or who present for the first time with dyspepsia are first undergone endoscopy.
One of the following 3 approaches can be applied to patients under the age of 45, who have no warning signs and are thought to have functional dyspepsia:
"Test and cure" for H. pylori
Giving direct empiric acid suppression or prokinetic therapy
If it has not been done before, approach according to the result by performing endoscopy
In patients whose symptoms do not improve with empirical therapy or eradication of H. pylori, or whose symptoms recur frequently, further investigation is initiated with endoscopy and other tests.
• In functional dyspepsia, patients can sometimes benefit from antidepressant treatment.
