Non-ulcer dyspepsia

Non-ulcer dyspepsia (NUD) describes the manifestation and symptoms of indigestion without a known cause. NUD stomach pain is also known as functional dyspepsia.

Definition & Facts

Non-ulcer dyspepsia is a form of indigestion or dyspepsia that is not influenced by peptic ulcers, though the symptoms are analogous to dyspepsia caused by ulcers. Such symptoms include upper abdominal discomfort and abdominal bloating.

In most cases, there is no apparent cause; however, the condition can flare up from overeating, eating in a hurry, and eating while agitated or stressed. Women are stricken more frequently than men. Additional symptoms frequently include nausea and burping. Associated conditions include gastroparesis in which food is released from the stomach to the small intestine too slowly and gastroesophageal reflux disease or GERD. 

Symptoms & Complaints

• A discomforting or burning feeling in the upper abdomen or lower chest.
• Burping
• Bloating or swelling
• Nausea
• Flatulence (gas)
• In some cases, symptoms of IBS or irritable bowel syndrome may be present.
• Feeling full too quickly with meals

In most circumstances, symptoms appear to start from the upper stomach.

Causes

The causes of non-ulcer dyspepsia are currently unidentified. Factors that may contribute to the manifestation of non-ulcer dyspepsia include: 

• Drinking excessive amounts of alcohol or caffeine
• Smoking
• A bacterial infection, Helicobacter pylori infection or H. pylori normally found in the stomach of certain people with NUD. All the same, this bacterium is found in many people and cause no discomfort.
• Poor muscle function of the stomach wall
• Some medications, particularly nonsteroidal anti-inflammatory drugs like ibuprofen as well as aspirin may contribute to the onset of this condition. Additional medications like corticosteroids, antibiotics, theophyllines, calcium channel blockers, iron, and nitrates may also be culprits.
• Some foods such as chocolate, spicy foods, peppermint, and tomatoes have been suspected of causing symptoms.
• Anxiousness, stress, or depression are believed to contribute to NUD symptoms

Diagnosis & Tests

Diagnosis will begin with the health care professional inquiring about the patient's medical history, family history, and list of symptoms. He or she will also perform a physical examination.

Diagnosing non-ulcer dyspepsia requires ruling out other digestive disorders. Several other conditions must be eliminated such as stomach cancer, gallstones, and peptic ulcer disease. Stool samples, blood tests, biopsies of the upper digestive tract, breath tests, and X-rays may be performed to search for irregularities in the gastrointestinal tract.

The patient will likely undergo an endoscopy. This test requires the doctor to peek inside the stomach and the first section of the small intestine or duodenum, by sliding a narrow, limber tool called an endoscope down the esophagus. When a person has NUD, the stomach interior appears normal.

Treatment & Therapy

Treatments that may help with managing the signs and symptoms of NUD include:

• OTC or over-the-counter antacids and anti-gas remdies that contain simethicone
• Medicines known as H-2 receptor blockers used to decrease acid production.
• Medicines used to fortify the esophageal sphincter.
• Medications that control muscles spasms with the ingredients hyoscyamine and dicyclomine
• Antidepressants in low dosages.
• Antibiotics
• Psychotherapy sessions with a counselor or therapist may help relieve signs and symptoms that are not helped by medications. A counselor or therapist can teach relaxation techniques that may help the NUD patient cope with their condition.
• Lifestyle and diet changes that require eating smaller and more frequent meals, avoiding foods that irritate the condition, and chewing food slower.
• Staying clear of factors that result in excessive air-swallowing such as carbonated drinks and chewing gum.
• Not laying down immediately after eating a meal
• Decreasing stress by identifying stress triggers, learning meditation, or relaxing and do enjoyable activities like a favorite sport or hobby.
• Regular exercise throughout the week

A doctor might prescribe a medicine to balance or decrease the acid production in the stomach. In addition, there are other therapies like motility stimulants and antispasmodic medicines that will help the stomach discard food more efficiently and decrease NUD complaints. It’s worth noting that despite treatment, symptoms may continue for months or years before disappearing.

Prevention & Prophylaxis

• Eating smaller portions and chewing food slower at meal times.
• Steering clear of eating within three-hours of going to sleep to allow the body adequate time to process the meal.
• Decreasing or quitting entirely any consumption of tea, coffee, and alcohol.
• Staying away from fried and fatty foods.
• Acquiring the habit of controlling stress that can initiate bouts of abdominal discomfort.
• Adopting a safe diet plan if overweight or obese to reduce pounds
• Avoid medications that aggravate the digestive tract like aspirin