All About Dyspepsia

 December is the most festive time of the year and is also the busiest.  Endless parties everywhere, lechon, alcoholic beverages, shopping for gifts and clothes, food preparation for the Noche Buena and the Media Noche, class and family reunions, sleepless nights, etc.. -  all these can be stressful. Before you know it, you are already complaining of stomach discomfort, burping, nausea and bloating.  All these are symptoms of dyspepsia.

Dyspepsia is a medical term that describes discomfort or pain in the upper abdomen. It is not a disease but it is actually a group of symptoms which often include bloating, nausea and burping.  In layman's term, dyspepsia is called indigestion or upset stomach.  Indigestion is usually caused by stomach acid / gastric acid coming into contact with the mucosa of the digestive system - the sensitive protective lining of the digestive system. Stomach acids break down the mucosa, causing irritation and inflammation, which trigger the symptoms of indigestion.

Indigestion is usually related to lifestyle and what we eat and drink. It may also be caused by infection or some other digestive conditions. Some common causes include:eating too much, eating too fast, consuming too much fatty/greasy  and spicy foods, too much alcohol,  too much caffeine, emotional trauma, smoking, intake of some medications (antibiotics and NSAIDs), gastritis, pancreatitis and peptic ulcers.

Most people with dyspepsia or indigestion complain of  pain and discomfort in the stomach or chest area. The sensation usually appears soon after consuming food or drink. In some cases symptoms may appear some time after a meal. Some people feel full during a meal, even if they have not eaten much.  Nausea,belching and  sensation of bloating/fullness are also commonly noted.  Heartburn, the sensation of a burning feeling behind the breastbone is also common.  Mild indigestion is really no cause for concern.  However, if symptoms persist for more than two weeks, it is best to seek professional advice.  If the symptoms are severe and if the following symptoms like loss of appetite, weight loss, jaundice (yellow discoloration of skin and eyes), black stools,  chest pain radiation to the jaw, neck or arm,  shortness of breath occur; please see your physician immediately.


Treatment for dyspepsia may depend on the severity of symptoms and its causes.
Diet and lifestyle modification is indicated if the symptoms are mild and is of less occurrence. This usually involves consuming less fatty foods, less caffeine, alcohol and chocolates.  Smoking should be stopped because this affects gastric motility.  Sleep in a more upright position(i.e., propped up on a pillow) to help the digestion of food.  Try to get enough sleep and reduce stress levels.

If symptoms are severe, medications may be indicated.
Antacids are usually the first medications that doctors recommend.  These are OTC med, thus no prescription is necessary. (Ex.  Maalox, Kremil-S, Mylanta)

H2-receptor antagonists - ex.  Ranitidine, Cimetidine, Famotidine.  They reduce the levels of gastric acids and their effects last longer than the antacids.

PPI (proton pump inhibitor) - ex.  omeprazole, pantoprazole.  They have stronger effects compared to H2receptor antagonists.  These drugs are also helpful for those with GERD.

Prokinetics - ex. domperidone--helps stimulate movement of the stomach, better digestion, and gastric emptying.

Antibiotics -  if Helicobacter pylori is causing peptic ulcers in relation to  indigestion an antibiotic is given.

Antidepressants - if no causes for indigestion are found after a thorough evaluation and the patient has not responded to treatments, the doctor may prescribe antidepressants. Antidepressants sometimes ease the discomfort by reducing the patient's sensation of pain.