Dyspepsia

Dyspepsia

·        = Upper abdominal discomfort. Includes bloating, fullness, early satiety, nausea, anorexia, heartburn, regurgitation. Chronic not acute.

·        Exclude bilary colic, pancreas and heart pain 

·        Functional/idiopathic/essential dyspepsia = all investigations normal but still pain = Up to 60% of dyspepsia. ?Increased visceral sensitivity, ?delayed gastric emptying, ?H Pylori gastritis

·        Abdominal pain without significant pathology very common

·        Ask about weight: if overweight – think reflux, if loosing weight think cancer

·        Oesophagitis doesn‟t cause anaemia until proved otherwise

·        Types:

o   Reflux like ® heartburn/regurgitation – treat with empiric H2 antagonist

o   Dysmotility like ® bloating, nausea, fullness (?delayed gastric emptying) – treat with prokinetics (e.g. cisapride & domperidone)