Functional Dyspepsia
Functional gastrointestinal disorder (FGID) is the most common disorder affecting the gut affecting up to 40% people in the world. The disorder is a combination of abnormal motility and sensitivity of the nerves of the intestine as well as altered gut flora and immune system. The good news is there are NO structural abnormalities that can be seen by blood tests, endoscopy or X-ray.
Symptoms
Patients have the following symptoms in varying degree;
- abdominal pain
- dysphagia (difficulty swallowing)
- dyspepsia or burning sensation
- feeling of fullness (early satiety)
- bloating
- diarrhoea
- constipation
Terminology of the Condition
According to the ROME IV classification of FGID, Functional Dyspepsia is the term referring to patients with postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). In general, PDS is a postprandial syndrome while EPS is not but there is a degree of overlap between the 2 conditions.
Management of Functional Dyspepsia
Management of functional dyspepsia is recommended along the following guidelines;
1. Conservative Treatment
- Lifestyle changes include having regular gentle exercise (such as walking for 20-30 minutes a day) and cut down (or avoid) caffeine and alcohol
- Improve your mental health by reducing stress or anxiety in your life
- Having balanced diet at regular meal times and avoid unhealthy food habits
- Cognitive Behavioral Therapy can help patients relax and provide a sense of control over these symptoms while Diaphragmatic Breathing Exercises can help reduce belching or regurgitation
2. Medication
- Pro-kinetic medications such as Itopride (Ganaton), Cisapride (Propulsid) or Metoclopramide which promotes gastric motility and improves gastro-duodenal coordination can provide symptomatic relief after around 7-10 days of use. Some side effects of pro-kinetic medications include abdominal cramps, nausea or vomiting, diarrhoea, mood change and drowsiness.
- Proton pump inhibitors (PPIs) are medications which reduce the production of acid such as Lansoprazole (Prevacid), Rabeprazole (Pariet), Pantoprazole (Controloc), Esomeprazole (Nexium) and Dexlansoprazole (Dexilant). The most common side effects (usually mild and therefore easily tolerated) of PPIs are headache, diarrhoea or constipation, flatulence, nausea or vomiting and rashes.
Your doctor may recommend to use the lowest doses and shortest duration of treatment necessary for the condition to reduce the side effects.
Prognosis
Functional dyspepsia is associated with a lot of disturbing symptoms which can affect the quality of patient’s life. As the root cause of these disorders is still incompletely understood there remains no cure for them. Nonetheless, most patients get some form of relief from the treatment described above.
Discuss the treatment options with your Pharmacist or Doctor
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