Dyspepsia , indigestion - Causes, Symptoms and Treatment .MF .
Dyspepsia - this is the most common cause of a patient to see a doctor - physician and gastroenterologist.Includes a set of symptoms:
- pain or discomfort in the epigastric (upper middle abdomen),
- rapid saturation,
- bloating (flatulence),
Symptoms may be connected or not connected with food intake, physical activity.
Discomfort - an unpleasant sensation which is not regarded by the patient as pain, but it has many shades (feeling of fullness, heaviness, heat).
rapid saturation - a feeling of satiety after eating small amounts of food that does not give the opportunity to eat until the end of the normal daily portion of food.
Symptoms of dyspepsia not associated with dysfunction of the large intestine
(reduction or disappearance of symptoms after a bowel movement, the change in the frequency and nature of the chair).
Dyspepsia not is a specific syndrome and can occur both in functional disorders, and with organic lesions of the gastrointestinal tract.
Common causes of dyspepsia:
- hurried meal.Digestive juices do not manage to stand out.Food is chewed bad, so bad is mixed with digestive enzymes of saliva.
- Certain foods.
- Use of certain beverages.Carbonic acid and sugar in them can cause bloating and flatulence.Caffeine increases gastric acidity and irritate inflamed sites (also acts alcohol), and in addition, stimulates the release of stress hormones.
- Stress.Impair digestion as associated with the release of hormones (in particular, epinephrine, and cortisone), which redistribute the bloodstream from the digestive tract into the muscle.Stress also contributes to swallow air while eating (aerophagia).
- Exercise soon after a meal.It redistributes the bloodstream from the digestive tract to the muscles.
- nonsteroidal anti-inflammatory agents.
Diseases accompanied by dyspepsia
Approximately half of patients with organic dyspepsia often associated with peptic ulcer disease, GERD (gastroezofagoreflyuksnaya disease), rarely pancreatitis, cholelithiasis, cholecystitis, tumors of the stomach and pancreas.
organic dyspepsia (caused by disease) is characterized by functional dyspepsia Availability: Seasonal pain (exacerbations more frequently in spring and autumn), the advent of night pain, relieves meal, intense heartburn (more than 2 times per week), a decrease in body weight, the presence of pathologicalchanges in the diagnostic data.
for functional dyspepsia ( "something is not ate") is characterized by a number of complaints with the general satisfactory condition and long-term, favorable course of disease progression.
In the event of functional dyspepsia play the role of the following factors:
1. emotional stress, trauma, depression, stress.
2. Violation diet: irregular eating, overeating, "snacking" at night.
3. Smoking, drinking alcoholic beverages.
4. Infection with the gastric mucosa by the bacterium H. pylori.
5. The impact of environmental factors: high temperatures, high atmospheric pressure, vibration.
leading mechanism for the development of dyspepsia is a violation of the nervous regulation of motor function of the stomach and duodenum.
manifested: reflux of duodenal contents into the stomach, slowing gastric emptying, violation of gastroduodenal coordination, decreased gastric mucosal sensitivity to stretch.
Diagnostics for dyspepsia:
1. FEGDS (fibrogastroduodenoscopy) with biopsy.Held to exclude peptic ulcer disease, GERD, esophageal cancer, stomach.
2. ultrasound of internal organs.Eliminates liver disease, gall bladder, pancreas, thyroid gland.
3. The test to determine infection with H. pylori.
4. intragastric pH monitoring (monitoring eliminates GERD)
5. Complete blood count.Identification of anemia of inflammation.
6. Fecal occult blood.It identifies hidden bleeding from the gastrointestinal tract.
7. Study of gastroduodenal motor - allows you to explore the motor-evacuation function of the stomach and to reveal its violation, in case of dispute:
- ultrasound determination of rate of gastric emptying;
- 13C - oktanoevy breath test.
If, after careful examination of the overall organic cause has not been established in this case, a diagnosis functional dyspepsia.But, despite the absence of organic pathology in these patients significantly affected the quality of life, which requires long-term treatment.
Sometimes the patient survey, the survey demonstrate evidence of the absence of serious disease in itself gives a positive therapeutic effect.
By the way physicians treat when there dyspepsia:
Seek need your GP (general practitioner).You may need advice gastroenterologist, oncologist.
importance of timely treatment to the doctor in case of occurrence, along with dyspepsia, anxiety symptoms: dysphagia (impaired, difficulty swallowing), repeated vomiting (especially with blood), decreased or loss of appetite, weight loss, pale skin,increase in body temperature, changes in laboratory parameters.The first appearance of dyspeptic symptoms in patients older than 45 years, as a rule, evidence of a serious organic disease (a complication of the disease) and require immediate inspection GP - general practitioner, family doctor.
treatment of dyspepsia:
recommended the observance of individual dietary regime with the exclusion or limitation of individual intolerance of the product.
Quitting smoking, drinking.The positive effect of walking on the yield of 1-1.5 hours before bedtime, exercise at the gym, fitness, swimming and other physical exercise improves the patient's well-being.
In identifying infection H. pylori eradication is carried out (total kill) therapy under medical supervision.
to remove the symptoms of the disease using antisecretory drugs aluminum antacids (Maalox Almagelum gastrotsid, Gaviscone), proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, rabeprazole), motility stimulants (domperidone), eliminating the pain that neutralize the hydrochloric acid.Antacids are used four times a day, 40 minutes after a meal and pain, but no more than six times per day.They are used for a week, if dyspepsia persist, consult your doctor, the dose proton pump inhibitors, prokinetic and dosing frequency will recommend attending physician.
to placebo (apparently positive therapeutic effect, which is not associated with the influence of drugs, and with a degree of self-hypnosis of the patient) to 60% in patients with functional dyspepsia confirms the role of neuro-psychiatric factors in its occurrence.Their elimination, normalization of relations in the family and at work, rational regime of work and rest helps to get rid of this symptom.Showing different types of psychotherapy, antidepressant medication under the supervision of a therapist.
therapists Vostrenkova I.N