Digestive Problems
Diseases: Stomach and Duodenum: Non-Ulcer Dyspepsia
In this common problem, patients suffer from indigestion and other symptoms suggestive of an ulcer but no abnormality is found on investigation. There are probably several different subtypes of the disorder with some patients suffering from symptoms like an ulcer, others have symptoms more like gastro-esophageal reflux disease (GERD) and yet others have symptoms in keeping with slow stomach emptying.
The cause(s) are unknown at present. Some patients also have symptoms suggestive of irritable bowel syndrome and the disorder may overlap with this condition. HP infection is present in many patients with this condition but just now there is no good evidence that HP therapy is of benefit.
Non-ulcer dyspepsia (NUD) usually affects young adults and women are affected more often than men. Abdominal pain is present, and bloating, dyspepsia and nausea are often present as well. There may also be symptoms of irritable bowel syndrome.
How is NUD diagnosed?
There is no specific test or investigation which will diagnose this condition and the diagnosis is usually made after ruling out other disorders e.g. peptic ulcer disease, gallstones or cancer of the stomach. Upper endoscopy is performed for this reason and possibly an ultrasound scan of the upper abdomen to look for gallstones.
What treatments are available?
Many patients respond well to explanation and reassurance that there is no serious underlying disease present. Steps should be taken to look for anxiety, stress, or other psychological factors which may be contributing to the symptoms as treating these may also be helpful. General attention to diet, smoking and alcohol habits should also be addressed.
Treatment with medications has variable success. Some but not all patients obtain relief from antacids or acid suppressing drugs and some patients with symptoms suggestive of a problem with stomach emptying may be helped by medications which increase emptying ("prokinetics"). These include Metoclopramide, Domperidone and Cisapride.
Despite treatment the symptoms may persist for months or years before disappearing.