diseases

DYSPEPSIA


Introduction
It is an extremely prevalent disorder, affecting about 80% of the population. But, surprisingly, most of the affected people don't have any underlying abnormality.


Definition:
"Dyspepsia" or "indigestion" is a collective term used for any symptoms thought to originate from the upper gastrointestinal tract (esophagus, stomach, gall bladder) and is generally meal related.

Causes and risk factors:
Any of the factors which hamper normal digestion and absorption of the ingested food, either due to excess of acid production in the stomach, or due to lack of enzymes required for digestion of certain foods, or any other motility disorders of the esophagus or intestines may give rise to these set of symptoms.

Causes can be divided into various groups for a better understanding:
. Upper gastrointestinal disorders: pepticulcer disease, acute gastritis, gall stones, any disturbances of propulsion of the food from the esophagus into the stomach
. Other gastrointestinal disorders: Pancreatic diseases, hepatic diseases, some diseases of the intestines
. Systemic diseases: renal failure
. Drugs: some drugs may be responsible for such symptoms due to their ineffective digestion or absorption in the intestines. Medicines like aspirin, some iron supplements or corticosteroids may be the causes
. Alcohol ingestion may also lead to such symptoms
. Psychological factors like anxiety, depression may lead to dyspepsia

The following factors may further add to the risk:
. Type A personalities: people who are very anxious, always hurried, who worry a lot and having faulty eating habits are at an increased risk
. Persons having no fixed meal timings are more prone to have indigestion
. People who skip meals, either as a part of dieting or due to occupational setbacks also may experience these symptoms

Depending on the above causes, patients having dyspepsia can be classified as to having the following types of dyspepsia

Where a specific cause can be identified as regards to any abnormality of the gastrointestinal tract or, any other factor directly responsible for the dyspepsia:
. Acid dyspepsia: Due to excessive acid secretion in the stomach or due to reflux of this acid into the esophagus
. Alcoholic dyspepsia: Due to excessive intake of alcoholic beverages
. Biliary dyspepsia: When the quality or quantity of bile is insufficient
. Cardiac dyspepsia: Patients experiencing a heart attack may sometimes present with the symptoms of dyspepsia
. Gastric dyspepsia: It is caused by faulty stomach function i.e. when the contents of the stomach take a longer time than normal to reach the intestines
. Gastrointestinal dyspepsia: this is due to faulty functioning of the stomach and the intestines
. Hepatic dyspepsia: It is caused due to liver diseases

Where no specific cause can be identified as in above cases, frollowing terms may be used:
. Non ulcer dyspepsia or functional dyspepsia: When the symptoms of dyspepsia are usually longstanding, but the investigations don't reveal any abnormality
. Flatulent dyspepsia: When belching, abdominal distension, early satiety are the prominent symptoms
. Dysmotiliy like dyspepsia: When symptoms are more like those present in dysmotility disorders of the esophagus; but no such findings are obvious on investigations

Screening and diagnosis

The patients may have following group of symptoms:
Pain
. Pain may be described very vaguely by the patient. The location of the pain depends on the affected organ in the abdomen. For e.g.; the patient may complain sub sternal pain(pain in the centre of the chest),may have pain in the upper part of the abdomen, on the right or left upper half of the abdomen or around the umbilicus . Also, the pain may be related to the ingestion of food or to fasting. The patient may complain of pain immediately after consumption of food, or after 15mins or after many hours of ingestion. If a long gap is left between two meals, some of the patients may experience pain
. In some cases, the pain may be intermittent and in some others, it may be continuous

Heartburn
. Another common symptom is a sensation of burning or warmth in the chest, which is termed as heartburn.Occassional heartburn may be common in normal persons, but severe and frequent burning indicates some underlying pathology
. Some of the patients may experience the heartburn more severely on stooping or after a heavy meal
. Mostly, heartburn is related with appearance of salty or sour or bitter water in the mouth

Food intolerance
. Some patients may attribute eating of certain foods to the appearance of the symptoms of dyspepsia
. They may feel a kind of distress every time they have particular food stuff
. Citrus fruits, fatty foods, foods of a thick consistency are the common culprits

Belching
. Belching is seen commonly in persons who are used to gulp excessive air due to rapid eating, who drink carbonated drinks, cigar smoking etc. Aerophagia
. The patients having complaint of belching since a long time can be observed to swallow air before every belch
. Belching which follows aerophagia, gives a temporary relief to the patient, but a vicious cycle may ensue

The air which is not belched reaches the stomach and produces post prandial (after meals) fullness and pressure in the abdomen. This may be relieved by defecation or by passing flatus.

But, few of the patients may complain of alarming signs and symptoms like weight loss, anemia, vomiting, hamematemesis (vomiting of blood), malaena (blood in stools), dysphagia (difficulty in swallowing), or any abdominal mass. These should be immediately consulted for.

Diagnosis
Dyspepsia poses a challenging and difficult diagnostic problem due to its varied and non specific presentation.

The detailed description of the symptoms, including the nature of discomfort, frequency and nature of occurrence, relation to meals, exacerbating and relieving factors will be of immense help in the diagnosis.

Certain investigations are advised if the age of onset of symptoms is after 40 years, or the symptoms do not respond to conventional therapy. These investigations supplemented with the above history will help confirm the diagnosis by finding out the cause of dyspepsia.

Liver function tests or kidney function tests may be helpful to diagnose any disturbances in the functioning of the liver or the kidneys.

Esophago-gastro-duodenoscopy (where an instrument is passed through the esophagus, stomach and the duodenum to visualize any abnormalities in these structures) may be helpful. If any abnormal lesions are found, then the biopsy of the lesion may be helpful for further diagnosis.

Esophageal PHmetry is a test in which the acid content of the esophagus is determined. This helps in diagnosis of acid reflux disease.

Ultrasonography may be useful to determine any abnormality in the pancreas or the biliary system (pertaining to the liver and gall bladder).

Homoeopathic treatment:
In homoeopathy, we prescribe a remedy similar to the symptoms of the patient so that the patient may get relief from the symptoms for the time being. Thus, the complaints of pain, heartburn, belching may be relieved immediately with the help of this acute remedy.

This prescription will be followed by another constitutional medicine which will be based on the symptoms as well as the patient's physical and mental makeup as a whole.

This constitutional medicine will help relieve the recurrent and long lasting complaints of dyspepsia. The intolerance to any foodstuffs will be removed and the patient's start tolerating those foods again.

Thus, unlike conventional therapy which can relieve the complaints only for the time being, homoeopathy can take care of your symptoms for the time being as well as prevent their recurrence and halt the disease process.

Patient care:
. The patient should take care that he has his meals daily at some fixed, regular timing
. He should avoid eating or drinking hastily
. He should never skip his meals
. Avoidance of drinking aerated drinks, alcoholic beverages
. The patient should simply avoid "what he cannot tolerate"
. Practicing yoga regularly may help the patient relieve stress and anxiety

Follow Us