Dyspeptic disorders and their possible causes. Dyspepsia: what is it

Dyspepsia I Dyspepsia (dyspepsia; Greek dys- + pepsis)

indigestion and gastrointestinal tract. The term "dyspepsia" in pediatrics was previously used to refer to an independent functional disease of the gastrointestinal tract in children of the first year of life, manifested by vomiting and diarrhea. It is now believed that diarrhea in children of this age, as a rule, are symptoms of various infectious diseases (for example, coli infection (Coli infection) , salmonellosis (Salmonellosis) , staph infection (staph infection) , enterovirus diseases (Enterovirus diseases)) or are caused by impaired intestinal absorption in fermentopathy (see Malabsorption syndrome) .

Dyspepsia occurs due to poor nutrition (alimentary D.) or insufficient secretion of digestive enzymes (gastrogenic, pancreatogenic, enterogenic, hepatogenic D.). Alimentary D. appears as a result of the use of one type of food for a long period; fermentative, putrefactive and fatty D. are distinguished. Fermentative D. is noted with excessive consumption of carbohydrates (, honey, bread products, fruits, peas, beans, cabbage, etc.), as well as fermentation drinks (for example, kvass), as a result of which conditions are created in the intestine for the development of fermentative microflora. Putrefactive D. occurs when protein foods predominate in food, especially lamb or pork meat, which is digested more slowly in the intestines, as well as when stale meat products are used. Fatty, or soapy, D. is due to excessive intake of fats, especially slowly digested, refractory (pork, lamb).

With enzymatic insufficiency, D. occurs due to a violation of the secretory function of the stomach, the exocrine function of the pancreas, the production of intestinal juice, and bile secretion. Such D. can be functional, but is more often the result of organic diseases of those or; other digestive organs. So, gastrogenous D. is observed with achlorhydria and achilia (see Stomach) , atrophic gastritis e , long-term decompensated pyloric stenosis, gastric cancer. Pancreatogenic D. is observed in chronic pancreatitis , tumors of the pancreas (pancreas) , cystic fibrosis . Enterogenic D. appears in chronic enteritis , many fermentopathies - disaccharidase deficiency (disaccharidase deficiency) , celiac disease (Celiac disease) , diseases occurring with exudative enteropathy (exudative enteropathy) . Hepatogenic D. occurs with violations of the bile outflow (for example, with strictures of the biliary tract, cancer of the major duodenal papilla). Often D. is mixed (for example, with a combination of chronic atrophic gastritis with enteritis).

In the pathogenesis of D., incomplete nutrients are important, due to their excessive intake into the gastrointestinal tract or insufficient release of digestive enzymes, as well as the formation of a large amount of toxic substances (ammonia, indole, skatole, low molecular weight fatty acids, hydrogen sulfide, etc.) due to active reproduction bacterial flora in the proximal small intestine and the development of dysbacteriosis. As a result, the small intestine is irritated and intensified, which reduces the contact time of the intestinal contents with the digestive juices and further disrupts the digestive processes, causing an increase in the symptoms of D. The toxic substances entering the cause intoxication. A certain role belongs to the hypersecretion of the mucous membrane of the intestinal wall in response to chemical and mechanical chyme, as well as local allergic reactions.

Fermentative D. is manifested by flatulence, rumbling in the intestines, the release of a large amount of lawn, and frequent stools. liquid, slightly colored, frothy, with a sour smell; contains a large amount of starch grains, crystals of organic acids, fiber, iodophilic. The reaction of feces is sharply acidic. With putrid D., stools are also frequent, stools are liquid, dark in color with a putrid odor. Symptoms of general intoxication are noted: a decrease in appetite, weakness, decreases. Characteristic (see Cal) , the reaction of feces due to the formation of a significant amount of ammonia is sharply alkaline. With fatty D., the stools are light, plentiful, with a greasy sheen, have a neutral or alkaline reaction. They contain a lot of undigested neutral fat (in the form of drops), crystals of fatty acids and their insoluble salts (soaps).

In case of dyspepsia caused by insufficient secretion of digestive enzymes, there is an unpleasant taste in the mouth, loss of appetite, flatulence, rumbling, transfusions in the abdomen, and sometimes short-term spastic pains. There is abundant intestinal gas, stool up to 3-5 times a day, sometimes more often. Patients complain of poor general health, weakness, increased, in some cases - headaches. When examining feces, you can find the remains of undigested food: with pancreatogenic D., feces are plentiful, with a greasy sheen.

Correctness plays an important role in treatment. With all types of alimentary D. for 1-1.5 days. appoint . Then, with putrefactive D., the amount of carbohydrates in the daily ration is increased, with fermentation, proteins are increased while the amount of low-molecular carbohydrates is reduced, and with fatty D., the intake of fats, especially refractory ones, is limited. With D., due to a deficiency of digestive enzymes, accompanied by diarrhea, baking is directed to the main; within 2-5 days, diet No. 4 is recommended, then No. 46, replacement therapy is carried out with acidin-pepsin, abomin, pancreatin, polyzyme, etc. Symptomatically, with diarrhea, imodium, astringents (kaolin, calcium carbonate, etc.), with burnet roots, alder seedlings, etc.).

Alimentary D., as a rule, does not last long. However, if the patient's nutrition is not normalized, there is a protracted course of the process, which can be complicated by inflammation of the intestinal mucosa, the occurrence of enteritis or enterocolitis. D.'s course caused by insufficiency of digestive enzymes depends on a basic disease.

Prevention comes down to rational nutrition, prevention and timely treatment of diseases of the digestive system.

Bibliography: Abasov I.T. and Sahakyan A.G. and therapy of chronic diseases of the small intestine, Baku, 1977; Belousov A.S. Differential diseases of the digestive system, M., 1984; Beyul E.A. and Ekisenina N.I. Chronic enteritis and colitis, M., 1975; Diseases of the digestive system, ed. Ts.G. Masevich and S.M. Ryssa, L., 1975; Beix P.A. , per. from English, M., 1982; Vasilenko V.X. and Grebnev A.L. Diseases of the stomach and duodenum, M., 1981; Frolkis A.V. Enteral insufficiency, L., 1989.

II Dyspepsia (dyspepsia; Greek, from Dis- + pepsis digestion)

indigestion.

Dyspepsia is fermentative(d. fermentativa) - intestinal D., characterized by impaired digestion of carbohydrates, with a sharp increase in fermentation processes in the intestine.

Dyspepsia gastrogenous(d. gastrogena;. D. gastric) - D., characterized by a violation of the processes of digestion of food in the stomach.

Dyspepsia putrefactive(d. putrida) - intestinal D., characterized by a violation of the digestion of proteins with the development of decay processes in the intestine.

Dyspepsia gastric(d. gastrica) - see. Dyspepsia gastrogenous.

Intestinal dyspepsia(d. intestinalis) - D., characterized by a violation of the processes of digestion of food in the intestines.

Urinary dyspepsia(d. urinosa) - D., caused by intoxication with chronic urinary retention.

Soapy dyspepsia- D., due to impaired absorption of fats in the small intestine.

Dyspepsia, nervous(d. nervosa) - D., caused by a violation of the nervous regulation of digestive functions.

Dyspepsia pancreatic(d. pancreatica) - D., due to insufficiency of the exocrine function of the pancreas.

Dyspepsia parenteral(d. parenteralis) - D., accompanying any infectious disease (flu, measles, etc.), caused by intoxication and fever.

Dyspepsia hepatic(d. hepatica) - D., due to insufficiency of bile secretion by the liver and characterized by a violation of the digestion of fats.

Physiological dyspepsia(d. physiologica; syn.) - D., developing in newborns on the 3-5th day of life and due to adaptation to new nutritional conditions; manifested by rapid liquid stools of a greenish color, bloating.

III Dyspepsia (dyspepsia)

a disease of infants that occurs as a result of a discrepancy between the volume and composition of food and the physiological capabilities of the child to digest it and is manifested mainly by gastrointestinal disorders.

Dyspepsia alimentary(d. alimentaria) - see simple dyspepsia.

Dyspepsia non-toxic- see Dyspepsia is simple.

Dyspepsia is simple(syn. D. alimentary, D. non-toxic) - D., manifested by anxiety, poor appetite, diarrhea and delayed weight gain.

Dyspepsia toxic(d. toxica) - D. with signs of acidosis, toxemia and dehydration.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

Synonyms:

See what "Dyspepsia" is in other dictionaries:

ICD 10 K30.30. Dyspepsia (from other Greek. δυσ prefix that denies the positive meaning of the word and ... Wikipedia

- (Greek, from dys, and pepsis digestion). Difficulty in digestion. Dictionary of foreign words included in the Russian language. Chudinov A.N., 1910. DYSPEPSIA Greek, from dys, and pepsis, digestion. Indigestion; heavy digestion, depending on ... ... Dictionary of foreign words of the Russian language

Modern Encyclopedia

- (from dis ... and Greek pepsis digestion) indigestion, manifested by heartburn, belching, heaviness in the pit of the stomach (gastric dyspepsia), bloating, cramping pains, diarrhea (intestinal dyspepsia), regurgitation, vomiting, ... ... Big Encyclopedic Dictionary

DYSPEPSIA- intestinal, dyspepsiainte stinalis (from the Greek. dys prefix to denote a qualitative violation and pepsis digestion), indigestion in the intestines, an intestinal disease that has long been known in pediatrics, but relatively recently studied in the clinic ... Big Medical Encyclopedia

Dyspepsia- (from dys ... and Greek pepsia digestion), indigestion, manifested by heartburn, belching, heaviness in the pit of the stomach (gastric dyspepsia), bloating, cramping pains, diarrhea (intestinal dyspepsia), regurgitation, vomiting, ... ... Illustrated Encyclopedic Dictionary

Dyspeptic phenomena are a group of disorders of the digestive system. Dyspeptic phenomena develop due to an insufficient amount of special enzymes that are involved in the digestion of food. Violation of the motility of the digestive tract leads to inhibition of the normal process of digestion of food that has entered the stomach and its assimilation. Because of this, dyspeptic phenomena develop.

At the same time, with the development of dyspeptic phenomena, inadequate for the digestive tract or excessively large amounts of decomposition products of nutrients, which include organic acids and hydrogen sulfide, irritate the intestinal mucosa and cause the development of too rapid intestinal motility. Violation of the digestive tract adversely affects the state of the intestinal microflora, leading to the occurrence of dysbacteriosis.

How do dyspepsia manifest?

Dyspeptic phenomena, accompanied by fermentation processes, are manifested in severe flatulence, rumbling in the intestinal tract, and the release of a significant amount of gas. At the same time, the stool is characterized by pallor and liquid, foam impurities, and a sour smell. In the process of coprology, the presence of a large number of impurities of starch, organic acid compounds, and vegetable fiber is established.

Putrefactive dyspeptic phenomena, as well as fermentation, is expressed in diarrhea, in which the stool has an almost black color, the smell of rot. Due to the general poisoning of the body with food decay products, appetite disorders, general weakness and lethargy, and a decrease in working capacity are very often observed. Microscopic analysis shows an increased nitrogen content in the feces.

Fatty dyspeptic phenomena are characterized by light-colored feces, which have abundance and greasy luster. Coprological analysis reveals the presence in them of a large amount of undigested fat, fatty acids and salts. Diagnosis of dyspeptic phenomena is based on anamnesis data, conversations with the patient about the specifics of his diet, clinical symptoms of the disease, and copology results. It is worth noting that in some cases, symptoms of the inflammatory process of the intestinal mucosa are not observed.

Differential diagnosis in the development of dyspeptic phenomena is important to distinguish this group of disorders from other diseases of the digestive system - atrophic gastritis, insufficiency of secretory function, pancreatitis, pancreatic insufficiency, chronic enteritis, enterocolitis, etc.

Establishment according to the anamnesis of the factor of malnutrition and irrational nutrition of the patient, provided that there are no pathological disorders on the part of the secretory function, proves that dyspeptic phenomena are indeed functional in nature. Rapid relief of manifestations of dyspeptic phenomena, subject to the indispensable normalization of the regimen and diet, is also proof of the correct diagnosis.

Even a perfectly healthy person can face discomfort in the abdomen. Usually the problem appears as a result of a change in habitual nutrition or after overeating. But sometimes the symptoms of discomfort in the gastrointestinal tract (GIT) make themselves felt too often. And in some cases, it becomes a constant companion. Dyspepsia is often at the root of the problem. How to determine the line between the natural process of digestion and the first symptoms of a developing dyspeptic syndrome? What are the treatment options for this disease?

What is it: a description of the pathology

In medicine, the term dyspepsia (or dyspeptic syndrome, indigestion) means a set of syndromes that occur in the body as a result of a dysfunction of the digestive system. Pathology is manifested by a variety of malfunctions in the gastrointestinal tract. Most often, there are complaints about the disturbed process of digestion of food and delayed bowel movements. Patients experience abdominal pain, bloating, heaviness after eating. Many experience nausea and vomiting.

Dyspepsia is classified as an acid-dependent disease, since its development is often based on impaired gastric secretion. And as a result of the aggressive effect of gastric juice on the upper gastrointestinal tract, the patient develops characteristic symptoms.

Dyspepsia is a disturbance in the functioning of the digestive system.

Pathology occurs not only against the background of diseases of the stomach. Its appearance can provoke a variety of violations in the operation of other systems.

Dyspepsia is a common gastroenterological pathology. Up to 40% of people in developed countries face similar symptoms. An unpleasant condition can torment not only the adult population, but also children.

Features of dyspepsia in children

Babies have an imperfect digestive system. Therefore, she is not able to digest rough food. Any error in nutrition can provoke a violation of the functioning of the gastrointestinal tract. Babies often experience episodic digestive disorders, which are manifested not only by dyspepsia, but also by diarrhea.

Cause pathology in infants can:

• errors in feeding (stale mixture, improper preparation, frequent feeding, constant overfeeding, sudden changes in nutrition);
• various diseases (colds);
• intestinal infections (penetration of a bacterial agent into the gastrointestinal tract).

Dyspeptic syndrome can signal the development in the body of both harmless and life-threatening conditions. Therefore, it is important to consult a doctor in a timely manner!

What is dyspepsia - video

Classification of dyspepsia

Doctors distinguish 2 main forms of pathology:

1. Functional. The patient has only functional failures in the work of the gastrointestinal tract. At the same time, organic tissue lesions are not detected. Functional dyspepsia is divided into:
   1. Ulcerative. The patient experiences pain in the epigastric region, heartburn, belching. Symptoms often appear at night. Often tormented by "hungry" pain.
   2. Dyskinetic (non-ulcerative). Pursues a feeling of fullness, heaviness of the stomach after eating. There is swelling, nausea. Early satiety is typical.
   3. Nonspecific. All symptoms are present in the patient at the same time.
2. Organic. The syndrome is provoked by organic damage to the digestive tract. Symptoms are pronounced and torment the patient for a long time.

Depending on the causes that provoked dyspepsia, there are several types of pathology:

1. Alimentary. Its occurrence is dictated by errors in food. Several varieties are known:
   1. Fermentation. This type is characterized by the abuse of carbohydrates (bread, sugar, various fruits, cabbage, legumes), as well as drinks with fermentative properties (beer, kvass).
   2. Putrid. This type is dictated by an excessive addiction to protein foods (fish, meat products, eggs, poultry). Putrefactive dyspepsia can occur after eating low-quality meat.
   3. Fatty (or soapy). The pathology is based on a large intake of fats in the body. Especially, heavy for the digestive system (refractory), such as lamb fat, pork.
2. Toxic. This form occurs when the body is poisoned. It is characterized by a metabolic disorder. Depending on the root cause, there are:
   1. Intoxication. This type can be provoked by influenza, the presence of purulent infections, any surgical pathology, exposure to toxic components.
   2. Intestinal toxicity. A variety of intestinal infections (salmonellosis, dysentery, viral enteritis) can lead to dyspeptic syndrome.
3. Neurotic (nervous). Against the background of experiences, stress, mental illness, drug use, disturbances occur in the area of ​​the brain that is responsible for the functioning of the stomach. Pathology is usually sluggish.
4. simple dyspepsia. Pathology is manifested by acute indigestion, usually with diarrhea, vomiting. But at the same time, the general condition was not significantly disturbed. This condition often occurs in infants as a result of dietary changes.
5. Biliary. Pathology is dictated by disorders in the functioning of the gallbladder, liver. Dyspepsia is usually accompanied by a bitter or metallic taste, heaviness in the area of ​​the right hypochondrium.
6. Enzymatic. Dyspepsia is provoked by insufficient production of enzymes in the body that ensure high-quality digestion of food. There are the following types of pathology:
   1. Gastrogenic. There is insufficient synthesis of gastric enzymes.
   2. Enterogenic. Deficiency of intestinal juices is diagnosed.
   3. Pancreatogenic. The required amount of enzymes is not produced by the pancreas.
   4. Hepatogenic or hepatic. Little bile is produced by the liver.

To provoke dyspepsia in a child can be any errors in nutrition.

Causes of dyspeptic syndrome

Many diseases are accompanied by dyspeptic syndrome. An unpleasant condition occurs in patients suffering from:

1. GERD (gastroesophageal reflux disease). Food fragments with gastric juice are thrown into the esophagus, causing damage and irritation.
2. Chronic gastritis. This is an inflammation of the stomach that occurs for a long time with periods of remission and exacerbation.
3. Diaphragmatic hernia. There is penetration of the esophagus from the sternum into the abdominal area through the esophageal opening.
4. Cholecystitis. Inflammatory disease of the gallbladder.
5. Ulcerative lesions of the gastrointestinal tract.
6. Gallstone disease. Stones form in the gallbladder.
7. Duodenogastric reflux. From the duodenum, the contents, consisting of enzymes, semi-digested food, bile acids, are thrown into the stomach, causing damage to the mucous membrane.
8. postcholecystectomy syndrome. An unpleasant condition that occurs in patients who have undergone gallbladder removal.
9. Tumors of the gastrointestinal tract. Any neoplasms (including malignant) of the stomach, pancreas, esophagus.
10. Pyloric stenosis. The connection of the stomach with the duodenum is narrowed.
11. Pancreatitis.
12. Diabetes mellitus (high glucose level).
13. Achlorhydria. Decreased acidity of gastric juice.
14. Chronic enterocolitis. Inflammatory-dystrophic bowel disease, in which its functions (secretory, motor) are impaired.
15. Viral infections, poisoning, purulent diseases, accompanied by intoxication of the body.
16. Intestinal obstruction. The contents of the intestine do not pass well through the tract or do not pass at all.
17. Hepatitis A (viral). Infectious disease of the liver, in an acute form.

Depending on the underlying cause that provoked dyspepsia, the pathology can be both infectious and non-infectious.

Provoking factors

The following points can lead to pathology:

1. Disrupted nutrition. Poor quality food, irrational diet often cause dyspepsia.
2. Hypersecretion. In this condition, there is an increased release of hydrochloric acid. Often this leads to the development of dyspepsia and gastritis.
3. The use of drugs. Antibiotics, contraceptives, antitumor, hormonal, anti-tuberculosis drugs can disrupt the digestive system.
4. Psycho-emotional experiences, stress, depression.
5. Alcohol abuse, smoking.
6. Excessive addiction to coffee, tea.

The development of dyspepsia leads to malnutrition

Symptoms of dyspepsia

Pathology is characterized by such signs:

1. Pain in the epigastric region. Discomfort can be of a different nature: constant, paroxysmal. It can be permanent or episodic. Sometimes the pain is associated with the use of food (for example, in chronic) or with the time of year (exacerbation of ulcerative lesions).
2. . It can occur after taking certain foods or medications.
3. Nausea. A painful condition can occur even on an empty stomach. Quite often, nausea appears immediately after eating a meal.
4. Bloating, distention of the stomach, a feeling of heaviness in the abdomen.
5. Belching.
6. , a large accumulation of gas in the intestines.
7. Chair disorder. The patient may experience both diarrhea and a tendency to constipation. Most often there are complaints of irregularity and frequent stools.
8. Change in feces. With dyspepsia, the color, texture, and smell of stools can change significantly. For example, the stench of feces indicates the course of putrefactive processes in the intestines. A sour smell indicates fermentation in the gastrointestinal tract. If the feces become sandy or light gray, then this is the result of a bile deficiency.
9. Body temperature. Hyperthermia is characteristic of intestinal infections, viral pathologies, which are accompanied by dyspeptic syndrome.

Features of some types

By a combination of some signs, the following forms of dyspepsia can be suspected:

1. Putrid. It manifests itself as intoxication of the body. A person has a headache, weakness occurs. The patient complains of general malaise, nausea. The stool becomes dark in color. Characterized by frequent bowel movements with liquid contents.
2. Fermentation. There is frequent rumbling, flatulence. The patient has severe abdominal pain. The person complains of constant diarrhea. The stools are light in color and frothy.
3. Fatty. There are no clear symptoms. The clinical picture is poorly expressed. The patient is faced with heaviness in the abdomen, flatulence, belching. Sometimes there are complaints of pain in the abdomen. The stools are whitish, normally formed.

Dyspepsia is manifested by abdominal pain, belching, heartburn, nausea

The main differences between functional and organic dyspepsia - table

signs	functional dyspepsia	organic
Severity of complaints	periodic	Constant
Duration of pathology	Significant	non-durable
Pain localization	Variable, spreading to neighboring areas	Limited, in a certain area
The effect of stress on the onset of symptoms	high influence	No connection
Weight loss	Minor	Significant
Influence of food intake and food quality on the occurrence of pathology	Does not depend	Very dependent
Functional disorders in the gastrointestinal tract	strongly expressed	Little expressed
Complaints about sleep disturbance	Does not depend	Average connection
Functional complaints about failures in other organs	Very pronounced	not significant

Diagnosis of pathology

Before issuing referrals for examination of the patient, the doctor will establish the following points:

1. The study of patient complaints. When pains appear, how often do they occur, what provoked their intensification.
2. Study of medical history. The doctor will analyze what pathologies were previously diagnosed in the patient (gastritis, ulcer, cholecystitis, etc.).

If dyspeptic syndrome is suspected, the doctor will recommend undergoing diagnostics, which includes not only confirmation of the pathology, but also its differentiation from other pathologies.

The doctor will examine the patient's complaints and assess his condition

Laboratory diagnostics

1. Blood tests. Allows you to determine the inflammation in the body. In addition, they indicate a violation of the functioning of the pancreas, kidneys, liver.
2. Coprogram. This fecal analysis is designed to detect undigested food debris, coarse fibers and fat.
3. Analysis of feces for the presence of blood. The presence of occult blood indicates ulcerative lesions of the digestive tract.

Instrumental Methods

To correctly establish dyspepsia, the following measures may be necessary:

1. Hydrochloric acid synthesis test. Analyzing the ratio of pH and volume of the material, pathological dyspepsia can be suspected.
2. Esophagogastroduodenoscopy. An optical instrument allows you to study the mucous membranes of the upper digestive tract. During the study, a biopsy is taken for further examination of the cells under a microscope.
3. Ultrasonography. The organs of the abdominal cavity are being studied. Detects the presence of tumors.
4. Impedance-pH-metry. Several electrodes are inserted into the esophagus. With the help of alternating current, the acidity of the medium is measured.
5. Examination for Helicobacter pylori.
6. Radiography. With the help of a contrast agent, the movement of masses along the digestive tract is studied. The event reveals the narrowing of the esophagus, tumors.
7. Colonoscopy. Using an endoscope, the doctor examines the condition of the colon mucosa.
8. Electrogastroenterography. The study confirms the violation of the motility of the intestines and stomach.
9. CT scan. An examination is used to detect tumors that are difficult to diagnose or damage to the intestines, esophagus, stomach.
10. Antroduodeal and esophageal manometry. Determines the contractile function of the digestive tract.

Esophagogastroduodenoscopy makes it possible to study the upper parts of the digestive system

Treatment of pathology

Therapy of dyspeptic syndrome implies only an integrated approach. If conditions arise that threaten the life of the patient (dysentery, intestinal infections), you must immediately call an ambulance.

It is important to provide the patient with first aid in a timely manner, depending on the symptoms that arise:

1. In the case of hyperthermia (above 39 C), an antipyretic is justified.
2. With severe diarrhea and vomiting, it is necessary to use rehydration solutions that protect against dehydration.
3. If the patient suffers from severe diarrhea, an antidiarrheal drug is recommended.

Patients who are faced with the first symptoms of dyspepsia are advised to adjust their lifestyle.

It is necessary to adhere to such non-drug methods of treatment:

1. Hiking. After eating, it is strictly forbidden to lie down. It is not recommended to even sit. It is best to take a short walk after eating, for 30-60 minutes. Such actions activate intestinal motility.
2. Proper charging. In the case of dyspepsia, it is necessary to limit exercises that develop the abdominal muscles.
3. Choice of clothes and accessories. It is necessary to select things of the appropriate size. Do not tighten the stomach with a belt. Women are advised to give up corsets and bras that tighten the chest.
4. Dinner. The last meal should take place 3 hours before bedtime.
5. High pillow. The head during sleep should be significantly higher than the body. This will prevent reflux of gastric contents into the esophagus.

After eating, it is good to take small walks.

If the pathology is detected in the initial stages, then non-drug treatment in combination with the right diet is enough to provide an excellent therapeutic effect.

Medical treatment

Unfortunately, many patients go to the doctor when the pathology is already progressing. In such situations, it is impossible to do without medical assistance.

Drug therapy usually includes the following drugs:

1. Painkillers. They are designed to reduce pain in the abdomen. Such medicines are in demand: Drotaverin, No-Shpa.
2. Hydrogen pump blockers. Means can reduce the acidity of the stomach. These medicines are useful for sour belching and heartburn. Usually prescribed: Omeprazole, Ultop, Omez, Lanzoptol, Losec Maps, Rabeprazole, Pariet, Sanpraz, Esomeprazole, Pantoprazole, Nexium.
3. H2-histamine blockers. This group of drugs is also aimed at reducing the acidity of the stomach. It differs from the above drugs in a weaker effect. May be recommended: Famotidine, Gastrosidin, Ranitidine, Kvamatel, Ranisan.
4. Antacids. Preparations that neutralize hydrochloric acid. Therapy may include: Maalox, Phosphalugel, Gastal, Actal, Protab.
5. enzyme preparations. They restore the lack of enzymes and help digest food. Such medicines are effective: Mezim, Pancreatin, Festal, Pancreazin.
6. Prokinetics. To reduce nausea and protect against vomiting, the patient is prescribed: Motilium, Metoclopramide, Cerucal, Cisapride, Coordinax, Prepulsid, Cysap.
7. Drugs that improve the functioning of the digestive tract. Therapy sometimes includes the defoamer Simethicone and activated charcoal. This combination improves digestion and facilitates the access of enzymatic substances to digested food, by reducing foam and absorption of harmful components.
8. Antibiotics. These drugs are prescribed for intestinal infections. If the unpleasant condition is caused by the penetration of bacteria into the digestive system, the doctor will recommend the patient to resort to antibiotic therapy. One of the effective drugs is Alpha Normix.

If dyspepsia is provoked by stress, then antidepressants are recommended to the patient.

Medications for dyspepsia - photo

No-Shpa perfectly relieves pain and spasms Omeprazole is useful for sour belching and heartburn Ranitidine reduces stomach acid Maalox, Almagel help to neutralize hydrochloric acid Mezim compensates for the deficiency of pancreatic enzymes Motilium helps eliminate nausea, vomiting Activated charcoal absorbs harmful substances in the digestive system

Diet food

An important place in the treatment of dyspeptic syndrome is given to the correct diet. The diet depends entirely on the type of pathology.. However, there are general recommendations that all patients with dyspepsia should follow.

Basic diet rules

1. Frequent meals. It is recommended to eat food 5-6 times a day.
2. Refusal to overeat. Single portions should be small. Overeating is strictly contraindicated, especially at night. But at the same time, starvation is also harmful.
3. Calm state. Eating food, it is recommended to exclude any stress. You should not watch TV during a meal or talk emotionally.
4. liquid food. The diet must necessarily contain broths and soups.
5. Harmful products. Flavors, artificial additives, concentrates should be excluded from nutrition. Preference is given to food of natural origin.
6. Temperature regime. It is not recommended to eat hot food or too cold. Food should be at an average (comfortable for the body) temperature.

Useful and harmful foods for dyspepsia - table

Harmful products

Food good for the body

fast food; alcohol; fatty meat and fish products; coffee; smoked, salted, fried, marinated; soda and raw water; tomato paste; fatty broths, soups; yeast dough; fruit juices (except permitted); rice, corn grits; sorrel, garlic, green onions; beans, beans, peas; raw vegetables, fruits (except permitted); margarine, animal fats.

low-fat meat products: veal, rabbit, poultry; a variety of fish: cod, pike perch, hake, pike; boiled eggs, scrambled eggs; liquid soups; milk jelly, low-fat cheese, cottage cheese casserole, fermented milk products; buckwheat, oatmeal, wheat porridge, semolina; vegetables: tomatoes, pumpkin, zucchini, cucumbers, zucchini, broccoli, sweet peppers, cauliflower, potatoes; biscuit cookies, crackers; fruits: apricot, pomegranate, persimmon, strawberry, peach, blueberry, orange, watermelon, strawberry; marshmallow, marshmallow, caramel; green or black tea, juices (pumpkin, birch, carrot), jelly, rosehip broth, compote.

Useful products for dyspepsia - photo

Beneficial low-fat rabbit meat You can eat boiled eggs Healthy vegetable soups Useful cottage cheese casserole for dyspepsia Allowed to use buckwheat porridge Beneficial effect on the digestive tract pumpkin It is recommended to give preference to biscuit types of cookies instead of muffin
Persimmon is recommended for functional dyspepsia Rosehip decoction has a beneficial effect on the digestive tract

Features of nutrition, depending on the type of pathology

1. Patients suffering from fermentative dyspepsia need to build their diet on protein products. Limit carbohydrate intake whenever possible.
2. If fatty dyspepsia is diagnosed, then animal fats are excluded from the diet, replacing them with vegetable fats.
3. If putrefactive dyspepsia is detected, the diet should contain a large amount of vegetable carbohydrates. Proteins are consumed only easily digestible and in small quantities. Meat with this form of pathology is contraindicated.
4. When diagnosed with alimentary dyspepsia, the patient needs to establish a regimen and adhere to proper nutrition.

Folk remedies

In alternative medicine, there are many excellent remedies that are successfully used to treat dyspepsia. But you can use alternative therapy only after consultation with your doctor.

1. Dill infusion. Dill grains (1 tsp) are poured with boiling water (200 ml). Infuse the mixture for 20 minutes. Filter. It is necessary to use the product after meals, 30 ml each.
2. Fennel decoction. Fennel berries (10 g) pour hot water(200 ml). The agent is brought to a boil and boiled over low heat for about 15 minutes. The cooled broth is filtered and diluted with boiled water to 200 ml. All liquid must be drunk within one day, dividing it into small portions.
3. Medicinal infusion. It is necessary to combine in equal proportions: mint, yarrow, sage, chamomile. The dry mixture (0.5 tsp) is poured with boiling water (200 ml). The remedy is insisted for 10-15 minutes. Filter. It is necessary to consume three times a day, before meals, 0.5 cups each.
4. Healing infusion. The following medicinal plants are mixed in equal proportions: yarrow, licorice root, mustard seeds, anise fruits, buckthorn bark. Collection (1 tablespoon) is brewed with boiling water (300 ml). The remedy is infused for half an hour, then filtered. It is recommended to use twice a day, 0.5 cups.

Folk remedies for dyspepsia - photo

Infusion of dill seeds allows you to normalize the digestive system Fennel decoction reduces flatulence, relieves pain Chamomile provides an excellent antibacterial effect in the digestive tract
Yarrow, in combination with other components, helps to improve the functioning of the digestive tract Buckthorn bark provides a laxative effect

Treatment prognosis

If dyspepsia occurs once, after eating poor-quality food or errors in the diet, then it will not bring tangible consequences. Pathology is quickly cured and has the most favorable prognosis.

With a pronounced dyspeptic disorder that occurs for a long time, it is necessary to seek help from doctors. Since this phenomenon characterizes serious violations in the functioning of the body. In this case, the prognosis depends on the identified disease and the degree of its neglect.

Possible Complications

Negative consequences are usually associated with the pathology that provoked dyspepsia.. Patients may experience the following:

1. Loss of appetite for a long time.
2. Sharp weight loss.
3. Mallory-Weiss syndrome. Pathology in which there is a rupture of the mucosa at the junction of the esophagus and stomach. Such bleeding is a serious threat to the life of the patient.

Prevention

1. Balanced, rational nutrition. Avoid overeating. Refusal of low-quality and stale products.
2. Physical exercise. Sports activities should be moderate. It is important to maintain a healthy lifestyle.
3. Bad habits. It is necessary to completely abandon the intake of alcoholic beverages and smoking.
4. hygiene standards. Washing hands, using only clean products.
5. Regular examination by a doctor.

Prevention involves choosing the right, healthy diet

Dyspepsia does not apply, in principle, to pathologies dangerous to health. However, ignoring such a problem can lead to disruption of the functioning of the gastrointestinal tract. And the state of a person during the manifestation of symptoms is extremely unpleasant. That is why it is important to pay attention to all violations of the digestive tract in a timely manner. This recommendation will allow you to easily and quickly cope with the pathology and restore health.

Dyspepsia (translated from Greek - "poor digestion") is a chronic disorder of the intestines. If after eating you feel pain in the abdomen and other unpleasant symptoms, there is every reason to suspect that you have this disease. It should be noted that pain in dyspepsia is chronic. If they persist for at least 12 weeks a year, a doctor can make a diagnosis. It is believed that about 50% of our compatriots suffer from this disease. It is very important to treat dyspeptic symptoms as early as possible in order not only to alleviate the patient's condition, but also to protect against the development of complications.

Like many other diseases of the digestive tract, dyspepsia occurs due to malnutrition. Therefore, adequate treatment is based primarily on a healthy diet. Traditional healers recommend additionally using decoctions and infusions of plants that normalize digestion, stimulate intestinal activity, and eliminate fermentation processes. Such comprehensive measures will help to forget about discomfort in the abdomen forever.

Symptoms of dyspepsia

The disease can be manifested by the following symptoms:

• feeling of heaviness after eating;
• nausea;
• vomit;
• stool disorders (diarrhea with foam impurities, putrid odor, pieces of undigested food, oil inclusions, etc.)

These problems vary in intensity and do not appear every day. However, if indigestion lasts 3 months or longer, dyspepsia syndrome can be diagnosed.

Varieties of the disease

Intestinal dyspepsia is divided into two large groups - organic and functional. The first group includes disorders that have arisen due to various diseases.
Organic dyspepsia in children and adults can be caused by such diseases of the gastrointestinal tract:

• gastroesophageal reflux disease;

Functional dyspepsia is an independent disease that can be caused by:
taking certain drugs (antirheumatic drugs, salicylates, antibiotics, iron and potassium supplements);

Functional dyspepsia, in turn, is also divided into several varieties:

• fermentative dyspepsia;
• putrefactive dyspepsia;
• fatty dyspepsia;
• toxic dyspepsia

Fermentative dyspepsia is caused by excessive consumption of sugar, yeast, and other fermented products. Putrefactive dyspepsia affects people who consume an excessive amount of protein (primarily meat) that does not have time to be digested in the gastrointestinal tract. Fatty dyspepsia, as the name implies, appears in lovers of fatty foods. And, finally, toxic dyspepsia is the result of poisoning the body with toxins.
Organic gastric dyspepsia is diagnosed mainly in adults over 45 years of age, and is very rare in young patients. Functional dyspepsia, in turn, is more common in children.

Diet

To avoid intestinal upset, you need to follow a few rules of healthy eating.

Treatment at home

Functional dyspepsia in children is easily treated with folk remedies. Herbal preparations improve intestinal digestion and reduce abdominal pain. When taken regularly, they completely eliminate the disease.

Dandelion

- the most popular plant around the world. For therapeutic purposes, its roots, leaves and flowers are used. It is very useful to drink dandelion tea after antibiotic treatment to restore the intestines. You can use the juice of fresh leaves and decoction of dried roots.
Dandelion home remedies for indigestion:

Caraway

Everyone knows this fragrant spice. Cumin contains carvone and limonene, flavonoids and organic acids. Cumin fruits stimulate the secretion of digestive juices, have antispasmodic properties, and restore normal intestinal microflora. Herbalists recommend using cumin for putrefactive and fermentative dyspepsia, as well as for patients with flatulence: pour half a teaspoon of the fruit with a glass of boiling water, and drink it warm three times a day.

Mint

Mint contains essential oils, tannins, flavonoids, vitamin C and carotene. An infusion of mint leaves helps with gastritis and enteritis, and especially with flatulence and dyspepsia. A cup of mint tea will help improve digestion and is used after heavy meals.
In acute dyspepsia, it is recommended to drink an alcohol tincture of peppermint. You can buy it at a pharmacy, or you can cook it yourself: pour 100 g of fresh chopped grass with 250 ml of alcohol and leave for 7 days. This tincture relaxes the intestinal muscles and relieves pain. The patient is given 20-30 drops of the product, dissolving in a small amount of water.

Melissa

- has a pleasant lemon smell, which is associated, in particular, with the content of volatile substances, tannins and many trace elements, including copper. The plant is known for its sedative properties, which is why it is often used for bowel disorders. It is especially recommended to make an infusion of mint and lemon balm for digestion in the ratio of 2 teaspoons of mint to one spoon of lemon balm. Pour the mixture with a glass of boiling water, insist under the lid for 20 minutes and drink after straining.

Wormwood medicinal

It is a 1.5 m high shrub widely cultivated in Europe for its medicinal properties. Pharmacological preparations are made from it for diseases of the digestive system. Compositions with wormwood are used primarily for functional dyspepsia in old age. We recommend putting a tablespoon of dry grass in a thermos, pour a liter of boiling water and leave overnight. In the morning, strain and drink in small portions throughout the day.

Strong herbal tea

If you have toxic indigestion or other type of indigestion and no treatment or diet helps, try this potent herb:

• Rhubarb root - 100 g;
• Wormwood - 50 g;
• Calamus root - 50 g

Pour two tablespoons of this collection into 500 ml of boiling water, cover and leave for 2 hours. Strained drink drink 4 times a day for 100 ml. Treatment should last at least 2 weeks. Repeat courses of medication from time to time to always keep your intestines normal.

Dyspepsia is a collective term denoting various digestive disorders, mainly of a functional nature. It is not an independent symptom, but rather a syndrome.

Dyspepsia syndrome includes a complex of symptoms that reflect disorders of the gastrointestinal tract ( from the Greek dys - violation, peptein - digest). The duration of symptoms in dyspepsia syndrome is 3 months or more. The clinical picture includes pain or discomfort in the epigastric region, bloating, and sometimes stool disorders. Most often, these symptoms are associated with eating, but can also be caused by emotional overload.

In recent decades, scientists have noted a close relationship between stress and dyspepsia syndrome. Apparently, it is no coincidence that the term "dyspepsia" was widely used in medicine in the Middle Ages and denoted a disease caused by nervous disorders along with hypochondria and hysteria.

Causes of dyspepsia

There is a wide variety of causes that can cause dyspepsia. Very often, several causes and / or risk factors are simultaneously involved in the development of this syndrome. The modern concept of the causes of dyspepsia has been actively developed in recent years. Today, scientists, in a number of possible causes contributing to the development of dyspepsia, consider a number of factors, namely hypersecretion of hydrochloric acid, dietary errors, bad habits, long-term medication, Helicobacter Pylori infection, neuropsychic and other factors.

The causes of dyspepsia are:

• stress;
• genetic predisposition;
• biliary pathology ( bile) systems;
• pathology of the gastrointestinal tract ( gastrointestinal tract).

Helicobacter pylori and other bacteria in the development of dyspepsia

An important role in the development of dyspepsia is played by the microbial factor, namely Helicobacter Pylori. Many researchers confirm the etiological role of this microorganism in the formation of dyspepsia syndrome. They are based on data from the clinical picture of dyspepsia in patients with Helicobacter Pylori. They also believe that the severity of the syndrome is related to the degree of contamination of the gastric mucosa. Evidence for this theory is the fact that after antibiotic therapy ( against Helicobacter) manifestations of dyspepsia are significantly reduced.

Confirmation that the state of the nervous system plays an important role in the development of dyspepsia is the fact that stressful situations often provoke a deterioration in the condition of patients with this disease.

Genetic predisposition to dyspepsia

In recent years, research has been actively conducted to identify the genetic predisposition to dyspepsia. As a result of these studies, a gene was identified that is associated with the work of the digestive organs. Disruption of its expression may explain this pathology.

Pathology of the biliary system

In the hepatobiliary system of the body, the formation of bile occurs continuously. The gallbladder serves as a reservoir for it. In it, bile accumulates until it enters the duodenum. From the gallbladder during digestion, bile enters the intestine, where it participates in the process of digestion. Bile demulsifies ( breaks down into small particles) fats, facilitating their absorption. Thus, the biliary system takes an important part in digestion, and therefore the slightest dysfunction can provoke the development of dyspepsia.

The most common functional disorders of the biliary system, namely various dyskinesias ( motor disorders). The prevalence of these disorders ranges from 12.5 to 58.2 percent. In persons over 60 years of age, functional disorders of the biliary system are observed in 25 to 30 percent of cases. It is important to note that dyskinesia predominantly affects women. Functional disorders of the biliary system include functional disorder of the gallbladder, functional disorder of the sphincter of Oddi, and functional pancreatic disorder.

The flow of bile into the digestive tract is provided by the accumulative function of the gallbladder and its rhythmic contractions. With each meal, the gallbladder contracts two to three times. If this does not happen, then bile begins to be secreted in insufficient quantities. Insufficient participation of bile in the process of digestion provokes symptoms such as heaviness in the epigastrium, nausea and others. This is explained by the fact that the lack of bile leads to the fact that food fats are not absorbed by the body, which explains the symptoms of dyspepsia.

Pathology of the gastrointestinal tract in dyspepsia

Various diseases of the gastrointestinal tract can also be the cause of dyspeptic syndrome. It can be gastritis, peptic ulcer or pancreatitis. In this case, we are not talking about functional, but about organic dyspepsia.

The most common disease that manifests itself as symptoms of dyspepsia is gastritis. Chronic gastritis is a disease that affects more than 40 to 50 percent of the adult population. According to various sources, the frequency of this disease is approximately 50 percent of all diseases of the digestive system and 85 percent of all diseases of the stomach.

Despite this prevalence, chronic gastritis does not have a specific picture and is often asymptomatic. Clinical manifestations are extremely variable and nonspecific. Some patients may show "flaccid stomach" symptoms, while others may show "irritable stomach" symptoms. However, most often, patients have symptoms of intestinal dyspepsia, namely flatulence, rumbling and transfusion in the abdomen, diarrhea, constipation, and unstable stools. This symptomatology can be supplemented by astheno-neurotic syndrome ( weakness, fatigue).

The second most common is gastric ulcer. It is a chronic disease with periods of exacerbation and remission. The main morphological feature of this disease is the presence of a defect ( ulcers) in the wall of the stomach. Pain is the leading symptom of peptic ulcer disease. This takes into account its periodicity, rhythm and seasonality. In contrast to functional dyspepsia, in this case there is a clear relationship between food intake and the appearance of pain. According to the time of appearance, they can be divided into early ones, ( 30 minutes after eating), late ( two hours after eating) and "hungry", appearing 7 hours after the last meal. In addition to pain symptoms, the clinical picture is manifested by various dyspeptic phenomena - heartburn, nausea, belching. All these and other symptoms indicate a violation of the evacuation of food from the stomach. Appetite, as a rule, does not decrease, and sometimes even increases.

Types of dyspepsia

Before proceeding to the existing types of dyspepsia, it is necessary to divide dyspepsia into organic and functional. Organic dyspepsia is one that is caused by certain diseases. For example, it can be peptic ulcer, reflux disease, malignant tumors, cholelithiasis and chronic pancreatitis. Based on this, organic dyspepsia is divided into gastric, intestinal and other types of dyspepsia. If, with a thorough examination, no diseases can be identified, then we are talking about functional ( non-ulcer) dyspepsia.

Depending on the causes, there are several types of dyspepsia. As a rule, the same symptoms are characteristic of all of them. The difference between them is the reason for their development and the peculiarity of pathogenesis ( occurrence).

Types of dyspepsia are:

• gastric dyspepsia;
• fermentative dyspepsia;
• putrefactive dyspepsia;
• intestinal dyspepsia;
• neurotic dyspepsia.

gastric dyspepsia

In most cases, the presence of symptoms of dyspepsia is associated with pathology of the stomach and duodenum ( upper intestine). At the heart of gastric dyspepsia are such frequent diseases as gastritis, reflux, gastric ulcer. This pathology is widespread among the population, and it accounts for about one third of all clinical cases. Gastric dyspepsia is characterized by polymorphic ( diverse) clinical picture, but the severity of its symptoms does not correlate ( not related) with the severity of mucosal damage.
The syndrome of gastric dyspepsia is manifested by pain in the epigastric region, which is not associated with impaired bowel function. The duration of symptoms is at least 12 weeks.

Many experts in the development of gastric dyspepsia assign the main role to the microbial factor, namely Helicobacter Pylori. Proof of this are studies that have shown that the elimination of this factor leads to a decrease or complete disappearance of the symptoms of gastric dyspepsia. So, against the background of antibacterial treatment, there is a positive dynamics of morphological changes ( these changes are visible on fibrogastroduodenoscopy). Other scientists and clinicians deny the etiological role of this microbe in the development of gastric dyspepsia syndrome. One way or another, the use of antibacterial drugs to remove this microbe from the body is not a mandatory item in the treatment of gastric dyspepsia.

Fermentative dyspepsia

Fermentative dyspepsia is a type of dyspepsia, which is based on excessive gas formationcaused by fermentation. Fermentation is the process of splitting products in anoxic conditions. The result of fermentation are intermediate metabolic products and gases. The reason for fermentation is the intake of a large amount of carbohydrates into the body. Instead of carbohydrates, insufficiently fermented foods, such as kvass, beer, can act.

Normally, carbohydrates are utilized ( are absorbed) in the small intestine. However, when there are a lot of carbohydrates, they do not have time to be metabolized and begin to “roam”. The result of this is excessive gas formation. Gases begin to accumulate in the intestinal loops, causing bloating, rumbling and colicky pains. After passing gas or taking antiflatulents ( espumizan) the above symptoms subside.

Symptoms of fermentative dyspepsia include:

• bloating;
• colicky pains;
• stool 2 to 4 times a day.

The consistency of feces with fermentative dyspepsia becomes soft, and the color acquires a light yellow tint. Sometimes there are gas bubbles in the stools, which gives them a sour smell.

Putrid dyspepsia

Putrid dyspepsia is a type of dyspepsia, which is based on intense processes of decay. The processes of decay are caused by protein foods, as well as some inflammatory processes in the intestines. Protein food in this case becomes a substrate for pyogenic flora, which triggers putrefactive mechanisms. Clinical manifestations of putrefactive dyspepsia are symptoms such as bloating, frequent diarrhea ( stool up to 10 - 14 times a day). The feces at the same time become dark in color and acquire a fetid odor.
In the diagnosis of putrefactive dyspepsia, microscopic examination of feces is of great importance. Microscopy reveals many undigested muscle fibers.

Intestinal dyspepsia

Intestinal dyspepsia is a symptom complex that combines digestive disorders and enteral syndrome. Clinically, it is expressed in flatulence, impaired stool ( polyfeces), pain syndrome. With intestinal dyspepsia, the stool becomes very frequent, from 5 times a day or more. The pains are bursting in nature and are localized mainly in the mesogastrium.

At the same time, enteral syndrome is manifested by metabolic disorders, in particular, a violation of protein and lipid metabolism. Mineral metabolism disorders are also present. Since vitamins are absorbed in the intestine, hypovitaminosis is detected when it dysfunctions ( hypovitaminosis A, E, D). This can lead to dystrophic changes in other organs.

biliary dyspepsia

The basis of biliary dyspepsia is the pathology of the biliary tract. Most often, these are functional disorders ( i.e. dyskinesia), in the development of which stress is of great importance. Since the nervous system plays a leading role in the regulation of the contractile function of the gallbladder and bile ducts, any stressful situation can lead to the development of gallbladder dyskinesia. The pathogenesis of biliary dyspepsia can be very variable, but always comes down to dysregulation of biliary tract motility. This means that under the influence of trigger factors ( stress, violation of the alimentary regime) there is a change in the motility of the biliary tract, which can be expressed either in its strengthening or in its weakening. Both lead to the development of symptoms of dyspepsia.

When the motility of the biliary tract changes, the volume and composition of the ejected bile changes. Since bile plays an important role in the process of digestion, any changes in its composition lead to dyspeptic manifestations. In addition to psychogenic factors, the development of functional biliary pathology is influenced by hormonal imbalance. Thus, an imbalance between the production of cholecystokinin and secretin provokes an inhibitory effect on the contractile function of the gallbladder.

The cause of biliary dyspepsia can also be diseases such as hepatitis, cholangitis, cholecystitis. In this case, the development of dyspepsia is associated with inflammatory changes in the biliary tract.

Symptoms of biliary dyspepsia
The clinical picture of biliary dyspepsia is due to the degree of motor dysfunction of the gallbladder. Pain symptoms dominate. In this case, pain can be localized both in the epigastrium and in the right upper quadrant of the abdomen. The duration of pain varies from 20 to 30 minutes or more. As with functional dyspepsia, the pain in this case does not regress after defecation or after taking antacids. In biliary dyspepsia, the pain syndrome is associated with nausea or vomiting.

Dyspepsia syndrome in psychiatry or neurotic depression

Dyspepsia syndrome occurs not only in the practice of a gastroenterologist, but also in a psychiatrist. Somatic symptoms, stubbornly pursuing the patient for 2 years, without the presence of any organic lesions, are part of the structure of various psychosomatic disorders. Dyspepsia syndrome can mask diseases such as depression, anxiety and panic disorder. Most often, dyspepsia is observed with depression. So, there is a type of depression, which is called masked. He is not characterized by such classical complaints as depression, low mood, and a labile emotional background. Instead, somatic, that is, bodily complaints, come to the fore. Most often, these are complaints from the cardiovascular or gastrointestinal system. The first category includes symptoms such as heart pain, shortness of breath, tingling in the chest. Gastrointestinal symptoms include epigastric pain, nausea, and discomfort after eating. Thus, dyspepsia syndrome can remain the main symptom of depression for a long time.

Symptoms of neurotic dyspepsia are:

• nausea;
• belching;
• heartburn;
• pain in the epigastric region;
• difficulty swallowing;
• discomfort in the stomach, intestines;
• intestinal disorders;

Often, dyspepsia can be supplemented by other complaints. Most often, these can be complaints from the cardiovascular system, namely palpitations, interruptions and pain in the heart, sensations of pressure, compression, burning, tingling in the chest.

To date, more than 250 bodily complaints have been described that occur in depression. In general, the variety of complaints can be so great that it makes diagnosis difficult. A diagnosis requires at least four bodily symptoms in men and six in women. The difficulty of diagnosis lies in the fact that patients do not complain of depressed mood or any other emotional states. However, long-term observation can reveal irritability, fatigue, poor sleep, internal tension, anxiety, depressed mood.

functional dyspepsia

According to the new classification, functional dyspepsia is a complex of symptoms that occurs in adults and children older than one year. Functional dyspepsia includes pain, nausea, a feeling of fullness in the stomach, as well as bloating and regurgitation. Also, for patients with functional dyspepsia, intolerance to fatty foods is characteristic. The duration of symptoms must be at least 3 months in the last six months. The term "functional" means that during the examination it is not possible to identify an organic disease.

The prevalence of functional dyspepsia, like many other functional digestive disorders, is very high throughout the world. So, among Europeans, every fifth suffers from functional dyspepsia, and every third in the USA. At the same time, the percentage of women suffering from dyspepsia significantly exceeds the percentage of men with a similar disease. Functional dyspepsia is noted among all age groups, however, as they grow older, its frequency of occurrence increases.

Prevalence of functional dyspepsia among different age groups

Reasons for the development of functional dyspepsia

pathogenesis ( set of mechanisms) the development of functional dyspepsia has not been studied enough to date. It is believed that functional dyspepsia is a disease based on impaired regulation of the motility of the digestive tract, namely the stomach and duodenum. Proper motor disturbances in this case include a decrease in the accommodation of the stomach to the food entering it and a delay in gastric emptying due to reduced motility. Thus, there is a disorder in the coordination of those links that regulate the contractility of the gastrointestinal tract, which leads to the development of dyskinesia.

Visceral hypersensitivity also plays a key role ( increased sensitivity of internal organs). It is she who causes disorders in the adaptation of the stomach to incoming food and difficult evacuation from it. Disturbed accommodation of the stomach to incoming food is observed in more than 40 percent of patients. The consequence of this are symptoms such as rapid satiety, a feeling of fullness in the stomach and pain after eating. Gastric secretion in functional dyspepsia, as a rule, is not disturbed.

Also, most patients with functional dyspepsia have duodenal dysfunction. It is expressed in increased sensitivity to acid coming from the stomach. The consequence of this is a slowdown in the motility of the organ and a delay in the evacuation of the contents from it. As noted above, patients with functional dyspepsia are characterized by intolerance to fatty foods. This intolerance is due to hypersensitivity to fats.

Recent studies suggest that a substance called ghrelin plays an important role in the development of functional dyspepsia. Ghrelin is a peptide synthesized by the endocrine cells of the stomach. With functional dyspepsia, there is a violation of the secretion of this peptide, which normally regulates the digestive organs. Active secretion of ghrelin in healthy individuals occurs on an empty stomach, which stimulates the motor activity of the stomach and gastric secretion. Studies have shown that the level of ghrelin in the blood on an empty stomach in patients with functional dyspepsia is much lower than in healthy people. This causes the development of symptoms such as a feeling of rapid satiety and fullness in the stomach. It was also found that in patients suffering from dyspepsia, the level of ghrelin in the blood plasma after meals does not change, while in healthy individuals it decreases.

Symptoms of functional dyspepsia

Functional dyspepsia is characterized by repeated pain attacks in the upper abdomen. Unlike irritable bowel syndrome, in functional dyspepsia, pain and a feeling of fullness do not go away after a bowel movement. Also, the symptoms are not related to changes in stool frequency. The main distinguishing feature of this pathology is the absence of signs of inflammation or other structural changes.

According to the Rome diagnostic criteria, there are several variants of functional dyspepsia.

Options for functional dyspepsia are as follows:

• Ulcer-like functional dyspepsia characterized by epigastric pain on an empty stomach such "hungry" pains are very characteristic of stomach ulcers, from which the name). The pain syndrome disappears after eating and antacids.
• Dyskinetic functional dyspepsia accompanied by discomfort in the upper abdomen. Discomfort worsens after eating.
• Nonspecific functional dyspepsia. Complaints present in this variant of dyspepsia do not refer to any particular type of dyspepsia.

According to the Rome diagnostic criteria, functional dyspepsia is also classified into postprandial distress syndrome and epigastric pain syndrome. The first syndrome includes discomfort and a feeling of fullness that occurs after eating a normal amount of food. Patients with this variant of dyspepsia are characterized by rapid satiety. The pain syndrome is characterized by periodic pains in the epigastric region, which are not associated with food intake.
It should be noted that this classification is typical only for adults. Since it is difficult to obtain an accurate description of complaints in children, functional dyspepsia is not classified in pediatric practice.

In patients with functional dyspepsia, the quality of life is significantly reduced. It is associated with the above symptoms ( pain and nausea), as well as the fact that there is a need to limit yourself to certain foods and drinks. Diet and constant pain provoke social problems. Despite the fact that dyspepsia is functional in nature, the degree of decrease in the quality of life in such patients is comparable to organic pathology.

An important feature of functional dyspepsia is its consistency. All the digestive organs are affected to varying degrees. So, more than 33 percent of patients also have symptoms of gastroesophageal reflux, while the frequency of signs of irritable bowel syndrome is almost 50 percent.

Dyspepsia in children

Dyspepsia is typical not only for adults, but also for children. Their course of dyspepsia, as a rule, is characterized by a favorable prognosis. Manifestations of dyspepsia in children are very variable and extremely unstable.

Doctors assign the main role in the development of dyspepsia syndrome in children to Helicobacter Pylori and the phenomenon of dyskinesia. This is confirmed by studies proving an increase in the prevalence of infection with this microorganism in children with dyspepsia syndrome. While in children who do not suffer from dyspepsia, the infection rate is much lower. Also in children there is a positive trend in the use of antibacterial agents aimed at the destruction of the microbe.

An important role in the development of dyspepsia in children is played by motor disorders of the stomach. It has been established that only 30 percent of children have a normal evacuation function of the stomach. In children who do not suffer from dyspepsia, this percentage reaches 60 - 70 percent. Also, in these children, an expansion of the antrum of the stomach on an empty stomach and after eating is often detected. The degree of expansion correlates ( interconnected) with the severity of dyspeptic syndrome. In addition to the bacterial factor and dyskinesia, cerebral pathology is considered as an etiological factor ( birth trauma), age-related features of the functioning of the neuroendocrine system.
For children and adolescents with dyspepsia, appetite disorders such as bulimia and anorexia are characteristic.

Diagnosis of dyspepsia in children
Research plays an important role in the diagnosis of dyspepsia syndrome in children.
gastroduodenal pathology. For this purpose, fibrogastroduodenoscopy is performed ( FGDS), direct and indirect detection of Helicobacter Pylori. Also in the diagnosis, the history of the disease plays a significant role, namely the presence of such symptoms as hungry night pains, discomfort in the upper abdomen, belching of acidic contents, heartburn.

Diagnosis of dyspepsia

Dyspepsia syndrome is one of the most common manifestations of gastrointestinal pathology. More than 5 percent of primary visits for medical care are provoked by dyspepsia. In gastroenterology, dyspepsia syndrome is one of the most common complaints. As already noted, there are two types of dyspepsia - organic and functional ( non-ulcerative). The first is characterized by the presence of pathology, for example, ulcers, gastritis, duodenitis. Functional is characterized by the absence of any gastrointestinal lesions.

Diagnostic criteria for dyspepsia are as follows:

• Feeling pain or discomfort localized in the epigastric region. Pain is subjectively assessed by the patient as an unpleasant sensation or a feeling of “tissue damage”.
• Feeling of fullness and stagnation of food in the stomach. These sensations may or may not be food related.
• fast saturation is perceived by the patient as a feeling of fullness in the stomach immediately after the start of a meal. This symptom does not depend on the amount of food taken.
• Bloating perceived as a feeling of fullness in the epigastric region.
• Nausea.

Diagnostic criteria for organic dyspepsia

Dyspepsia according to the ICD

According to the international classification of diseases of the tenth revision ( ICD-10) dyspepsia is encoded with the code K10. However, this type of dyspepsia excludes neurotic or nervous dyspepsia. These two varieties of dyspeptic syndrome are related to somatoform dysfunction of the autonomic nervous system and therefore are not included in the section of gastrointestinal pathology.

The diagnosis of dyspepsia is based on the patient's persistent symptoms of dyspepsia for at least 12 weeks per year. With functional dyspepsia, organic diseases should not be detected, and irritable bowel syndrome should also be excluded.

Differential diagnosis of dyspepsia
Symptoms of dyspepsia are found in patients with irritable bowel syndrome, enteritis, stomach cancer. This must be taken into account when making a differential diagnosis. To exclude the above diseases, instrumental and laboratory tests are carried out. These include general and biochemical blood tests, coprogram and fecal occult blood tests, ultrasound ( ultrasound), endoscopic and X-ray examination ( x-ray).

Instrumental and laboratory studies for dyspepsia

Method	What is being done for?
Fibrogastroduodenoscopy(FGDS)	Excludes ulcer, gastritis, pancreatitis or other organic pathology of the gastrointestinal tract.
Ultrasonography(ultrasound)	Detects or excludes cholelithiasis, chronic pancreatitis. The method is informative for biliary dyspepsia.
Scintigraphy with technetium isotopes	Determines the rate of gastric emptying.
Electrogastrography	Registers the electrical activity of the stomach and the contraction of its walls. In a healthy person, the frequency of contractions of the stomach is about 3 waves per minute.
Gastroduodenal manometry