Dyspepsia is
the term used to describe symptoms such as bloating and nausea which are
thought to originate from the upper gastrointestinal tract. There are many
causes including some arising outside the digestive system. Heartburn and other
‘reflux’ symptoms are separate entities and are considered elsewhere. Although
symptoms often correlate poorly with the underlying diagnosis, a careful
history is important to detect ‘alarm’ features requiring urgent investigation
and to detect atypical symptoms which might be due to problems outside the
gastrointestinal tract. Dyspepsia affects up to 80% of the population at some
time in life and many patients have no serious underlying disease. Patients who
present with new dyspepsia at an age of more than 55 years and younger patients
unresponsive to empirical treatment require investigation to exclude serious
disease.
Cause of dyspepsia
Upper gastrointestinal disorder
1. Peptic
ulcer disease
2. Acute
gastritis
3. Gallstones
4. Motility
disorders eg esophageal spasm
5. Functional
(non-ulcer dyspepsia and irritable bowel syndrome
Other gastro intestinal disorders
1. Pancreatic
disease (cancer chronic pancreatitis)
2. Hepatic
disease (hepatitis, metastasis)
3. Colonic
carcinoma
Systemic disease
1. Non-steroid
anti-inflammatory drugs (NSAIDs)
2. Iron
and potassium supplements
3. Corticosteroids
4. Digoxin
Others
1.
Alcohol
2.
Psychological (anxiety, depression)
Alarm features of dyspepsia
·
Weight loss
·
Anaemia
·
Vomiting
·
Hematimiasis and/or melaena
·
Dysphagia
·
Palpable abdominal mass
