DM - Gastroenterology, MD MEDICINE, MBBS
For a healthy body, proper digestion and absorption of food is very important. The digestion is an extremely intricate process and involves many organs. Impairment in any of the organs can hamper the digestive process, leading to a very common condition called dyspepsia. It is caused by malfunction of one of the muscular organs along the digestive tract including esophagus, stomach, small and large intestines and colon.
Causes: While dyspepsia is more a symptom, there are various reasons that lead to it including gastritis, peptic ulcer disease, infections, motility disorders, gastroesophageal reflux disease (GERD), cancers of the digestive tract or any other abnormality in the digestive tract.
Evaluation: When a patient has chronic dyspepsia or indigestion, the first thing to do is a thorough evaluation to find out the underlying cause. As noted above, there are functional and nonfunctional causes leading to dyspepsia. While gastric ulcers or polyps are visible during an endoscopy, conditions like gastritis and malignancy can only be diagnosed under microscopic examinations.
Some of the tests that are used for evaluation of the cause of dyspepsia include:
1. X-ray: Any growth would be visible on an x-ray and further testing can then be done to confirm the exact nature of it.
2. Endoscopy: This will allow the doctor to see the actual digestive tract and identify any structural abnormalities or growth.
3. Colonoscopy: If the problem is suspected to be in the lower gastrointestinal tract, then a colonoscopy may be in indicated.
4. Gastric emptying study: This study can also reveal the abnormalities in the digestive tract
5. Culture: Dyspepsia caused by Helicobacter pylori can be diagnosed through cultures of the stomach contents.
Treatment: The treatment of dyspepsia is quite complicated and cannot be clearly outlined given the various conditions that it is associated with. Even specific foods can induce indigestion in some people. Therefore, a multipronged approach is required to treat dyspepsia.
Education: The affected person should be educated about the non-life-threatening nature of the problem and its chronicity. Some of the drugs used in treatment include:
1. Proton pump inhibitors: These reduce the amount of acid produced in the stomach and thereby help in relieving symptoms.
2. Promotility drugs: They improve the movement of the muscles in the intestinal tract and are so used in managing dyspepsia.
3. Antibiotics: If an infection is suspected, antibiotics are effective.
4. Smooth muscle relaxants: Drugs like hyoscyamine and methscopolamine have been shown to provide relief in some patients.
5. Psychotropic drugs: Anxiety and depression are frequently seen in people with dyspepsia, and managing these can help reduce the dyspepsia.
As noted, the causes, symptoms, and management are very specific to individuals and needs to be managed by the doctor.