Functional Dyspepsia

What is Functional Dyspepsia?

Functional dyspepsia is a disorder of the gut brain interaction (DGBI) in which you may experience early satiety (feeling full from even small amounts of food); feeling excessively full after meals; and/or pain or burning in the stomach (just beneath ribcage on the left). These symptoms occur despite the absence of any visible, structural disease– like acid reflux or ulcers–or any objectively observable dysfunction of the stomach, such as a delayed rate of stomach emptying.

What causes Functional Dyspepsia?

As is the case for other DGBIs, functional dyspepsia is caused by faulty communication between the brain and the nerves of the stomach, resulting in hypersensitivity to even normal stimuli. Things like larger volume meals, spicier foods, higher fat foods, alcohol, more acidic foods or carbonation that might not bother someone else can trigger over-sensation in the brain when you have functional dyspepsia, and this results in feelings of discomfort or pain. In some cases, feelings of fullness and discomfort can be aggravated by the failure of the stomach to stretch adequately to accommodate a normal amount of food.

How do we diagnose Functional Dyspepsia?

Diagnosing functional dyspepsia involves ruling out other diseases that could be responsible for the symptoms, including acid reflux, ulcers/H pylori infection and slow stomach emptying (gastroparesis). Sometimes, lack of response to even high dose acid suppression may be used to diagnose functional dyspepsia.

How is Functional Dyspepsia Treated?

Functional dyspepsia can be treated through a combination of dietary change and medications. Our dietitians will work with you to understand how frequently you eat, what you eat/drink and when you typically experience symptoms to create recommendations on meal size, frequency, texture and composition to help reduce triggering the hypersensitive pain response. There are also a few over-the-counter dietary supplements with evidence to support their helpfulness in managing symptoms of functional dyspepsia.

When dietary modification is not sufficient to manage symptoms of functional dyspepsia, there are several medications that can be useful in targeting the dysregulated brain-gut communication signals. Certain types of anti-depressant medications can be used off-label to help interrupt abnormal pain and sensory processing by the brain; when used to treat functional dyspepsia, these medications are prescribed at doses much lower than those used to treat depression or affect mood in any significant way.

In addition, some behavioral interventions administered by GI psychologists can also help change the way the brain processes signals from the digestive tract.