Irritable Stomach or Functional Dyspepsia

Irritable Stomach (Functional Dyspepsia): Medical History

Medical history (history of illness) represents an important component in the diagnosis of functional dyspepsia (FD; irritable stomach syndrome). Family history Is there a history of frequent gastrointestinal disorders in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological … Irritable Stomach (Functional Dyspepsia): Medical History

Irritable Stomach (Functional Dyspepsia): Or something else? Differential Diagnosis

Respiratory System (J00-J99) Chronic pulmonary disease Endocrine, nutritional and metabolic diseases (E00-E90). Diabetes mellitus Cardiovascular system (I00-I99) Coronary artery disease (CAD) – disease of the coronary arteries. Myocardial infarction (heart attack) Infectious and parasitic diseases (A00-B99). Parasites (e.g., Giardia lamblia, Strongyloides, Anisakis). Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87). Cholelithiasis (gallstones). Cholecystitis … Irritable Stomach (Functional Dyspepsia): Or something else? Differential Diagnosis

Irritable Stomach (Functional Dyspepsia): Classification

Functional dyspepsia (FD) is defined by the Rome Consensus Conferences and classified as “functional gastroduodenal disorders.” Dysfunctional dyspepsia exists when at least one of the following symptoms is present: Early feeling of satiety, so that normal-sized portions cannot be eaten. Unpleasant feeling of fullness postprandial (after eating). Epigastric pain (epigastric means “referring to the upper … Irritable Stomach (Functional Dyspepsia): Classification

Irritable Stomach (Functional Dyspepsia): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Auscultation (listening) of the heart [due todifferential diagnoses: coronary artery disease (CAD) (disease of the coronary arteries); myocardial infarction … Irritable Stomach (Functional Dyspepsia): Examination

Irritable Stomach (Functional Dyspepsia): Test and Diagnosis

2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT); alkaline … Irritable Stomach (Functional Dyspepsia): Test and Diagnosis

Irritable Stomach (Functional Dyspepsia): Drug Therapy

Therapy goals Improvement of the symptomatology Improvement of disease management If necessary, freedom from symptoms Therapy recommendations Helicobacter pylori eradication: if Helicobacter pylori is found to be positive, eradication (complete elimination of the pathogen) should be given as first-line therapy (see gastritis/stomach mucosa inflammation for details); recommendation based on a meta-analysis in which eradication was … Irritable Stomach (Functional Dyspepsia): Drug Therapy

Irritable Stomach (Functional Dyspepsia): Diagnostic Tests

Functional dyspepsia (FD; irritable stomach syndrome; dyspeptic complaints) is a diagnosis of exclusion. Only after all organic causes have been excluded with certainty may the diagnosis be made. Mandatory medical device diagnostics. Esophago-gastro-duodenoscopy (EGD; endoscopy of esophagus, stomach, and duodenum) with biopsies (sampling) from all suspicious lesions + H. pylori testing (biopsy from duodenum); in … Irritable Stomach (Functional Dyspepsia): Diagnostic Tests

Irritable Stomach (Functional Dyspepsia): Prevention

To prevent functional dyspepsia (FD; irritable stomach syndrome), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Dietary habits: High-fat meals (inhibition of gastric emptying). Hot spices Stimulant consumption Tobacco (smoking) Psycho-social situation Psychological stress Anxiety Disease-related risk factors Food intolerances, which can be very individual, such as dairy products (lactose … Irritable Stomach (Functional Dyspepsia): Prevention

Irritable Stomach (Functional Dyspepsia): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate functional dyspepsia (irritable stomach syndrome; dyspeptic complaints): Leading symptoms Belching / excessive air burping Feeling of pressure in the stomach (gastric pressure)/postprandial (“after eating”) fullness. Crampy abdominal discomfort (abdominal pain), possibly also as epigastric fasting pain. Nausea (nausea)/vomiting Feeling of fullness or early satiety The discomfort often occurs … Irritable Stomach (Functional Dyspepsia): Symptoms, Complaints, Signs

Irritable Stomach (Functional Dyspepsia): Causes

Pathogenesis (development of disease) The cause of functional dyspepsia is heterogeneous and multifactorial. The exact pathomechanism of irritable stomach syndrome is not yet clear. However, psychological problems probably play an important role. In addition, hypersensitivity of the afferent innervation of the stomach is probably present (dysfunction of the autonomic nervous system). The dyspeptic complaints are … Irritable Stomach (Functional Dyspepsia): Causes