Dyspepsia and peptic ulcer disease

Question 1

What is the more common name for indigestion?

Answer 1

Indigestion

Question 2

What is dyspepsia?

Answer 2

This is discomfort or pain that occurs following eating

Question 3

What is the Rome IV criteria for functional dyspepsia?

Answer 3

Bothersome epigastric pain
Bothersome epigastric burning
Bothersome postprandial fullness
Bothersome early satiation
Symptom onset 6 months prior to diagnosis
Symptoms active within last 3 months
No evidence of structural disease

Question 4

What are some causes of dyspepsia?

Answer 4

Functional dyspepsia (75%) - No underlying structural abnormality, usually linked with other conditions e.g. IBS

Organic dyspepsia (25%)
- GORD
- Peptic ulcer disease
- Drugs (especially NSAIDs and COX2 inhibitors)
- Gastric cancer

Question 5

What are some examples of sub-types of functional dyspepsia?

Answer 5

Epigastric pain syndrome
Post-prandial distress syndrome

Question 6

What is meant by epigastric pain syndrome?

Answer 6

This is the presence of bothersome epigastric pain or burning which may be induced or relieved by ingestion of a meal, which can lead to bloating or belching nausea

Question 7

What is meant by post-prandial distress syndrome?

Answer 7

This is the presence of bothersome post-prandial fullness or early satiation, but may also include pain, bloating, belching and nausea

Question 8

Who is most at risk of functional dyspepsia?

Answer 8

Females
Younger patients
IBS
Psychological comorbidities
High BMI
Enteric infection (H.pylori)
Regular NSAID use

Question 9

What are some red flag symptoms in dyspepsia?

Answer 9

Weight loss
Over 55

Question 10

How is functional dyspepsia treated?

Answer 10

Regular exercise
Avoidance of dietary triggers
Acid suppression
Gut-brain neuromodulators e.g. tricyclic antidepressants
Anti-psychotics, CBT, hypnotherapy, stress management