Functional dyspepsia

Question 1

What is it?

Answer 1

When there is no evidence of a culprit structural disease causing the dyspepsia, often associated with other gut disorders eg IBS

Question 2

Who gets it?

Answer 2

20-40% globally
More common in H.Pylori infection
More common if NSAID use
Overlap with GORD/IBS

Question 3

How does it present?

Answer 3

Needs to have atleast 1 to be functional dyspepsia
-Bothersome post-prandial fulness
-Epigastric pain
-Epigastric satiation
-Epigastric burning
AND
-No evidence of a structural disease at upper endoscopy

Question 4

How is functional dyspepsia diagnosed?

Answer 4

Detailed history and GI examination
Diagnosis of exclusion: HP -ve + No findings on OGD
- If uncomplicated: epigastric tenderness only
If complicated:
-Cachexia
-Mass
-Evidence of gastric outflow obstruction
-Peritonism

Question 5

How is functional dyspepsia treated?

Answer 5

if no alarm symptoms

• Check H. Pylori status and eradicate if infected
• If HP -ve treat with acid inhibition as required

Question 6

What are alarm symptoms?

Answer 6

Masses 
Dysphagia 
GI blood loss 
Persistent vomiting 
Unexplained weight loss

Question 7

Definition of Dyspepsia?

Answer 7

Umbrella term used to describe collection of symptoms seen within upper GI disease

• Epigastric pain
• Post-prandial fullness
• Early satiety
• +/- belching/bloating