{"id":1687,"date":"2025-11-08T04:00:00","date_gmt":"2025-11-08T00:00:00","guid":{"rendered":"http:\/\/vitamed.test\/dyspepsia-diagnosis-and-treatment\/"},"modified":"2026-09-15T17:13:37","modified_gmt":"2026-09-15T13:13:37","slug":"dyspepsia-diagnosis-and-treatment","status":"publish","type":"post","link":"https:\/\/vitamed.production.am\/en\/dyspepsia-diagnosis-and-treatment\/","title":{"rendered":"DYSPEPSIA: DIAGNOSIS AND TREATMENT"},"content":{"rendered":"

<\/p>\n

\"DYSPEPSIA:<\/figure>\n

<\/p>\n

Dyspepsia <\/strong>(from Greek dys – bad, peptein – to digest) is a symptom or a group of symptoms originating from the stomach and duodenum.<\/p>\n

Main Dyspeptic Symptoms:<\/p>\n

•    Epigastric pain
\n•    Burning sensation in the upper abdomen
\n•    Postprandial fullness or heaviness
\n•    Early satiety
\n•    May also include nausea, vomiting, and belching<\/p>\n

Classification<\/h2>\n

There are two main types of dyspepsia:<\/p>\n

1. Functional Dyspepsia (FD) — without an identifiable organic cause<\/strong><\/p>\n

According to the Rome IV criteria, two subtypes are defined:
\n•    Postprandial Distress Syndrome (PDS): characterized by post-meal fullness and early satiety
\n•    Epigastric Pain Syndrome (EPS): characterized by epigastric pain or burning of varying intensity
\nSymptoms can be continuous or intermittent. Food intake often triggers symptoms, though they can also occur during fasting.<\/p>\n

Diagnostic criteria for FD:<\/strong><\/p>\n

Presence of at least one of the following symptoms for the past 3 months, with symptom onset at least 6 months prior to diagnosis, in the absence of structural disease:
\n•    Postprandial fullness
\n•    Early satiety
\n•    Epigastric pain or burning<\/p>\n

Etiology<\/h2>\n

Causes of Functional Dyspepsia:<\/strong>
\n•    Delayed gastric emptying
\n•    Visceral hypersensitivity to gastric distention
\n•    Alterations in gut microbiota
\n•    Gut–brain axis dysfunction<\/p>\n

Causes of Organic Dyspepsia:<\/strong>
\n•    Gastroesophageal reflux disease (GERD)
\n•    Esophagitis
\n•    Gastritis
\n•    Peptic ulcer disease
\n•    Gastric cancer
\n•    Celiac disease
\n•    Chronic biliary or pancreatic diseases<\/p>\n

Risk Factors:<\/strong>
\n•    Female sex
\n•    Smoking
\n•    NSAID use
\n•    Depression
\n•    History of acute gastrointestinal infections
\n•    Food allergens
\n•    Helicobacter pylori infection<\/p>\n

Diagnosis<\/h2>\n

Clinical criteria for Postprandial Distress Syndrome:
\nPresence of one or both of the following symptoms at least three times per week:<\/p>\n

1.    Early satiety that prevents finishing a normal-sized meal
\n2.    Postprandial fullness<\/p>\n

Additional symptoms:<\/strong><\/p>\n

•    Epigastric pain after meals
\n•    Bloating
\n•    Belching
\n•    Nausea<\/p>\n

Note: Symptoms do not improve after defecation (helps distinguish from IBS).<\/p>\n

Physical Examination:<\/strong><\/p>\n

•    May reveal epigastric tenderness or discomfort in the right or left upper quadrants
\n•    No specific or pathognomonic findings
\n•    Often entirely normal<\/p>\n

Laboratory and Instrumental Investigations:<\/strong><\/p>\n

1.    Helicobacter pylori testing
\n       o    A patient with H. pylori-positive gastritis is considered to have FD only if symptoms persist 6–12 months after eradication
\n2.    Complete blood count
\n3.    Blood biochemistry
\n4.    Fecal occult blood test
\n5.    Stool test for parasites
\n6.    Esophagogastroduodenoscopy (EGD)
\n7.    Abdominal ultrasound
\n8.    If necessary: abdominal CT\/MRI, others as indicated<\/p>\n

Differential Diagnosis<\/h3>\n

"Alarm symptoms" warrant further investigation to exclude organic disease:
\n•    Fever
\n•    Unexplained weight loss
\n•    Blood in stool
\n•    Dysphagia
\n•    Anemia
\n•    Leukocytosis
\n•    Elevated ESR
\n•    Age over 60 years<\/p>\n

Features suggestive of organic dyspepsia:<\/p>\n

•    Nocturnal symptoms
\n•    Progressive symptom severity<\/p>\n

Functional dyspepsia typically presents with normal laboratory and imaging findings.<\/p>\n

Dyspepsia can also be associated with:
\n•    Pregnancy
\n•    Use of certain medications (e.g., NSAIDs, antibiotics)
\n•    Diabetes mellitus
\n•    Chronic kidney disease<\/p>\n

Dyspepsia Treatment<\/h2>\n

General Approach:<\/strong>
\n•    Establishing a strong physician–patient relationship
\n•    Dietary modification: avoid saturated fats, spices, coffee, tea, carbonated drinks
\n•    Cessation of harmful habits (smoking, alcohol)
\n•    Discontinuation of NSAIDs when possible
\n•    Psychotherapy when indicated<\/p>\n

Pharmacologic Therapy:<\/strong>
\n•    Proton pump inhibitors (PPIs): for patients with epigastric pain syndrome
\n•    Eradication therapy: for H. pylori-positive cases
\n•    Prokinetics: metoclopramide, domperidone
\n•    Antidepressants: amitriptyline, venlafaxine, mirtazapine
\n•    Anxiolytics: as clinically indicated<\/p>\n","protected":false},"excerpt":{"rendered":"

Dyspepsia (from Greek dys \u2013 bad, peptein \u2013 to digest) is a symptom or a group of symptoms originating from the stomach and duodenum.<\/p>\n","protected":false},"author":1,"featured_media":1682,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[173,171],"tags":[],"class_list":["post-1687","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en","category-blog"],"acf":[],"_links":{"self":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1687","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/comments?post=1687"}],"version-history":[{"count":3,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1687\/revisions"}],"predecessor-version":[{"id":6519,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1687\/revisions\/6519"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media\/1682"}],"wp:attachment":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media?parent=1687"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/categories?post=1687"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/tags?post=1687"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}