Dyspepsia - Causes, Symptoms, Diagnostics and Treatment

Dyspepsia

Dyspepsia - This is a disruption of digestion due to the causes of organic and functional nature. The symptoms are pains in the upper part of the belly of unclear localization, nausea, heartburn, a sense of overcrowding of the stomach, fast saturation after meal and others. The diagnosis is established only in case of excluding another pathology of the gastrointestinal examination, the fundamental importance of the upper digestive tract has an endoscopic examination. Treatment is symptomatic: enzyme preparations, means for improving the motorcycle gastrointestinal motorcycle, etc. It is of great importance to psychotherapy - after classes with a psychologist, most patients note a decrease in the intensity of complaints.

General

Dyspepsia is one of the main problems of modern gastroenterology, since uncertain complaints about digestive discomfort places up to 40% of the population of developed countries, while only every fifth addresses to doctors. Digestion disorders may have an organic or functional basis.

Organic dyspepsia arises against the background of various pathology of the digestive organs (gastritis, ulcerative disease, inflammatory diseases of the hepatobiliary system, pancreas and different intestinal departments, digestion tumors, etc.). The functional dyspepsia is said in the case when, in the presence of symptoms of the violation of the stomach, no organic pathology is detected, which could call these complaints. Women suffer from a functional dyspexia 1.5 times more often than men; The main age contingent, which detects this disease, make up the face 17-35 years.

Dyspepsia

Dyspepsia

Causes of dyspepsia

The pathology is assumed to be a psychosocial disease, in which the regulation of the functions of the stomach and the initial departments of the intestine is disturbed as a result of various stress factors. In addition to emotional overvoltage, the causes of the development of functional dyspepsia may be dysfunction, the reception of some drugs, increase the secretion of hydrochloric acid, helicobacter seamation of the gastric mucosa, dyskinesia of the initial departments of the digestive tract, disruption of digestion of complex sugars and others. It is known that hypovitaminosis (vitamin deficiency And group B) can also contribute to the development of dyspepsia.

As a result of the impact of the listed factors on the wall of the stomach, the sensitivity of visceral receptors increases, the discoordination of the motility of the stomach and the small intestine occurs, the normal secretion of digestive juices is disturbed. Manifestations of these disorders are gastroparesis (accompanied by weight in epigastria, nausea and vomiting), increased visceral susceptibility susceptibility (feeling of the overflow of the stomach, hungry pain in the opposite region), incomplete relaxation of the muscular layer of the organ (the feeling of early saturation), slowing the promotion of dietary masses from the stomach in the intestines.

Diseases such as food allergies, gastroesophageal reflux disease, a diaphragmal hernia with a displacement of the abdominal esophagus in a chest cavity, gastritis, ahlorohydry, ulcerative disease, cholecystitis, state after cholecistectomy, pancreatitis, pylororostenosis, pylorostenosis , Tumors of the GCT, various infections of the digestive tract.

The most common cause of dyspepsia in children are nutritional toxicinosis, in which case, to the fore, along with dyspeptic, the toxicosis syndrome is released. Since the signs of organic dyspepsia are discussed in sections on the relevant diseases of the gastrointestinal tract, this article will be part of the functional dyspepsia.

Pathogenesis

As a result of the impact of the listed factors on the wall of the stomach, the sensitivity of visceral receptors increases, the discoordination of the motility of the stomach and the small intestine occurs, the normal secretion of digestive juices is disturbed. Manifestations of these disorders are gastroparesis (accompanied by weight in epigastria, nausea and vomiting), increased visceral susceptibility susceptibility (feeling of the overflow of the stomach, hungry pain in the opposite region), incomplete relaxation of the muscular layer of the organ (the feeling of early saturation), slowing the promotion of dietary masses from the stomach in the intestines.

Dyspepsia classification

Based on the pathogenetic principle, the functional and organic dyspepsia distinguish. Organic pathology accompanies various diseases of the digestive tract, and the functional proceeds against the background of the absence of organic lesion of the gastrointestinal tract. For the causal factor, the following dispersion options are allocated:

  • Alimentary - Usually associated with a violation of the ratio of the main nutrients in the diet. The fermentation dyspepsia develops when the carbohydrates is predominant in the carbohydrate menu, shredder - proteins and stupid meat, soap - when re-fulfilled by refractory fats.
  • Enzymatic - associated with insufficient formulation of digestive enzymes. Depending on which enzyme failure developed in which the organ, the gastrogen, pancreatogenic, hepatogenic and enterogenic dyspepsia is distinguished.
  • Dyspepssentials in Mal Absorption Syndrome - associated with impaired nutritional suction in the intestine.
  • Infectious - develops with different intestinal infections, most often in dysentery and salmonelles.
  • Inxication - arises with acute poisoning, heavy common infections, extensive injuries.

There are also four clinical forms of functional dyspepsia: Yazve-like, dyskinetic, reflux-like and uncertain.

Symptoms of dyspepsia

The diagnosis of functional disorder is established in the presence of three mandatory criteria. The first one is the complaints of pain and discomfort in the upper half of the abdomen on the middle line for one week monthly, or 12 weeks a year. The second is the lack of organic changes in the gastrointestinal tract in physical, endoscopic and ultrasound examination of the upper digestive tract. The third criterion is the lack of signs of irritable bowel syndrome (relief of symptoms after defecation or changing the character and frequency of the chair).

There are a number of features, in the presence of which the diagnosis is excluded: it is dysphagia, an increase in body temperature, the appearance of blood in a chair, inflammatory changes in clinical analyzes, anonymous weight loss, anemia. If there are listed symptoms, a deeper examination of the patient is required for the formulation of the right diagnosis.

There are four options for the flow of functional dyspepsia, each of which has its clinical and physical signs. A yazwned-like version is manifested by sufficiently strong night or hungry pain in the epigastric region, often arising after emotional overvoltage. The pain syndrome is borne by meals, introducing antacids. A characteristic feature is a sense of fear during an attack, obsessive thoughts about the presence of an incurable disease.

The diskinetic option is expressed by a feeling of overcrowding the stomach after eating, heaviness in the epigastria, nausea, bloating. Possible vomiting, bringing relief. Patients note that after eating rapid saturation occurs. Reflux-like dyspepsia is manifested by heartburn, a feeling of burning pain behind the sternum, belching and joking the acid. The last form of the disease is uncertain, or non-specific - characterized by polymorphism of symptoms, while allocating one presenter is not possible. For functional dyspepsia, a long time is characterized by no progression of symptoms.

Diagnostics

The consultation of the gastroenterologist will allow to identify the leading complaints, decide on the necessary amount of research. The diagnosis of functional dyspepsia is established only after a complete examination of the patient and the exclusion of other pathology of the gastrointestinal tract. The following studies are required: Consultation of an endoscopist doctor for eviopagogastroduodenoscopy, ultrasound of the abdominal bodies, blood tests (generally increasing and biochemical blood tests), Cala's research to assess digestive activities, detecting hidden blood.

With functional dyspepsia during EGDS changes in the mucosa are not visualized. In the ultrasound of the abdominal organs, chronic pancreatitis, gall-eyed disease can be detected. Deviations in analyzes with this diagnosis usually does not happen. For differential diagnosis with other gastrointestinal diseases, additional research may be required. With the radiography of the stomach, the expansion of the body cavity can be detected, slowing the evacuation of food. On the electroasterography, a violation of the stomach peristals is recorded (most often the gentle of its rhythm).

To determine the acidity, a study of gastric juice is carried out, intragastric pH-metry (possibly both an increase and lowering pH). To assess the degree of relaxation of the stomach, an anthrododenal pressure gauge is used, during which a special sensor transmitting pressure indicators is introduced into the organ cavity. With functional dyspepsia, the manometry may indicate insufficient relaxation or, on the contrary, relaxation of the stomach walls.

In a situation where symptoms are progressing, or not enough against the background of treatment, two different studies are required to detect Helicobacter infection. The use of methods with different diagnostic mechanisms (determination of the Helicobacter in feces using the ELISA, PCR diagnostics Helicobacter, determining the blood of antibodies to the Helicobacter method of the ELISA, the respiratory test for Helicobacter) will avoid the error.

Repeated consultation of the gastroenterologist After receiving the results of all studies, it makes it possible to eliminate organic pathology, to determine the diagnosis of functional dyspepsia and assign proper treatment. It is known that the organic reasons for disorders are found in 40% of patients with characteristic complaints for this disease, so the diagnostic search primarily should be aimed at identifying these diseases. Functional dyspepsia should be differentiated with irritable intestinal syndrome, functional vomiting, aerophage.

Treatment of dyspepsia

The main objectives that the doctor pursues when appointing the treatment of functional pathology is to reduce the intensity of symptoms, prevention of recurrence of the disease. Hospitalization in the department of gastroenterology is usually shown only for complicated research, with difficulties of differential diagnosis. The main directions of therapy of functional dyspepsia are: correction of lifestyle and nutrition, drug and psychotherapeutic measures.

To normalize the day mode, situations that provoke stresses and experiences, physical and emotional overload should be eliminated. It is recommended to refuse to eat alcohol, smoking. It is necessary to allocate time for daily physical culture activities - they improve both the patient's overall condition and the function of digestive organs. It is also necessary to pay great attention to the power regimen. From the diet, fried, extractive and acute food, carbonated drinks, coffee are excluded.

It is necessary for small portions, carefully chew food, prevent overeating and long interruptions between meals. After eating, you need to actively move, do not lie to rest. If there are signs of dyspepsia, it is recommended to refuse to use non-steroidal anti-inflammatory funds, as they adversely affect the state of the stomach mucosa. These activities are leading in the treatment of functional dyspepsia.

If the patient is not able to independently normalize the power mode, it may be necessary to help the nutritionist. The specialist will explain the need to comply with the frequency and volume of each meal, harming overeating and long breaks in nutrition. A nutritionist will also control the qualitative composition of food - the presence of sufficient protein and vitamins, dietary fiber.

The cure from the functional dyspepsia is impossible without a deep psycho-emotional restructuring. For this, it is necessary not only to reduce the number of stresses to a minimum, but also change the patient's attitude to negative situations. This may contribute to sports, water treatments, yoga classes. The attending physician must support trusting relationships with a patient, explain in detail the causes and mechanisms for the development of the disease - only in this case it is possible to obtain the desired effect on treatment. Greater productivity of therapy can be achieved when prescribing sedative preparations (Valerian, dyeing grass), antidepressants (fluvoxamine, fluoxetine).

Medicase treatment is prescribed depending on the form of dyspepsia. With a jewelry-like version, the main group of drugs - antacids and antisecretory agents: aluminum hydroxide in combination with magnesium hydroxide, proton pump inhibitors, H2 receptor blockers and others. With diskinetic form of dyspepsia, preoxes are used: domperidone or metoclopramide. The remaining options for functional dyspepsia suggest the use of various combinations of antacids and prokinetics.

If the symptoms of dyspepsia are not regressed against the background of the treatment, other drugs from these groups should be used, or change the combination of drugs. It is also recommended to conduct a study on h.pylori (if it has not been done), with a positive result - to carry out the eradication of microorganism with antibacterial agents. Antichelicobacter therapy in 25% of cases significantly facilitates the course of dyspepsia.

We should not forget about the alarming symptoms that may appear in a patient with dyspepsia: dysphagia, bleeding from various sections of the gastrointestinal tract, unmotivated weight loss. If the patient places the following complaints, it is necessary to repeat endoscopic and other studies for the timely detection of hazardous pathology of the gastrointestinal tract (cancer of the stomach, cancer of the small intestine, etc.).

Prediction and prevention

Functional dyspepsia worsens the course of the patient's life, but the prognosis of this disease is favorable. In the absence of alarming symptoms listed above, the presence of a serious tract pathology is unlikely. However, for dyspepsia, a wave-like flow is characterized, so after the course of therapy, the high probability of recurrence of symptoms is preserved. Specific dispersion prevention measures are not developed, but maintaining a healthy lifestyle, rational nutrition and the elimination of stressful situations significantly reduce the likelihood of developing this disease.

IMPORTANT!

Information from this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, diagnostic studies should appoint only the attending physician. To make a diagnosis and proper appointment of treatment, you should contact your attending physician.

DISPERSIONS: Causes of appearance, in which diseases there are, diagnosis and methods of treatment. Definition Under the term dyspepsia understand the complex of disorders pointing to the violation of the normal activity of the stomach and accompanied by various symptoms that are preserved for 3 months in a row. Dyspepsia is manifested by painful sensations or sense of gravity (overflow) at the top of the abdomen. Such discomfort may not be associated with meals, accompanied by nausea, bloating, heartburn, belching. Dyspepsia can be a symptom of various functional and organic disorders of the gastrointestinal tract, and in its occurrence it is necessary to consult a specialist. Varieties of dyspepsia
  • There are many types of dyspepsia.
    • Alimentary dyspepsia is the result of continuous non-compliance with the rules of food intake and unbalanced nutrition. Alimentary dyspepsia has three subtypes:
    • The fermentation subtype - caused by excessive consumption of simple carbohydrates (sugars, flour products, fruits, legumes, etc.), fermented vegetables and fermentation drinks (kvass, beer), as a result of which the intestinal microbiota balance is shifted towards the ferrous flora;
    • Pinged subtype - caused by excessable protein food (meat products and semi-finished products that require a lot of time to digest);
  • The fatty subtype - caused by excessive consumption of products saturated with refractory fats (porks, lamb, etc.).
Dyspepsia in disruption of the motor function of the gastrointestinal tract (accelerated or slow-down food evacuation from the gastrointestinal tract). Causes of Dispsia

Dyspepsia is the result of a variety of pathological mechanisms. The emergence of a complex of symptoms characteristic of dyspepsia is due to a quarter of cases by a slowdown in the gastric emptying. In this case, vomiting also joins pain, the feeling of gravity is joined and a significant decrease in appetite.

Part of the patients has increased sensitivity of the gastric mucosa and duodenum to stretch the food masses, which causes a spasm of smooth muscles and painful sensations.

Approximately a third of cases there is a violation of the regulation of cutting the muscles of the stomach with a nervous system, as a result of which spasms occur, which cause pain during the reduction of the stomach.

Transferred infections in a light form, sluggish inflammatory lesions of the stomach and duodenum lead to the development of functional changes in the operation of the digestive system. Various genetic factors predict to the development of such dyspessions.

Among the diseases that are accompanied by the symptoms of dyspepsia, chronic gastritis and gastroduodenite should be highlighted.

These diseases are often found in adolescent and young age, when there are not enough time to properly and, importantly, regular food. There is a breakdown of mucus, which protects the mucous membrane of the stomach from mechanical and chemical effects (especially from hydrochloric acid, which is part of the gastric juice). Dyspepsia is a constant satellite of the ulcer of the stomach and duodenal. Symptoms of ulcers are very diverse and depend on its location in the wall of the organ. If diarrhea does not quickly pass, calcium carbonate is prescribed 0.5-1 g 3-4 times a day, magnesium perhydro 0.5 g 3 times a day. For a long time, the use of vegetables rich in coarse vegetable fiber - cabbage, legumes, cucumbers, beets, etc.Pains may be after meals or, on the contrary, "hungry pains". Other symptoms of dyspepsia with ulcerative disease - belching, nausea or even vomiting after meals.

In recent years, the medical community is becoming increasingly important in the development of symptoms of dyspepsia gives infection

Helicobacter Pylori (H. Pylori)

. The damage to the mucous membrane of the stomach occurs when the vital activity of this bacterium increases and disrupts the balance between protective and affecting. Bacterium is very resistant to acidic content of the stomach and is able to significantly damage the mucous membrane, up to the development of ulcerative defects. If instead of a special course of eradication therapy (for the destruction of this bacterium), only symptomatic treatment is carried out, then in the autumn-spring period there are exacerbations of gastroduodenitis and gastric ulcer.

Treatment of putrid dyspepsiaAlong with the infectious causes of the development of dyspepsia, psychosocial factors of the appearance of unpleasant symptoms are distinguished. Stresses, depressive and disturbing states lead to a violation of the regulation of the right rhythm and adequate amount of secretion of gastric content.

The extraction of hydrochloric acid increases and the mucous membrane of the stomach is damaged.

Gastroesophageal reflux disease (GERB) is one of the frequent causes of the appearance of symptoms of dyspepsia. Patients feel a feeling of burning in the bottom of the chest, especially after meals and when the slope is down, in the lying position.
  • Paints arise due to the cast of sour and aggressive gastric content in the esophagus, while the mucosa of the esophagus suffers.
  • In some cases, the symptoms of dyspepsia can talk about the development of some diseases of the heart. One of the most frequent causes of pain is an abdominal form of myocardial infarction.
  • Classical symptoms of dyspepsia can be joined by reduced blood pressure.
  • Symptoms arise due to the special location of the heart attack - on the bottom surface of the heart, right above the diaphragm and the stomach.
  • The long and uncontrolled reception of some drugs (for example, non-steroidal anti-inflammatory drugs) leads to a violation of the balance of factors for the protection of the stomach and aggression factors. Acid damages unprotected mucousness to form erosions and ulcers.
  • Pre-providing factors for the development of symptoms of dyspepsia and diseases of the gastrointestinal tract:
  • Nutrition of the power mode (big breaks between meals);
  • Nutrition "on the run", dry;
abuse of spicy, acidic, sharp, fried products; very hot or very cold food; Smoking and alcohol abuse (especially strong spirits), coffee; diabetes;
  • kidney disease;
Burns, massive injuries and other causes of pronounced pain.

What do doctors contact?

The emergence of symptoms of dyspepsia requires an appeal to a therapeutic profile doctor: therapist or pediatrician. After the inspection, the doctor will appoint a set of instrumental and laboratory research and will send if necessary for a narrow specialist. Consultation of the gastroenterologist, surgeon, cardiologist may be required.

Diagnosis and examination when symptoms of dyspepsia

Treatment of dyspepsia

During the survey, it is possible to use both laboratory and instrumental research methods.

Clinical blood test;

What to do during dyspepsia? A temporary solution to the problem is the use of antacid drugs when pain in the stomach area appears. But it should not be abused by this group of drugs, because With prolonged use, another mechanism forces the occurrence of unpleasant sensations is formed: due to the reaction with hydrochloric acid accumulates a large amount of carbon dioxide in the stomach, which leads to the appearance of a feeling of stomach overflow and belching. In the occurrence of pain immediately after eating it is not necessary to take painkillers, they will not have a proper effect.

With frequent episodes of discomfort and pain in the area of ​​the stomach, you must contact a specialist for examination and selection of treatment.

A temporary solution to the problem is the use of antacid drugs when pain in the stomach area appears. But it should not be abused by this group of drugs, because With prolonged use, another mechanism forces the occurrence of unpleasant sensations is formed: due to the reaction with hydrochloric acid accumulates a large amount of carbon dioxide in the stomach, which leads to the appearance of a feeling of stomach overflow and belching.

At the heart of the treatment of any disease of the gastrointestinal tract lies compliance with the diet.

It is important to take care of the stomach from chemical, thermal and mechanical impact. This means that the food should not be very acute and spicy, it should be warm, but not hot and desirable without crusts and other sharp and hard elements. It is preferable to cook for a pair or cook. Roasted and smoked dishes are undesirable. The entire day diet is divided into 5-6 receptions. In a diet for people suffering from the diseases of the stomach, soups, fish and non-bubble varieties of meat, bird, dairy products, with the exception of sharp and salty cheeses are welcome. Bread is better to eat a little dried. It should be abandoned from coffee, carbonated drinks, salted and sharp sauces, onions, cabbage and mushrooms - all these products are irritated by the inflamed wall of the stomach and enhance damage. The gentle mode also includes a refusal of smoking and alcohol intake.

As the drug treatment of gastritis and ulcerative diseases of the stomach, special eradication patterns of therapy aimed at destruction are used as the medication

H. pylori.
  1. and restoring the balance of factors of aggression and protection of the gastric mucosa.
  2. These treatment regimens appoint a doctor when confirming availability

IMPORTANT!

Information from this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, diagnostic studies should appoint only the attending physician. To make a diagnosis and proper appointment of treatment, you should contact your attending physician.

With the help of instrumental and laboratory research methods. In some cases, surgical treatment of stomach ulcer disease is required.

For the treatment of gastroesophageal reflux disease there are two treatment options. The conservative method includes a lifestyle correction (a decrease in body weight, rejection of snacks, reducing the number of slopes, eating no later than 2 hours before sleep), the use of drugs suppressing the secretion of hydrochloric acid (mainly proton pump inhibitors) , prokinetics, normalizing the motor function of the stomach, and some other means. Sometimes surgical antirefluux correction of this state is required.

The emergence of symptoms of dyspepsia when taking medicines requires access to the attending physician to correct therapy and the prevention of side effects.

Sources:

Vasilyev Yu.V. Functional dyspepsia. Modern ideas about the problem and capabilities of therapy. Medical Council, magazine. No. 6. 2013. P. 94-98.

Also lies in the appointment of the diet. After one hungry day, they go to the diet rich in carbohydrates. It is advisable for 2-3 days to prescribe fruit juices, grated apples 1-1.5 kg per day. Then in the food diet includes mucous boars from rice, semolina porridge on water, cruck, white bread. After 5-7 days, butter is added, fresh low-fat fish, chicken meat, vegetable soups, potato or carrot puree. Natural gastric juice, nitric acid bismuth, Pancreatin, Levomycetin, are recommended from medication.

Lyalyukova E.A., Drozdov V.N., Kareva E.N., Silver S.Yu., Starodubtsev A.K., Kigova D.O. Dyspepsia Uncomfortable: Differential diagnosis, patient maintaining tactics on an outpatient stage. Attending physician, magazine. № 8, 2018. P. 15-19.

Information is verified by an expert

Lishova Ekaterina Aleksandrovna

Higher medical education, work experience - 19 years

Why does digestion disruption arise? :

  • There is such a concept as functional dyspepsia. Characteristic symptoms are obvious, and during gastroduodenoscopy in the stomach and duodenum, the doctor does not detect any pathological changes. There are no them in other organs. Most often, such uncompaired is caused by errors in a diet (a lot of fatty, acute foods, caffeine, alcohol, chocolate, soda), too fast food (when a person "eats on the go" and "swallows, not chewing"), by the side effects of drugs, Strong and frequent stresses, violation of the motorcycle stomach and intestines.
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  • Head of the hospital, doctor-therapist
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  • Often, if it is not possible to find other causes of dyspepsia, doctors establish a diagnosis of "chronic gastritis".
  • Digestion disorder is characteristic of the following diseases
  • Gastroesophageal reflux disease: when the contents of the stomach throws into the esophagus.
  • Gastritis, gastroduodenitis, ulcerative ulcer of the stomach and duodenum.
  • An irritable bowel syndrome is a chronic disorder from the colon, which manifests itself in the form of constipation, diarrhea, spastic abdominal pain.

Chronic pancreatitis - inflammation of the pancreas.

Diseases of the gallbladder: cholecystitis, gallstone disease, bile colic.

Liver diseases: hepatitis, cirrhosis.

Obesity: At the same time, the pressure inside the abdominal cavity increases.

The intolerance of some foods. For example, lactase insufficiency, in which due to lack of enzyme lactase, the absorption of lactose - milk sugar is disturbed. Symptoms of dyspepsia occur after eating milk and dairy products.

Malignant digestive tumors, the side effect of chemotherapy and radiation therapy.

  • In what cases do you need to consult a doctor?
  • If the symptoms of dyspepsia are saved longer than 2 weeks, it is necessary to refer to the doctor - therapist or a gastroenterologist. You should not hide a visit to the hospital if dyspepsia is accompanied by such symptoms as frequent vomiting, weight loss, black, tar chair, jaundice (skin and eye proteins and chest proteins), chest pain (especially if she is in hand, neck , jaw), respiratory disorder, high sweating. If the symptoms of indigestion are very strong, and you feel bad, you need to immediately call "ambulance". For correctly diagnose the disease, which led to disorder of digestion, the doctor may prescribe common and biochemical blood tests, endoscopic studies (gastroscopy, colonoscopy), X-ray, ultrasound, CT, MRI abdominal organs.
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  • How can I reduce the symptoms of dyspepsia at home?

Improve the condition will help some changes in lifestyle. Follow these recommendations:

Do not eat. Take food more often, but in small portions.

Treatment of fatty dyspepsia

Do not lie right away after eating - wait 2-3 hours. Do not eat at night.

Avoid products that exacerbate the symptoms of dyspepsia: alcohol, coffee, chocolate. And in general, if you notice that your condition worsens after receiving certain types of food, it is better to avoid.

Support normal weight.

Refuse smoking.

These measures will help improve the condition, but do not get rid of the disease, which caused dyspepsia. Visit the doctor and pass the survey will still have to.

Dyspepsia is not always caused by serious diseases - but you cannot know for sure, which led to the disorder in your case, until the exact diagnosis is set. Visit the gastroenterologist's doctor at Medicine 24/7 Medical Center. Sign up for reception by phone: +7 (495) 230-00-01.

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  • Psychotherapist, Candidate of Medical Sciences, Member of the Russian Professional Psychotherapeutic League
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  • Therapists most often appeal to complaints that are characteristic of the disorders of the digestive system. And what is the symptoms of dyspepsia in an adult, everyone should know. The diagnosis requires a serious differential approach, since this group includes all non-specific signs of the symptom complex of the gastrointestinal tract. The treatment of dyspepsia directly depends on the causes of the disease, and this is in most cases the deficiency of digestive enzymes or incorrect power.
  • Symptoms and signs of dyspepsia
  • Dispassia syndrome is disorders of digestion and symptoms that are peculiar to various diseases of the gastrointestinal tract and their border phases.
  • When digestion is disturbed, symptoms appear, which are combined by a common name - the dyspeption of the stomach, refers here:
  • problems with swallowing;
  • nausea and vomit attacks;

belching;

Pain in the area of ​​the stomach;

heartburn;

rumbling in the stomach;

bloating;

constipation, diarrhea.

Dispersion of the stomach and intestines causes pain in the epigastric area. They can be both fairly intense and in the form of light discomfort. There is a sense of rapid saturation and overcrowding, and as a result of this, also nausea, belching, heartburn. Another disturbing sign is the loss of appetite, and quickly and sharply. After that, a person begins to shrink weight. Intestinal dyspepsia is accompanied by a yarn in the abdomen, meteorism, diarrhea or constipation.

The violation of the food digestion process in the intestines may indicate such pathology as divergeoz, diverticulitis, enzymopathy, enteritis, colitis, tumors in the intestine, irritable bowel syndrome, pancreatic disease, metabolic pathology. The intestinal dyspepsia may indicate that it develops infection (dysentery, cholera, bowel tuberculosis, salmonellosis, etc.).

  • Allocate 2 main groups of dyspeptic disorders - functional dyspepsia and organic. In the first case, only violations of the body of the body are found, that is, functional lesions, and in the second they are exclusively organic. In the latter case, symptoms will be more pronounced, while disorders continue for a long time.
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Causes of occurrence

Several forms allocate depending on the reasons that cause the development of the syndrome:

Simple dyspepsia. It is also called an alimentary. Caused by food problems. In turn, there is a fat (soapy), a fermentation and putrid dyspepsia. In the latter case, it develops if protein products predominate in food or non-freight meat is used. The fermentation develops from excessive consumption of carbohydrates (bread, cabbage, legumes, sugar) and beverages causing fermentation (beer and kvass). Fat dyspepsia is developing with the unlimited consumption of fatty food, it is especially true of pork and lamb;

  • Dyspepsia associated with a shortage of enzymes secreted for digesting food in the intestine and stomach. In turn, it happens to be a gastrogen (lack of enzymes in the stomach), pancreatogenic (deficit of the substances of the pancreas), enterogenic (lack of intestinal juices), hepatogenic (insufficient selection of bile from the liver);
  • Dyspepsia, which is associated with the problems of food suction in the intestine in Malabsorption syndrome. As a result, the nutrient components do not come from the bowel into the blood;
  • Dyspepsia, which is associated with intestinal infections. In this case, it can be both dysentery and salmonellosis.
  • Inxication. It is manifested due to poisoning under different diseases, including flu, surgical pathologies in acute form, as well as when using poisons.
  • All of these factors can contribute to the occurrence of the disease. Symptoms and treatment of dyspepsia of the stomach and intestines are directly dependent on the cause.
  • Risk factors

These include:

Frequent and strong stress, emotional tension. In this case, pathology will have neurotic genesis;

Some use of medicines. This applies to antibiotics, hormonal or antitumor and other means;

Incorrect meals Most often it concerns overeating;

intoxication. In this case, there may be both a disease of viral or bacterial origin and domestic poisoning;

excessive excretion of hydrochloric acid;

Problems with motorcycle gastrointestinal tract.

These are the main factors that contribute to the emergence of dyspepsia.

Complications

Gastric dyspepsia occurs in case of such diseases such as esophagitis, GERB, cancer, stenosis or ulcer of esophagus, cancer, or presence of benign tumors, peripesophagitis, sclerodermia, diverticulous. Also, the presence of dyspepsia of the stomach and intestines may indicate diseases of the muscles, the central and peripheral nervous system, the pathology of the internal organs, for example, the narrowing of the esophagus can be caused by cysts and tumors that oppress it from the outside. It also concerns the aortic aneurysm, vascular anomalies, thyroid hyperplasia.

  • Complications of dyspepsia are most often associated with the main ailment, which causes the appearance of this syndrome. The patient can lose weight dramatically, lose appetite for a long time. One of the difficult consequences is Mallory Weis's Syndrome. In this case, the mucous layers of the lower part of the esophagus are breaking, where it goes into the stomach. Because of this, gastric bleeding begins. It can be fairly intense and even lead to a fatal outcome. Most often, the occurrence of Mallory Weisse syndrome is associated with multiple bits of vomiting.
  • When should you consult a doctor

For the treatment of dyspepsia of the stomach or intestines, you need to contact the gastroenterologist. Do not tighten with a campaign to the doctor. Special attention should be paid to such symptoms as abdominal pain at night, sharp rapid slimming, nausea, vomiting, frequent belching, bouts of heartburn. Diagnostics can be carried out at JSC "Medicine" (Clinic Academician of the Roytberg), which is located in the center of Moscow.

Preparation for visiting a doctor

To visit the gastroenterologist, special training is required. Do not tighten with a visit to the doctor, if there are problems with the digestive system. It is necessary to remember all the symptoms that have recently arose, and then tell their doctor. It is also recommended to take an empty stomach, as it is possible that you will be sent to pass materials for analyzes, to pass surveys.

  • Diagnosis of dyspepsia
  • Before starting the treatment of dyspepsia, it is necessary to undergo a survey, which includes not only the description of the complaints, external inspection, but also the following:
  • Laboratory studies are a common and biochemical blood test, the study of the feces for blood, a coprogram;

Instrumental studies - an acid discharge test with stomach, esophagogastroduodenoscopy, a study of gastric materials for the presence of chielicobacter pylori, ultrasound of the abdominal organs, colonoscopy, radiography, computed tomography, esophageal and anthroduodenal pressure gauge.

You can go through the diagnosis in JSC "Medicine" (Clinic Academician of the Roytberg), which is located in the Central District of Moscow, not far from the metro station Tverskaya, Novoslobodskaya, Belarus, Chekhovskaya. If there is a disease, you may need not only consultation of the gastroenterologist, but also other specialists: psychiatrist, neuropathologist, cardiologist, endocrinologist.

Treatment

Medical therapy is necessary for the treatment of dyspepsia. Separately, it is necessary to get rid of diarrhea or constipation, and for this purpose, special means are prescribed. Other drugs are also prescribed for the treatment of dyspepsia and facilitating the patient's condition:

anesthetic (antispasmodics);

  • means that reduce the level of acidity in the stomach;
  • Enzymes to improve digestion processes.
  • Treatment should be comprehensive and systemic. It is necessary to carry out the therapy of the disease, which caused dyspepsia, that is, gastritis, duodenitis, GERD, cholecystitis, ulcer of the stomach or intestines, the alaugh of the pancreas.

Home Treatments

When dyspepsysia, the doctor's recommendation must be observed. It is necessary to sleep on a high pillow, walking at least an hour after each meal. It is forbidden to delay the belt, do exercises for the muscles of the press. Be sure to eat correctly. We will have to abandon products causing heartburn. It is not allowed to overeat.

Myths and dangerous misconceptions in the treatment of dyspepsia

Basic delusion:

Nausea, heaviness and bloating will be held independently. They are temporary, so you can not go to the hospital;

Antispasmodics or enzymers remove the severity in the stomach, unpleasant sensations in the intestine;

If you use sour or sharp, then discomfort will disappear.

All listed opinions are fundamentally incorrect. Do not rely on the myths, in which they used to believe. When alarming symptoms appear, you must contact a specialist.

Prevention

  • It is necessary to switch to rational food, abandon the harmful and non-baking products, smoking. Be sure to comply with the norms of hygiene, lead a healthy lifestyle. Moderate physical exertion is allowed. It is necessary to regularly undergo planned inspections from the doctor, to treat any diseases in a timely manner.
  • How to sign up for a gastroenterologist
  • You can sign up for the specialists of the JSC "Medicine" (clinic of Academician of the Roytberg) by calling +7 (495) 775-73-60 (around the clock) or using the feedback form on the site. The address of the clinic: the 2nd Tver-Yamsk lane. ten.
  • Causes and symptoms

About 40% of patients who appeal to the gastroenterologist complain of pain in the abdominal cavity, the severity and feeling of the overflow of the stomach. To these symptoms often join heartburn, nausea, belching. Such problems do not always mean that the patient occurs some significant structural changes in the gastrointestinal tract, but they themselves interfere with a comfortable life, and therefore require treatment.

Preparation for visiting a doctor

Roman Criteria III (Diagnostic Criteria related to the problems of the gastrointestinal tract, published by the Roman Foundation) determine the functional dyspepsia as a complex of symptoms: pain and a feeling of burning in the epigastric region (the epigastric area is a conditional triangle with vertices that are in the lower ribs and solar plexus), sensation Overflowing it after eating and early saturation. If, as a result of the diagnostics, organic diseases are detected, and the listed symptoms are repeated in the patient for 3 months over the past six months, the diagnosis "functional dyspepsia" is considered confirmed.

With functional dyspeption, symptoms occur directly as a result of a violation of the secretion of hydrochloric acid, motility disorders and changes in sensitivity to stimples (visceral sensitivity) of the stomach, and not due to inflammatory changes. The appearance of these functional disorders affect:

  • heredity;
  • Eating some products (red pepper, onions, mayonnaise, nuts, citrus, chocolate, coffee, carbonated drinks);
  • smoking (2 times increases the risk of pathology);
  • Psychosocial factors, stress.

The table below provides a detailed characteristic of symptoms of functional dyspepsia.

Functional dyspepsia worsens the quality of the patient's life, but its symptoms can be eliminated. Treatment can be divided into an uncommon and medicinal.

Improper treatment requires a patient compliance with simple power rules and the normalization of lifestyle: 2fractional nutrition;

restriction of consumption of fatty and acute food, coffee;

refusal of smoking and alcohol;

Refusal to use non-steroidal anti-inflammatory funds.  

Since the cause of functional dyspepsia may be stress, often for the removal of symptoms is enough psychotherapy. Drug treatment is aimed at lifting the symptoms of the disease, which can be divided into two groups: pain and burning in the epigastric region; The feeling of overflow of the stomach and early saturation. For each group of symptoms there is its own standard of treatment. The patient may also have a combination of these signs, the so-called mixed functional dyspepsia. In this case, therapy will include drugs to eliminate all the symptoms of the disease. On clinical guidelines, pain and burning in the epigastric region are removed by drugs from groups H

- Antigistamine or proton pump inhibitors. Patients, faced with pain in the stomach, often resort to antacids, but such treatment is ineffective.

Classical means, with a sense of stomach overflow and early saturation, prokinetics are considered. Clinical recommendations for the treatment of functional dyspepsia are advised to prescribe tapes of metoclopramid or domperidone. Due to the large number of side effects, such drugs also include the use of teaching drugs. Drug treatment is aimed at lifting the symptoms of the disease, which can be divided into two groups: pain and burning in the epigastric region; The feeling of overflow of the stomach and early saturation. For each group of symptoms there is its own standard of treatment. The patient may also have a combination of these signs, the so-called mixed functional dyspepsia. In this case, therapy will include drugs to eliminate all the symptoms of the disease. The block diagram below shows an exemplary treatment algorithm for functional dyspepsia, corresponding to clinical guidelines. Remember, the therapy must appoint a doctor. Do not self-medicate!

Functional dyspepsia for gastritis Drug treatment is aimed at lifting the symptoms of the disease, which can be divided into two groups: pain and burning in the epigastric region; The feeling of overflow of the stomach and early saturation. For each group of symptoms there is its own standard of treatment. The patient may also have a combination of these signs, the so-called mixed functional dyspepsia. In this case, therapy will include drugs to eliminate all the symptoms of the disease. Recent studies show that the symptoms of functional dyspepsia may occur with chronic gastritis associated with bacteria

Helicobacter pylori.

. If, during the diagnosis, bacteria are detected in the patient, first of all three-component antibacterial therapy (treatment of the first line) is prescribed. It includes preparations from a group of proton pump inhibitors and 2 antibiotics - clarithromycin and amoxicillin.
If there is a patient intolerance of penicillin or the absence of positive results of the treatment of the first line, four-component therapy (treatment of the second line) is used. It consists of taking drugs from a group of proton pump inhibitors in combination with bismuth preparations of dicyrate, tetracycline and metronidazole.
If, after treatment, the symptoms of dyspepsia do not appear within 6-12 months, then the diagnosis of "dyspepsia associated with infection is made

The block diagram below shows the diagnostic algorithm and possible antibacterial therapy options in the presence of bacteria.

Dyspepsia " The preservation of the same symptoms after successful getting rid of the bacteria proves the presence of a functional dyspepsia in a patient.

The block diagram below shows the diagnostic algorithm and possible antibacterial therapy options in the presence of bacteria.

In the gastroy The information is familiarized. Do not self-medicate! Information sourcewww.gastro-j.ru

Details Posted by: LDZ Neuron

Published: 10 November 2015

- digestive disorders and gastrointestinal tract, a complex of symptoms, characteristic of many diseases, as well as border states. The main causes of dyspepsia are the lack of digestive enzymes causing insufficient suction syndrome, or what happens most often, rude errors in nutrition.

Digestion disorder of the gastrointestinal tract: dyspepsia Enzymatic dyspepsia - Disorders associated with the enzymatic activity of digestive organs. Functional dyspepsia

(PD) - a complex of unpleasant symptoms after eating. In this case, no organic pathology is detected during the examination. In almost half of the cases of PD, in combination with irritable bowel syndrome, therefore experts refer to the group of biopsychosocial diseases. To the main reasons that cause functional dyspepsia include psychological injuries and stress.

It is these factors that are detected in most patients with a functional dyspepsia. In some cases, the cause of the disease is the increase in susceptibility of the gastric wall to stretching, in such patients, as a rule, the motor function of the stomach is not violated. If pathology is accompanied by symptoms characteristic of ulcerative disease, the reason for the appearance of dyspepsia in this case can be the release of hydrochloric acid in the amount exceeding the norm. Intestinal dyspepsia

may develop on the background of improper nutrition, in this case it is called

  • Alimentary dyspepsia
  • . In the development of intestinal dyspepsia, a well-known value is a constitutional weakness of the intestines, as well as sensitization (increased sensitivity) to individual varieties of food - protein, carbohydrate or fat. Distinguish the ferment, rotten and fat dyspepsia.
  • Brodyl dyspepsia
  • It is caused by excessive use of food products rich in carbohydrates: fruits, legumes, cabbage, kvass, honey, etc., as a result of which an acidophilic (fermentation) flora is formed in the intestines. Along with the change in the intestinal flora in the development of ferment dyspepsia, a well-known role is played by the rehabilitation of the pancreas diastation, as a result of which the process of cleavage of carbohydrates is disturbed.
  • Snipped dyspepsia
  • It occurs when excessive use of products of protein origin, especially requiring a long time to digest. Toxic substances formed during the breakdown of proteins become the cause of intoxicating the patient's body. Basically, this refers to red meat varieties (lamb, pork, beef) and their derivatives (sausages and other meat products), the abuse of which stimulates the development of the intestinal rotary microflora. It is caused by eating too much refractory fats, such as ram and swine fat and their derivatives.

Symptoms of dyspepsia

Dyspepsia, which is a consequence of enzyme failure, the following types:

Hepatogenic (hepatic origin);

  • Cholecystogenic (caused by violation of the bile);
  • Pancreatorate (lack of pancreatic enzymes);
  • Gastrogen (caused by a violation of the secretory function of the stomach);
  • Enterogenic (intestinal juice is disturbed);
  • Mixed dyspepsia.

Symptoms of dyspepsia can manifest itself in different ways, which depends on the specific type of disorder, however, there are signs that are simultaneously characteristic of all types of disease.

  • Different types of dyspepsia have the following general symptoms:
  • The emergence of unpleasant sensations in the so-called exspigal region, that is, in the upper part of the abdomen. The patient experiences feelings of breach and gravity, sometimes there are painful sensations of various intensities;
  • belching. Rare single cases of belching are not signs of the disease. On dyspepsia is only the constant frequent belching;

Nausea, heartburn. The patient experiences an unpleasant feeling of burning in the upper part of the abdomen, as well as in the progressed area. This feeling appears at the time of hitting the aggressive contents of the stomach in the esophagus. In the norm of such phenomena should not happen;

Details flatulence. The feeling of bloating, as well as the reinforced gas separation, can be caused by the increased formation of gases in the intestine;

Stool disorder. Patients who suffer from dyspepsia have an irregular, as a rule, a rapid chair. Dyspepsia, which is caused by a disadvantage of the digestive enzyme, has the following signs:

It is these factors that are detected in most patients with a functional dyspepsia. In some cases, the cause of the disease is the increase in susceptibility of the gastric wall to stretching, in such patients, as a rule, the motor function of the stomach is not violated. If pathology is accompanied by symptoms characteristic of ulcerative disease, the reason for the appearance of dyspepsia in this case can be the release of hydrochloric acid in the amount exceeding the norm. nausea;

An unpleasant taste in the mouth; transfusion and rumbling in the abdomen, malaise, weakness;

Sometimes patients experience headaches and insomnia. Kale often contains a large amount of food that is poorly blocked. Manifested by such unpleasant symptoms as pain, discomfort in the pancreas area after making food, accompanied by weight, overflow, early saturation.

Treatment of dyspepsia

Brodyl dyspepsia.

The main symptoms of the fermentation dyspepsia are the blown of the intestine with the release of a large amount of gases, a frequent liquid foam chair with a sour smell. Pain in belly tolerant or absent. A very typical sign of ferment dyspepsia is the nature of the feces. They are weakly painted, contain little gas bubbles, a large amount of starchy grain, fiber, iodophilic microbes and organic acids.

Largely reminds intoxication: the patient feels weakness and general malaise, feels nauseous and severe headache. Cal is dark and liquid, has an unpleasant and rather sharp smell, the chair at the same time.

Fat dyspepsia

Unlike other types of dyspepsia, is not characterized by frequent diarms. Patients suffering from fatty dyspepsia are feeling a feeling of overflow and gravity in the abdomen, complain of meteorism and belching, as well as severe pains that begin after half an hour after meals. Cal has a whitish color and severe shine: these are the remains of fat that does not have time to digest. Chair at the same time.

Dyspepsia in young children manifests itself in tightening and bloating. Chair is frequent, more than six times per day, feces has green, bless flakes come across. The child at the same time is capricious, sleeping badly and eats.

Before the treatment of intestinal dyspepscape, the type of disease is determined in order to find the desired diet in the first day of therapy. With an alimentary dyspepsia, the patient is recommended for two days to fully refrain from eating. The transition to the usual diet should be gradual and consistent. In the case of a ferment dyspepsy, the patient should refrain from products rich in carbohydrates. At adipose dyspepsia, a diet with a low fat content is prescribed, with a peptic dyspepsia, the patient needs to limit the admission to protein food into the body. The treatment of enzymatic dyspepsia requires the reception of drugs containing digestive enzymes.

Treatment of functional dyspepsia A very important role in the treatment of functional dyspepsia is played by dietherapy and rejection of bad habits. Nicotine, alcohol, coffee, breaking the motorcycle gastrointestinal tract, can provoke recurrences of the disease. A balanced diet for patients in this case implies frequent and fractional nutrition, and the content of saturated fatty acids in their food diet is recommended noticeably reduced.

When the diskinetic form of pathology, the main preparations for the treatment of dyspepsia are prokinetics (methoclopramide and domperidone), which have a beneficial effect on the motor function of the GCT. It should be remembered that 20-30% of patients with metoclopramide, especially during long-term reception, causes undesirable side effects from the CNS in the form of drowsiness, fatigue and anxiety, therefore the drug of choice in the treatment of functional dyspepsia is domperidon, which does not cause similar side effects. Treatment of intestinal dyspepsia

Treatment of fermentation dyspepsia

It is limited, and it is better to fully exception from the edible diet of carbohydrates for 3-4 days. The general condition of patients with this form of dyspepsia suffers slightly. The ferodyl dyspepsia in acute form with the correct diet is quickly eliminated. However, sometimes in non-compliance with the dietary mode, dyspepsia can take a chronic flow. The aggressive factor is Ahilia. Dyspepsia in some cases can go to chronic enteritis and chronic enterocolitis. After 1-2 hungry days, an increased amount of proteins should be prescribed (cottage cheese, low-fat meat, boiled fish), meat broth with a small amount of white bread. In the future, they gradually include in the diet of porridges on water, fruit puree and kisins (see diet number 4 by Pessner). After 2-3 weeks, vegetables and fruits are allowed.

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