Dyspepsia commonly known as indigestion is a common condition causing pain or discomfort in the the upper middle part of your stomach area. This may be associated with bloating, burping, nauseous, vomiting, early satiety or feeling full faster during or after meals. The pain may comes and goes but it can also be persistent. Dyspepsia symptoms may vary between individual and can have serious underlying cause.
Dyspepsia or indigestion is not a disease but its a collection of symptom that are associated with various diseases of the stomach, gallbladder or from certain medications. Dyspepsia may have no cause in 75% of the cases (called functional dyspepsia) and in 25% of cases may have underlying organic causes such as gastroesophageal reflux disease (GERD), peptic ulcer disease, duodenal ulcer and gastric or esophageal cancer. Evaluation of dyspepsia require history, physical examination and several tests to rule out sinister cause. Several medication such as pain killer (NSAIDS), antibiotic and osteoporosis medication can also cause indigestion.
Presence of alarm symptoms or ‘red flags’ will require prompt endoscopic evaluation to rule out peptic or duodenal ulcer and gastric cancer such as:
- Age more than 50 years
- Recurrent vomiting of foods or blood (haematemesis)
- Passing black-colored stool (melaena)
- Loss of appetite
- Unexplained weight loss
- Difficulty swallowing (dysphagia) or painful swallowing (odynophagia)
- Presence of mass in the abdomen
- Family history of gastrointestinal cancer
- Anemia in blood test
Helicobacter pylori or H. pylori is a type of bacteria that infect your stomach and usually acquired during childhood. It is spread by fecal contamination in the water and food. It can also be passed from one person to another by saliva. Infection with H. pylori is very common and about 60% of the world population have it. For most people it usually does not cause any symptoms or ulcers in the stomach. However for some it may cause stomach symptoms like dyspepsia.
H. pylori can cause damage the protective lining of your stomach allowing acid and bacteria to cause further inflammation and formation of ulcer. H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid so it can live for years in the stomach undetected. Untreated H.pylori infection can also cause digestive tract cancer such as stomach cancer
Several method of testing for H.Pylori includes using urea breath test, blood and stool testing. H.Pylori can also be tested from the tissue biopsy taken during endoscopy procedure.
In patient with dyspepsia and H.pylori infection, eradication treatment can provide significant improvement of their persistent symptoms and prevent complications such as stomach ulcer and cancer. However, H.Pylori infection is not easy to cure and re-infection may recur. The standard treatment is triple therapy with using PPI and two antibiotics for 10- 14 days. Additional therapy with Probiotic have shown to work against H.pylori and reduce risk of adverse effects from H.pylori eradication treatment. Repeat testing is done at 4- 6 weeks to ensure clearance of H.pylori infection.
If you suffered from dyspepsia and would like to get further information on the testing and treatment available, talk to our doctor.