Functional dyspepsia (FD) is defined as chronic
upper, centered abdominal discomfort or pain excluding the predominant
symptom, heartburn. Associated symptoms are early satiety, nausea,
vomiting, abdominal distension, bloating, and anorexia. For many years
motor (movement) abnormalities in the stomach have been investigated and
thought to be the cause of FD. As usual, psychosomatic theories are
popular and patients are often prescribed tranquilizers or
antidepressants. Stress and anxiety are linked to motility problems and
inadequate theories of FD (and IBS) were
formulated.
FD suffers responds poorly to common drug therapies
and the majority of sufferers have episodic symptoms that reduce the
quality of life and result in increased use of healthcare resources.
Since FD is a rather vague diagnosis, symptoms
often overlap with peptic ulcers, esophagitis and irritable bowel
syndrome. It is easy to confuse acid reflux into the esophagus (GERD)
with FD. Most gastroenterologists will not classify heartburn as
“dyspepsia.” If esophagitis is present, FD cannot be diagnosed. By
strict definition, patients with FD have undergone upper intestinal
endoscopy that has revealed no lesions that can explain symptoms.
Investigation may include testing and possibly treatment for Helicobacter
pylori. If infection is present, antisecretory therapy with H2-receptor
antagonists or proton-pump inhibitors can be tried but these therapies
are often not effective. One has to recall that H Pylori is often found
in asymptomatic patients and their presence does not automatically mean
that they are the cause of disease.
Here are the basic principles:
Digestive disorders are common diseases that
originate in the food supply. Diet revision should be primary therapy.
The solution is to adjust the incoming food supply until the problem is
resolved.
The gastrointestinal tract is a sensing, reactive
device which monitors the material flowing through it. Symptoms arising
from this system provide information about its dysfunction. Seven basic
symptoms alert the patient to gastrointestinal tract displeasure with
food choices - nausea, heartburn, vomiting, bloating, pain, constipation
and diarrhea.
Further down in the stomach, a surface reaction
results in upper-middle abdominal pain and nausea; sometimes nausea and
even vomiting are triggered. These are defensive responses that reject
the offending food and usually relieves pain and other discomforts. Some
patients induce vomiting to avoid discomforts after eating.
Recurrent irritation in the upper GIT is
food-caused until proven otherwise. Obviously smoking, drinking
alcoholic beverages, coffee and teas are the first problems to
eliminate, but surface "allergy" to common, "normal" foods may also be
responsible. Symptoms from the upper digestive tract are often
associated with lower abdominal pain, bloating, constipation and
diarrhea. A trial of diet revision can provide prompt relief. If the
clearing diet is unsuccessful, further investigation is always required.
Self-therapy of milder symptoms - dyspepsia and
early ulcer-like symptoms consists of retreating to Alpha Nutrition
Phase 1 foods, using brown rice instead of white rice with the option
of taking tagamet or zantac as recommended by the manufacturer. Remember
that the bedtime dose is very important because your stomach will spend
8 hours or more in a near-empty condition vulnerable to the action of
accumulating acid.
Phase 1 of the Alpha Nutrition should be sustained
for 2 weeks or until all symptoms are gone and then food is reintroduced
using the medium track. Foods from Phases 2 and 3 are slowly
reintroduced next. If adequate diet revision does not resolve symptoms
promptly and/or prevent recurrent gastritis or ulcers, you need further
medical assessment and treatment.
