Lower functional dyspepsia

Lower functional dyspepsia is also referred to as irritable bowel syndrome. This is pain or discomfort lasting at least 12 weeks from the previous year, which:
 * 1) they alleviate or disappear after defecation;
 * 2) are associated with a change in the frequency and / or character of the faeces.


 * The diagnosis of irritable bowel syndrome is further supported by feelings of urgency on the stool, a feeling of imperfect emptying, mucus passage, bloating and distension of the abdomen, the patients usually do not wake up from sleep.
 * The etiopathogenesis is the same as in upper functional dyspepsia.

Clinical picture

 * Abdominal pain and discomfort, constipation, diarrhea, feeling empty.
 * Alarming symptoms and risk factors are: 1. age over 50 (colorectal cancer), 2. temperature,  3. weight loss,  4. blood or pus in the stool,  5. steatorhea,  6. dehydration.

Diagnostics

 * Per exclusion (exclude colorectal cancer, diverticular colorectal disease, IBD (Inflammatory Bowel Disease), intestinal infections).
 * Anamnesis, physical examination, laboratory examination (as in upper dyspepsia) + stool examination (OK, cultivation, parasitology), imaging techniques (ultrasound).
 * Colonoscopy is not indicated, but it has a positive effect in terms of reassuring the cancerophobic patient.

Therapy

 * 1)  In case of diarrhea dominance - test with exclusion of lactose in the diet, antidiarrheals, addition of soluble fiber.
 * 2) When constipation dominates - regime measures (sufficient hydration, soluble fiber, defecation stereotypes), sometimes it is necessary to administer laxatives.
 * 3) Painful symptomatology - antispasmodics (pinaverin…).
 * The use of antidiarrheals and laxatives should be carefully considered and possible side effects monitored.

related articles

 * Upper functional dyspepsia

Source

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