Functional dyspeptic syndrome

Functional dyspeptic syndrome is a set of non-specific symptoms such as feelings of discomfort, abdominal pressure, fullness after eating, belching, heartburn, creasing, overflow in the intestines, bloating.

Etiology

The cause can be either:

• primary - gastrointestinal tract disorder,
• secondary - a disorder of an organ other than the digestive tract (liver, pancreas, gallbladder).

Differential diagnosis and examination

As part of the patient's screening process, it is most important to distinguish possible serious organic impairment (cancer, gastroduodenal ulcer , nonspecific intestinal inflammation , etc.) that may have similar nonspecific symptomatology from functional impairment.

The basis is (as usual) a careful history , on the basis of which we should decide on the next step. We should look for:

• dietary error,
• the duration of the problem,
• dependence of symptoms on food intake → gastroduodenal ulcer.

On the one hand, it is sometimes unnecessary to subject patients to unnecessary many invasive examinations, but on the other hand, we should look for warning signs that are indications for a very detailed examination of the patient:

• nausea, vomiting, constipation, diarrhea, stool, mucus or blood in the stool, abdominal pain, anemic appearance, fever, weight loss, vomiting blood…

Differential diagnostics

• esophageal varices , strictures, achalasia, esophageal reflux disease, esophageal cancer (adenocarcinoma, squamous cell carcinoma),
• gastroduodenal ulcer, gastritis, gastropathy, gastric tumors
• malabsorption syndrome (celiac disease), nonspecific intestinal inflammation, diverticulosis, GIT infections, bowel tumors
• circulatory disorders in portal hypertension (congestion in the GIT),
• diseases of the gallbladder and bile ducts, tumor of subhepatic region , chronic pancreatitis .

Types and classifications

We can encounter two classification systems:

International Classification system

• used worldwide except the Czech Republic,

• 5 groups based on the most expressed symptoms after the exclusion of organic disease:

• 1. esophageal disorders
  2. gastroduodenal disorders,
  3. intestinal disorders,
  4. functional abdominal pain,
  5. biliary disorders.

Mařatka's classification

• • a typically Czech classification created by Professor Mařatka in the 1960s,
  • still used and preferred over the international classification system,
  • distinguishes only upper and lower functional dyspeptic syndrome:

Upper functional dyspeptic syndrome

• digestive disorders of the upper tube (esophagus, stomach and duodenum).

See Upper Functional Dyspepsia for more information .

Lower functional dyspeptic syndrome

• digestive disorders at the level of the small and large intestine.

See Lower Functional Dyspepsia for more information .

Links

Related Articles

• upper functional dyspepsia
• lower functional dyspepsia

References

• CZECH, Richard, et al. Internal. 1st edition. Prague: Triton, 2010. 855 pp.  ISBN 978-80-7387-423-0 .