Stomach dyspepsia: symptoms, causes, methods of diagnosis and treatment. Features of treatment and diet for various types of dyspepsia

Dyspeptic disorders occur in most people. This is a complex pathological condition that accompanies many gastrointestinal diseases, and can also manifest itself due to errors in diet and emotional overload. It is very important to diagnose the disease in time in order to properly approach its treatment.

What is dyspepsia

Dyspepsia is a complex of painful symptoms in the stomach, which is often accompanied by indigestion. This disease is acid-dependent and manifests itself in most people with increased secretory function of the digestive glands. Dyspeptic syndrome may indicate the presence of a certain gastrointestinal pathology or be an independent disease. Sharp release of hydrochloric acid occurs in the stomach various reasons. Dyspepsia can occur in both adults and children. In the first case, the symptoms are especially acute, while in the second they may be periodic and not appear so clearly.

Structure digestive system shows the close proximity of all organs. Dyspepsia is often caused by pathology near the organs located near the stomach.

What is dyspepsia - video

Classification of pathology

Dyspeptic syndrome is divided into functional and organic. The first type is characterized by the presence of certain symptoms in almost healthy people. The second type of disease appears against the background of other gastrointestinal pathologies. Functional dyspepsia has the following classification:

1. Ulcer-like syndrome. In its manifestations, this type is similar to gastric ulcer, but does not have characteristic defects of the mucous membrane.
2. Dyskinetic. Symptoms occur immediately after eating. And are often accompanied by intestinal manifestations: flatulence, false urges to defecation.
3. Non-specific. Has mixed symptoms of the forms listed above. Practically does not occur in children.

There is also the following classification of dyspeptic syndrome:

1. Alimentary species. It develops against the background of errors in the diet and the predominance of one or another product in the diet. This type is divided into:
   • fermentative form - occurs when there is a significant amount of carbohydrate food in the diet;
   • putrefactive - develops when consuming large amounts of protein, especially stale protein;
   • soapy or fatty - occurs when there is a predominance of fats in the menu.
2. Toxic. Arises against the background of various food poisoning, as well as in case of intoxication toxic substances. Divided into the following subtypes:
   • intoxication - manifested by both stomach pain and intestinal upset;
   • intestinal toxicosis - develops against the background of depression normal microflora and introduction of pathogenic.
3. Neurotic. Appears in the background increased anxiety and other psychological disorders.
4. Simple. May have mixed symptoms of several types. However, it does not manifest itself too sharply. There are mild symptoms.
5. Biliary. Associated with the release of bile into the stomach. This process causes characteristic symptoms. Accompanied by gallbladder dysfunction.
6. Enzymatic. Develops due to insufficient quantity digestive enzymes. Divided into:
   • gastrogenic type - occurs when the production of hydrochloric acid and enzymes in the stomach is disrupted;
   • enterogenous - develops as a result of a violation of secretion in the intestine;
   • pancreatogenic - is a consequence of a lack of pancreatic enzymes;
   • hepatogenic - occurs when the production of bile by the liver is impaired.

Causes and development factors

Dyspeptic syndrome may have the following causes:

• infections that enter the stomach when eating poor quality food;
• chronic gastritis with increased secretory function;
• chronic pancreatitis and cholecystitis;
• cholelithiasis;
• chronic enterocolitis and sigmoiditis;
• taking some medicines: antibiotics, non-steroidal anti-inflammatory drugs, hormonal contraceptives and acetylsalicylic acid.

Foods that increase acidity can be a provoking factor. gastric juice and promote hypersecretion, causing heartburn, pain and burning in the epigastrium. These primarily include sour, fatty and fried foods, as well as fast food.

Main symptoms of the disease

The distinctive signs of pathology directly depend on its form. The alimentary species is characterized by:

• flatulence;
• pain in the abdomen;
• belching;
• feeling of fullness in the stomach.

The toxic type has the following symptoms:

• nausea;
• vomiting;
• burning in the epigastrium;
• diarrhea;
• increase in body temperature.

Neurotic dyspepsia manifests itself:

• increased nervousness;
• burning in the stomach;
• nausea;
• lump in throat;
• alternating diarrhea and constipation.

The biliary type is characterized by:

• burning in the epigastrium;
• change in stool color;
• morning sickness;
• pain in the right hypochondrium;
• diarrhea.

Enzymatic dyspepsia manifests itself:

• nausea;
• heaviness in the stomach and a feeling of fullness;
• vomiting;
• diarrhea with residue undigested food.

Differences in symptoms of organic and functional dyspepsia - table

Diagnostic tests

In the presence of dyspeptic manifestations, a whole range of diagnostic studies is prescribed:

1. FGDS. It is a method of examining the gastrointestinal tract using a special endoscope - a thin tube with a camera that is placed through oral cavity into the esophagus and stomach to obtain a detailed picture of the mucous membrane. This reveals microscopic changes, as well as ulcers, erosions and polyps.
2. Colonoscopy. This method is similar to the previous one, however, with it, an endoscope is inserted through the rectum and thus any changes in the mucous membrane are diagnosed. In this case, it is possible to differentiate dyspepsia from intestinal cancer and other functional diseases.
3. Biochemical blood test. By using this method The level of liver parameters is determined, as well as the presence of the Helicobacter pylori bacterium in the blood.
4. Irrigoscopy. By using x-ray examination stomach and intestines, the condition of these organs is determined. The procedure is performed using liquid barium, which the patient must first swallow. It is this substance that is radiopaque and, enveloping the mucous membranes, allows one to obtain a detailed picture of the organs.
5. Ultrasound. Ultrasonography allows you to identify chronic pancreatitis, liver changes and the condition of the gallbladder.
6. Stool examination. Carried out to determine hidden blood and microorganisms that can cause dyspeptic disorders.

Drug treatment of dyspeptic disorders and first aid

First aid for acute manifestation dyspeptic syndrome is to eliminate symptoms. This is especially important if there is an infection. IN in this case you should take adsorbents that will help remove pathogens from the body toxic dyspepsia, as well as excessive amounts of hydrochloric acid. These drugs include Enterosgel and Activated carbon. If diarrhea occurs, then you can take Smecta.

Drug treatment of dyspeptic disorders depends on the manifestation characteristic symptoms. The following groups of drugs are most often used:

1. Intestinal antibiotics and antidiarrheals. Among the antiseptics that are used for toxic dyspepsia are Alpha Normix, which acts directly in the stomach and intestines. Antidiarrheal drugs used for prolonged diarrhea. Most often these are Loperamide and Smecta.
2. Antiemetic drugs. Used for constant nausea and vomiting. These drugs block the vomiting center in the brain and eliminate unpleasant manifestations. These include: Cerucal and Motilium.
3. Remedies for heartburn and burning in the stomach. Antacids help neutralize the aggressive components of hydrochloric acid and have an enveloping effect on the mucous membrane of the esophagus and stomach. The most commonly prescribed are Maalox, Rennie and Gastal.
4. Antispasmodics and motor stimulants. They help eliminate pain in the abdomen and accelerate the movement of food through all parts of the gastrointestinal tract, preventing fermentation processes. These include Trimedat.
5. Prebiotics and probiotics. Stimulate the growth of beneficial microflora and regulate intestinal function. The most popular of this line of products are: Linex and Hilak Forte.
6. Blockers proton pump. Used for hypersecretion of the digestive glands. These medications block the release of hydrochloric acid, lowering the acidity of the stomach. Most often prescribed: Omez and Nolpaza.
7. Enzymes. Promotes high-quality digestion of food in case of insufficient pancreas function. Pancreatin, Mezim and Creon are used.

Medicines used for dyspepsia - gallery

Alpha Normix is ​​an intestinal antibiotic
Smecta eliminates diarrhea and dyspeptic symptoms in the stomach. Motilium blocks the vomiting center in the brain.

Gastal envelops the gastric mucosa, relieving burning sensation Trimedat eliminates pain in the stomach and intestines Hilak Forte restores intestinal microflora
Omez blocks the release of hydrochloric acid Mezim improves the quality of digestion

Diet food and list of prohibited foods

Dietary nutrition in the presence of dyspepsia helps regulate digestion and prevents the occurrence of pain and flatulence. To do this, exclude all foods that can cause hypersecretion and fermentation processes in the intestines. These include:

• fresh fruits, especially apples, grapes and citrus fruits;
• fresh vegetables: eggplants, tomatoes, mushrooms, cabbage, legumes and onions;
• spices;
• soda;
• alcohol;
• semi-finished products;
• baking;
• fatty and fried foods;
• fast food;
• ice cream;
• sauces.

List of prohibited products - gallery

Fruits enhance fermentation processes in the intestines Vegetables have a negative effect on the irritated gastric mucosa Spices increase the secretion of hydrochloric acid
Alcohol is harmful to the digestive organs. Convenience foods increase secretion and fermentation. Baking contributes to heartburn and flatulence.
Confectionery products cause a burning sensation in the stomach Fatty dishes increase dyspepsia Fast food negatively affects the functioning of the gastrointestinal tract

Ice cream is not consumed due to its low temperature Sauces provoke increased secretion Lemonades irritate the mucous membranes of the gastrointestinal tract

• dairy and fermented milk products;
• porridge from buckwheat, millet and oats;
• vegetable stew of zucchini and potatoes;
• steamed fish cutlets;
• bananas and persimmons;
• jelly;
• rosehip decoction;
• mashed potatoes;
• vegetarian cabbage soup;
• noodle soups;
• pasta.

Dairy products help eliminate burning and pain in the stomach Cereal porridges improve the functioning of the gastrointestinal tract Vegetable stew is well digested
Steamed cutlets are very healthy Bananas promote bowel function
Persimmon renders astringent action, eliminating heartburn
Kissel coats the stomach Rosehip decoction reduces inflammation Mashed potatoes are not a secretion stimulant
You can add chicken to cabbage soup. Vermicelli soup can be seasoned with herbs.
Pasta does not provide negative influence on the gastrointestinal tract

Traditional methods of treatment

Traditional medicine methods are often used to treat dyspeptic disorders. The most effective recipes:

1. Anti-inflammatory collection that has an antispasmodic effect. To prepare the decoction you will need the following herbs: chamomile, mint, calamus and licorice. They should be taken to equal quantities and stir. 1 tbsp. l. The mixture must be poured with 350 ml of boiling water and put on low heat. After boiling for 10 minutes, cool and filter. Then take a quarter glass 3 times a day 20 minutes before meals for 10–14 days.
2. Remedy for stomach pain. To prepare it you will need 1 medium potato. It must be peeled and grated, then squeeze the juice through cheesecloth into a glass. Add 0.5 tsp to it. honey and lemon juice. Mix everything thoroughly and heat slightly. Take 3 times a day 10 minutes before meals, warm, for a week.
3. A collection that regulates the functioning of the stomach and intestines. To prepare it you will need mint, chamomile and St. John's wort. They should be mixed in equal quantities. Take 1 tbsp. l. mixture and pour 300 ml of boiling water. Cover with a lid and let stand for about 30 minutes. Then filter and take a quarter glass 3 times a day, half an hour before meals, for 10 days.

Chewing flax seeds is very beneficial for the stomach and intestines. During this process, beneficial mucus is formed, which, when swallowed, has a beneficial effect on the condition of the mucous membrane of the digestive organs. Pain, burning and other unpleasant symptoms are eliminated. To do this, you should consume 1 tsp of flax seeds on an empty stomach. within a month. They need to be chewed thoroughly.

Calamus has a mild choleretic effect Lemon reduces nausea

Treatment prognosis and possible complications

When determining the cause and type of dyspeptic disorder, as a rule, the prognosis is favorable if you approach treatment comprehensively and follow all the doctor’s instructions. Consequences can only occur if the cause of the syndrome is a stomach ulcer, which, if not treated in a timely manner, can lead to bleeding. The same applies to pancreatitis and cholecystitis. In the first case, there is a risk of self-digestion of the organ, as a result of which you can end up on the operating table. Similar condition may be fatal.

Cholecystitis accompanied cholelithiasis, is also fraught with danger. This pathological process can cause blockage bile duct, as a result of which the organ will have to be removed.

Preventive actions

Prevention of dyspeptic disorders is as follows:

1. IN early diagnosis Gastrointestinal diseases: cholecystitis, pancreatitis, gastritis, ulcers, enterocolitis.
2. Reducing the level of anxiety, stress and emotional overload.
3. A balanced diet excluding foods that increase acidity.
4. I find it helpful in avoiding snacks and quick meals.

Dyspeptic disorders respond well to treatment, especially at the initial stage. An important point It is considered that the provoking factor is identified, after which the patient’s condition improves. Compliance with prevention helps normal operation gastrointestinal tract.

An integral part of any disease of the gastrointestinal tract is intestinal dyspepsia. The syndrome is characterized by disturbances of the digestive process and provokes the occurrence of dysbacteriosis and intoxication, as well as pathological conditions gastrointestinal organs. Dyspepsia responds well to treatment - the main thing is to watch your diet and not be nervous.

Description of the pathology

Dyspepsia is a malfunction of the digestive system that occurs due to a lack of enzymes for digesting food or poor nutrition(binge eating, " fast food", etc.). Because of this problem, people most often turn to gastroenterologists. Dyspepsia is popularly called “indigestion.” The pathology was discovered at the beginning of the last century. Doctors note that this syndrome especially worries people in the spring. Its presence is not life-threatening, but is accompanied by unpleasant symptoms. The manifestation of the disease over a long period of time indicates chronic gastrointestinal diseases. According to statistics, dyspepsia is observed in 40% of the population economically developed countries.

Risk group

Dyspepsia can occur in any person, but doctors identify a so-called “risk group”. This includes those people who are particularly likely to become ill:

• teenagers 13−17 years old;
• smokers;
• people leading sedentary lifestyle life;
• persons who frequently drink alcohol;
• food rule violators, lovers of large portions;
• people suffering chronic diseases Gastrointestinal tract.

Classification of dyspepsia

Occurs in children under one year of age physiological appearance dyspepsia, which occurs due to high sensitivity fragile organism to dietary errors.

Dyspepsia is conventionally divided into the following types:

• functional (nutritional);
• fermentation (caused by a lack of enzymes).

Functional dyspepsia occurs:

• putrid;
• fermentation;
• fatty (soapy).

Fermentation type includes:

• gastrogenic;
• pancreatogenic;
• enterogenous;
• hepatogenic;
• cholecystogenic dyspepsia.

Causes of intestinal dyspepsia

Nutritional dyspepsia occurs due to a lack of variety in the diet. Eating the same foods provokes one or another type of pathology:

The causes of the fermentation type of disease vary depending on which enzyme is missing:

• with gastrogenic dyspepsia, there is a lack of stomach enzymes;
• pancreatogenic - insufficient allocation pancreatic enzymes;
• enterogenous - little intestinal juice is secreted;
• hepatogenic - lack of bile (produced by the liver);
• cholecystogenic - failure in the secretion of bile (indicates gallbladder pathology);
• mixed dyspepsia combines several types.

Fermentation dyspepsia in adolescents occurs against the background of unstable hormone levels.

Main symptoms

There are symptoms of intestinal dyspepsia that are characteristic of each type of disease. If one or more of them occur regularly, you should go to the hospital. These include:

• discomfort, feeling of heaviness in the upper abdomen;
• nausea without vomiting;
• constipation or diarrhea;
• heartburn;
• bloating.

Each type of pathology has its own symptoms:

• Fermentation dyspepsia is manifested by diarrhea, nausea, flatulence, discomfort in the stomach, and an unpleasant taste in the mouth.
• The fermentative type of the disease is accompanied by frequent bowel movements, severe flatulence with characteristic sounds in the abdomen and pain due to the accumulation of gases.
• At putrefactive dyspepsia intoxication is observed. There is a loss of strength, nausea, headache. Loose stool has an abnormal smell of rot.
• The fatty type of the disease is manifested by diarrhea, while the feces are covered with a whitish coating - undigested fat. 0.5-1 hour after eating, pain or discomfort in the abdomen appears.
• Fermentation dyspepsia is characterized by muscle weakness, headache, sleep disturbances, and loss of strength.

Features of childhood dyspepsia

Dyspepsia is detected even in young children. The disease occurs due to mistakes made by parents while feeding the baby. Common reason- violation of the diet. Pathology develops if the child is suddenly fed large portions of food that is still unknown to him. In addition, the baby’s condition is affected by the mother’s diet and the medications she takes.

In teenagers this pathology arises due to hormonal imbalance. At this time, it is necessary to especially monitor the state of the child’s gastrointestinal tract using diagnostic methods. In the absence of serious gastrointestinal diseases, dyspepsia manifests itself in children in the same way as in adults. In children, the onset of the disease is difficult to determine. Parents should monitor the child’s well-being after eating, his appetite, and control his stool.

Diagnostics

Since dyspepsia is a collective syndrome affecting all organs of the gastrointestinal tract, the entire digestive system is diagnosed.

To determine the organ whose operation has failed, use following methods diagnostics:

1. Anamnesis collection. The existing symptoms and the presence of concomitant diseases are analyzed.
2. Lab tests. Do general analysis blood and urine. Sometimes the doctor prescribes “biochemistry”. To determine the type of disease, a stool test is performed.
3. Endoscopy (esophagus - intestines). With this procedure, the disease is detected even in early stage development. The presence of Helicobacter bacteria is determined.
4. Collection and analysis of gastric juice to determine acidity.
5. Using ultrasound, the presence of tumors and cysts is excluded or confirmed.
6. The presence/absence of tumors in the large intestine is determined using colonoscopy.
7. X-rays are done only if cancer is suspected.
8. Manometric studies indicate the level of peristalsis of the gastrointestinal tract.

Treatment of dyspepsia

In order for treatment to produce results, you must first determine the type of disease and eliminate the cause that led to indigestion. To do this, the doctor prescribes medications or complex therapy. Also required short-term fasting. Adults refuse food for 1.5 days, and children - for half a day. You need to drink a lot clean water without gas. After this, food is taken carefully, in fractional portions. Children are fed according to their age. To eliminate pain, it is recommended to stroke the abdomen clockwise. Infants should not be placed down after feeding to facilitate regurgitation.

In case of fermentative indigestion, it is forbidden to consume carbohydrates for 3-4 days. After fasting, it is recommended to eat low-fat foods rich in proteins (fish, cottage cheese, meat). Over time, lean porridges can be introduced into the diet, and after 2-3 weeks, vegetables and fruits. If the stool does not return to normal, the doctor prescribes medications to relieve inflammation and normalize peristalsis (Loperamide, Furazolidone).

The putrefactive form of the disease is also treated with hunger. Then a diet rich in carbohydrates and fiber is prescribed. Poultry and fish are allowed to be eaten no earlier than a week after the start of therapy. Among medications, antibiotics are prescribed to suppress putrefactive microflora (Levomycetin) and stomach and pancreatic enzymes (Pancreatin, Acidin-pepsin).

Fat indigestion can be eliminated by eliminating fat from the diet. Be sure to eat low-fat foods rich in proteins (cottage cheese, fish). You can eat carbohydrates, but not much. The diet is accompanied by the use of drugs “Calcium carbonate” and “Bismuth subcitrate”. In addition, ascorbic and nicotinic acid are prescribed.

is a digestive disorder caused by organic and functional reasons. Symptoms include pain in the upper abdomen of unclear localization, nausea, heartburn, a feeling of fullness in the stomach, rapid satiety after eating, etc. The diagnosis is established only if other gastrointestinal pathology is excluded; endoscopic examination upper sections digestive tract. Treatment is symptomatic: enzyme preparations, means for improving gastrointestinal motility, etc. Great value has psychotherapy - after sessions with a psychologist, most patients note a decrease in the intensity of complaints.

Prognosis and prevention

Functional dyspepsia worsens the patient's life, but the prognosis is of this disease favorable. With absence alarming symptoms listed above, the presence of serious gastrointestinal pathology is unlikely. However, dyspepsia is characterized by a wave-like course, so after a course of therapy it persists high probability recurrence of symptoms. Specific measures for the prevention of dyspepsia have not been developed, but management healthy image life, balanced diet and the exclusion of stressful situations significantly reduce the likelihood of developing this disease.

After all, dyspepsia is a disorder characterized by a non-specific symptom complex discomfort in the gastrointestinal tract. In the series “dyspepsia: what is it - symptoms - treatment”, a special problem is the stage of searching for the sources of symptoms, which is complicated by many patients ignoring the manifestations of gastrointestinal discomfort.

Only every tenth patient with dyspepsia seeks medical assistance. However, you cannot lightly “brush it off” if dyspepsia is discovered: what is it - the result of an error in the diet, or maybe the symptoms malignant neoplasm- sometimes not just the return of comfortable digestion, but also the patient’s life depends on finding out the reasons.

What it is?

Dyspepsia is a digestive and gastrointestinal disorder, a complex of symptoms characteristic of many diseases, as well as borderline states. The main causes of dyspepsia are a lack of digestive enzymes, causing the syndrome insufficient absorption, or, what happens most often, gross errors in nutrition.

Causes

Symptoms of dyspepsia can occur in anyone and at any age. If the disease is not treated, it may develop chronic form. There are several main reasons that provoke the development of functional dyspepsia:

• psycho-emotional stress (pathology of neurotic origin develops);
• taking certain groups of medications (antibiotics, antitumor drugs, hormonal drugs);
• errors in nutrition, consumption of large amounts of nutrients (carbohydrates, proteins and fats). This is the main reason for the development of putrefactive, fatty and fermentative dyspepsia;
• intoxication of the body with household poisoning, viral infections and purulent diseases;
• increased secretion of hydrochloric acid;
• motility disorders of the gastrointestinal tract.

The main causes of functional dyspepsia include psychological trauma and stress.

Types of dyspepsia

Nutritional or functional dyspepsia is of the following types:

1. Putrid dyspepsia. Occurs due to excessive consumption of foods protein origin, especially those requiring a long time to digest. Toxic substances formed during the breakdown of proteins cause intoxication of the patient's body. This mainly applies to red meats (lamb, pork, beef) and their derivatives (sausages and other meat products), the abuse of which stimulates the development of putrefactive intestinal microflora.
2. Fatty (soapy) dyspepsia. Caused by eating too much refractory fats such as lamb and lard and their derivatives.
3. Fermentative dyspepsia. Caused by the predominance of foods with high content carbohydrates that cause fermentation (sweet and flour products, honey, fruits, peas, cabbage, legumes, etc.), as well as fermentation products (kvass, mash, pickled vegetables, etc.). At the same time, fermentative microflora develops in the intestines.

Dyspepsia resulting from enzyme deficiency, there are the following types:

1. Pancreatogenic (lack of pancreatic enzymes);
2. Gastrogenic (caused by a disorder secretory function stomach);
3. Enterogenous (disturbed secretion of intestinal juice);
4. Hepatogenic (liver origin);
5. Cholecystogenic (caused by impaired bile secretion);
6. Mixed dyspepsia.

Symptoms of different types of dyspepsia

Symptoms of dyspepsia can manifest themselves in different ways, since they directly depend on the specific type of pathology. However, all types and subtypes of dyspepsia are characterized by a number of similar symptoms:

1. Unpleasant sensations in the epigastric region (upper abdomen): a feeling of heaviness, fullness, sometimes pain of varying intensity;
2. Nausea;
3. Belching. Single belchings may not be a sign of a disorder, but constant ones indicate dyspepsia;
4. Heartburn. A burning sensation in the epigastric and retrosternal region that occurs when aggressive gastric contents enter the esophagus, which should not normally occur;
5. Flatulence. A feeling of fullness in the abdomen caused by increased gas formation in the intestines, as well as increased gas production;
6. Stool disorder. A characteristic symptom of dyspepsia is irregular bowel movements, usually frequent.

Symptoms of fermentative dyspepsia:

• bloating in the lower abdomen, and excessive gas;
• frequent bowel movements (loose, foamy stools, light in color and sour odor).

Symptoms of organic (enzymatic) dyspepsia:

• rumbling and transfusion in the abdomen;
• frequent passing of gas;
• nausea without vomiting;
• unpleasant taste in the mouth;
• frequent bowel movements (loose stools);
• the presence of food residues in the stool;
• fatigue and weakness;
• headaches and poor sleep.

Symptoms of putrefactive dyspepsia:

• signs of intoxication;
• nausea and vomiting (see also - how to get rid of nausea);
• headaches, dizziness;
• weakness and malaise;
• frequent loose stools (stools are dark and have a strong odor).

Symptoms of fatty dyspepsia:

• noticeable pain 30 minutes after eating;
• feeling of heaviness in the stomach and fullness;
• belching and flatulence;
• copious stools (stools are whitish and greasy).

Diagnosis of dyspepsia

In order to identify a patient with dyspepsia of one type or another, comprehensive measures are taken. You will need to consult doctors such as a gastroenterologist, an infectious disease specialist and a therapist. Depending on the symptoms of the disease, the following procedures may be prescribed:

• Ultrasound examination makes it possible to identify chronic pancreatitis and gallstone disease.
• Esophagogastroduodenoscopy - allows you to detect reflux esophagitis, gastric ulcers, stomach tumors and other organic diseases.
• X-ray examination.
• Electrogastroenterography - allows you to identify gastroduodenal motility disorders.
• Clinical blood test.
• Blood chemistry.
• General stool analysis, stool occult blood test.
• Stomach scintigraphy helps identify gastroparesis.
• Antroduodenal manometry - allows you to examine gastric motility and duodenum.
• Esophagomanometry - which allows you to evaluate the contractile activity of the esophagus, the coordination of its peristalsis with the work of the lower and upper esophageal sphincters (LES and UES)
• Daily pH-metry allows you to exclude gastroesophageal reflux disease.
• Determination of infection of the gastric mucosa by the bacterium Helicobacter pylori.

Treatment of dyspepsia

Treatment of patients with dyspepsia should be comprehensive and include not only the prescription of medications, but also measures to normalize lifestyle, diet and diet.

Functional dyspepsia

Treatment of functional dyspepsia is general character. The patient is advised to exclude salty, spicy and fatty foods. Eat in small portions, but often (from 6 times a day). If necessary, you can additionally assign:

• Antacids (Gaviscon, Almagel);
• H+-pump inhibitors (Omeprazole, Rabeprazole, Lansoprazole);
• Sedatives (Phenazepam, Adaptol, Grandaxin).

Fermentative dyspepsia

• For fermentative dyspepsia, treatment should begin with a diet low in carbohydrate foods. It is allowed to eat high-protein dishes (boiled meat, meat broth, butter, steamed chicken), it is necessary to reduce the amount of bread, potatoes, vegetables and fruits, baked goods, and cereals.
• Adsorbent substances (Smecta, Polysorb, Neosmectin), probiotics (Acipol, Laktofiltrum, Bifiform, Bifikol) and enzyme preparations for dyspepsia (Creon, Pancreatin) are used. As you recover, carbohydrate-containing foods are gradually introduced into the diet, but in limited quantities. The menu and allowed dishes are determined depending on the cause of the development of this syndrome.

Putrid dyspepsia

• Therapy is carried out similarly to the fermentation form. First of all, the patient is recommended to eat a diet that excludes protein (all types of meat and fish, dairy products, eggs, etc.). You should also use sorbents and probiotics. As a rule, enzyme preparations are not used during the treatment process. The need for antibiotic therapy is determined by the doctor.

Intestinal dyspepsia. First of all, it is necessary to treat the underlying disease:

• Intestinal infections - antibiotics;
• Food Toxins – Elimination general intoxication and the use of local local detoxicants (Enterodes, Polysorb MP);
• Crohn's disease - prescription of hormonal therapy.

If you have any of these conditions, you should not eat foods high in fiber. It is important to take sorbents (Smecta, Smectin, activated carbon, etc.), which are quite effective in eliminating the syndrome. To reduce pain, it is possible to prescribe antispasmodics (Drotaverine, Kellin, etc.).

Gastric dyspepsia

To eliminate this syndrome, the underlying disease should be treated. Depending on this it will change medical tactics. If the cause of dyspepsia is gastritis or peptic ulcer, the following treatment measures are recommended:

• If the role of Helicobacter is proven, the doctor prescribes complex antimicrobial therapy, which necessarily includes 2 antibiotics;
• A diet excluding fatty, salty and spicy foods. You should also not eat foods enriched with fiber (rye bread, fruits, vegetables, juices, etc.), as they can increase pain;
• It is possible to prescribe medications that create a protective shell for the gastric mucosa (De-Nol, Sucralfate, etc.).
• Acidity should be normalized to treat dyspepsia. Increased secretion hydrochloric acid can be eliminated with “H+-pump inhibitors” (Omeprazole, Rabeprazole, Lansoprazole) and antacids(Gaviscon, Almagel). At low acidity you can stimulate acid-forming cells with Pentaglucide or plantain juice;

The discovery of an open ulcer or tumor is often an indication for surgery. If a patient has a hormonal disease, treatment can only be determined by an endocrinologist.

Folk remedies

IN folk medicine There are quite a lot of recipes that are used for stomach dyspepsia. But before starting such treatment, you need to visit a doctor.

The most effective recipes:

1. Fennel. To prepare the medicine, you need to take 10 g of fennel berries, pour 200 ml of boiling water and heat until boiling (over low heat for about 15 minutes). Then cool the broth, strain and add boiled water to it so that the result is the original volume. The entire amount of the medicine should be drunk throughout the day in small portions.
2. Cumin/marjoram. Prepare healing drink: Place crushed cumin and marjoram seeds in 200 ml of boiling water and leave for 15 minutes. This remedy should be taken twice a day at a dose of 100 ml per dose.
3. Grind the roots of elecampane. Take 1 teaspoon of raw material and pour 200 ml of cold boiled water. Do not heat or boil! The medicine is infused for 8 hours, then filtered and taken 1/3 cup three times a day before meals. Duration of treatment – ​​2 weeks.
4. Prepare 375 g aloe, 625 g honey and 675 ml red wine. Wash and finely chop the aloe leaves, mix with the rest of the ingredients. You need to take the medicine 1 teaspoon before meals - this is the dosage for the first 5 doses. In the future, it is recommended to take 2 teaspoons twice a day before meals. The duration of treatment with this medicine is a minimum of 2 weeks, the maximum period of use is 2 months.

Deciding on treatment for gastric dyspepsia traditional methods you can't do it on your own. Only after consulting a doctor can you be sure that it is safe to use homemade decoctions/infusions.

Prevention of dyspepsia

A healthy diet is the main requirement for the prevention of dyspepsia of any type. A healthy diet is based on several rules related to the quality, quantity and culture of food consumption.

Norms healthy eating the following:

• refusal of strict diets;
• maintaining the proportions between proteins, fats and carbohydrates;
• limited consumption of fast food, semi-finished products;
• adequate consumption of vegetables and fruits;
• use salt in accordance with the recommended norm.

Measures to prevent dyspepsia are as follows:

• compliance with the rules of a healthy diet;
• control of bad habits;
• adequate response to stress;
• control of one's own condition.

If there is a predisposition to the development of diseases of the gastrointestinal tract, heartburn and belching periodically appear, increased gas formation, constipation or diarrhea is noted, then it is necessary to be more careful about own health. It is necessary to undergo an examination by a gastroenterologist once a year - this will help identify early stage dyspeptic disorders.

Translated from Greek, dyspepsia means indigestion. It's a constant companion various pathologies gastrointestinal tract (GIT). A gastroenterologist diagnoses 40% of patients with “functional dyspepsia.” In this case, indigestion is not associated with organic damage to the gastrointestinal tract. The symptoms of dyspepsia vary. Its manifestations depend on whether digestion is impaired in the esophagus, stomach or intestines. Before prescribing treatment, you should understand what dyspepsia is - separate disease or still a symptom of various pathologies.

What is dyspepsia

Dyspepsia is a symptom complex indicating various diseases. First of all, when a patient comes to a gastroenterologist with complaints of, or other manifestations of digestive disorders, the clinician recommends undergoing an examination. Often, during the examination, an organic lesion is detected. Dyspepsia indicates the following diseases:

• reflux esophagitis;

Basic clinical manifestations dyspepsia is observed not only with lesions of the gastrointestinal tract. Digestive disorders occur as a result of pathologies of other organs and systems. For example, when:

• hypo-, ;
• coronary disease hearts;
• diseases of the biliary system;
• connective tissue diseases;
• water-electrolyte imbalance.

In ¾ of patients, after undergoing a full examination, gastrointestinal pathologies or other diseases accompanied by dyspepsia are not detected. Although clinical manifestations of digestive disorders torment the patient for at least 6 months. In this case, the clinician diagnoses “functional dyspepsia.” Factors favoring the appearance of this disease are:

1. Smoking and alcohol abuse. Nicotine addiction increases the risk of developing functional dyspepsia by 2 times. If you refuse this bad habit In patients, the motor function of the stomach is restored. Alcohol is a poison that not only contributes to the development of dyspepsia. He destroys nerve cells. Because of it, the liver suffers, as it must remove all kinds of toxins, and when it fails, other organs come under attack.
2. Nutritional errors. Excessive consumption contributes to the appearance of dyspepsia. strong tea, coffee. Patients with dyspepsia try not to eat red peppers, onions, nuts, citrus fruits, mayonnaise, chocolate, nuts, carbonated drinks, as they cause worsening.
3. Long-term use medicines. The occurrence of digestive disorders is promoted by: aspirin, antibiotics, theophylline, potassium and iron supplements.
4. Neuropsychic factors. Acute stressful situation inhibits the motility of the stomach and duodenum, and this leads to the appearance typical symptoms digestive disorders. Patients with functional dyspepsia have an increased level of anxiety, a tendency to depression, and hypochondriacal and neurotic reactions.
5. H. pylori. Some researchers believe that these bacteria play a significant role in the development of functional dyspepsia. This infection is detected in patients in 60-65% of cases, so this factor is not the main factor in the development of the disease.

In most patients, the cause of functional dyspepsia is a violation of the evacuation ability of the stomach and duodenum.

Only a doctor can determine whether dyspepsia is a symptom or an independent disease by conducting a study. to install accurate diagnosis, first of all you need to pay attention to the main symptoms.

How does dyspepsia manifest?

In case of digestive disorders, patients present various complaints, which include: general term"dyspepsia". This:

• dysphagia (difficulty swallowing);
• pain, discomfort in the epigastric region;
• belching;
• nausea, vomiting;
• heartburn;
• rumbling in the stomach;
• diarrhea, constipation.

Esophageal dyspepsia is manifested by dysphagia. Patients complain of difficulty swallowing, the inability to swallow liquid (with spasm of the esophagus) or solid food. There is a feeling of a lump in the throat, pain when swallowing, and food getting into other organs. Dysphagia occurs with all diseases of the esophagus, for example:

• esophagitis;
• gastroesophageal reflux disease;
• esophageal ulcer;
• benign tumors of the esophagus;
• periesophagitis;

In addition, dysphagia may indicate other diseases not associated with organic damage to the esophagus:

1. Diseases of the central, peripheral nervous and muscular systems. Patients with esophageal spasm, esophageal atony and cardial achalasia complain of esophageal dyspepsia.
2. Pathologies neighboring organs. Dysphagia occurs when there is narrowing of the esophagus caused by a tumor or mediastinal cysts, central cancer light, mitral disease, vascular anomalies, hyperplasia thyroid gland and etc.

With dyspepsia caused by diseases of the stomach and duodenum, patients complain of:

1. Pain in the epigastric region. It can be intense, or patients feel discomfort in the epigastric region.
2. Rapid satiety, feeling of fullness, nausea.
3. Belching. With hypersecretion of gastric juice, patients complain of sour belching and heartburn. Belching of air and food occurs with achlorhydria.

Gastric dyspepsia occurs when:

• peptic ulcer;
• gastritis;
• benign tumors;
• stomach cancer.

Alarming symptoms accompanying gastric dyspepsia, are loss of appetite, sudden, without good reason, loss of body weight.

At intestinal dyspepsia patients complain about:

• rumbling in the lower and middle abdomen;
• flatulence (increased gas evolution);
• flatulence;
• diarrhea;
• constipation.

Digestive disorders in the intestines indicate the following pathologies:

• infectious intestinal diseases (dysentery, intestinal tuberculosis, cholera, typhoid paratyphoid diseases);
• irritable bowel syndrome;
• enteritis;
• colitis;
• Crohn's disease;
• ischemic colitis;
• dysbacteriosis;
• intestinal tumors;
• enzymopathies;
• stomach diseases (dumping syndrome, gastritis, cancer);
• pathology of the pancreas;
• diseases of the endocrine system;
• gynecological diseases;
• metabolic pathologies.

In patients with functional dyspepsia, various symptoms predominate. Depending on this, the following options are distinguished: clinical course diseases:

1. Ulcer-like. Patients complain of hunger and night pain in the epigastric region. They intensify when nervous tension, anxiety, fear.
2. Dyskinetic. Characterized by rapid satiety, a feeling of fullness in the stomach, bloating, rarely accompanied by nausea and vomiting.
3. Non-specific. A combination of signs of ulcer-like and dyskinetic variants of the disease. Often these are accompanied by symptoms of gastrointestinal pathologies (abdominal pain that disappears after defecation, constipation).

Only a doctor can determine what exactly causes dyspepsia by conducting an examination. Special attention attention should be paid to “symptoms of anxiety”:

• night abdominal pain;
• abdominal pain is the only sign of the disease;
• fever;
• enlarged liver, spleen;
• leukocytosis;
• high ESR;
• deviation from norms in biochemical analysis blood.

For an accurate diagnosis, in addition to a thorough examination and interview of the patient, the following is necessary:

• general and and urine;
• general stool analysis and occult blood test;
• Ultrasound of the abdominal organs;
• determination of gastric juice acidity;
• assessment of the motor-evacuation function of the stomach (X-ray, electrogastroenterography, food probe test, etc.);
• determination of H. Pylori infection.

Often the patient is referred for additional consultations with an endocrinologist, cardiologist, neurologist, or psychiatrist. And only after an accurate diagnosis is established, treatment begins. It depends on the cause of the disease.

How to treat dyspepsia

Digestive disorders caused by organic lesions disappear after successful treatment of the underlying disease. To get rid of functional dyspepsia, you need complex therapy, including:

1. Patient education. Psychological training is needed to help the patient reduce anxiety and relieve tension.
2. Correction of nutrition and smoking cessation. Patients should not drink strong coffee or tea. Meals should be fractional, at least 6 times a day. No spicy or fatty food. Particularly effective frequent use food with a predominance of symptoms of early satiety, a feeling of heaviness in the stomach.
3. Drug therapy. What medications the patient needs depends on the course of functional dyspepsia.

• antisecretory drugs;
• eradication of H. Pylori (if this group of bacteria is identified).

If the disease is dyskinetic, prokinetics are most effective.

For nonspecific dyspepsia, antisecretory drugs and prokinetics are combined.

Since the groups of these medications include various drugs, then which of them to take will be prescribed by the doctor, taking into account the individual characteristics of the patient, the presence of contraindications and other diseases.

If symptomatic drug therapy does not give a positive effect, it is necessary to conduct a re-examination. If organic lesions are not detected, then the patient is prescribed:

• neuroleptics;
• antidepressants;
• tranquilizers.

Very often the cause of functional dyspepsia is nervous stress, depression, so patients need additional treatment. Depending on the type of disorder, various therapeutic techniques are recommended:

1. Methods that are effective for increased anxiety muscle relaxation, art therapy, autogenic training. Anxiolytics are prescribed.
2. At low mood, adynamia, general strengthening drugs, psychostimulants, and neurometabolites are recommended.
3. The melancholic type is characterized by the fact that patients do not believe in a cure. Often the disease is a somatic mask of endogenous depression. Such patients also need treatment from a psychiatrist, since there is a high risk of suicide. Medications prescribed include antidepressants (amitriptyline), neurometabolites, and psychostimulants.
4. If the patient is completely indifferent to treatment (usually relatives bring such patients to the doctor), then antidepressants are prescribed in combination with psychostimulants, and short-term courses of positive psychotherapy are necessary.
5. When denying the disease (for some patients, the defense mechanism is triggered in such a way that they attribute their malaise to random factors and believe that everything will go away on its own), it is necessary to outline the seriousness of the situation. Explain what research has shown and the consequences of not treating.
6. If the disease is caused by visceral hypersensitivity, then it is advisable to prescribe new classes of drugs: agonists of kappa-opioid receptors (fedotozin), antagonists of 5-HT3serotonin receptors, which are also prokinetics (alosetron, cilanosetron).

Before prescribing to a patient psychotropic drugs, it is necessary to ensure that the patient adheres to all recommendations. Usually, the use of this group of drugs causes a negative attitude, and you need to take them constantly, for at least 2 months. Abrupt refusal from medications leads to withdrawal syndrome, the patient’s well-being significantly worsens.