indigestion n : a disorder of digestive function characterized by discomfort or heartburn or nausea [syn: dyspepsia, stomach upset, upset stomach]

English

Noun

1. A common medical condition most often caused by eating too quickly.

Translations

• Italian: indigestione
• Russian: несварение желудка
• Telugu: అజీర్ణము

Dyspepsia (from the Greek "δυς-" (Dys-), meaning hard or difficult, and "πέψη" (Pepse), meaning digestion) or indigestion is chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected with eating. It can be accompanied by bloating, belching, nausea or heartburn. Dyspepsia is a common problem, and is frequently due to gastroesophageal reflux disease (GERD) or gastritis, but in a small minority may be the first symptom of peptic ulcer disease (ulcer of the stomach or duodenum) and occasionally cancer. Hence, unexplained newly-onset dyspepsia in people over 55 or the presence of other alarm symptoms may require further investigations.

Signs and symptoms

The characteristic symptoms of dyspepsia are upper abdominal pain, bloating, fullness and tenderness on palpation. Pain worsened by exertion and associated with nausea and sweating may also indicate angina.

Occasionally dyspeptic symptoms are caused by medication, such as calcium antagonists (used for angina or high blood pressure), nitrates (used for angina), theophylline (used for chronic lung disease), bisphosphonates, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs, used as painkillers)..

Antacids and sucralfate were found to be no better than placebo in a literature review. H2-RAs have been shown to have marked benefit in poor quality trials (30% relative risk reduction due to serious adverse events such as torsades¬, and publication bias has been cited as a potential partial explanation for such a high benefit. This German-made phytopharmaceutical was found to be equivalent to cisapride and significantly superior to metochlopramide at reducing the symptoms of functional dyspepsia over a four week period. Retrospective surveillance of 40,961 children (12 years and under) found no serious side-effects.

Currently, PPIs are, depending on the specific drug, FDA indicated for erosive esophagitis, gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, eradication of H. pylori, duodenal and gastric ulcers, and NSAID-induced ulcer healing and prevention, but not functional dyspepsia. There are, however, evidence-based guidelines and literature that evaluate the use of PPIs for this indication. A helpful chart summarizing the major trials is available from the functional dyspepsia guidelines published in the World Journal of Gastroenterology in 2006. The study evaluated these agents in patients at 4 weeks and 6 months and noted that omeprazole had a significantly better response at 6 months (31%) than cisapride (13%) or placebo (14%) (p = 0.001) while it was just above the cutoff for being statistically significantly better than ranitidine (21%) (p = 0.053). Omeprazole also showed a significant increase in quality of life scores over the other agents and placebo in all but one category measured (p = 0.01 to 0.05).

The ENCORE study, which was a follow-up of patients from the OPERA study, showed responders to omeprazole therapy had fewer clinic visits than non-responders (1.5 vs 2.0) over a three month period (p

See also

• Abdominal pain
• Gastritis
• Functional bowel disorder

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