GUT HEALTH SPECIAL
Gut pain and bloating that’s not IBS could be caused by functional dyspepsia. In their new book, What Every Woman Needs to Know About Her Gut, authors Professor Barbara Ryan and Elaine McGowan explain why this little-known stomach issue matters.
ALMOST EVERYONE has heard of irritable bowel syndrome (IBS), but do you know anything about functional dyspepsia (FD)? It’s a common condition, causing symptoms in hundreds of millions of people worldwide. Yet it’s poorly recognised by GPs. FD affects approximately one-in-five adults, making it even more common than IBS. It is estimated more than 800 million people worldwide have FD. It’s actually a sister condition to IBS and it can be described as “irritable stomach” affecting the upper digestive system.
WHAT ARE THE SYMPTOMS?
You might feel unpleasantly full after eating a normal-sized meal (post-prandial fullness). You feel abnormally full after a small amount of food. You could have pain or burning in the upper abdomen, just below your breastbone.
Symptoms will be severe enough to prevent your normal activities. Other common symptoms include nausea, excessive belching or feeling bloated after eating. Just as with IBS, FD has two types: symptoms related to eating (post-prandial distress syndrome) or symptoms related to pain that occurs without eating (epigastric pain syndrome). However, the two types may overlap in many people.
HOW TO BE DIAGNOSED
To be diagnosed with FD, symptoms must be present for at least three days per week, for at least three months, and have started more than six months previously. Also, other diseases need to be ruled out, such as a hiatus hernia, acid reflux, ulcers, gallstones or coeliac disease. Many people are misdiagnosed as having acid-related conditions and given PPI medications [proton-pump inhibitors], which are ineffective for FD. So, you may need blood tests, or an upper digestive endoscopy or an abdominal ultrasound before you can be diagnosed.
ANXIETY TRIGGER
For some people, the symptoms are a minor inconvenience: a bit of bloating after eating or some occasional nausea. However, for others, symptoms can have a hugely negative impact on quality of life. Most of the symptoms of FD occur after eating (post-prandial), although the pain in the upper abdomen may be more constant. If you get unpleasant symptoms when you eat, you might start to dread eating, and to worry about these symptoms. This is called “symptom anticipation”, which brings added anxiety, and can lead to you avoiding food. Just like IBS, symptoms can be triggered by stress or may be more long-lasting.
