35 years
Hallo I feel I am always full my stomach hurts and I feel I cant eat what shall I do?
Aug 19, 2014
The majority of patients with dyspeptic symptoms are eventually diagnosed with what we call functional dyspepsia (FD), in which similar symptoms are precipitated by a variety of disorders. FD is a group of symptoms thought to originate in the upper digestive tract (stomach and upper small intestine) in the absence of any structural or metabolic disease likely to explain the symptoms. It remains possible, however, that dyspeptic symptoms may be due to underlying diseases such as peptic ulcer or gastritis.
Causes of Functional Dyspepsia
The causes of functional dyspepsia are poorly understood and various. Some research suggests a genetic predisposition. H. pylori, the bacteria notorious for causing ulcers in the stomach and duodenum (the 1st segment of the small intestines), when causing an active infection, may produce dyspeptic symptoms in a small group of patients, yet there is not enough evidence to support the explanation that this bacterium is a cause of symptoms in a majority of patients. In some patients, pychological factors may influence the symptom experience.
In a significant number of patients with FD, changes in gastric function have been noted: in an estimated 40% of patients, the stomach fails to relax normally in response to a meal. This is known as "impaired accommodation" and may manifest itself as a feeling of fullness and pressure in some patients. Impaired stomach contractions and abnormal stomach emptying may also be seen.
Impaired stomach emptying can induce symptoms of bloating and early feeling of fullness. In as many as two-thirds of patients with functional dyspepsia, heightened perception of stomach activity, which is termed visceral hypersensitivity, has been described.
Treatment Options
Treatment options for functional dyspepsia generally include one or a combination of:
• Diet modifications:
Inconclusive evidence suggests that dietary fat may trigger or worsen symptoms and patients often report feeling better by eating low-fat meals, and more frequent, smaller meals.
• Eradication of H. pylori: in case of a proven peptic ulcer disease, with antibiotics and a stomach acid inhibitor
H2 blockers such as ranitidine (Zantac) are the 1st line treatment option. If these agents do not prove effective, a proton pump inhibitor (PPI) – omeprazole (Gastrimut), rabeprazole (Pariet), or esomeprazole (Nexium), is used.
• Prokinetic (enhances the contractions of the stomach and intestines to facilitate the digestive process) and antiemetic (treat nausea) agents: Symptoms of early feeling of fullness, upper abdominal fullness, and discomfort after eating may respond to these drugs. The most commonly used are Motilium (domperidone) and Primperan (metoclopromide)
• Centrally acting therapies (target the parts of the brain responsible for controlling digestion): such therapies may aid in relieving the symptoms. Tricyclic antidepressants, used in doses lower than required to treat depression, may improve symptoms of dyspepsia in patients who have failed to benefit from treatment with H2 blockers or prokinetics. Selective serotonin reuptake inhibitors (SSRIs), which are another type of antidepressant, seem to have some effect in the treatment of other functional digestive disorders. Hypnotherapy may improve dyspeptic symptoms in some patients.
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