Complaints & connections · borters.ch
Dyspepsia functionalis
The stomach is not damaged but too sensitive — and the one step that genuinely ends a share of the cases is looking for Helicobacter.
Also known as: functional dyspepsia · irritable stomach · functional stomach complaints
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
In functional dyspepsia the complaints are real and the findings are unremarkable. That is no contradiction: the stomach is not damaged but too sensitive — it stretches less well when eating, reports normal stimuli as unpleasant and sometimes empties late. Two forms can be told apart, and they need different things. In one, eating is at the front: fullness after normal portions, early satiety, belching. In the other, pain or burning in the pit of the stomach, often independent of meals. The diagnosis is made when the pattern fits and there are no warning signs — not only once everything else has been excluded. Warning signs would be an onset after fifty, weight loss, vomiting, trouble swallowing, anaemia or black stools; then an endoscopy is done. One step is almost always worthwhile, because it genuinely ends a share of the cases: looking for the stomach germ Helicobacter and treating it if it is there. Medicines are also often overlooked — anti-inflammatory painkillers, iron and antibiotics cause exactly this picture.
Early fullness, heaviness for hours and nausea point to the stasis — and that has causes and levers of its own, from portion size through the walk to the medication list.
A breath or stool test is enough to look. If Helicobacter is found and treated, the complaints disappear for good in a share of those affected — that is the one step with this prospect.
Fat delays gastric emptying most. Five small meals with less fat work better in the fullness form than any preparation.
Anti-inflammatory painkillers, iron, potassium tablets, bisphosphonates and antibiotics irritate the stomach directly. Leaving out or replacing works faster than any diet.
The combination of peppermint and caraway oil is among the few plant remedies with a usable basis for this kind of complaint.
Stomach and nervous system are closely linked here. Sleep, movement and relaxation methods act on the sensitivity itself — they are not a consolation prize.
Onset after fifty, weight loss, vomiting, trouble swallowing, anaemia, black stools or stomach cancer in the family. Then endoscopy is the shorter road, not the longer one.
Lightly crush a teaspoon of the seeds, pour over hot water, cover and steep for ten minutes.
Filled to hand warmth, wrapped in a cloth, applied for 20 to 30 minutes.
Single-celled organisms in the stool are as common in people without complaints. Finding them does not end the search — the attribution stays open.
Acid blockers help about one in ten people more than a dummy — they work where acid is involved, and in functional dyspepsia it often is not. Prokinetics speed up emptying when sluggishness is to the fore. What works most reliably in reviews are low-dose tricyclic antidepressants — not for mood, but because they damp pain perception in the stomach; they need four to eight weeks. A Helicobacter course helps some people lastingly.
About ten to twenty in a hundred people are affected. The diagnosis needs complaints on at least three days a week over three months, beginning at least six months ago — and a normal scope, done from fifty or with warning signs. A treatment trial is judged over four to eight weeks. About one in three also has an irritable bowel; the complaints move back and forth over years.
Early satiety and fullness after normal portions mark one of the forms. It responds best to smaller, more frequent and less fatty meals.
The other form. It resembles heartburn but is not the same — and responds to different remedies.
A share of cases begins exactly like that. That is not bad news: this form often runs a better course and improves over months.
Anti-inflammatory painkillers are the commonest avoidable cause and are rarely mentioned, because they are bought without a prescription.
These signs do not belong to functional dyspepsia. Together with an onset after fifty or stomach cancer in the family they lead to endoscopy.
Anaemia does not fit functional dyspepsia. It is one of the warning signs that lead to an endoscopy rather than to further trials.
An iron deficiency with no evident reason points to a silent loss of blood in the digestive tract — and is therefore likewise a reason to look more closely.
Coeliac disease can present as plain dyspepsia, without diarrhoea. A value that finds a treatable cause if there is one.
A long-standing diabetes slows gastric emptying. Fullness and early satiety then have a different explanation of their own.
Soluble fibres like psyllium and oats bind water and make the stool supple. Wheat bran and a lot of raw vegetables, by contrast, increase bloating and pain in a sensitive gut — this distinction explains most of the failures.
Fibre without water makes the stool harder instead of softer. The two belong together, and the effect only sets in after some days.
Draws water into the bowel and therefore works with a sluggish stool. The belly shows the upper limit: if the stool gets too loose, the dose at once was too high.
Yoghurt, kefir, sauerkraut and the like bring living cultures with them. Many tolerate them well; with a strongly bloated belly they can also do the opposite in the first weeks.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
The hunger hormone from the stomach also drives emptying. In functional dyspepsia emptying is slowed in some of those affected — hence the fullness after a few bites.
Fat in the small intestine releases this hormone and slows the stomach. With a sensitive stomach it is therefore not the amount that decides but the fat share of the meal — several small, lower-fat meals sit better.
The link between tension and stomach complaints is not imagined: stress measurably changes how sensitive the stomach wall is to stretching. The same contents then hurt more.
Eat slowly, track triggers.
Camomile and lemon balm are the traditional choice for a nervous stomach.
The connection between tension and stomach is especially close here — described in studies.
Caraway and peppermint together are one of the few plant remedies with decent studies for functional dyspepsia — as an enteric-coated capsule, not as drops on sugar.
As a belly massage clockwise, diluted. In babies with wind the massage is the part that reliably does something.