Functional dyspepsia is a kind of chronic indigestion — a stomach ache, a feeling of fullness or bloating during and after meals. You’re diagnosed with FD when no obvious cause for your symptoms can be found. There are many treatment options, but there’s no one solution that works for everyone.
Dyspepsia is another word for indigestion. People with chronic indigestion often report feelings of stomach pain, over-fullness and bloating during and after eating. Other common symptoms include acid reflux, heartburn and excessive burping. These symptoms resemble peptic ulcer disease, but when tested, only 1/3 of people will have a stomach ulcer — the other 2/3 will have functional dyspepsia.
A functional disorder is an ongoing problem with your bodily functions that can’t be explained by physical causes. You have symptoms, and doctors can observe those symptoms, but they can’t find any mechanical reason for them. Gastrointestinal diseases are often “functional” rather than structural. Doctors don’t always understand why they occur. It may be that the brain and nerves are involved.
If you have frequent symptoms of indigestion, your healthcare providers will look to see if they can find anything wrong with your GI tract — such as an ulcer or structural problem. If they can’t, they’ll diagnose your condition as simply functional dyspepsia (FD). Sometimes FD is also described as nervous dyspepsia, non-ulcer dyspepsia or pseudo-ulcer syndrome.
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Functional dyspepsia is considered one of the most common functional disorders. Estimates say 10% to 20% of people who seek healthcare for their symptoms may have functional dyspepsia. But because many people never seek healthcare for their symptoms, the number of those who have it might be much higher than we know.
Dyspepsia symptoms are sporadic: They come and go without clear reasons, and it’s hard to tell if anything in particular makes them better or worse. While functional dyspepsia is chronic — ongoing over a long period of time — it may disappear for a while and then return for unknown reasons. To be diagnosed, you must have had symptoms within the last three months and persistently for at least six months. You’ll also have more than one of the following symptoms:
Some healthcare specialists classify functional dyspepsia symptoms into two categories:
Not everyone’s symptoms fall neatly into these two categories, but when they do, it helps healthcare specialists focus on treating those symptoms as a group.
Gastritis and dyspepsia share many symptoms, and you can have both. Gastritis, which is inflammation of the stomach lining, usually has a traceable cause. It might be a bacterial infection, overuse of certain pain medications that erode the stomach lining (NSAIDs), or too much stomach acid. These things can be tested for and treated. If you have functional dyspepsia, gastritis may be part of the equation, but not all of it. You may discover and treat the cause of your gastritis and experience some relief from those symptoms, but not total relief.
GERD can also be a factor in functional dyspepsia. Heartburn, belching and the sour taste that sometimes comes with acid reflux are all among the symptoms of functional dyspepsia. If you have GERD, it’s not hard for healthcare providers to recognize. Chronic acid reflux does visible damage to your esophagus over time. GERD is also relatively easy to treat with medications that reduce stomach acid. If you’ve treated your GERD, but you still have symptoms of indigestion, you might be diagnosed with functional dyspepsia.
IBS (irritable bowel syndrome) is another functional disorder, like functional dyspepsia. They even have similar nicknames. Functional dyspepsia has been called “irritable stomach syndrome,” and IBS has been called “nervous stomach”. However, IBS is really concerned with the bowels, especially the large intestine or colon. Functional dyspepsia symptoms are more involved with the stomach and the upper small intestine. FD pain is more of a burning sensation in the upper GI tract, while IBS pain is more like cramping in the bowels due to constipation or diarrhea.
The term “indigestion” assumes that something is going wrong with your digestive process. But this could be a lot of things. Doctors don’t have clear answers for what causes functional dyspepsia, but they have some suggestions. Some of these include:
You may be more likely to experience functional dyspepsia if you:
When you explain your symptoms to your healthcare provider, they will test you for common causes. Tests may include:
If there’s no evidence of a structural or biochemical disease, and your symptoms have been persistent for three months or more, you’ll be diagnosed with FD.
If you’ve tested positive for a bacterial infection, you’ll be treated with antibiotics for the infection first. But if functional dyspepsia persists, and no other direct cause can be found, the remaining treatment options are focused on managing symptoms. This is a trial-and-error process. Medication might include:
These medications may help if they happen to target the factors contributing to your symptoms. But functional dyspepsia is often more complicated than that, and medications overall have only a moderate success rate in treating FD.
Some other therapies that people use to manage their symptoms include:
Among those who seek medical care for their functional dyspepsia, only 20% report permanent relief. How long does functional dyspepsia last? For most people, it’s a chronic condition that comes and goes indefinitely, depending on many factors. The best thing you can do is to try and manage your symptoms as they arise, and try to develop an awareness of the foods, stress triggers and lifestyle habits that affect your symptoms. The good news is that FD is not a dangerous or progressive condition. It should get better at least at times, and it shouldn’t get worse.
Functional disorders like FD are complex. They often involve the brain and nervous system, diet and lifestyle factors as well as organic causes in your digestive system. That’s what makes them so tricky for both patients and healthcare providers to manage. Medical testing can help rule things out, but often can’t tell you exactly what’s going on. In the end, you are the one in the best position to notice what makes your symptoms better or worse. As you try out different therapies and work to reduce your triggers, you’ll find your own way to live with functional dyspepsia.
Seek medical attention if:
A note from Cleveland Clinic
Functional dyspepsia can be a frustrating diagnosis for people who experience it and are looking for solutions. On one hand, it’s a benign condition that won’t endanger your life. But on the other hand, there is no definitive cause or cure. Even so, medical testing can help put you on the path to relief. It can identify or rule out certain contributing factors and give your healthcare provider important information about your condition. Your provider will use the evidence they find to prescribe the best medication they can to help you. And if the first prescription doesn’t work, that will tell them what to suggest next.
Last reviewed by a Cleveland Clinic medical professional on 01/10/2022.
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