Functional dyspepsia - a disease of the stomach, in which the violation occurs or serkretoprodutsiruyuschey motor function of the stomach, accompanied by pain and dyspepsia, but organic or anatomical changes can not be identified. Functional disorders of the stomach affects up to 30% of the adult population of the planet. These diseases include:
functional (non-ulcer) dyspepsia;
aerophagia;
spasm of the pylorus (pilorospazme);
habitual vomiting.
Causes of functional disorders of the stomach are primarily acute and chronic stress. Quite often lead to functional disorders of eating disorders:
meals at different times, with large gaps
eating, drinking large amounts of fat and carbohydrates, sharp, acidic and fried foods.
Adverse effect on the gastric mucosa have smoking and excessive drinking. Often functional disorders of the stomach are found in patients of food allergy.
Disease may contribute to the effects of vibration, ionizing radiation, climate change. Very often there are disorders of function of the stomach when moving to a country with hot climate and a significant change in the nature of power.
Functional disorders of stomach diseases are accompanied by several other agencies:
gastro-intestinal tract (liver, bile duct, pancreas, intestine)
nervous system
endocrine organs
Heart
vascular system
Many diseases of the blood and metabolism.
Adverse effect on the gastric mucosa have some drugs, especially nonsteroidal anti-inflammatory drugs (diclofenac, orthofen, indomethacin, etc.) and glucocorticoid hormones.
Functional non-ulcer dyspepsia
In this condition the patient concerned about pain and discomfort in the stomach, bloated stomach feeling crowded. These feelings may not be directly related to food intake. There may be complaints of nausea, bloating, less frequent heartburn, vomiting, regurgitation. The patient often does not tolerate fatty foods. All these complaints are amplified in a state of psycho-emotional or physical stress. An examination of the patient to identify any disease can not be.
There are four options for functional dyspepsia.
Reflyuksopodobny. In this embodiment, a patient having complaints of heartburn, stomach pain, a burning sensation behind the breastbone, belching. Typically, the intensity of pain increases after physical exertion, bending, eating, after psycho-emotional experiences.
Ulcer-like. In this embodiment, functional dyspepsia pain occur on an empty stomach, sometimes at night. The patient has to wake up because of pain in the stomach. Meal or antacid drugs dramatically reduces the pain, or pain disappear.
Diskineticheskih option. This option is also called the motor, and often manifests a feeling of heaviness in the stomach, a feeling of fullness. Quickly the feeling of satiety. After the meal concerned belching, nausea and flatulence. Sometimes there are long bouts of vomiting.
Mixed or non-specific version of the manifest variety of complaints.
All four options are accompanied by headaches, dizziness, impaired by various psychoemotional sphere, mood swings. In contrast, gastric ulcer for functional disorders are not characterized by seasonality (exacerbation in spring and autumn), circadian rhythm of pain.
Typically, the functional state is not progressing and not complicated, and proceed for a long time on one level. Patients usually do not lose weight, and weight loss has arisen due to the common features of disorders of the nervous system. Such patients must be carried out a detailed examination to rule out other diseases of the gastrointestinal tract.
Aerophagia and gastric pneumatosis
Aerophagia, or pneumatosis of the stomach - this is a functional disorder of the stomach. When aerofagii is swallowing of air. Normally, air is swallowed and healthy. But, in this case a small amount of air, about 2-cubic centimeters, swallowed while eating. This air accumulates in the stomach in the form of "gas" or "air" bubble. The air then enters the intestine and there is gradually absorbed.
When the patient swallows aerofagii air, both during and outside of the meal. The reasons for enhanced ingestion of air often serve as psychogenic disorders: stress, nervous shock.
Aerophagia common in hysterical disorders. Respiratory diseases may also be accompanied by increased swallowing of air due to breathing difficulties, resulting in the oral cavity mucous dries up and people are often forced to swallow. Sometimes, patients swallow air when too champ, hasty meal, with enough chewed food when swallowed large chunks.
Organic causes that can lead to aerofagii - a failure of the lower esophageal sphincter (cardia), hiatal hernia.
Usually seen aerophagia loud belch air, which may be aggravated by psycho-emotional arousal. Often this regurgitation is independent of food intake. The patient complains of a feeling of fullness, bloating upper abdomen after eating. These complaints are reduced after a burp. Less commonly, there is a hiccup.
Sometimes when there aerofagii manifestations of the cardiovascular system. It may be interruptions in the heart, a feeling reinforced heartbeat, heart pain after eating. Pain in the heart may resemble angina, so be sure to have carried out a detailed examination to rule out diseases of the cardiovascular system. The patient may complain of feeling short of breath, shortness of breath that occur after eating and better after burping.
Stretching the stomach wall and the lower esophageal sphincter, promotes aerophagia hiatal hernia, where part of the stomach, together with the lower opening of the esophagus is squeezed into the chest cavity. Aerophagia is more common in younger women, and is prolonged.
To diagnose aerofagii performed X-ray, which revealed high standing dome of the diaphragm and a large gas bubble in the stomach. Appointed by the electrocardiogram, ultrasound of the abdominal cavity. Must be appointed fibroezofagogastroduodenoscopy.
Habitual vomiting
Habitual vomiting occurs most often in hysteria. In response to the appearance, color or smell of a certain kind of food there is a reflex contraction of the stomach and begins vomiting. It's functional status usually appears in childhood. Usually habitual vomiting does not occur after eating and before eating, or even a meal. Habitual vomiting occurs easily, the patient becomes accustomed to this state, and it is not too worried. Such vomiting rarely occurs in crowded places.
For the diagnosis of habitual vomiting is very important history of the disease. To rule out other diseases of the gastrointestinal tract necessarily carried out a detailed examination of the patient holding fibroezofagogastroduodenoscopy.
Pilorospazme
Pilorospazme - a spasm of the pylorus, or pyloric, which is located in the transition of the stomach into the duodenum. This condition is most common in patients with neuroses. After a meal or shortly after a meal there is pain in the epigastric region and profuse vomiting. In this condition may occur a significant weight loss patients, because the food just did not have time to digest.
For the diagnosis and exclusion pilorospazme organic diseases of the stomach, pylorus or duodenum necessarily conducted a detailed examination of patients.
Treatment pilorospazme conducted on the principles of treatment of neuroses.
