Functional Dyspepsia

[largemarge52]

I have recently been diagnosed with Functional Dyspepsia. In February I started having abdominal pain, bloated feeling, feeling of fullness after I eat and nausea. I went and saw my family physician that put me on protonix and sent me for an Upper GI which came back with mild reflux. The Protonix did not help so she put me on prevacid and sent me to see a specialist. The specialist did an Upper Endoscopy and Ultrasound which both came back normal. Also there is no presence of blood in my stool. And my stools seem to be normal it is mostly my stomach area. My question is my specialist has not tested me for Helicobacter Pylori because he said my endoscopy was normal and did not show any inflammation and I have not been out of the country is theist correct. Also the pain I have in my stomach is sharp and stabbing pain which every where I have looked is not a symptom of Dyspepsia. My specialist placed me on Zelnorm and I have felt a little better. I just want to know will this ever go away or what else can I do? I am tired of not feeling good and I don’t think my doctor really cares. The pain is so bad sometimes I can’t even get out of bed and the nausea makes me not want to eat so I have lost 10 pounds.

[Kevin Pho, MD]

You have had a pretty comprehensive evalation for dyspepsia.  H Pylori is a bacteria that is associated with ulcers and inflammation.  If the upper endoscopy did not show this, then it would be unlikely that H Pylori is present.  

Zelnorm is a treatment for irritable bowel.  This diagnosis is certainly reasonable if everything else is negative.

You can also consider a 24-hr pH study with esophageal motility studies as well as a gastric emptying scan.  Both of these more uncommon conditions can lead to dyspepsia-like symptoms.

You can discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[yoshi]

you can get hector pylori bacteria anywhere from filthy food and water.

[largemarge52]

I forgot I also have to belch all the time and that usally releived some of the bloating.

[TJV]

  H pylori has nothing to do with being out of the country.  It  essentially appears as  gastritis on endoscopy, so if there is nothing there, what can he biopsy?   If you feel uncomfortable about h pylori,   ask for an h pylori blood test.  

Even if you tested positive for h pylori, its unlikely to be causing any symptoms. ,  because you have no endoscopic evidence of inflammation. You should also ask for a gastric emptying study to rule out gastroparesis, as that too can cause pain and nausea.  

  Functional dyspepsia is basically a diagnoses of exclusion.   Request a ph test for GERD , and manometry. GERD can certainly cause your symptoms. Half of those with GERD have a negative endoscopy, so you need a ph test to rule out GERD , as the ph test is  the definitive  test.  

Have you had a colonoscopy?  IBS can also cause those painsas well as nausea.  Really GERD, IBS , etc are all intertwined, many people have several of these conditions overlapping. They are all chronic episodic conditions.

[yoshi]

why is GERD,IBS intertwined?
This is what i dont understand-the stomach connected to the intestines is rather narrow,why would IBS or any abdominal problem be causing GERD??
But I have found removing water retention and keeping bowel movement going help with Gerd and acid reflux,why??