A patient’s story
Michael, a 42 year old manager, noticed persistent upper abdominal discomfort, early fullness, and bloating after meals. Tests repeatedly came back normal, yet his symptoms continued to affect daily life.
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After specialist review, he was diagnosed with functional dyspepsia, a common but often misunderstood gut brain disorder.
What is functional dyspepsia?
Functional dyspepsia (FD) is a chronic digestive disorder causing symptoms from the upper digestive tract, despite normal scans and blood tests. Unlike ulcers or reflux disease, FD shows no structural damage. Instead, symptoms arise from altered gut function and sensitivity.
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Common symptoms include upper abdominal pain, nausea, bloating, early satiety, and post meal discomfort. FD frequently overlaps with IBS, anxiety, and other disorders of gut brain interaction.
What causes functional dyspepsia?
FD develops due to a combination of functional changes rather than one single cause.
Key contributors include:
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Delayed stomach emptying
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Visceral pain hypersensitivity
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Abnormal stomach muscle contractions
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Altered acid handling
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Stress and anxiety
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Hormonal influences
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Certain foods or medications
What is postprandial distress syndrome?
Postprandial distress syndrome (PDS) is a subtype of functional dyspepsia. Symptoms worsen after eating and include intense fullness, pressure, bloating, and nausea.
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Even small meals may trigger discomfort due to impaired stomach relaxation.
Visceral pain hypersensitivity
This refers to an increased sensitivity of gut nerves. Normal digestion may feel painful, leading to cramping, burning, or pressure without visible disease. It plays a major role in functional dyspepsia.
Other related functional conditions
FD may overlap with:
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Supragastric belching, driven by behavioural air movement
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Low stomach acid, affecting digestion
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Bile salt malabsorption, causing bloating and diarrhoea
Identifying overlap improves treatment success.
How is functional dyspepsia diagnosed?
Diagnosis involves:
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Careful symptom assessment
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Blood and stool tests
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Gastroscopy, when appropriate
Once serious disease is excluded, FD can be diagnosed confidently.
How is functional dyspepsia treated?
Treatment focuses on symptom control and gut brain regulation:
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Dietary modification
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Acid suppression or neuromodulators
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Prokinetic medication
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Psychological therapies, when needed
Expert Assessment for Ongoing Indigestion
Persistent upper gut symptoms deserve specialist care.
Our gastroenterologists identify functional causes and create personalised treatment plans.