Dyspepsia

Your doctor will likely review your signs and symptoms and perform a physical examination. A number of diagnostic tests may help your doctor determine the cause of your discomfort and rule out other disorders causing similar symptoms. These may include:

Blood tests. Blood tests may help rule out other diseases that can cause signs and symptoms similar to those of functional dyspepsia.

Tests for a bacterium. Your doctor may recommend a test to look for a bacterium called Helicobacter pylori (H. pylori) that can cause stomach problems. H. pylori testing may use your blood, stool or breath.

Endoscopy. A thin, flexible, lighted instrument (endoscope) is passed down your throat so that your doctor can view your esophagus, stomach and the first part of your small intestine (duodenum). This will also allow the doctor to collect small pieces of tissue from your duodenum to look for inflammation.

Functional dyspepsia that is long lasting and isn't controlled by lifestyle changes may require treatment. What treatment you receive depends on your signs and symptoms. Treatment may combine medications with behavior therapy.

Medications

Medications that may help in managing the signs and symptoms of functional dyspepsia include:

Over-the-counter gas remedies. Drugs that contain the ingredient simethicone may provide some relief by reducing intestinal gas. Examples of gas-relieving remedies include Mylanta and Gas-X.

Medications to reduce acid production. Called H-2-receptor blockers, these medications are available over-the-counter and include cimetidine (Tagamet HB), famotidine (Pepcid AC) and nizatidine (Axid AR). Stronger versions of these medications are available in prescription form.

Medications that block acid 'pumps.' Proton pump inhibitors shut down the acid "pumps" within acid-secreting stomach cells.

Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR), omeprazole (Prilosec OTC) and esopremazole (Nexium 24HR). Proton pump inhibitors are also available by prescription.

Antibiotics. If tests indicate that a common ulcer-causing bacterium called H. pylori is present in your stomach, your doctor may recommend antibiotics in combination with acid-suppressing medication.

Low-dose antidepressants. Tricyclic antidepressants and drugs known as selective serotonin reuptake inhibitors, taken in low doses, may help inhibit the activity of neurons that control intestinal pain.

Prokinetics. Prokinetic agents help your stomach empty more rapidly and may help tighten the valve between your stomach and esophagus, reducing the likelihood of upper abdominal discomfort.

Medications to relieve nausea (anti-emetics). If you feel nauseated after eating, your doctor may recommend an anti-emetic, such as promethazine, prochlorperazine or meclizine.