Nonulcer dyspepsia (NUD), or functional dyspepsia, is a very common, benign gastrointestinal problem. This term generally refers to persistent or recurrent upper abdominal pain or discomfort. Other common symptoms include nausea, bloating and abdominal fullness after meals. The diagnosis of NUD is made following the exclusion of other medical illnesses which can cause similar symptoms, such as gastroesophageal reflux disease (GERD), ulcer disease, gallstones, and diseases of the pancreas. Frequently, abdominal studies such as an ultrasound, upper gastrointestinal (GI) X-ray or endoscopy (procedure where pictures of the stomach lining are taken with a flexible instrument with a camera lens) are performed to exclude these other medical conditions before the diagnosis of NUD is made.

NUD has many similarities to irritable bowel syndrome (IBS). These two conditions are usually differentiated by whether the abdominal pain is associated with abnormal bowel habits; if this association is present, it may be considered to be IBS rather than NUD. Like IBS, the cause of NUD is not well understood but is most likely to be caused by an alteration in the perception of sensations arising from the gut.

Other possible causes of NUD have been investigated. Although up to 50% of patients with NUD have evidence of Helicobacter pylori infection, which is a bacterial infection in the stomach that is associated with ulcer disease, a clear relationship has not been established with NUD. Thus, it is not surprising that studies have not yet definitively proven that improvement of NUD occurs with cure of Helicobacter pylori infection. Another possible cause of NUD is an alteration in the function of the stomach, resulting in a delayed emptying of the stomach contents. About 25-50% of patients with NUD have slowed emptying from the stomach which may, in part, explain the increased symptoms after meals.

Not all patients need medication for their symptoms. Eating low-fat meals or smaller, more frequent meals may help reduce the symptoms experienced after eating. There are various medications which have been shown to improve symptoms in patients with NUD, although some of these studies have conflicting results. Similar to IBS, there has not been any single treatment which has been shown to significantly improve the overall symptoms in patients with NUD. Medications used to treat NUD include agents to decrease stomach acid, prokinetic agents (enhance stomach empyting), antispasmodics, and antibiotics to treat Helicobacter pylori. The type of medications used to treat a patient’s symptoms can be determined by one’s physician. We are presently conducting studies in patients with NUD in order to improve our understanding of the cause of NUD and to find more effective treatments. If you are interested in obtaining more information or woud like to participate in our research studies, please call (310) 268-3432.