Materiały źródłowe

• #1 Diagnosis of Indigestion – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia/diagnosis

  Your doctor may use your symptoms, a medical and family history, a physical exam, and tests to diagnose the cause of indigestion. […] Your doctor will ask about your symptoms to diagnose the cause of indigestion. Your doctor may diagnose functional dyspepsia if you have pain, a burning feeling, or discomfort in your upper abdomen, or feeling full too soon while eating a meal, and another cause for your indigestion cant be found. […] To help diagnose the cause of indigestion, your doctor will take a medical and family history. […] Doctors may use medical tests to help find the cause of indigestion. If specific causes are not found, your doctor may diagnose functional dyspepsia and recommend treatments. […] Your doctor may perform an upper gastrointestinal (GI) endoscopy to diagnose diseases and conditions that may be causing your indigestion, such as gastritis, peptic ulcer, stomach cancer or cancer in another part of the digestive tract. […] Your doctor may use imaging tests such as x-rays, computed tomography scans (CT), or ultrasound to look for diseases and conditions in your digestive tract that may be causing your indigestion. […] Your doctor may find an H. pylori infection by performing an upper GI biopsy.

• #2 Functional Dyspepsia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

  Functional dyspepsia is a kind of chronic indigestion. A healthcare provider may diagnose you with functional dyspepsia if they cant find any direct cause for your symptoms. […] Functional dyspepsia is chronic indigestion with no identifiable cause. Dyspepsia is another word for indigestion a pattern of symptoms that occur together after eating and while youre digesting. […] Healthcare providers diagnose functional dyspepsia by confirming your symptoms and ruling out other causes. These include chronic acid reflux (GERD) and peptic ulcer disease. […] Functional dyspepsia symptoms can be sporadic. Providers only diagnose it if they: Have been persistent for at least three months, Originally appeared at least six months ago, Arent relieved by burping, passing gas or pooping, Dont meet the criteria for biliary colic or gallbladder pain.

• #2 Functional Dyspepsia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

  If tests reveal any underlying factors, like bacterial overgrowth or a motility disorder, your provider will treat those first. But usually, treating these isnt enough to relieve functional dyspepsia. Your provider will suggest other treatment options to relieve your symptoms. […] For most people, functional dyspepsia is a chronic condition that comes and goes throughout their lives. It may take some trial and error to figure out which therapies and habits improve your symptoms.

• #3 Indigestion (Dyspepsia) – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia

  Indigestion may happen from time to time or be chronic. […] Your doctor may diagnose the cause of indigestion based on your symptoms, medical history, a physical exam, and tests. Tests may include upper GI endoscopy, imaging and H. pylori testing. […] How doctors treat indigestion depends on the cause.

• #4 Indigestion – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/indigestion/diagnosis-treatment/drc-20352215

  Your health care provider is likely to start with a health history and a thorough physical exam. Those evaluations may be enough if your indigestion is mild and you’re not experiencing certain symptoms, such as weight loss and repeated vomiting. […] But if your indigestion began suddenly, and you are experiencing severe symptoms or are older than age 55, your provider may recommend: […] Laboratory tests, to check for anemia or other metabolic disorders. […] Breath and stool tests, to check for Helicobacter pylori (H. pylori), the bacterium associated with peptic ulcers, which can cause indigestion. […] Endoscopy, to check for issues in your upper digestive tract, particularly in older people with symptoms that won’t go away. A tissue sample, called a biopsy, may be taken for analysis. […] Imaging tests (X-ray or CT scan), to check for intestinal obstruction or another issue.

• #5 Functional dyspepsia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/functional-dyspepsia/diagnosis-treatment/drc-20375715

  For functional dyspepsia, some basic questions to ask include: What’s likely causing my symptoms? […] What tests do I need? […] Is my condition likely temporary or chronic? […] What are the alternatives to the primary approach you’re suggesting? […] Are there restrictions that I need to follow? […] Should I see a specialist? […] You’ll likely be asked a few questions, such as: When did your symptoms begin? […] What, if anything, seems to improve your symptoms? […] What, if anything, appears to worsen your symptoms?

• #5 Functional dyspepsia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/functional-dyspepsia/diagnosis-treatment/drc-20375715

  In some cases, other tests may be done to see how well the stomach empties its contents. […] Functional dyspepsia that can’t be managed with lifestyle changes may need treatment. Treatment depends on symptoms. It may combine medicines and behavior therapy. […] Some medicines may help manage symptoms of functional dyspepsia. […] If tests find H. pylori in the stomach, antibiotics may be prescribed along with acid-suppressing medicine. […] Working with a counselor or therapist may relieve symptoms that aren’t helped by medicines. […] A combination of peppermint and caraway oils may offer some benefit for functional dyspepsia. […] A Japanese herbal remedy called rikkunshito also may be helpful. Researchers found it improved belly pain, heartburn and bloating better than placebo. […] You may start by seeing someone on your primary healthcare team. Or you may be referred right away to a doctor who specializes in the treatment of diseases of the stomach and intestines, called a gastroenterologist.

• #5 Functional dyspepsia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/functional-dyspepsia/diagnosis-treatment/drc-20375715

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. The tiny camera provides a view of the esophagus, stomach and the beginning of the small intestine, called the duodenum. […] Several tests can help find the cause of the discomfort and rule out other disorders. These may include: […] Blood tests may help rule out other diseases that can cause symptoms like those of functional dyspepsia. […] A bacterium called Helicobacter pylori (H. pylori). H. pylori can cause stomach problems. H. pylori testing may involve a stool sample, the breath or tissue samples of the stomach taken during endoscopy. […] An upper endoscopy uses a tiny camera on the end of a flexible tube to visually examine the upper digestive system. This allows a medical professional to collect tissue samples to look for infection or inflammation.

• #6 Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatments

  https://www.webmd.com/heartburn-gerd/indigestion-overview

  Your doctor will ask you about your medical history and perform a physical exam. […] Your doctor may also order some tests, such as: […] An upper gastrointestinal (GI) endoscopy. Your doctor will use a small, flexible tube with a light and a camera to look at your esophagus, stomach, and duodenum (the first part of your small intestine). Your doctor may also take some tissue samples for a biopsy at the same time. Using this test, your doctor may be able to see if you have peptic ulcer disease, gastritis, or cancer. […] Other imaging tests, such as X-rays, computed tomography (CT) scans, or an ultrasound. […] Tests to look for signs of Heliobacter pylori (H. pylori) infection. H. pylori is a bacteria that causes peptic ulcer disease, which can be a cause of chronic indigestion. Your doctor may want you to take a blood or stool test. They may also want you to take a urea breath test. During this test, you swallow a capsule, liquid, or gel that has urea labeled with a special carbon atom in it. H. pylori bacteria will take in the labeled urea and change it to carbon dioxide. If you have H. pylori bacteria in your stomach, you will breathe out this labeled carbon dioxide. Your doctor can then measure how much of this labeled carbon dioxide you breathe out.

• #7 Dyspepsia or indigestion – causes, symptoms, diagnosis, treatment and prevention | TheHealthSite.com

  https://www.thehealthsite.com/diseases-conditions/dyspepsia-or-indigestion-causes-symptoms-diagnosis-treatment-and-prevention-163052/

  Dyspepsia or indigestion is a chronic functional disease of the gastrointestinal system that interferes with the digestion process of food in the stomach. It is often characterized by pain or discomfort in the upper abdomen. […] The diagnosis for dyspepsia usually happens with a physical examination and taking in account the medical history of the patient. The physical examination is conducted by pressing various parts of the stomach and chest to look for any abnormality. […] A blood test is usually done to check for any infection in the blood stream that can give the gastrointestinal tract a jolt. […] An endoscopy is done to check on the innards of the stomach for ulcers, inflammation or infection. […] A stool test is usually done to check if there is an H.pylori infection in the body.

• #8 Dyspepsia: Symptoms and Treatment | Doctor

  https://patient.info/doctor/dyspepsia-pro

  Diagnosing dyspepsia […] Always check for abdominal mass. […] Consider taking FBC to demonstrate another alarm feature – eg, iron-deficiency anaemia. […] Test for Helicobacter pylori. […] Routine endoscopic investigation of dyspeptic patients is not necessary but should be considered in patients over the age of 55 in whom: Symptoms persist despite treatment. […] There is raised platelet count or nausea or vomiting. […] There is a previous diagnosis of Barrett’s oesophagus (but consider risks vs benefits). […] Dyspepsia (treatment-resistant), aged 55 and over: consider oesophageal or stomach cancer: consider non-urgent, direct access upper gastrointestinal endoscopy. […] Dyspepsia with weight loss, aged 55 and over: consider oesophageal or stomach cancer: offer urgent, direct access upper gastrointestinal endoscopy (to be done within 2 weeks).

• #9 Evaluation and Management of Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1015/p1773.html

  Reflux-like dyspepsia, or GERD, can be distinguished from other gastrointestinal disorders with reasonable accuracy on the basis of symptoms. The two symptoms that define this disorder are heartburn and regurgitation. […] Dysmotility-like dyspepsia, or gastroparesis, is associated with symptoms of bloating, abdominal distention, flatulence and prominent nausea. […] Fortunately, malignancies are rare in patients with dyspepsia. The symptoms of gastric cancer are similar to those of other causes of epigastric pain. However, the presence of alarm symptoms, such as dysphagia, unexplained weight loss, history of gastrointestinal bleeding or clinical signs of anemia, may help to identify patients with more serious disease. […] A complete medication history, including prescription and over-the-counter drugs, should always be obtained as part of the evaluation of patients with dyspepsia.

• #9 Evaluation and Management of Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1015/p1773.html

  The initial evaluation of dyspepsia should include a complete blood count to rule out anemia. If the history and physical examination suggest the presence of gallstones or another hepatobiliary condition, liver function tests and sonographic evaluation should be ordered. […] After a thorough clinical evaluation and detailed history, conditions such as GERD, irritable bowel syndrome, biliary pain and medication-induced dyspepsia can most likely be confirmed or excluded. The remaining patients probably have ulcer-like, dysmotility-like or functional (nonulcer) dyspepsia. […] Most physicians agree that definitive diagnostic evaluation with endoscopy is indicated in older patients at higher risk for malignancy and in younger patients with alarm symptoms. […] Although empiric drug trials are falling out of favor, acid suppression still remains an option in patients with dyspepsia.

• #9 Evaluation and Management of Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1015/p1773.html

  The approach to previously uninvestigated dyspepsia is more difficult. It includes differentiating the cause of dyspepsia, selecting among the available options for initial management and distinguishing between patients who require endoscopy and those who can safely receive empiric drug therapy. […] Because the differential diagnosis of dyspepsia is broad, initial efforts should be focused on the most common etiologies. In about 50 to 60 percent of patients, a specific etiology is not identified (i.e., functional or nonulcer dyspepsia). Many of these patients are hypothesized to have an augmented perception of visceral pain. […] A thorough history is important in evaluating the patient with dyspepsia, although symptoms alone may not be very useful in establishing a specific diagnosis. […] Patients who present with dyspepsia should be asked about risk factors associated with peptic ulcers. If a patient has a history of ulcers, a recurrent lesion is likely. Risk factors for ulcers include a family history of ulcers, a history of nonsteroidal anti-inflammatory drug (NSAID) use and current cigarette smoking.

• #10 Approach to the adult with dyspepsia – UpToDate

  https://www.uptodate.com/contents/approach-to-the-adult-with-dyspepsia

  Dyspepsia is a common symptom with an extensive differential diagnosis and a heterogeneous pathophysiology. It occurs in up to 20 percent of the population, although prevalence rates vary depending on which diagnostic criteria are used to establish the diagnosis. Although most people with dyspepsia do not seek medical evaluation for their symptoms, dyspepsia is still a common reason for outpatient medical visits. In an analysis of ambulatory visits for chronic upper gastrointestinal symptoms in the United States, dyspepsia was the second most common reason for a visit, with more than 1.2 million visits annually. Although dyspepsia does not affect survival, it significantly reduces quality of life and results in substantial health care costs. […] The initial evaluation of individuals with new onset of dyspepsia includes a comprehensive history, focused physical examination, and laboratory testing. The goals of the initial evaluation are as follows: Identify patients who require urgent evaluation, including those with alarm features for gastroesophageal malignancy; Identify patients whose initial evaluation should include upper endoscopy; Identify organic causes of dyspepsia; Generate and narrow the differential diagnosis. The presence or absence of alarm features is a key component of the evaluation. Alarm features include overt gastrointestinal bleeding, dysphagia, odynophagia, persistent vomiting, family history of upper gastrointestinal cancer, unintentional weight loss, palpable mass or lymphadenopathy, and unexplained iron deficiency anemia.

• #10 Approach to the adult with dyspepsia – UpToDate

  https://www.uptodate.com/contents/approach-to-the-adult-with-dyspepsia

  The diagnostic approach to a patient with dyspepsia is based on the clinical presentation, patient’s age, and presence of alarm features. All individuals with dyspepsia should be tested for Helicobacter pylori and receive treatment if infection is detected. We perform upper gastrointestinal endoscopy in selected patients with dyspepsia to rule out gastroesophageal malignancy and evaluate for organic causes of dyspepsia, such as peptic ulcer disease, gastritis, peptic stricture, or gastric outlet obstruction. […] Approximately 25 percent of patients with dyspepsia are found to have an underlying organic disease on diagnostic evaluation. Approximately 75 percent of patients have functional (idiopathic or nonulcer) dyspepsia. The diagnostic approach to patients with dyspepsia depends on the patient’s age and the presence or absence of alarm features.

• #11 Indigestion: Symptoms, Causes, Remedies, and Treatment – Gastroenterology Consultants of Savannah

  https://www.gastrosav.com/blog/indigestion-symptoms-causes-and-more/

  Although uncommon, it is possible to have indigestion that is not related to any of these causes. Indigestion of this type is called functional or non-ulcer dyspepsia. The wide variety of causes makes an accurate diagnosis very important. […] If you are experiencing frequent stomach aches or any of the symptoms of indigestion, it is a good idea to talk with your doctor. […] Your doctor will also likely do blood tests and possibly X-rays of the stomach and small intestine to rule out certain causes and underlying conditions. Your doctor may also recommend an endoscopy which is a procedure that uses a tube with a tiny camera and light to examine parts of your digestive system. […] Depending on the underlying cause of your indigestion, your doctor will recommend the best treatment plan for you. This will typically include education about indigestion and recommendations for lifestyle changes to help alleviate discomfort. Your doctor may also recommend medications like a muscle relaxant or a promotility drug to either slow down or speed up the function of muscles in the digestive tract. […] Indigestion is a chronic condition and can last for months, years, or even a lifetime. However, with proper medical assessment and treatment, indigestion can be controlled and the symptoms reduced or removed so that you are not limited by the discomfort of indigestion.

• #12 Dyspepsia: Symptoms, causes, and treatments

  https://www.medicalnewstoday.com/articles/163484

  Dyspepsia, the medical term for indigestion, refers to discomfort or pain in the upper abdomen, often after eating or drinking. […] A doctor will diagnose dyspepsia if a person has one or more of the following symptoms: pain relating to the digestive system, a burning sensation in the digestive tract, feeling too full after eating, feeling full too quickly while eating. […] Treatment for dyspepsia depends on the cause and severity. Often, treating an underlying condition or changing a persons medication will reduce dyspepsia. […] A doctor will ask the person about their symptoms, their personal and family medical history, any other health conditions and medications that they are taking, their dietary habits. […] In some cases, a doctor may use the following tests to rule out an underlying health condition: Blood test: This can assess for anemia, liver problems, and other conditions. Tests for H. pylori infection: In addition to a blood test, these tests may include a urea breath test and a stool antigen test. Endoscopy: The doctor will use a long, thin tube with a camera to take images of the gastrointestinal tract during this procedure. They may also take a tissue sample for a biopsy. This can help them diagnose an ulcer or a tumor.

• #12 Dyspepsia: Symptoms, causes, and treatments

  https://www.medicalnewstoday.com/articles/163484

  Dyspepsia can also be a symptom of a wide range of health conditions, including: GERD, anxiety or depression, gallbladder inflammation, gastritis, gastroparesis, Helicobacter pylori (H. pylori) infection, irritable bowel syndrome, lactose intolerance, peptic ulcer disease, stomach cancer, medications, such as antibiotics and NSAIDs. […] Anyone who has concerns about new, severe, or ongoing dyspepsia should seek medical advice.

• #13 Functional Dyspepsia: Advances in Diagnosis and Therapy

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16055

  Meal induced symptoms are an important and increasingly recognized feature of FD. […] An objective test in FD that assesses meal related symptoms is the nutrient test meal. […] The diagnosis of FD remains one of exclusion as EGD is required to exclude peptic ulceration, esophagitis and malignancy. […] The most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. […] Only one therapy is known to change the natural history of FD: Helicobacter pylori eradication.

• #14 Functional Dyspepsia: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0115/p84.html

  Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. […] Functional dyspepsia is a diagnosis of exclusion; therefore, evaluation for a more serious disease such as an upper gastrointestinal malignancy is warranted. […] The more specific Rome IV criteria allow for a definitive diagnosis of functional dyspepsia to be made for patients who have normal upper endoscopy findings. […] The 2017 ACG/CAG guidelines recommend upper endoscopy be performed for all patients 60 years or older who present with at least one month of dyspepsia symptoms. […] A test and treat strategy for Helicobacter pylori for all patients younger than 60 years is a safe and effective option before treatment with acid suppression.

• #14 Functional Dyspepsia: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0115/p84.html

  Functional dyspepsia is the most common cause of dyspepsia, and many organic dyspepsia etiologies are rare; therefore, history is not useful in differentiating between functional and organic dyspepsia, and management does not depend on this differentiation. […] A systematic review of psychotropic medications compared with placebo for the treatment of functional dyspepsia included three trials of tricyclic antidepressants (TCAs) and found a reduction in dyspepsia symptoms. […] The ACG does not recommend the routine use of complementary and alternative medicines for the treatment of functional dyspepsia but states that these alternatives can be considered for patients who are motivated.

• #15 Indigestion – Wikipedia

  https://en.wikipedia.org/wiki/Indigestion

  A diagnosis for indigestion is based on symptoms, with a possible need for more diagnostic tests. In younger patients (less than 60 years of age) without red flags (e.g., weight loss), it is recommended to test for H. pylori noninvasively, followed by treatment with antibiotics in those who test positively. A negative test warrants discussing additional treatments, like proton pump inhibitors, with your doctor. An upper GI endoscopy may also be recommended. In older patients (60 or older), an endoscopy is often the next step in finding out the cause of newly onset indigestion regardless of the presence of alarm symptoms. However, for all patients regardless of age, an official diagnosis requires symptoms to have started at least 6 months ago with a frequency of at least once a week over the last 3 months.

• #16 Charlotte Gastroenterology & Hepatology | Indigestion – Charlotte Gastroenterology & Hepatology

  https://www.charlottegastro.com/patient-care/indigestion/

  Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms including a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen. […] To diagnose indigestion, the doctor asks about the persons current symptoms and medical history and performs a physical examination. The doctor may order x-rays of the stomach and small intestine. […] The doctor may perform blood, breath, or stool tests if the type of bacteria that causes peptic ulcer disease is suspected as the cause of indigestion. […] The doctor may perform an upper endoscopy. After giving a sedative to help the person become drowsy, the doctor passes an endoscopea long, thin tube that has a light and small camera on the endthrough the mouth and gently guides it down the esophagus into the stomach. The doctor can look at the esophagus and stomach with the endoscope to check for any abnormalities. The doctor may perform biopsiesremoving small pieces of tissue for examination with a microscopeto look for possible damage from GERD or an infection.

• #17 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Tests-for-Indigestion-(Dyspepsia).aspx

  An upper GI tract biopsy is sometimes also done during endoscopy, in which a small piece of tissue from the inner lining of the abdomen or stomach is removed and tested for digestive tract diseases, including H. pylori infection. […] If biopsy samples are collected, bacteria on the sample are firstly separated from the tissue and cultured, with H. pylori nucleic acids amplified using RT-PCR and identified by assay. […] The presence of H. pylori bacteria can also be confirmed in the stool, usually by enzyme immunoassay (EIA) or immunochromatography (ICA). […] The immune response to H. pylori infection can also be detected in the blood by elevated IgG and IgA antibodies, which can be detected by various serological tests, largely enzyme immunoassay.

• #18 Indigestion Symptoms: When To See A Doctor

  https://www.gastroconsa.com/indigestion-symptoms-when-to-see-a-doctor/

  To determine the cause of your indigestion, your doctor may recommend some tests, such as: Blood tests to check for infection or inflammation, Stool tests to check for infection or blood in the stool, Upper endoscopy to examine the esophagus, stomach, and upper small intestine, Abdominal ultrasound or CT scan to look for abnormalities in the digestive system, Gastric emptying study to evaluate the movement of food through the stomach. […] If you experience severe or frequent symptoms or any of the warning signs mentioned above, it’s time to schedule an appointment with a gastroenterologist. They can help you by diagnosing the underlying cause of your indigestion and recommend appropriate treatment.

• #19

  https://umiamihealth.org/en/treatments-and-services/gastrointestinal/indigestion

  Your GI doctor may order an upper endoscopy to confirm the diagnosis of indigestion. […] Your GI doctor may order an ultrasound of your gallbladder to confirm the diagnosis of indigestion. […] Your GI doctor may order a stomach emptying scan to confirm the diagnosis of indigestion. […] If an underlying disease is causing your indigestion, your GI doctor will prescribe medication to treat that disease. […] You may need to make changes to your diet, including eating several, small meals throughout the day, eating more slowly, and limiting spicy, fatty, greasy, or high-fiber foods. […] If you smoke, you should quit smoking and be sure you get enough sleep.

• #20 Diagnosing Gastroesophageal Reflux Disease | NYU Langone Health

  https://nyulangone.org/conditions/gastroesophageal-reflux-disease/diagnosis

  The Bravo pH monitoring system allows your doctor to measure the pH, or acidity, levels in your esophagus for 48 to 96 hours. […] Manometry testing assesses the pressure in and movement of the esophagus, so that doctors can determine how well food and liquids move from the mouth to the stomach and whether problems with muscles or nerves in the esophagus may be the cause of GERD. […] A barium swallow test, also called an upper GI series, is an X-ray test to examine the upper digestive tract. […] Using the results of diagnostic tests, NYU Langone doctors determine the best course of treatment, with the goal of reducing reflux, alleviating discomfort, healing irritation of the esophagus, and preventing progression to a more serious condition, such as Barretts esophagus.

• #21 GERD Diagnosis: Diagnosing Gastroesophageal Reflux Disease | Cooper University Health Care

  https://www.cooperhealth.org/services/gastroesophageal-reflux-disease-gerd/diagnosis

  Although an upper endoscopy is the most common diagnostic test for GERD, other diagnostic tests may be appropriate based on your unique circumstances, including: […] Blood tests are not an appropriate diagnostic test because GERD is not caused by a virus or bacteria. […] Upper endoscopy is the primary test used to diagnose GERD and requires sedation. […] High-resolution esophageal manometry is used to detect motility disorders of the esophagus and is often used to determine if there are problems with the way food moves from the esophagus to the stomach. […] In general, pH testing assesses the level of acid and non-acid reflux in the esophagus. […] A wireless esophageal pH test also called a Bravo test is a minimally invasive procedure that measures the level of acidity (pH level) in the esophagus. […] During a transnasal esophagoscopy (TNE), a thin, flexible tube is inserted into the nose, down through the esophagus and into the stomach.

• #22 Evaluation of dyspepsia – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/769

  Functional dyspepsia (sometimes called nonulcer dyspepsia) refers to a situation where investigations have not revealed a potential cause for the dyspepsia. It is generally reserved for patients with a normal endoscopy whose symptoms do not suggest GERD. […] The American College of Gastroenterology recommends that a diagnosis of nonerosive reflux disease should only be made if endoscopy is performed with the patient off proton pump inhibitors. […] The Rome IV classification subdivides functional dyspepsia into 3 categories: Postprandial distress syndrome (PDS), which is characterized by meal-induced dyspeptic symptoms, such as discomfort, pain, nausea, and fullness; Epigastric pain syndrome (EPS), which refers to epigastric pain, or epigastric burning, that does not occur exclusively postprandially, can occur during fasting, and can even be improved by meal ingestion; Overlapping PDS and EPS, which is characterized by meal-induced dyspeptic symptoms and epigastric pain or burning.

• #22 Evaluation of dyspepsia – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/769

  Dyspepsia is a symptom or a combination of symptoms that alerts a clinician to the presence of an upper gastrointestinal (UGI) problem. Typical symptoms include epigastric pain or burning, early satiety and postprandial fullness, belching, bloating, nausea, or discomfort in the upper abdomen. […] Clinicians using symptom-based assessment of UGI symptoms need to be aware of the diagnostic uncertainty inherent in this approach. These assessments can provide functional working diagnoses, but there is always a danger of misclassification. An important consequence of the inability to make a definitive diagnosis based on symptoms alone is an over-diagnosis of GERD and the under-recognition of Helicobacter pylori-related disease. […] The American College of Gastroenterology and the Canadian Association of Gastroenterology have published joint guidelines for the management of dyspepsia. The operational definition for dyspepsia used in the guideline is predominant epigastric pain. The authors recognize that patients may present with nausea, vomiting, or fullness but, providing that the patients primary concern is epigastric pain, they should be managed as patients with dyspepsia.

• #23 Functional Dyspepsia: Definition, Causes, Symptoms, Diagnosis, More

  https://www.healthline.com/health/functional-dyspepsia

  Functional dyspepsia (FD) is a chronic digestive condition that includes feelings of prolonged indigestion without a clear structural cause. […] Dyspepsia is the medical term for indigestion. When you experience symptoms of continuous indigestion without any structural abnormalities in the upper digestive area, healthcare professionals typically refer to your condition as functional dyspepsia. […] For a doctor to diagnose you with FD, you will generally have to experience symptoms for 3 months or longer. Your symptoms may come and go over time. […] A doctor may consider a diagnosis of FD after assessing your symptoms and medical history. Long-term feelings of early fullness when eating and prolonged fullness following meals, in addition to upper abdominal discomfort, may be enough for a doctor to diagnose FD.

• #23 Functional Dyspepsia: Definition, Causes, Symptoms, Diagnosis, More

  https://www.healthline.com/health/functional-dyspepsia

  The tests a doctor may order include: endoscopy, esophageal pH monitoring, blood tests, blood, stool, or breath tests for h. pylori bacteria, gastric emptying study. […] There is not one specific treatment for functional dyspepsia. Doctors may determine a potential underlying or contributing cause that they can treat, such as regulating the acid your stomach produces during digestion or helping your stomach empty food faster. Otherwise, treatment may focus on relieving your symptoms. […] Your doctor may recommend the following medications to help with FD symptoms: acid-blocking medications called proton pump inhibitors or H2 receptor blockers, antidepressants such as amitriptyline, which may support your digestive function, stomach-emptying medications such as metoclopramide, antibiotics, if you have the H. pylori bacteria in your body or your doctor suspects SIBO.

• #23 Functional Dyspepsia: Definition, Causes, Symptoms, Diagnosis, More

  https://www.healthline.com/health/functional-dyspepsia

  Psychological interventions may be beneficial in treating those with FD, according to a 2021 review. Interventions may include: cognitive behavioral therapy, psychotherapy, hypnotherapy, according to a 2019 review. […] Assessing your diet can be an important first step in managing FD. Factors like what, when, or how you eat may contribute to your symptoms. In some instances, dietary changes can provide long-term relief. […] FD occurs in each person differently. Symptoms can vary, and a doctor may order multiple tests to confirm a diagnosis or rule out potential contributing causes.

• #24 Assessment of dyspepsia – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/769

  A technical review from the American Gastroenterological Association for the evaluation of dyspepsia excludes patients with symptoms that suggest GORD, and includes only those with the typical symptoms. […] GORD and dyspepsia are related and may overlap. There is no gold standard for the diagnosis of GORD. The diagnosis is based on a combination of symptom presentation, endoscopic assessment of oesophageal mucosa, reflux monitoring, and response to therapeutic intervention. […] The extent or severity of the patient’s dyspepsia is measured by the patient’s report of the impact of symptoms on quality of life and function. The patient’s assessment of the severity of dyspepsia usually relates to the degree to which it affects work, sleep, diet, or leisure.

• #25 Indigestion – Guts UK

  https://gutscharity.org.uk/advice-and-information/symptoms/indigestion/

  The most common investigation for those suffering with indigestion is an upper gastrointestinal endoscopy (known as gastroscopy for short), which is done as a day case procedure in hospital. […] Treatment usually starts by looking for causes that can be remedied such as simple lifestyle changes. […] Some patients with indigestion can control their symptoms by taking over-the counter antacid tablets or liquids from the pharmacist. […] Many patients with indigestion find that their symptoms improve either through self-help or after they have been investigated and treated by their GP. […] For people who have longer-term indigestion associated with stress or anxiety, this can be treated by addressing the stress by seeking a referral to a psychologist for cognitive behavioural therapy or hypnotherapy.

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