Research Into Dyspepsia : Help Sought for the Sufferers of Indigestion

Almost everyone suffers from it at some time--that bloated feeling, or the kind of uncomfortable sensation that comes from overeating or indulging in too much greasy food. Sometimes it’s accompanied by nausea and often it’s over in a matter of hours.

What everyone knows as indigestion has been treated light-heartedly in numerous television commercials. But chronic indigestion can be a far more serious signal of other digestive diseases, ranging from a peptic ulcer to irritable bowel syndrome.

Researchers now are especially interested in a type of severe indigestion that seems to occur for no particular reason, lasts for three or more days, disrupts lives and results in lost work time.

Many Try Surgery

“Many unnecessary operations are performed to relieve the painful symptoms of this unknown indigestion,” says Dr. William Y. Chey, director of the Isaac Gorden Center for Digestive Diseases and Nutrition in Rochester, N.Y. Yet despite the surgery, “many patients continue to suffer from the symptoms,” says Chey, who is a leader in the study of this form of indigestion.

Indigestion--or dyspepsia, as it is referred to medically--affects people in a variety of ways. Most sufferers get it from eating or drinking too much, but people who have a deficiency of the enzyme lactase get indigestion when they consume milk or milk products. Without enough lactase, they are unable to properly digest the sugar lactose in milk. As a result, the sugar ferments in their digestive tract and causes painful gas.

Indigestion can also accompany other diseases, including stomach flu, gastritis or inflammation of the stomach lining, diseases of the gall bladder and the pancreas, and irritable bowel syndrome or spastic colon. Often it’s associated with a peptic ulcer.

Then there is the type of indigestion for which there is no apparent cause. Tests of the gastro-intestinal tract show nothing wrong, yet the condition persists, causing great discomfort.

Affected by Hormones

Among the most common sufferers of chronic dyspepsia are women, particularly those of childbearing age. Researchers say this may be related to the presence of estrogen in women, a hormone that helps regulate the menstrual cycle.

“Too often dyspepsia has been dismissed as a psychosomatic disease,” Chey says in a fact sheet for the Digestive Diseases Clearinghouse, a service of the National Institutes of Health. “However in recent years, doctors have begun to recognize that dyspepsia is often the result of a malfunctioning of the nervous system or the muscular activity of the stomach or small intestine.”

Chey says: “I tell people, ‘Look, you have this problem. This is not in your head. This can be managed through proper diet.’ Over 80% of the patients do very well.”

When tests have ruled out other digestive diseases, specialists recommend the following to help control chronic indigestion:

--Avoid greasy foods.

--Eliminate milk and milk products for those with a lactose condition.

--Switch to soft foods and, if necessary, to liquids when symptoms become particularly severe. A day or two of this regimen usually helps. So does eating five or six small meals during the day instead of three larger meals.

New Treatments Expected

Promising drugs are being developed that facilitate the emptying of food through the intestine, says Dr. Lawrence Johnson, chief of gastroenterology at the Army’s Walter Reed Hospital in Washington. “I think within the next five years that we will have a whole host of new treatments for chronic dyspepsia,” he says.

Future treatment also may focus on the use of special pacemakers for the stomach and intestine, similar to those that are implanted in the heart.

More information on dyspepsia and other digestive diseases is available free from the Digestive Diseases Clearinghouse, a service of the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases. Write to the clearinghouse at 1555 Wilson Blvd., Suite 600, Rosslyn, Va. 22209.