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This is a vague problem that is functional in nature and usually not due to an underlying structural cause. Belching, distension and abdominal sounds often occur in association with abdominal or epigastric pain. Dietary factors are often important in reducing symptoms; because similar symptoms may be due to more serious conditions, it is important to have an accurate diagnosis.
The upper GI tract consists of the organs where food is initially taken into the body and digestion begins, including the esophagus, stomach, pylorus and duodenum. Numerous conditions are possible in this area, some of which are: - Cardiospasm: Dilation of the esophagus due to the gastroesophageal sphincter failing to open properly and allow food into the stomach.
- Gastroesophageal Reflux Disease (GERD): Incompetent cardiac sphincter, causing backward flow of acid from the stomach up into the esophagus.
- Gastric Mucosal Tears: Lacerations in the mucosa of the gastroesophageal junction, where the esophagus passes through the diaphragm, or in the lining of the lower esophagus. Generally caused by repeated vomiting or retching (repetitive contractions of the abdominal muscles), it can cause profuse hemorrhaging.
- Esophageal Stricture: Narrowing of the esophagus due to scar tissue, resulting in difficulty swallowing.
- Esophageal Obstruction: Blockage of the esophagus caused by tumors or other foreign bodies such as improperly chewed food (often large pieces of meat) impacted in the lower esophagus.
- Esophageal Varices: Enlarged veins in the lower esophagus are a common complication of liver cirrhosis. If these veins rupture, massive bleeding may result.
- Hiatal Hernia: Movement of the upper part of the stomach up into the chest cavity resulting in retention of acid and other stomach contents which can then easily reflux into the lower esophagus.
- Dumping Syndrome: Rapid gastric emptying caused by the lower end of the small intestine (jejunum) filling too quickly with undigested food from the stomach. Symptoms include nausea, vomiting, diarrhea, bloating, shortness of breath, weakness, and dizziness. Stomach surgery is the main cause.
- Hypochlorhydria and achlorhydria: Insufficient stomach acid to sterilize the stomach and start protein digestion.
- Menetrier's Disease: A chronic condition with an unknown cause. Giant folds of tissue, possibly inflamed or containing ulcers, grow in the wall of the stomach and can interfere with the body's absorption of some proteins.
- Whipple's Disease: A malabsorption disease caused by bacteria. Although it can affect any system of the body, it usually attacks the small intestine. It interferes with the body's ability to absorb certain nutrients, causing weight loss, irregular breakdown of carbohydrates and fats, resistance to insulin, and malfunctions of the immune system. The disease can be cured, but if not recognized, it is usually fatal.
- Zollinger-Ellison Syndrome: Another disease of unknown cause leading to gastrin-secreting tumors in the pancreas, which promote an extreme form of peptic ulcer disease in both the stomach and duodenum.
- Peptic Ulcer Disease (PUD): Over 20 million Americans will suffer from a peptic ulcer in their lifetime.
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Signs, symptoms & indicators of Dyspepsia / Poor Digestion:
Conditions that suggest Dyspepsia / Poor Digestion: | | | | | Circulation |  Anemia (Iron deficiency) |
Digestion |
 Constipation
Lactose Intolerance |
Infections |
Blastocystosis (Blastocystis hominis) | In a person with weakened digestion or weakened immune response, blastocystis can produce a host of symptoms which appear to come and go and are very unpredictable. |
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Metabolic |
Bulimic Tendency |
Skin-Hair-Nails |
Psoriasis| | Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in elevated levels of amino acids and polypeptides in the bowel. These are metabolized by bowel bacteria into several toxic compounds. The toxic metabolites of the amino acids arginine and ornithine are known as polyamines (e.g., putrescine, spermidine, and cadaverine) and have been shown to be increased in individuals with psoriasis. Polyamines contribute to the excessive rate of cell proliferation. Lowered skin and urinary levels of polyamines are associated with clinical improvement in psoriasis, so digestive function should be evaluated. |
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Risk factors for Dyspepsia / Poor Digestion: | | | | | Circulation | Coronary Disease / Heart Attack |
Diet |
Dehydration |
Digestion |
Heartburn / GERD / Acid Reflux |
Environment / Toxicity |
Fluoride Toxicity| | Studies have shown that ingested fluoride damages gastroduodenal mucosa. Gastrointestinal discomfort can be an early warning sign of fluorosis, so fluoride toxicity should be considered a possible reason for non-ulcer dyspepsia and gastrointestinal discomfort in the form of dyspeptic symptoms should be an important diagnostic feature when identifying fluorosis patients and should not be dismissed as non-specific. [Susheela AK, Das TK, Gupta IP, Tandon RK, Kacker SK, Ghosh P, and Deka, Fluoride ingestion and its correlation with gastrointestinal discomfort, Fluoride, 1992, 25:l, pp.5-22]
The gastro-intestinal system is one of the most sensitive systems in the body to react adversely to fluoride toxicity. There are now many case histories available to establish the correlation of fluoride toxicity to gastro-intestinal problems. |
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Organ Health |
Gallbladder Disease |
Symptoms - Food - Preferences |
(Partial) vegetarian diet or vegan/raw food diet |
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Dyspepsia / Poor Digestion can lead to: | | | | | Infections | Blastocystosis (Blastocystis hominis)| | In a person with weakened digestion or weakened immune response, blastocystis can produce a host of symptoms which appear to come and go and are very unpredictable. |
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Skin-Hair-Nails |
Psoriasis| | Incomplete protein digestion or poor intestinal absorption of protein breakdown products can result in elevated levels of amino acids and polypeptides in the bowel. These are metabolized by bowel bacteria into several toxic compounds. The toxic metabolites of the amino acids arginine and ornithine are known as polyamines (e.g., putrescine, spermidine, and cadaverine) and have been shown to be increased in individuals with psoriasis. Polyamines contribute to the excessive rate of cell proliferation. Lowered skin and urinary levels of polyamines are associated with clinical improvement in psoriasis, so digestive function should be evaluated. |
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Recommendations and treatments for Dyspepsia / Poor Digestion: | | | | | Botanical |  Cayenne Pepper| | Although a few sources have recommended cayenne pepper as a potential treatment for dyspepsia, gastritis and even peptic ulcers, most modern herbal texts suggest avoiding the herb for persons with these conditions. A small clinical trial suggests that cayenne may be beneficial in some persons with functional dyspepsia. Approximately 850mg of cayenne powder in a capsule was given 3 times per day just before meals (0.7mg capsaicin per gram). [NEJM 2002;346: pp.947-48] |
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Diet |
 Therapeutic Fasting| | Fasting gives the digestive system a much-needed rest. After fasting, both digestion and elimination are invigorated. |
 Reduced Water Consumption| | Although dyspepsia is a sign of dehydration, it is generally recommended that you do not drink during a substantial meal, or from 1/2 hour before to 2 hours afterwards. |
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Digestion |
Hydrochloric Acid (Trial)| | Upper digestive symptoms are often due to hydrochloric acid (HCl) or pancreatic insufficiency and it can be difficult to distinguish between the two. The easiest way to find out is to do both an HCl and digestive enzyme trial, one at a time. Often a doctor's assistance is helpful in conducting these trials. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Achlorhydria
The complete absence or failure of stomach acid secretion.
Amino Acid (Amino Acids)
An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.
Arginine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. May promote the release of growth hormone. Involved in creatine synthesis, a compound that stores energy in muscle. Helps to remove ammonia from the body as part of the urea cycle.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Carbohydrates (Carbohydrate)
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Cardiac
Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.
Cardiospasm
A condition where the cardiac (gastroesophageal) sphincter fails to open properly and food cannot pass normally into the stomach. As a consequence the smooth muscle in the wall of the esophagus must contract more vigorously to force the food past the constricted sphincter. Eventually the muscle undergoes hypertrophy and the esophagus becomes dilated adjacent to the constricted sphincter because of retention of food.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Diaphragm
The thin muscle under the lungs and heart that separates the chest from the stomach/abdomen.
Diarrhea
Excessive discharge of contents of bowel.
Duodenum (Duodenal)
First portion of the small intestine between the pylorus and jejunum, connecting to the stomach.
Dyspepsia
Indigestion / poor digestion, usually with heartburn and/or regurgitation of stomach acids.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Epigastric
Relating to the area immediately above the stomach.
Esophagus (Esophageal)
Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.
Gastric
Of, relating to, or associated with the stomach.
Gastric Reflux Disease (Gastric Reflux, Gastroesophageal Reflux, Gastro-Esophageal Reflux Disease, GERD)
A common relapsing condition affecting approximately 10% of the U.S. population and caused by an abnormal exposure of the lower esophagus to refluxed gastric contents, causing irritation and injury to the esophageal tissues. GERD develops as a result of relaxations of the transient lower esophageal sphincter. Typical presenting symptoms are heartburn, an epigastric burning sensation and acid regurgitation. However, some patients may present with atypical symptoms such as chest pain, shortness of breath, wheezing, and coughing.
Gastritis
Inflammation of the stomach lining. White blood cells move into the wall of the stomach as a response to some type of injury; this does not mean that there is an ulcer or cancer - it is simply inflammation, either acute or chronic. Symptoms depend on how acute it is and how long it has been present. In the acute phase, there may be pain in the upper abdomen, nausea and vomiting. In the chronic phase, the pain may be dull and there may be loss of appetite with a feeling of fullness after only a few bites of food. Very often, there are no symptoms at all. If the pain is severe, there may be an ulcer as well as gastritis.
Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Hemorrhage (Hemorrhaging)
Profuse blood flow.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hiatal Hernia (Hiatal Hernias)
Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Hydrochloric Acid (HCl)
An inorganic acidic compound, excreted by the stomach, that aids in digestion.
Hypochlorhydria (Hypochlorhydric)
The condition of having low hydrochloric acid levels in the stomach, often the cause of digestive disorders.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Insulin
A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.
Jejunum
The lower end of the small intestine.
Malabsorption
Improper utilization of needed and available nutrients, either from impaired digestive function (such as B12 being unabsorbed because of gastritis), impaired absorption (poor Vitamin E absorption because of an inflamed ileum) or impaired transport (the diminished blood proteins of the advanced alcoholic). There are other causes as well.
Metabolite (Metabolites)
Any product (foodstuff, intermediate, waste product) of metabolism.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Mucous Membranes (Mucosa, Mucous Membrane, Mucus Membranes)
The membranes, such as the mouth, nose, anus, and vagina, that line the cavities and canals of the body which communicate with the air.
Nausea
Symptoms resulting from an inclination to vomit.
Ornithine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. Manufactured from arginine and functions similarly to arginine, it stimulates the human growth hormone and is made by the digestion of proteins and some compounds made from arginine. The major difference between the two is that ornithine enters cell mitochondria. Arginine does not.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Peptic Ulcer (Duodenal Ulcer, Duodenal Ulcers, Gastric Ulcer, Gastric Ulcers, Peptic Ulcers)
A general term for gastric ulcers (stomach) and duodenal ulcers (duodenum), open sores in the stomach or duodenum caused by digestive juices and stomach acid. Most ulcers are no larger than a pencil eraser, but they can cause tremendous discomfort and pain. They occur most frequently in the 60 to 70 age group, and slightly more often in men than in women. Doctors now know that there are two major causes of ulcers: most often patients are infected with the bacteria Helicobacter pylori (H. pylori); others are regular users of non-steroidal anti-inflammatory drugs (NSAIDS), which include common products like aspirin and ibuprofen.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Psoriasis
An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.
Pylorus
The sphincter muscle at the distal (lower) opening of the stomach. The pylorus only allows food to pass through after the digestive enzymes of the stomach have properly processed it. Once through the pylorus on its way to the duodenum, the food is still only partially digested.
Scar Tissue
Fibrous tissue replacing normal tissues destroyed by injury or disease.
Small Intestine (Small Bowel)
The small intestine lies between the stomach and the large intestine. It is about 6 meters (20 feet) long and its primary function is to digest (break down) food and absorb nutrients (vitamins, minerals, proteins, carbohydrates, and fats). The small intestine makes up more than 70% of the length and 90% of the surface area of the gastrointestinal (GI) tract.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Stricture
An abnormal narrowing of a bodily passage caused by, for example, scar tissue.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Ulcer (Ulceration, Ulcers)
Lesion on the skin or mucous membrane.
Last updated: May 11, 2008
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