Dyspepsia history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ajay Gade MD[2]]

The history and symptoms of dyspepsia are pain or a burning feeling in the upper portion of the stomach, nausea, bloating, sometimes uncontrollable burping, heartburn, fever, metallic taste, rumbling in the stomach, sense of fullness after eating, feeling as though something is lodged in the esophagus, pain and discomfort at the xiphoid region, sudden chills, comparable to those felt during fevers.

Obtaining the history is the most important aspect of making a diagnosis of dyspepsia. It provides insight into the cause, precipitating factors and associated comorbid conditions.

• A history of epigastric pain, dyspepsia, or prior peptic ulcer may suggest the diagnosis of dyspepsia.^[1][2][3]

• Prior use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) is important because these patients have an increased risk of gastric ulcer and a fourfold risk of significant GI bleeding compared with other patients^[4]

• Helicobacter pylori infection is more common in low socioeconomic status and increased number of siblings^[5]
• Alcoholics also frequently have peptic ulcers or gastritis^[6][4]
• Cigarette smokers have a significantly higher rate of the recurrent duodenal ulcer as compared with nonsmokers ^[7][8]

• Family history of dyspepsia increases the risk of peptic ulcer
• History of dyspepsia in mother increases the risk of dyspepsia in children

• The majority of patients with the dyspepsia are symptomatic but some people do not show any symptoms (silent ulcer).
• The hallmark of dyspepsia:
  • Episodic gnawing or burning epigastric pain which occurs one to five hours after meals or on an empty stomach
  • Nocturnal pain relieved by food intake, antacids, or antisecretory agents^[2]
  • Chronic use of NSAIDs

Common symptoms of dyspepsia include:

• Episodic epigastric pain
• Heartburn
• Bloating
• Nausea and vomiting
• Waterbrash
• Indigestion
• Hematemesis
• Melena
• Loss of appetite

Less common symptoms of dyspepsia include:

• Intolerance to fatty food

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