Nonulcer Stomach Pain

Nonulcer stomach pain, also known as functional dyspepsia or nonnuclear dyspepsia is a common condition which can be long lasting.

This term used to describe signs and symptoms of indigestion that have no obvious cause.

The signs and symptoms of this condition are similar to those of ulcers, such as pain or discomfort in the upper part of the abdomen, often accompanied by bloating, belching and nausea.

The signs and symptoms of nonulcer stomach pain may include:

• A burning sensation or discomfort in the upper part of the abdomen or lower chest which is sometimes relieved by foods or antacids
• Bloating
• Belching
• An early feeling of fullness when eating
• Nausea

In most cases the cause of nonulcer stomach pain is not clear. It is considered as a functional disorder, which means it's not necessarily caused by a specific disease.

Part of a physical exam and medical history, doctors may also carry out a number of diagnostic tests for nonulcer stomach pain which may include:

• Blood tests to help rule out other causes of signs and symptoms similar to those in nonulcer stomach pain.
• Tests to check for the presence of Helicobacter pylori (H. pylori) that is associated with a gastric ulcer. H. pylori testing may use blood, stool or breath.
• Endoscopy, a test in which a thin, flexible, lighted instrument (endoscope) is passed through the throat to help doctors to view the esophagus, stomach and first part of the intestines (duodenum).

Treatment is usually required for long-lasting cases of nonulcer stomach pain that do not respond to lifestyle changes. The type of treatment depends on the signs and symptoms of a patient.        

Medications that can be used in the treatment of nonulcer stomach pain include:      

• Over-the-counter simethicone- containing remedies, such as Mylanta and Gas-X, which may provide relief by reducing gas.
• H2 receptor blockers, such as cometidine (Tagamet HB), famotidine (Pepcid AC), nizatidine ( Axid AR) and ranitidine (Zantac 75) which reduce acid production.                                                  
• Proton pump inhibitors (PPI's), such as lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC),  which reduce acid production.    
• Prokinetics, which help the stomach to empty slowly and may help to tighten the valve between the esophagus and the stomach.
• Low-dose tricyclic antidepressants to inhibit the activity of neurons that cause intestinal pain.
• Antibiotics if tests indicate a patient has H. pylori in the stomach.

Behavioral therapy which involves a patient talking to a therapist and practising relaxation techniques can help to reduce stress and thus relieve some symptoms of nonulcer stomach pain.                                                                                                                                                                                                                                                           

Alternative remedies for nonulcer stomach pain include:

• Herbal supplements which may include a combination of peppermint and caraway oil. These supplements may relieve fullness and gastrointestinal spasms. Artichoke leaf extract may also reduce symptoms of nonulcer stomach pain including vomiting, nausea, and abdominal pain.
• Relaxation techniques such as meditation and yoga which can help to reduce stress. It is important to note that none of these treatments have been shown to cure nonulcer stomach pain.

Lifestyle changes that can relieve symptoms of nonulcer stomach pain include the following:

• Eating smaller, more frequent meals and chewing slowly and thoroughly.
• Avoiding foods that can trigger nonulcer stomach pain , such as fatty and spicy foods, caffeine, chocolate and carbonated beverages.
• Avoiding certain drugs, such as pain killers which may irritate the stomach lining.
• Reducing stress by spending time doing sports or hobbies and through yoga or meditation.

The risk factors for nonulcer stomach pain include:

• Excessive intake of alcohol or caffeinated beverages
• Smoking
• Taking certain medications, such as over-the-counter pain relievers including aspirin and ibuprofen (Advil, Motrin IB) which may irritate the stomach