Non-Ulcer Dyspepsia

What is non-ulcer dyspepsia?

Non-ulcer dyspepsia (NUD) is a common problem wherein patients suffer from indigestion and other symptoms suggestive of an ulcer, but no abnormality is found on investigation. For this reason, we refer to NUD as a disorder.

There are probably several different subtypes of the disorder, with some patients suffering from symptoms like an ulcer, while others have symptoms more often associated with gastroesophageal reflux disease (GERD) or slow stomach emptying (gastroparesis).

Non-ulcer dyspepsia usually affects young adults with women being affected more often than men.

What causes non-ulcer dyspepsia?

The causes of NUD are presently unknown. Some patients may have symptoms suggestive of irritable bowel syndrome (IBS) and the disorder may overlap with this condition. Helicobacter pylori infection can also be present in many patients with this condition but currently there is no good evidence that HP therapy is of any benefit.

What are the symptoms of non-ulcer dyspepsia?

• abdominal pain
• bloating
• indigestion
• nausea

There may also be symptoms of irritable bowel syndrome.

How is NUD diagnosed?

There is no specific test or investigation which will diagnose this condition and the diagnosis is usually made after ruling out other disorders such as:

• peptic ulcer disease
• gallstones
• stomach cancer

Upper endoscopy is performed for this reason and possibly an ultrasound scan of the upper abdomen to look for gallstones.

What treatments are available?

Many patients respond well to explanation and reassurance that there is no serious underlying disease present.

Steps should be taken to look for:

• anxiety
• stress
• emotional events

Psychological factors which may be contributing to the symptoms as treating these may also be helpful. General attention to diet, smoking and alcohol habits should also be addressed.

Treatment with medications has variable success. Some patients obtain relief from antacids or acid-suppressing drugs, and some patients with symptoms suggestive of a problem with stomach emptying may be helped by medications which increase emptying.

Despite treatment, the symptoms may persist for months or years before disappearing.