I think many of you have experienced pain, burning in the upper abdomen, or a feeling of fullness after meals. Usually, the next step is a gastroscopy, and sometimes erosions are found in the stomach. As a result, this condition is most often interpreted as a “gastritis flare-up.” But is that really the case? The anatomy of our stomach is such that the mucosal layer does not have pain receptors (special structures that perceive pain). This means that even if there is hyperemia (redness) or erosion (a superficial defect), a person physically cannot feel it.
So what actually hurts?
The muscular layer of the stomach is rich in nerve endings — and it is exactly them that transmit the full picture of discomfort.
What is functional dyspepsia?
Functional dyspepsia is a condition characterized by discomfort and pain in the upper abdomen, along with a feeling of early satiety after meals, but without structural or organic diseases of the stomach. In other words, even without visible pathology, a person can experience significant discomfort.
What should be done first?
We start with a detailed discussion of symptoms, family history, medication history, and lifestyle — collecting a full picture about your health and eating habits. Then, if there are no “red flags” (warning signs of organic disease), we check for Helicobacter pylori.
Helicobacter pylori — what is it?
This bacterium lives in the stomach, usually acquired in early childhood. It can trigger unpleasant symptoms, and its long-term presence increases the risk of gastric cancer. If detected, we discuss treatment — many patients already experience improvements at this stage.
If there is no Helicobacter pylori — then what?
Functional dyspepsia is a multifactorial condition. It usually results from a combination of:
- hypersensitivity of the nervous system
- high levels of stress (anxiety, overwork, depression)
- features of the gastric and intestinal microbiome
- immune system reactions
It is more common among smokers, overweight individuals, and people under chronic stress.
What’s next?
Do you need a strict diet? No. Modern nutrition has long moved away from prohibitions. The main approach is to identify your individual trigger foods and limit them. Most patients with dyspepsia know exactly which foods provoke their symptoms.
Medication treatment is stepwise. I stay in touch with my patients, as we re-evaluate therapy after 4–8–12 weeks.
Diagnosis and treatment of functional dyspepsia is a delicate and gradual process. Close cooperation between doctor and patient helps achieve remission, improve quality of life, and restore the “taste” and joy of eating. If you experience abdominal discomfort or unpleasant symptoms after meals, I will be glad to see you for a consultation at A CLINIC in Tbilisi!