Epidemiology and Etiology

Although the most common, peptic ulcer is hardly the only organic source of dyspepsia. Esophagitis; hiatus hernia; gastritis; carcinoma of the stomach, colon, or pancreas; Crohn's disease; disease of the biliary tract; chronic nephritis; or any of several other conditions, including pregnancy, can produce indigestion. In approximately half of the cases of dyspepsia, however, no lesion can be found, and symptoms arise from derangements of motor, secretory, or absorptive functions, especially delayed gastric motility, esophageal reflux, and hyperacidity. This functional indigestion has been related to physical stress (aerophagia, fatigue, dietary indiscretion) and, more commonly, to nervous stress. Anxiety, anger, frustration, and other indications of emotional turmoil can significantly impair digestive function in sensitive or tense individuals (a similar psychic component - chronic tension and repression of emotion - has been implicated in peptic ulcer). Because the symptoms of functional dyspepsia are virtually identical to those of peptic ulceration, the condition has also been termed X-ray negative dyspepsia and nonulcerative dyspepsia; the term endoscopy-negative dyspepsia has been proposed as well in recent years.

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