IndigestionIndigestion (dispepsia) adalah perasaan samar ketidaknyamanan di perut bagian atas atau abdomen selama atau setelah makan. Hal ini dapat meliputi:

Perasaan panas, terbakar, atau sakit di daerah antara pusar dan bagian bawah tulang rusuk Sebuah perasaan penuh yang mengganggu dan terjadi segera setelah makan dimulai atau

ketika selesai

Kembung atau mual adalah gejala yang kurang umum.

Indigestion TIDAK sama dengan heartburn.

Pertimbangan

Indigestion biasanya bukan pertanda dari masalah kesehatan yang lebih serius, kecuali gejala lain juga terjadi, seperti penurunan berat badan atau kesulitan menelan.

Indigestion adalah masalah umum.

Walau jarang, ketidaknyamanan akibat serangan jantung sering keliru dengan indigestion.

Penyebab

indigestion dapat dipicu oleh:

Minum terlalu banyak alkohol Makan pedas, makanan berlemak, atau berminyak Makan (makan berlebihan) terlalu banyak Makan terlalu cepat Emosional stres atau gugup Makanan tinggi serat Merokok Terlalu banyak kafein

Penyebab lain indigestion adalah:

Batu empedu Gastritis (ketika lapisan perut menjadi meradang atau bengkak) Pembengkakan pankreas (pankreatitis) Ulkus (perut atau tukak usus) Penggunaan obat-obatan tertentu seperti antibiotik, aspirin, dan obat anti-inflammatory drugs

(NSAIDs)

Perawatan di rumah

Mengubah cara anda makan dapat meredakan gejala.

Sediakan waktu yang cukup untuk makan. Kunyah makanan dengan hati-hati dan benar-benar. Hindari berbicara saat makan. Hindari excitement atau beraktivitas setelah makan. Lingkungan yang tenang dan beristirahat dapat membantu meringankan stres yang

berhubungan dengan indigestion.

Hindari aspirin dan NSAID lainnya. Jika memang harus meminumnya, lakukan saat perut terisi.

Antasida dapat meredakan gangguan pencernaan.

Test yang dapat mendukung diagnosis

Abdominal ultrasound Blood tests (depending on the suspected cause)

Esophagogastroduodenoscopy  (EGD )

Upper GI and small bowel series

Alternative Names

Dyspepsia; Uncomfortable fullness after meals

Dyspepsia is a chronic or recurrent burning discomfort or pain in the upper abdomen that maybe caused by diverse processes such as gastroesophageal reflux, peptic ulcer disease, and “nonulcer dyspepsia,” a heterogeneous category that includes disorders of motility, sensation, and somatization. Gastric and esophageal malignancies are less common causes of dyspepsia. Careful historytaking allows accurate differential diagnosis of dyspepsia in only about half of patients. In the remainder, endoscopycan be a useful diagnostic tool, especiallyin those patients whose symptoms are not resolved by an empirical trial of symptomatic treatment.

INDIGESTION

MECHANISMS The most common causes of indigestion are gastroesophageal acid reflux and functional dyspepsia. Other cases are a consequence of a more serious organic illness.

Gastroesophageal Acid Reflux Acid reflux can result from a variety of physiologic defects. Reduced lower esophageal sphincter (LES) tone is an important cause of reflux in scleroderma and pregnancy and may also be a factor in patients without other systemic conditions. Many individuals show frequent transient LES relaxations, during which acid bathes the esophagus. Overeating and aerophagia can transiently override the barrier function of the LES, whereas impaired esophageal body motility and reduced salivary secretion prolong acid exposure. The role of hiatal hernias is controversial—although most reflux patients exhibit hiatal hernias, most individuals with hiatal hernias do not have excess heartburn.

Gastric Motor Dysfunction Disturbed gastric motility is purported to cause acid reflux in some cases of indigestion. Delayed gastric emptying also is found in 25 to 50% of functional dyspeptics. The relation of these defects to symptom induction is uncertain; many studies show poor correlation between symptom severity and the degree of motor dysfunction. Abnormal gastric fundic relaxation after eating may cause selected dyspeptic symptoms such as bloating, fullness, nausea, and early satiety. A current focus of investigation is developing drugs that enhance fundic relaxation.

Visceral Afferent Hypersensitivity Disturbed gastric sensory function may also cause functional dyspepsia. Visceral afferent hypersensitivity was first demonstrated in patients with irritable bowel syndrome who had heightened perception of rectal balloon inflation without changes in rectal compliance. Patients with dyspepsia may experience discomfort with fundic distention to lower pressures than healthy control subjects.

Other Factors Helicobacter pylori has a clear etiologic role in peptic ulcer disease, but ulcers cause only a minority of cases of dyspepsia. The importance of H. pylori in the genesis of functional dyspepsia is controversial, but most investigators believe it is of minor importance. In contrast, functional dyspepsia is associated with a reduced sense of physical and mental well-being and is exacerbated by stress, suggesting an important role for psychological factors. Analgesics cause dyspepsia; nitrates, calcium channel blockers, theophylline, and progesterone promote acid reflux. Other exogenous factors that induce acid reflux include ethanol, tobacco, and caffeine via LES relaxation. Genetic factors may contribute to development of acid reflux.

DIFFERENTIAL DIAGNOSIS _ Gastroesophageal Reflux Disease Gastroesophageal reflux disease (GERD) is prevalent in Western society. Heartburn is reported once monthly by 40% of Americans

and daily by 7 to 10%. Most cases of heartburn occur because of excess acid reflux; however, some patients exhibit heightened sensitivity to normal amounts of acid exposure.

Functional Dyspepsia Functional dyspepsia, defined as _3 months of dyspepsia without an organic cause, is also common. Nearly 25% of the populace has abdominal discomfort at least six times yearly, but only 10 to 20% consult physicians. Functional dyspepsia accounts for 60% of cases of dyspepsia. Most patients with functional dyspepsia follow a benign course, but a small number with H. pylori infection or on nonsteroidal anti-inflammatory drugs (NSAIDs) progress to ulcer formation. As with idiopathic gastroparesis, some cases of functional dyspepsia appear to result from prior gastrointestinal infection.