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2.  Dyspepsia is a collective term for any symptoms
thought to originate from the upper gastrointestinal
tract.

3. MECHANISMS
Gastroesophageal Acid Reflux
Gastric Motor Dysfunction
Visceral Afferent Hypersensitivity
Other Factors

4. Gastroesophageal Acid Reflux
 Reduced lower esophageal sphincter
(LES) tone
 Frequent transient LES relaxations
 Overeating and aerophagia
 Impaired esophageal body motility
and reduced salivary secretion
 hiatal hernias

5. Gastric Motor Dysfunction
 Delayed gastric emptying
 Impaired gastric fundus relaxation
after eating

6. Visceral Afferent Hypersensitivity
 Disturbed gastric sensory function is proposed as a
pathogenic factor in functional dyspepsia.
 Individuals with functional heartburn are believed to
have heightened perception of normal esophageal pH.

7. Other Factors
 Helicobacter pylori
 Psychological factors
 Analgesics
 Nitrates, calcium channel blockers, theophylline, and
progesterone promote acid reflux.
 Exogenous stimuli that induce acid reflux include
ethanol, tobacco, and caffeine via LES relaxation
 Genetic factors

8. Causes of dyspepsia
• Peptic ulcer
disease
UPPER GI • Acute gastritis
DISORDER • Gall stones
• Motility disorders
• Functional

9. • Pancreatic
disease(cancer,chronic
OTHER GI pancreatitis)
DISORDERS
• Hepatic disease
• Colonic carcinoma

10. SYSTEMIC • Renal failure
DISEASES • Hypercalcemia

11. • NSAIDS
• Iron and potassium
DRUGS supplements
• Corticosteroids
• Digoxin

12. Other Causes
 Alcohol
 Psychological-anxiety,depression
 Alkaline reflux esophagitis
 Opportunistic fungal or viral esophageal infections
 Intolerance of other carbohydrates (e.g., fructose, sorbitol)
 Small-intestinal bacterial overgrowth
 Celiac disease, Ménétrier's disease
 Infiltrative diseases (sarcoidosis and eosinophilic
gastroenteritis)
 Mesenteric ischemia, thyroid and parathyroid disease, and
abdominal wall strain .
 CCF and Tuberculosis

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