Nonulcer Dyspepsia

Abstract

Dyspepsia defies accurate definition and yet has been part of our language for centuries. It is a syndrome often related to eating that includes epigastric pain, discomfort, bloating, and fullness. The epigastrium is the area below the breastbone often referred to as “the pit of the stomach.” Many individuals with dyspepsia may complain of gas, nausea, vomiting, and heartburn, and some may even choose to call their symptoms “indigestion.” Athough dyspepsia has many qualifying terms, such as “acid,” “nervous,” “functional,” and “essential,” they tell us little about the patient’s complaint or its cause. Ovarian, gallbladder, and appendiceal dyspepsia are meaningless terms. The only consistent features of dyspepsia are its location in the epigastrium and its chronicity, periodicity, and relationship to eating, which leads the doctor to suspect a peptic ulcer. Nonulcer dyspepsia (NUD) then is a functional gastrointestinal disorder featured by chronic, recurrent, often meal-related, epigastric discomfort that is initially suspected to be due to a peptic ulcer but subsequently found not to be.

How are we to explain this . . . disease that is not; this wealth of balsams for sufferings which cannot be named? Is there no distress to lull, no pain to lenify?

T. C. Allbutt (1884)