What is the Difference Between Functional Dyspepsia and Gastroparesis

Functional dyspepsia and gastroparesis are two upper gastrointestinal disorders. Upper gastrointestinal disorders are disorders that affect the upper GI tract, which runs from the esophagus to the stomach. Both functional dyspepsia and gastroparesis normally present common symptoms such as nausea, vomiting, fullness, and bloating.

The key difference between functional dyspepsia and gastroparesis is their cause. Functional dyspepsia is a chronic indigestion due to something wrong with the digestive process while gastroparesis is the delayed gastric emptying due to damage to a nerve called vagus nerve, which controls stomach muscles.

CONTENTS

1. Overview and Key Difference
2. What is Functional Dyspepsia 
3. What is Gastroparesis
4. Similarities – Functional Dyspepsia and Gastroparesis
5. Functional Dyspepsia vs Gastroparesis in Tabular Form
6. Summary – Functional Dyspepsia vs Gastroparesis
7. FAQ: Functional Dyspepsia and Gastroparesis

What is Functional Dyspepsia?

Functional dyspepsia is as known as the chronic indigestion. It has been estimated that 10% to 20% of people who seek medical care for their symptoms, may have functional dyspepsia. The typical symptoms of this condition are epigastric pain, bloated stomach, early satiety, heart burn, acid reflux, nausea and vomiting. It can be caused by impaired stomach emptying, food allergies, Helicobacter pylori infection, and visceral hypersensitivity.

Functional dyspepsia can be diagnosed through physical examination, blood test, upper endoscopy, breath test, and gastric emptying studies. Furthermore, the treatment options for functional dyspepsia are giving medications such as antibiotics, pump inhibitors (PPIs) and H2 receptor blockers, prokinetic agents, low-dose antidepressants, phytotherapy, acupuncture, behavioral therapy, diet changes, and lifestyle changes.

What is Gastroparesis?

Gastroparesis is a condition that affects the normal spontaneous motility of the stomach muscles. It is caused by damage to the vagus nerve and its branches by diseases like diabetes, or surgery to the stomach or small intestine. Moreover, signs and symptoms of gastroparesis include nausea, vomiting, abdominal bloating, a feeling of fullness after eating a few bites, acid reflux, vomiting indigested food eaten a few hours earlier, changes in the blood glucose levels, lack of appetite, weight loss and malnutrition.

The diagnosis of gastroparesis is made through physical examination, gastric emptying tests, upper gastrointestinal endoscopy, and ultrasound. Furthermore, treatment options for gastroparesis may include changes to diet, giving medications such as metoclopramide and erythromycin that stimulate stomach muscle movements, diphenhydramine, ondansetron, prochlorperazine to control nausea and vomiting, relamorelin a drug that speeds up gastric emptying and surgery.

Similarities Between Functional Dyspepsia and Gastroparesis

1. Functional dyspepsia and gastroparesis are two upper gastrointestinal disorders.
2. Both are non-mucosal disorders.
3. Both have similar symptoms, such as nausea, vomiting, fullness, and bloating.
4. They can be diagnosed through physical examination and imaging testing.
5. They can be treated through changes to the diet, specific medications, and therapy.

Difference Between Functional Dyspepsia and Gastroparesis

Definition

1. Functional dyspepsia is a condition that affects the normal digestion process.
2. Gastroparesis is a condition that affects the normal motility of the stomach muscles.

Peak Prevalence

1. Functional dyspepsia peaks around 20 to 30 years of age.
2. Gastroparesis peaks around 50 to 60 years of age.

Cause

1. Functional dyspepsia is caused by impaired stomach emptying (gastroparesis), food allergies, Helicobacter pylori infection, and visceral hypersensitivity.
2. Gastroparesis can be caused by diabetes, or surgery to the stomach or small intestine that causes damage to the vagus nerve.

Signs and Symptoms

1. Signs and symptoms of functional dyspepsia include pain or burning in the stomach, bloating, nausea after eating, excessive belching, early fullness when eating, stomach pain, bloody vomit, dark, tarry stools, shortness of breath, pain in the jaw, neck, arm, and unexplained weight loss.
2. Signs and symptoms of gastroparesis  include indigestion, bloated stomach, feeling full quickly, upper abdominal pain, nausea and vomiting, regurgitation, loss of appetite, acid reflux, blood sugar fluctuations, and constipation.

Diagnosis

1. Functional dyspepsia can be diagnosed by physical examination, testing that may involve stool samples, breath, or tissue samples of the stomach and endoscopy.
2. Gastroparesis can be diagnosed with physical examination, capsule endoscopy, upper GI series, CT scan, MRI, abdominal ultrasound, gastric emptying scintigraphy (GES), gastric motility breath test (GEBT), and SmartPill test.

Treatment

1. Functional dyspepsia can be treated with gas remedies (simethicone), giving medicines to reduce acid production (H2 receptor blockers and proton pump inhibitors), antibiotics, low dose antidepressants, prokinetics, medicines to relieve nausea (promethazine, prochlorperazine and meclizine).
2. Gastroparesis can be treated with drugs to stimulate stomach muscles (metoclopramide), antiemetics, controlling blood sugar levels, injecting botulinum toxin, surgery to place a feeding tube or jejunostomy tube, and gastric bypass surgery.

The following table summarizes the difference between functional dyspepsia and gastroparesis.

Summary – Functional Dyspepsia vs Gastroparesis

Functional dyspepsia and gastroparesis are two upper gastrointestinal disorders with overlapping symptoms. However, functional dyspepsia is the prolonged feeling of indigestion, discomfort, or fullness in the upper abdomen while gastroparesis is the delayed gastric emptying. This is the summary of the difference between functional dyspepsia and gastroparesis.

FAQ: Functional Dyspepsia and Gastroparesis

1. What foods trigger functional dyspepsia?

• Functional dyspepsia may be triggered by eating certain types of food such as pickles, sausages, vinegar, bolognas, tea, grains, soft drinks, red pepper, pasta, pizza, and salty foods, which aggravate symptoms of indigestion.

2. What is the treatment for functional dyspepsia?

• The treatment options for functional dyspepsia include proton pump inhibitors, H2-receptor antagonists, prokinetic agents, antidepressants, phytotherapy, acupuncture, behavioral therapy, diet changes, and lifestyle changes.

3. What is the main cause of gastroparesis?

• Diabetes is the most common cause of gastroparesis. It can damage the vagus nerve and pacemaker cells in the stomach wall, affecting its ability to move food properly.

4. What are the risk factors for gastroparesis?

• Risk factors for gastroparesis include diabetes, gastrectomy, systemic sclerosis, viral infections, certain medications that slow stomach emptying (like narcotic painkillers), nervous system diseases (such as Parkinson’s disease), and underactive thyroid (hypothyroidism).

5. Can gastroparesis be cured?

• Gastroparesis is a chronic condition. The appropriate treatment options for gastroparesis include changes to the diet, surgery, giving a new drug in development called relamorelin that speeds up gastric emptying and reduce vomiting, endoscopic pyloromyotomy, gastric electrical stimulation, and pacing.

Reference:

1. Francis, Pilin. “Functional Dyspepsia.” U.S. National Library of Medicine.
2. “Gastroparesis.” Cleveland Clinic.

Image Courtesy:

1. “Abdominal Pain Pain Appendicitis Free Photo” (CC0) via NeedPix
2. “GastroparesisXray” By Dong Seok Lee1 and Sang Jin Lee –(CC BY 3.0) via Commons Wikimedia

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