Indigestion (Dyspepsia)
Dyspepsia, or indigestion, means pain or discomfort related to the digestion of food. It is a term used to cover a range of different symptoms including heart burn (where there is a sensation of acid rising up the behind the breastbone) nausea, stomach ache at the lower end of the breastbone (called epigastric pain), a sensation of fullness, burping or belching, pain centred on the middle of the abdomen on eating, increased tummy rumbling (called borborygmi) and flatulence (increased production of wind, called flatus, through the back passage). Infants and young children frequently complain of abdominal pain, which may, in fact be related to disease elsewhere in the body. (There is a sign, called Gairdner’s sign after a wise old paediatrician, which says that if you ask a child to place one finger on the place where the pain is the worst, then the nearer the finger is to the navel, the further from the stomach is the source of the pain). It can be associated with, for example, ear infections or generalised viral infections.
Many infants regurgitate part of their feed not because of difficulties with digestion (regurgitation and vomiting are not the same) but because the sphincter at the top of the stomach is incompetent, because they’ve swallowed air with the milk and the milk comes back when the air comes up, and because they spend a lot of time horizontal. It usually stops when the child is a year old. Some children have severe symptoms, and suffer from gastro-oesophageal reflux disease (GORD, see oesophagus in the chest cavity section) and may need agents to thicken the feed. Older children suffer dyspepsia from the same causes as adults, though more rarely (because hopefully they aren’t smoking, drinking and working to excess). Infection with the agent helicobacter pylori, associated with many cases of dyspepsia, gastritis and peptic ulcer disease (see stomach and duodenum disorders in the digestive tract section) may be the cause, and if detected in persistent cases, should be treated.
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