Functional dyspepsia: Signs, symptoms & best remedies

Heather Campbell
 min read

Functional dyspepsia is when an examination of the stomach does not reveal any abnormalities or causes for gastric distress. The condition is then referred to as functional gastric distress, functional stomach upset, or functional dyspepsia.

Functional dyspepsia: Signs, symptoms & best remediesAbout one in four people in the United States have stomach problems at some point. The cause is often heartburn (reflux), or perhaps a stomach ulcer.

As a general rule, functional dyspepsia is common and the symptoms often significantly impact daily life. Functional dyspepsia is usually due to a hypersensitive stomach or delayed gastric emptying, and is diagnosed when all other possible conditions or diseases have been eliminated.

Sometimes conditions have been ruled out by a medical examination, and people are still left with stomach problems for which no identifiable cause is found and thus these are referred to as functional stomach complaints.

Functional gastrointestinal symptoms are not medically severe but the symptoms are very annoying and sometimes even very painful.

Read on to discover the causes, symptoms, and various tips to minimize discomfort.

Functional dyspepsia: Introduction of the stomach

The stomach is an essential part of our digestive system. In the stomach, food is kneaded and mixed with gastric juice.

The inside of the stomach is lined with a thick layer of mucous membrane protecting the stomach from the acidic gastric juice.

Gastric juice contains, among other things, hydrochloric acid and enzymes. The enzymes already break down the food, and hydrochloric acid kills pathogenic bacteria in the food.

The outside of the stomach consists of a thick layer of muscle which cause food to be ground up and mixed with gastric juice.

There is a sphincter at the junction of the esophagus and the stomach. This opens when food from the esophagus enters the stomach and then closes again. The sphincter keeps food from flowing from the stomach back into the esophagus.

Food remains in the stomach for an average of three hours (or much longer if you suffer from gastroparesis, a situation in which food passes through the stomach slower than usual). With fatty foods, the stomach needs more time. Then the pre-processed food passes through the stomach outlet in small portions to the duodenum.

Cause of functional dyspepsia

The two most common causes of functional stomach upset are a hypersensitive stomach and delayed gastric emptying, also known as a lazy stomach or gastroparesis.

Hypersensitive stomach

In a hypersensitive stomach, one is hypersensitive to stimuli from the gastrointestinal tract.

A person with functional stomach discomfort then feels pain while another person (eating the same food) feels nothing and there doesn’t seem to be an explanation for this.

There is nothing unusual about the mucous membrane of the stomach and esophagus.

In many people, the cause is likely to be a combination of several factors such as a passed infection, upset stomach movement, diet, or psychological factors.

Lazy stomach

A lazy stomach results from a disturbance in the movement of the stomach. This is also called delayed gastric emptying.

The stomach muscle contracts too little or too irregularly with a lazy stomach. As a result, the food is not properly ground and stays in the stomach longer than usual.

Sometimes the food will stay in the stomach for 5 hours or longer instead of the usual 3 hours.

The cause of a lazy stomach is generally unknown, although stress and tension can be a factor.

Diabetes can also cause a lazy stomach because the high blood sugars have damaged the nerves that control the stomach.

Complaints and symptoms in functional gastrointestinal disorders

Symptoms that may occur with a hypersensitive stomach and delayed gastric emptying include the following:

You may also suffer from heartburn (reflux) with a lazy stomach. Due to gastric contents flowing back into the esophagus, you may further experience a painful or burning sensation near the sternum.

When to see a doctor due to symptoms?

See your doctor if you’re experiencing any of the following:

  • In case of severe pain at the top of the abdomen
  • If you suffer from black, thin, sticky stools
  • If you have lost more than 10 pounds in a short period, with no apparent cause
  • If you vomit regularly
  • If you feel that the food does not want to sink properly into the esophagus

Diagnosis of functional dyspepsia

Usually, a doctor makes a diagnosis based on the pattern of symptoms.

Depending on the severity of the symptoms, you may be referred to a hospital for further testing to rule out other conditions.

If no abnormalities are found on examination, and the stomach symptoms persist, you will be diagnosed with functional stomach problems.

Symptoms of functional stomach upset

Worldwide, medical specialists have established criteria for when a person can be diagnosed with functional gastritis.

Functional gastrointestinal symptoms exist if one or more of the following symptoms occur:

  • Pain in the stomach area
  • An annoying full feeling after meals
  • Rapid saturation
  • A burning sensation in the stomach area

The symptoms must have started at least 6 months ago. If the patient meets the above criteria for 3 of those 6 months, functional gastrointestinal symptoms might be diagnosed.

If the symptoms could also indicate another condition, that should be ruled out first.

The following tests may be done to rule out another condition:


A gastroscopy is a keyhole examination of the stomach. The doctor goes through your mouth and esophagus to your stomach with a flexible tube (endoscope).

On the endoscope are a small camera and a light that allows the doctor to see the inside of your stomach.

Thanks to a gastroscopy, conditions such as gastric mucosal inflammation, infection with Helicobacter pylori bacteria, or an ulcer can be ruled out.

This examination can also demonstrate or exclude damage to the esophagus.

If the doctor can find food debris from previous days during a gastroscopy, there may be a lazy stomach.

A gastroscopy can be unpleasant, so it is always good to consider whether or not a gastroscopy is really necessary.

If there is functional stomach discomfort, it is usually not helpful to undergo a gastroscopy because no abnormalities can be seen in the stomach itself.

Gastric emptying study

A gastric emptying test allows a doctor to diagnose a lazy stomach. Prior to the examination, you will eat a test meal containing a small amount of radioactive material.

Then you will sit in front of a special camera for 1 to 2 hours. The path taken by the test meal can be followed in this way.

This examination is also called a gastric emptying scintigraphy. Scintigraphy indicates the use of radioactivity.

Treatment of functional dyspepsia

Because the cause of the symptoms is unknown, it is not possible to treat functional stomach pain in a targeted way.

Sometimes adjustments in your diet help reduce symptoms, and your doctor may prescribe medication for the pain if necessary.

In some cases of an oversensitive stomach, low doses of certain antidepressants can reduce stimuli from the gastrointestinal tract.

These medications are only prescribed when symptoms severely limit you or are accompanied by significant weight loss. Your doctor will advise you accordingly.

For delayed gastric emptying, the doctor may, in some cases, prescribe medications that stimulate the action of the muscles in the stomach.

Called prokinetics, these drugs cause the muscles in the stomach wall to contract more regularly and speed up gastric emptying.

There are all kinds of remedies for sale at pharmacies and drugstores to relieve your stomach discomfort. For example, mixtures of herbal plant extracts.

If your symptoms are not so severe, you can try these remedies for a while. Ask the pharmacy or drugstore which medicine is best in your case.

If your symptoms don’t disappear after a few weeks or are bothering you, go to your doctor.

In case of stomach discomfort, always be careful with the (regular) use of aspirin and anti-inflammatory painkillers (so-called NSAIDs).

If used recklessly and thoughtlessly, these medications can actually make stomach problems worse.

What can I do about functional stomach upset?

Certain foods are known to cause or exacerbate stomach upset.

However, it is often very personal what people get complaints from. Avoid the products that bother you as much as possible but try to keep eating a varied diet.

When you eliminate a specific group of foods (dairy products, for example) from your menu, there might be resulting deficiencies. As a result, you may actually develop more symptoms.

Are you unsure? Then a dietitian can help you with personalized and balanced nutrition advice.

Tips and advice for an oversensitive stomach

  • Try to avoid stress as much as possible and make sure there is enough relaxation, for example, through exercise and other physical activity. Visit a sauna, take a nice walk, go shopping, etc.
  • Don’t eat too late at night. This is definitely not ideal for digestion and the stomach.
  • Don’t drink alcohol or as little as possible. Alcohol irritates the mucous membrane in the esophagus and stomach and can weaken the sphincter between the stomach and esophagus.
  • Avoid foods that can cause stomach upset. Examples are coffee, strong tea, peppermint, chocolate, carbonated drinks, highly spiced foods, and fatty foods.
  • Avoid substantial and/or fatty meals.
  • Start the day with a good breakfast. Definitely don’t skip this one!
  • Stop smoking. Smoking irritates the stomach lining and can weaken the sphincter between the stomach and esophagus.
  • Eat regularly and chew your food well. Take your time, and don’t gulp down the food like a starving animal!

Tips and advice for a lazy stomach

  • If the hot meal in the evening causes more symptoms, it is better to move this meal to the afternoon. Your digestive system then has more time to process all the food in the afternoon.
  • After eating, do not lie down or fall still. Stay upright for at least 30 minutes or take a walk after meals. This is conducive to the digestive system.
  • Opt for liquid foods if symptoms are very severe. Solid food stays in the stomach longer than liquid food. If your symptoms increase as soon as you consume solid foods, it is better to replace them in whole or in part with liquid foods, such as soup.
  • Eat slowly and chew the food well.
  • Fat and fiber can inhibit gastric emptying. Therefore, be careful with fatty and high-fiber products.
  • Divide your meals and spread them out well throughout the day. Instead, eat several small meals rather than 3 large meals a day.

Functional dyspepsia: Conclusion

Functional dyspepsia may not be life threatening but it can certainly impact your quality of life.

While this article has outlined some symptoms and solutions, it is always better to consult a professional if you’re unsure.

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About Heather Campbell

As a nutritionist, my field of specialization is science-based nutritional advice but more importantly, it is my goal to share capturing and inspiring stories, examples and solutions which can help plus-size individuals overcome their specific difficulties. Read More