Definition

The term “Irritable Stomach” or “Functional Dyspepsia” refers to a collection of symptoms related to the upper gastrointestinal system, such as abdominal pain or discomfort, bloating, early satiety, and nausea, without any identifiable organic disease to explain these symptoms.

Pathogenesis

The exact cause of irritable stomach is complex and often unclear. Contributing factors may include abnormalities in gastrointestinal motility, heightened sensitivity of the gut, psychological stress, and dietary habits.

Diagnosis

The diagnosis of irritable stomach is primarily based on the patient’s clinical presentation and history. It is often a diagnosis of exclusion, requiring the elimination of other organic conditions through tests such as endoscopy, imaging, or other investigations.

Treatment

Treatment focuses on symptom relief and may include:

  • Dietary changes: Reducing intake of fatty foods and caffeine.
  • Medications: To address abdominal pain, discomfort, or nausea.
  • Psychological support: For underlying stress or depression, psychotherapeutic interventions or medications may be helpful.

Ongoing medical follow-up and close collaboration with the patient to evaluate and adjust treatments are crucial for successfully managing the condition.

Key figures: Symptoms are present for months by definition, with a fluctuating course. Gastroscopy is recommended from about 45 to 50 years with new symptoms, and at any age when alarm features are present.

Organic causes must be excluded first, in particular Helicobacter pylori gastritis and gastro-oesophageal reflux, with which it frequently overlaps.

Frequently asked questions

What is functional dyspepsia?

Persistent upper gastrointestinal symptoms such as fullness, early satiety, epigastric pain and bloating, without any structural abnormality on investigation. Functional does not mean imaginary: what is disturbed is how the stomach empties, distends and perceives stimuli, and visceral hypersensitivity is measurable.

Does stress cause it?

Stress genuinely contributes, through the gut brain axis and by increasing visceral hypersensitivity, so that normal sensations such as distension after a meal become uncomfortable. That does not make the symptoms imaginary, nor is the treatment purely psychological.

Is gastroscopy necessary?

It is recommended in people over about 45 to 50 with new symptoms, and at any age when alarm features are present: weight loss, difficulty swallowing, persistent vomiting, anaemia, bleeding or a family history of gastrointestinal cancer. In younger patients without these, testing for Helicobacter pylori is a reasonable first step.

Sources


Content last updated: September 2026 (14/09/2026).