Functional Dyspepsia is a disorder similar to Irritable Bowel Syndrome (IBS) which affects the stomach rather than the bowel and just like IBS, it is diagnosed after ruling out underlying structural, or biochemical causes such as peptic ulcers, gastritis, or Gastro-Esophageal Reflux Disorder (GERD).
Symptoms of Functional Dyspepsia may include pain or burning called epigastric pain syndrome (EPS), getting full quickly when eating and/or feeling excessively full after eating called postprandial distress syndrome (PDS), feeling bloated, or experiencing reflux. Significantly, not all individuals have the same symptoms.
Functional Dyspepsia and IBS Surge After the Pandemic
A recent study[1] of over 4000 adults in both the US and UK that was done in two stages (a) in 2017 before the pandemic then (b) again in 2023, after the pandemic found that Functional Dyspepsia rose almost 44% (from 8% to 12%), and IBS increased 28% (from 5% to 6%) after the pandemic.
It was also found that Functional Dyspepsia and IBS were often associated with people experiencing long-COVID, or diagnosed with anxiety disorder, or depression.
The Role of the Gut-Brain Axis
Functional Dyspepsia is sometimes referred to as having a “nervous stomach” because of the known interaction between the gut and the brain, along what is called the “gut-brain axis”. The gut-brain axis involves the vagus nerve, which is the longest nerve in the human body and which connects the brain to the organs, including the stomach, intestines, heart and lungs.
Since symptoms of Functional Dyspepsia and some cases of IBS are more pronounced when the individuals are under stress, interventions may not only include dietary modifications, but may also include behavior interventions that can help relax the gut by affecting the vagus nerve.
Symptoms Vary Between Individuals
Individuals with Functional Dyspepsia may experience some symptoms, but not others, so dietary treatment must be individualized for each person, and some of the interventions used may be similar to those used for other functional disorders, such as IBS, or for digestive disorders such as Gastro-Esophageal Reflux Disorder (GERD), hiatus hernia, or Small Intestinal Bacterial Overgrowth (SIBO), or interventions that are unique to Functional Dyspepsia.
For example, addressing the symptom of bloating may involve use of a low-FODMAP diet implemented over three stages which is also used in some individuals with Irritable Bowel Syndrome (IBS), depending on which foods are causing the symptoms.
If acid reflux is one of the symptoms that people are experiencing, dietary interventions and lifestyle interventions may be similar to those used in Gastro-Esophageal Reflux Disorder (GERD), or to help decrease stomach pain, dietary recommendations may involve reducing irritants such as spices, alcohol, coffee and caffeine.
Some dietary inventions are specific to those with Functional Dyspepsia, such as when people are experiencing feeling “overfull” after eating, even when the meals are small.
Dietary interventions for Functional Dyspepsia are definitely not “one-sized-fits-all”, and as it is with Irritable Bowel Syndrome, dietary treatment must be individualized to each person’s symptoms.
Role of Behaviour Interventions in Functional Dyspepsia
Since Functional Dyspepsia (and sometimes IBS, as well) involve gut-brain interaction, there are some behavioral interventions that often used such as specific types of breathing exercises that affect the vagus nerve, help relax the gut, thus minimizing symptoms.
Some Final Thoughts
Functional disorders like Functional Dyspepsia or IBS are diagnosed based on symptoms, rather than lab tests because they don’t involve a structural or biological abnormality. As with IBS, a diagnosis of Functional Dyspepsia is made by a doctor after ruling out disease states, or biological causes.
Just as the diagnosis of Functional Dyspepsia is made based on symptoms, so too is which dietary modifications will be most appropriate. Choosing which approaches to use and the order in which to implement those dietary modifications can significantly shorten the length of time it takes until someone begins to feel better, and this is where the help of a Dietitian experienced in both digestive disorders and functional disorders comes in.
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Joy
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Reference
- Palsson, Olafur et al. The Prevalence and Burden of Disorders of Gut-Brain Interaction (DGBI) before versus after the COVID-19 Pandemic, Clinical Gastroenterology and Hepatology, Volume 0, Issue 0, DOI: 10.1016/j.cgh.2025.07.012
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