Dyspepsia

Treatment

Because the causes of functional dyspepsia are not understood, treatment can be challenging. Treatment depends on the patient and symptoms, but usually involves some form of lifestyle changes or behavioral therapy, and possibly medication. Patients treated at Mayo Clinic may be eligible to participate in clinical trials to evaluate new treatment options.

Lifestyle Changes

Lifestyle changes such as improving diet (lowering intake of fats, for example), increasing exercise, and decreasing stress and fatigue can reduce symptoms in many patients. The patient's treatment team guides patients in making these changes.

Behavioral Therapy

Some patients may need additional assistance to change a behavior, such as swallowing air while eating (aerophagia), or to respond better to psychological or social factors affecting their dyspepsia. Mayo Clinic behavioral therapists help patients address these issues.

Medication

Several kinds of drugs are used to help manage symptoms:

Antibiotics to Treat Helicobacter pylori (H. pylori) infection

Patients who do not have peptic ulcers may still test positive for H. pylori. Eradicating the bacteria appears to help reduce dyspepsia symptoms in some patients and usually involves a combination of antibiotics such as amoxicillin (Amoxil), clarithromycin (Biaxin), or sometimes metronidazole (Flagyl) and tetracycline (Sumycin).

Proton Pump Inhibitors

These drugs, which block acid secretion, include omeprazole (Prilosec) and lansoprazole (Prevacid).

Acid Blockers (Histamine-2 Receptor Antagonists)

Drugs such as ranitidine (Zantac), cimetidine (Tagamet), and famotidine (Pepcid) suppress acid production.

Prokinetics

Domperidone, tegaserod or metoclopramide help increase stomach emptying or relaxation.

Mucosal-protecting Agents

Drugs such as sucralfate (Carafate) and bismuth subsalicyclate (Pepto-Bismol) help protect the lining of the stomach and small intestine. Pepto-Bismol is generally only used in combination with H. pylori eradication therapy.

Low-dose Antidepressants

Antidepressants such as amitriptyline and fluoxetine (Prozac) affect how the brain and nerves process pain. They may also improve stomach emptying and expansion to accommodate food, although these potential effects are being studied.