DYSPEPSIA or INDIGESTION, a term vaguely given to a group of pathological symptoms. Dyspepsia may occur in almost any organic disease of moment, particularly if it involves the ali mentary canal, but here the term is used to describe derangement of the natural process of digestion, without obvious change in the organs concerned in the act.
The condition may depend on (a) the food, and (b) the organ ism. In respect of food common causes are indigestible articles of diet, overeating, irregular and over-hasty meals, insufficient mastication especially of smoked or salted meat, whether from haste or poor dentition. Drinks are a common source of dys pepsia, particularly new beer, vinegar, acid wines and tea. Even too much water at mealtimes may cause indigestion, since the food in the mouth is softened by water instead of saliva, and, the gastric juice being diluted, digestion in the stomach is too slow and prolonged. Mention must also be made of chronic alcoholism and excessive tobacco smoking.
Of the causes which concern the organism, nervous influences come first. Crises in the money market are a fertile source of dyspepsia among financiers. Bad news, worry or mental trouble may take away all power of digestion and even provoke vomiting. General weakness and atony affect the stomach also, and, if the muscles of the abdominal wall be much wasted, they fail to support the abdominal viscera. Hence results a general tendency for these organs to fall (visceroptosis), when an obstinate dys pepsia is a very marked feature. Again, dyspepsia is often one of the early symptoms of renal disease, or, in young people, of pulmonary tuberculosis. In fact, any condition which lessens the general well-being of the organism as a whole, apart from its producing a permanent morbid condition in the stomach, may yet interfere with the normal digestive processes and so give rise to dyspepsia.
Symptoms.—A furred tongue, foul breath, disturbance of appetite, nausea and vomiting, oppression in the chest, pain, flat ulence and distension, acidity, pyrosis and constipation or diar rhoea are the commonest symptoms.
When the attack is acute, e.g., a few hours after a heavy meal following severe exertion, there is often pain with sickness and vomiting, after which the patient soon regains his former healthy state. In chronic cases the symptoms are somewhat different. A sensation of discomfort comes on shortly after a meal, and is more of the nature of weight and distension in the stomach than of actual pain, although this too may be present. These feelings may follow each meal, or only certain meals, and they may arise irrespective of the kind of food taken, or only after certain articles of diet. The stomach is dilated and lactic acid fermenta tion of the contained food leads to accumulation of gases which causes flatulence and eructations of an acid or foul character. Occasionally quantities of hot, sour, tasteless or bitter fluid pyrosis—or mouthfuls of half-digested food, regurgitate from the stomach. Temporary relief may be obtained when another meal is taken, but soon the discomfort returns as before. The appetite may be craving or deficient, or desirous of abnormal kinds of food. Constipation is more common in the chronic forms of dyspepsia, diarrhoea in the acute.
Symptoms in other parts are often more distressing than the merely gastric symptoms. Pains in the chest, shortness of breath ing, palpitation, headache, giddiness, affections of vision, coldness of the extremities, and general languor are common accompani ments of dyspepsia ; the nervous phenomena include sleeplessness, irritability, despondency and hypochondriasis.
The medicinal treatment of dyspepsia can only be undertaken by a physician, but the following is a very brief resume of the drugs he depends on. Bicarbonate of soda with some bitter, as quassia, gentian or columba, is much in vogue as a direct gastric stimulant. In irritable dyspepsia some form of bismuth in solution or powder; and, to assist digestion through the nervous system, nux vomica and strychnine can be relied on. Hydrochloric acid, pepsin and rennet are prescribed in many forms, but where there is much vomiting ingluvin is more efficacious than pepsin. When starchy food is badly borne, diastase is helpful, given either before or with the meal. To prevent fermentation, phenol, creosote and sulpho-carbolate of soda are all extremely useful in skilled hands ; and for intestinal decomposition and flatulent distension, bismuth salicylate with salol or 0 -naphthol is much used.
See also DIGESTIVE ORGANS; NUTRITION; DIET AND DIETETICS.