Causes of Chronic Nonulcer dyspepsia
Chronic Nonulcer dyspepsia Causes: Book Excerpts
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Dyspepsia:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Cholelithiasis.
Dyspepsia may occur with gallstones, usually after eating fatty foods. Biliary colic, a more common symptom of gallstones, causes acute pain that may radiate to the back, shoulders, and chest. The patient may also have diaphoresis, tachycardia, chills, a low-grade fever, petechiae, bleeding tendencies, jaundice with pruritus, dark urine, and clay-colored stools.
Cirrhosis
With cirrhosis, dyspepsia varies in intensity and duration and is relieved by taking an antacid. Other GI effects are anorexia, nausea, vomiting, flatulence, diarrhea, constipation, abdominal distention, and epigastric or right upper quadrant pain. Weight loss, jaundice, hepatomegaly, ascites, dependent edema, a fever, bleeding tendencies, and muscle weakness are also common. Skin changes include severe pruritus, extreme dryness, easy bruising, and lesions, such as telangiectasis and palmar erythema. Gynecomastia or testicular atrophy may also occur.
Duodenal ulcer
A primary symptom of a duodenal ulcer, dyspepsia ranges from a vague feeling of fullness or pressure to a boring or aching sensation in the middle or right epigastrium. It usually occurs 1.5 to 3 hours after a meal and is relieved by eating food or taking an antacid. The pain may awaken the patient at night with heartburn and fluid regurgitation. Abdominal tenderness and weight gain may occur; vomiting and anorexia are rare.
Gastric dilation (acute)
Epigastric fullness is an early symptom of gastric dilation, alife-threatening disorder. Accompanying dyspepsia are nausea and vomiting, upper abdominal distention, succussion splash, and apathy. The patient may display signs and symptoms of dehydration, such as poor tissue turgor and dry mucous membranes, and of electrolyte imbalance, such as an irregular pulse and muscle weakness. Gastric bleeding may produce hematemesis and melena.
Gastric ulcer
Typically, dyspepsia and heartburn after eating occur early in gastric ulcer. The cardinal symptom, however, is epigastric pain that may occur with vomiting, fullness, and abdominal distention and may not be relieved by eating food. Weight loss and GI bleeding are also characteristic.
Gastritis (chronic)
With chronic gastritis, dyspepsia is relieved by antacids; lessened by smaller, more frequent meals; and aggravated by spicy foods or excessive caffeine. It occurs with anorexia, a feeling of fullness, vague epigastric pain, belching, nausea, and vomiting.
GI cancer
GI cancer usually produces chronic dyspepsia. Other features include anorexia, fatigue, jaundice, melena, hematemesis, constipation, and abdominal pain.
Heart failure
Common with right-sided heart failure, transient dyspepsia may occur with chest tightness and a constant ache or sharp pain in the right upper quadrant. Heart failure also typically causes hepatomegaly, anorexia, nausea, vomiting, bloating, ascites, tachycardia, jugular vein distention, tachypnea, dyspnea, and orthopnea. Other findings include dependent edema, anxiety, fatigue, diaphoresis, hypotension, a cough, crackles, ventricular and atrial gallops, nocturia, diastolic hypertension, and cool, pale skin.
Hepatitis
Dyspepsia occurs in two of the three stages of hepatitis. The preicteric phase produces moderate to severe dyspepsia, a fever, malaise, arthralgia, coryza, myalgia, nausea, vomiting, an altered sense of taste or smell, and hepatomegaly. Jaundice marks the onset of the icteric phase, along with continued dyspepsia and anorexia, irritability, and severe pruritus. As jaundice clears, dyspepsia and other GI effects also diminish. In the recovery phase, only fatigue remains.
Hiatal hernia
Dyspepsia is a result of the lower portion of the esophagus and the upper portion of the stomach rising into the chest when abdominal pressure increases.
Pulmonary embolism
Sudden dyspnea characterizes pulmonary embolism, a potentially fatal disorder; however, dyspepsia may occur as an oppressive, severe, substernal discomfort. Other findings include anxiety, tachycardia, tachypnea, a cough, pleuritic chest pain, hemoptysis, syncope, cyanosis, jugular vein distention, and hypotension.
Pulmonary tuberculosis
Vague dyspepsia may occur along with anorexia, malaise, and weight loss. Common associated findings include a high fever, night sweats, palpitations on mild exertion, a productive cough, dyspnea, adenopathy, and occasional hemoptysis.
Uremia
Of the many GI complaints associated with uremia, dyspepsia may be the earliest and most important. Others include anorexia, nausea, vomiting, bloating, diarrhea, abdominal cramps, epigastric pain, and weight gain. As the renal system deteriorates, the patient may experience edema, pruritus, pallor, hyperpigmentation, uremic frost, ecchymoses, sexual dysfunction, poor memory, irritability, a headache, drowsiness, muscle twitching, seizures, and oliguria.
Other causes
Drugs
Nonsteroidal anti-inflammatory drugs, especially aspirin, commonly cause dyspepsia. Diuretics, antibiotics, antihypertensives, corticosteroids, and many other drugs can cause dyspepsia, depending on the patient's tolerance of the dosage.
Surgery
After GI or other surgery, postoperative gastritis can cause dyspepsia, which usually disappears in a few weeks.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Dyspepsia:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Cholelithiasis
Dyspepsia may occur with gallstones, commonly after intake of fatty foods. Biliary colic, a more common symptom of gallstones, causes acute pain that may radiate to the back, shoulders, and chest. The patient may also have diaphoresis, tachycardia, chills, low-grade fever, petechiae, bleeding tendencies, jaundice with pruritus, dark urine, and clay-colored stools.
Cirrhosis
In this chronic disorder, dyspepsia varies in intensity and duration and is relieved by ingestion of an antacid. Other GI effects are anorexia, nausea, vomiting, flatulence, diarrhea, constipation, abdominal distention, and epigastric or right-upper-quadrant pain. Weight loss, jaundice, hepatomegaly, ascites, dependent edema, fever, bleeding tendencies, and muscle weakness are also common. Skin changes include severe pruritus, extreme dryness, easy bruising, and lesions, such as telangiectasis and palmar erythema. Gynecomastia or testicular atrophy may also occur.
Duodenal ulcer
A primary symptom of duodenal ulcer, dyspepsia ranges from a vague feeling of fullness or pressure to a boring or aching sensation in the middle or right epigastrium. It usually occurs 1½ to 3 hours after eating and is relieved by food or an antacid. The pain may awaken the patient at night with heartburn and fluid regurgitation. Abdominal tenderness and weight gain may occur; vomiting and anorexia are rare.
Gastric dilation (acute)
Epigastric fullness is an early symptom of this life-threatening disorder. Accompanying dyspepsia are nausea and vomiting, upper abdominal distention, a succussion splash, and apathy. The patient may display signs and symptoms of dehydration, such as poor skin turgor and dry mucous membranes, and of electrolyte imbalance, such as irregular pulse and muscle weakness. Gastric bleeding may produce hematemesis and melena.
Gastric ulcer
Dyspepsia and heartburn after eating may occur in the early stages of a gastric ulcer. The cardinal symptom, however, is epigastric pain that may occur with vomiting, fullness, and abdominal distention and may not be relieved by food. Weight loss and GI bleeding are also characteristic.
Gastritis (chronic)
In this disorder, dyspepsia is relieved by antacids; lessened by smaller, more frequent meals; and aggravated by spicy foods or excessive caffeine. It occurs with anorexia, a feeling of fullness, vague epigastric pain, belching, nausea, and vomiting.
GI cancer
This type of cancer usually produces chronic dyspepsia. Other features include anorexia, fatigue, jaundice, melena, hematemesis, constipation, and abdominal pain.
Heart failure
Common in right-sided heart failure, transient dyspepsia may occur with chest tightness and a constant ache or sharp pain in the right upper quadrant. Heart failure also typically causes hepatomegaly, anorexia, nausea, vomiting, bloating, ascites, tachycardia, jugular vein distention, tachypnea, dyspnea, and orthopnea. Other findings include dependent edema, anxiety, fatigue, diaphoresis, hypotension, cough, crackles, ventricular and atrial gallops, nocturia, elevated diastolic blood pressure, and cool, pale skin.
Hepatitis
Dyspepsia occurs in two of the three stages of hepatitis. The preicteric phase produces moderate to severe dyspepsia, fever, malaise, arthralgia, coryza, myalgia, nausea, vomiting, an altered sense of taste or smell, and hepatomegaly. Jaundice marks the onset of the icteric phase, which also includes continued dyspepsia, anorexia, irritability, and severe pruritus. As jaundice clears, dyspepsia and other GI effects also diminish. In the recovery phase, only fatigue remains.
Hiatal hernia
In this disorder, dyspepsia results when the lower portion of the esophagus and the upper portion of the stomach rise into the chest as abdominal pressure increases.
Pancreatitis (chronic)
Dyspepsia is usually accompanied by severe continuous or intermittent epigastric pain that radiates to the back or through the abdomen. Anorexia, nausea, vomiting, jaundice, dramatic weight loss, hyperglycemia, and steatorrhea may also occur. The patient may have Turner’s or Cullen’s sign.
Pulmonary embolism
Sudden dyspnea characterizes this potentially fatal disorder; however, dyspepsia may occur as an oppressive, severe, substernal discomfort. Other findings include anxiety, tachycardia, tachypnea, cough, pleuritic chest pain, hemoptysis, syncope, cyanosis, jugular vein distention, and hypotension.
Pulmonary tuberculosis
Vague dyspepsia may occur along with anorexia, malaise, and weight loss. Common associated findings include high fever, night sweats, palpitations on mild exertion, a productive cough, dyspnea, adenopathy, and occasional hemoptysis.
Uremia
Of the many GI complaints associated with uremia, dyspepsia may be the earliest and most important. Others include anorexia, nausea, vomiting, bloating, diarrhea, abdominal cramps, epigastric pain, and weight gain. As the renal system deteriorates, the patient may experience edema, pruritus, pallor, hyperpigmentation, uremic frost, ecchymoses, sexual dysfunction, poor memory, irritability, headache, drowsiness, muscle twitching, seizures, and oliguria.
Other causes
Drugs
Nonsteroidal anti-inflammatory drugs, especially aspirin, commonly cause dyspepsia. Diuretics, antibiotics, antihypertensives, corticosteroids, and many other drugs can also cause dyspepsia, depending on the patient’s tolerance of the dosage.
Surgery
After GI or other surgery, postoperative gastritis can cause dyspepsia, which usually disappears in a few weeks.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Dyspepsia:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Cholelithiasis
Dyspepsia may occur with cholelithiasis (the formation of gallstones), commonly after intake of fatty foods. Biliary colic, a more common symptom of cholelithiasis, causes acute pain that may radiate to the back, shoulders, and chest. The patient may also have diaphoresis, tachycardia, chills, low-grade fever, petechiae, bleeding tendencies, jaundice with pruritus, dark urine, and clay-colored stools.
Cirrhosis
With cirrhosis, dyspepsia varies in intensity and duration and is relieved by ingestion of an antacid. Other GI effects are anorexia, nausea, vomiting, flatulence, diarrhea, constipation, abdominal distention, and epigastric or right-upper-quadrant pain. Weight loss, jaundice, hepatomegaly, ascites, dependent edema, fever, bleeding tendencies, and muscle weakness are also common. Skin changes include severe pruritus, extreme dryness, easy bruising, and lesions, such as telangiectasis and palmar erythema. Gynecomastia or testicular atrophy may also occur.
Duodenal ulcer
A primary symptom of duodenal ulcer, dyspepsia ranges from a vague feeling of fullness or pressure to a boring or aching sensation in the middle or right epigastrium. It usually occurs 1½ to 3 hours after eating and is relieved by intake of food or ingestion of an antacid. The pain may awaken the patient at night with heartburn and fluid regurgitation. Abdominal tenderness and weight gain may occur; vomiting and anorexia are rare.
Gastric dilation (acute)
Epigastric fullness is an early symptom of acute gastric dilation, a life-threatening disorder. Accompanying dyspepsia are nausea and vomiting, upper abdominal distention, succussion splash, and apathy. The patient with acute gastric dilation may display signs and symptoms of dehydration, such as poor tissue turgor and dry mucous membranes, and of electrolyte imbalance, such as irregular pulse and muscle weakness. Gastric bleeding may produce hematemesis and melena.
Gastric ulcer
Typically, dyspepsia and heartburn after eating occur early in a gastric ulcer. The cardinal symptom, however, is epigastric pain that may occur with vomiting, fullness, and abdominal distention and may not be relieved by food. Weight loss and GI bleeding are also characteristic.
Gastritis (chronic)
With chronic gastritis, dyspepsia is relieved by antacids; lessened by smaller, more frequent meals; and aggravated by spicy foods or excessive caffeine. It occurs with anorexia, a feeling of fullness, vague epigastric pain, belching, nausea, and vomiting.
GI cancer
GI cancer usually produces chronic dyspepsia. Other features include anorexia, fatigue, jaundice, melena, hematemesis, constipation, and abdominal pain. The patient may also experience pain after eating that isn’t relieved by antacids. Syncope, weakness, and weight loss may also occur.
Heart failure
Common with right-sided heart failure, transient dyspepsia may occur with chest tightness and a constant ache or sharp pain in the right upper quadrant. Heart failure also typically causes hepatomegaly, anorexia, nausea, vomiting, bloating, ascites, tachycardia, jugular vein distention, tachypnea, dyspnea, and orthopnea. Other findings include dependent edema, anxiety, fatigue, diaphoresis, hypotension, cough, crackles, ventricular and atrial gallops, nocturia, diastolic hypertension, and cool, pale skin.
Hepatitis
Dyspepsia occurs in two of the three stages of hepatitis. The preicteric phase produces moderate to severe dyspepsia, fever, malaise, arthralgia, coryza, myalgia, nausea, vomiting, an altered sense of taste or smell, and hepatomegaly. Jaundice marks the onset of the icteric phase, along with continued dyspepsia and anorexia, irritability, and severe pruritus. As jaundice clears, dyspepsia and other GI effects also diminish. In the recovery phase, only fatigue remains.
Hiatal hernia
With hiatal hernia, dyspepsia results when increased abdominal pressure causes the lower portion of the esophagus and the upper portion of the stomach to rise into the chest. Other signs and symptoms include heartburn and retrosternal or substernal chest pain. Signs and symptoms of possible complications include dysphagia, bleeding, and severe pain and shock.
Pancreatitis (chronic)
With chronic pancreatitis, a feeling of fullness or dyspepsia is usually accompanied by severe continuous or intermittent epigastric pain that radiates to the back or through the abdomen. Anorexia, nausea, vomiting, jaundice, dramatic weight loss, hyperglycemia, and steatorrhea may also occur. The patient may have Turner’s or Cullen’s sign.
Uremia
Of the many GI complaints associated with uremia, dyspepsia may be the earliest and most important. Others include anorexia, nausea, vomiting, bloating, diarrhea, abdominal cramps, epigastric pain, and weight gain. As the renal system deteriorates, the patient may experience edema, pruritus, pallor, hyperpigmentation, uremic frost, ecchymoses, sexual dysfunction, poor memory, irritability, headache, drowsiness, muscle twitching, seizures, and oliguria.
Other causes
Drugs
Nonsteroidal anti-inflammatories, especially aspirin, commonly cause dyspepsia. Diuretics, antibiotics, antihypertensives, corticosteroids, and many other drugs can cause dyspepsia, depending on the patient’s tolerance of the dosage.
Surgery
After GI or other surgery, postoperative gastritis can cause dyspepsia, which usually disappears in a few weeks.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Dyspepsia:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Cholelithiasis.Dyspepsia may occur with gallstones, usually after eating fatty foods. Biliary colic, a more common symptom of gallstones, causes acute pain that may radiate to the back, shoulders, and chest. The patient may also have diaphoresis, tachycardia, chills, a low-grade fever, petechiae, bleeding tendencies, jaundice with pruritus, dark urine, and clay-colored stools.
Cirrhosis.With cirrhosis, dyspepsia varies in intensity and duration and is relieved by taking an antacid. Other GI effects are anorexia, nausea, vomiting, flatulence, diarrhea, constipation, abdominal distention, and epigastric or right upper quadrant pain. Weight loss, jaundice, hepatomegaly, ascites, dependent edema, a fever, bleeding tendencies, and muscle weakness are also common. Skin changes include severe pruritus, extreme dryness, easy bruising, and lesions, such as telangiectasis and palmar erythema. Gynecomastia or testicular atrophy may also occur.
Duodenal ulcer.A primary symptom of a duodenal ulcer, dyspepsia ranges from a vague feeling of fullness or pressure to a boring or aching sensation in the middle or right epigastrium. It usually occurs 11⁄2 to 3 hours after a meal and is relieved by eating food or taking an antacid. The pain may awaken the patient at night with heartburn and fluid regurgitation. Abdominal tenderness and weight gain may occur; vomiting and anorexia are rare.
Gastric dilation (acute).Epigastric fullness is an early symptom of gastric dilation, a life-threatening disorder. Accompanying dyspepsia are nausea and vomiting, upper abdominal distention, succussion splash, and apathy. The patient may display signs and symptoms of dehydration, such as poor tissue turgor and dry mucous membranes, and of electrolyte imbalance, such as an irregular pulse and muscle weakness. Gastric bleeding may produce hematemesis and melena.
Gastric ulcer.Typically, dyspepsia and heartburn after eating occur early in gastric ulcer. The cardinal symptom, however, is epigastric pain that may occur with vomiting, fullness, and abdominal distention and may not be relieved by eating food. Weight loss and GI bleeding are also characteristic.
Gastritis (chronic).With chronic gastritis, dyspepsia is relieved by antacids; lessened by smaller, more frequent meals; and aggravated by spicy foods or excessive caffeine. It occurs with anorexia, a feeling of fullness, vague epigastric pain, belching, nausea, and vomiting.
GI cancer.GI cancer usually produces chronic dyspepsia. Other features include anorexia, fatigue, jaundice, melena, hematemesis, constipation, and abdominal pain.
Heart failure.Common with right-sided heart failure, transient dyspepsia may occur with chest tightness and a constant ache or sharp pain in the right upper quadrant. Heart failure also typically causes hepatomegaly, anorexia, nausea, vomiting, bloating, ascites, tachycardia, jugular vein distention, tachypnea, dyspnea, and orthopnea. Other findings include dependent edema, anxiety, fatigue, diaphoresis, hypotension, a cough, crackles, ventricular and atrial gallops, nocturia, diastolic hypertension, and cool, pale skin.
Hepatitis.Dyspepsia occurs in two of the three stages of hepatitis. The preicteric phase produces moderate to severe dyspepsia, a fever, malaise, arthralgia, coryza, myalgia, nausea, vomiting, an altered sense of taste or smell, and hepatomegaly. Jaundice marks the onset of the icteric phase, along with continued dyspepsia and anorexia, irritability, and severe pruritus. As jaundice clears, dyspepsia and other GI effects also diminish. In the recovery phase, only fatigue remains.
Hiatal hernia.Dyspepsia is a result of the lower portion of the esophagus and the upper portion of the stomach rising into the chest when abdominal pressure increases.
Pulmonary embolism.Sudden dyspnea characterizes pulmonary embolism, a potentially fatal disorder; however, dyspepsia may occur as an oppressive, severe, substernal discomfort. Other findings include anxiety, tachycardia, tachypnea, a cough, pleuritic chest pain, hemoptysis, syncope, cyanosis, jugular vein distention, and hypotension.
Pulmonary tuberculosis.Vague dyspepsia may occur along with anorexia, malaise, and weight loss. Common associated findings include a high fever, night sweats, palpitations on mild exertion, a productive cough, dyspnea, adenopathy, and occasional hemoptysis.
Uremia.Of the many GI complaints associated with uremia, dyspepsia may be the earliest and most important. Others include anorexia, nausea, vomiting, bloating, diarrhea, abdominal cramps, epigastric pain, and weight gain. As the renal system deteriorates, the patient may experience edema, pruritus, pallor, hyperpigmentation, uremic frost, ecchymoses, sexual dysfunction, poor memory, irritability, headache, drowsiness, muscle twitching, seizures, and oliguria.
Other causes
Drugs.Nonsteroidal anti-inflammatory drugs, especially aspirin, commonly cause dyspepsia. Diuretics, antibiotics, antihypertensives, corticosteroids, and many other drugs can cause dyspepsia, depending on the patient's tolerance of the dosage.
Surgery.After GI or other surgery, postoperative gastritis can cause dyspepsia, which usually disappears in a few weeks.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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