ETIOLOGY

1. Gastrointestinal Tract Dysfunction
• Peptic ulcer disease 5-15% of patients with dyspepsia.
• Gastro esophageal reflux disease is present in up to 20%
• Gastric cancer identified in 1% but rare in persons under age 45 years
• Gastro paresis (especially in diabetes mellitus)
• Lactose intolerance
• Malabsorptive conditions
• Parasitic infection (Giardia, strongyloides).

2. Food Intolerance
Acute, self-limited "indigestion" may be caused by
• Overeating
• Eating too quickly
• Eating high-fat foods
• Eating during stressful situations
• Drinking too much alcohol.
• Drinking too much coffee.

3. Drug Intolerance
Many medications cause dyspepsia, including
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Antibiotics (metronidazole, macrolides)
• Corticosteroids
• Digoxin
• Theophylline
• Iron
• Narcotics
4. Helicobacter Pylori Infection
Chronic gastric infection with H pylori as a cause of dyspepsia remains controversial. The prevalence of H pylori-associated chronic gastritis in patients with dyspepsia without peptic ulcer disease is 20-50%, the same as in the general population

5. Pancreatic Disease
• Pancreatic carcinoma
• Chronic pancreatitis


6. Biliary Tract Disease
• Cholelithiasis
• Choledocholithiasis

7. Functional or "Nonulcer" Dyspepsia
• Most common cause
• Accounts for up to 60 % of dyspepsia cases
8. Other Causes
• Diabetes
• Thyroid disease
• Renal insufficiency
• Myocardial ischemia
• Intra-abdominal malignancy
• Gastric volvulus
• Para esophageal hernia