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Avatar universal

Functional dyspepsia or food intolerance?

I'm a 21 y/o m. Currently finishing up year 3 out of 6 in pharmacy school.  I apologize in advance for the lengthy story.

Last summer (2009) I started to develop morning nausea and appetite loss. I was also belching a lot which brought little relief to stomach bloating that went along with it. I also developed upper abdominal pain half way in between my sternum and belly button.  I wound up going to the doc's who thought it was probably some acid production issue. He said to take Prilosec OTC for a couple weeks and if I wasn't better, go see a gastroenterologist.  The Prilosec brought only a little relief, and I noticed that spot on my stomach was tender to touch.  I saw the gastro who suspected maybe GERD or ulcer and performed an upper endoscopy on me to make sure. Only a little inflammation was seen, otherwise normal.  Shortly after this, I started back to school and had a couple mixed drinks with my roommates (I had, up to this point, very little reaction to the alcohol). However the next day I woke up with the worst gnawing stomach pain along with other hangover symptoms AND I BARELY DRANK ANYTHING.  My appetite was completely ruined for weeks. I had to force myself to eat. The gastro doc put me on Protonix thinking that would help. I had up and down days on it. I went to another GI doc for a second opinion.  By this time I was starting to lose weight (I was underweight at 120lbs to begin with), started having lower abdominal discomfort as well along with some constipation, so I became desperate.  I had a CT scan done, gastric emptying scan, blood work, Celiac's disease. Everything came out normal.  He eventually just said I have functional dyspepsia (basically, that he couldn't find anything else wrong with me).  He tried me on a low dose of tricyclic to take the edge off the pain. It worked for the most part but made my heart pound and race. He switched me to another tricyclic hoping I would have less side effects. My heart didn't race as much, but it also didn't seem to take away as much of the discomfort.  However, due to 20 min heart palpitation session, he thought it would be best I stop altogether. I did, and it's been hell all over again. My appetite still fluctuates. I seem to be unable to gain any of the weight (116lbs today) although my weight gain problem might have a genetic basis.  Both my GI doc and primary doc suggested this was probably due to depression/anxiety.  I was given Lexapro 10mg and couldnt get past the first dose.  I woke up in the middle of the night with fast heart rate, muscle spasms, and most of all, the worst burning stomach pain ever.  What little appetite I had left was ruined. I didn't take any of them after that and it took a week for my appetite to return to what it was before I took it.  

I eventually saw an internist who also told me this sounded like a functional GI disorder.  He suggested I take half the Lexapro for a week and then take the full pill.  I am scared that this will destroy my stomach again.  I was wondering if perhaps I had some type of food intolerance that's been undiscovered this whole time that's making me feel miserable.  I've noticed sometimes after eating I'll feel lousy but another time I'll eat the same thing I won't.  

I was also wondering if anyone else has been diagnosed with functional dyspepsia and has had similar symptoms to mine and how you've dealt with it.  This whole ordeal has almost ruined my life. I can't focus or study when I feel lousy. I don't go out anymore either, can't gain weight, and I'm having trouble figuring out what I can still eat.  What makes me even more depressed is that I feel like I'll have to live like this for the rest of my life.  I simply can't imagine being a practicing pharmacist and dealing with this every day.  This (along with other health problems I currently have) just continue to beat down on me.  I afraid I'm going to end up suicidal in the long run. :(
Best Answer
Avatar universal
Side note:  I have a recommendation if you are ever constipated.  Miralax.  About 3 years ago I had a colonoscopy (family history of colon cancer).  All was well, but given a description of some symptoms I was experiencing, the gastro doc diagnosed me with IBS - Constipation.  He had me on Zelnorm, but that was pulled off the market, so he told me to take a daily drink of the Miralax.   It worked like a charm and after all my life dealing with constipation, I call Miralax my liquid GOLD!  lol  :)   NOW....having said that, it did not help me at all during those 6 days I was on Desipramine.  I KNEW at that point, Desipramine was NOT good for me.  

Yes, the ginger root has always given me relief within 10 minutes.  There had been one time that it did not take the discomfort away completely, but it took a big edge off.  

Coffee is a BIG no-no.  :(  I love coffee though.  Are there any foods or drinks that trigger your FD?

Also, does your FD cause you to burp a lot (just air - no acid reflux)?  Do you have problems every day?  Do you ever have any good days?  I never know when it will hit me.  It seems to come on when I don't get enough sleep though, and then there are times when I can't figure out what caused it - no evident anxiety, no lack of sleep, no aggravating food.  Oh, greasy foods agitate me (potato chips or rich cream sauces)

My pain/burning/gnawing discomfort is localized to the upper stomach area only - dead in the upper center, sometimes along the left side (exactly where the stomach is).  If I'm having an "episode", it will even be tender to the touch.  My functional dyspepsia is UPPER area only.  I have no lower intestine problems, save for the rare, occasional irritable bowel syndrome flare up.  The symptoms are completely different too, so I know it's not related.

Yep, FD showed up right after that Luvox.  I'm going to discuss this with my doc in June.  I honestly think there is a connection.  I wonder if the Luvox screwed something up with that brain/gut connection that I've been reading about regarding functional dyspepsia.  

My OCD came on after the birth of my first child.  I do have some OCD triggers that seem to bother me just occasionally.   When I first started the Luvox ('98), I was in cognitive behavioral therapy.  I still use what I learned in CBT to this day when something triggers the OCD.  It's been very helpful.  

When I told my current gastro doc that I had been on Luvox for 10 years he looked at me like I was CRAZY!  He said that was too long.  I weaned myself off of it a year ago this past November.  I took 4 months to slowly wean off, but I suffered some severe discontinuation syndromes.  It is for this reason, that I am hesitate about any drug that works with the brain.  They are so incredibly powerful.  I swore off ever going back on an SRRI, but after this FD, I'm considering going back to one, if it can help.

I am a type A personality.  I stress easily and have a tendency towards anxiety.  I wish I was a cool cucumber like my husband; so easy going.  lol  

I have no doubt that anxiety makes FD worse, or even attributes to it coming on in the first place.  Have you ever considered getting treatment for the anxiety?  A psychiatrist and counselor (CBT) worked with me in tandem when I went on Luvox.  I felt like I was in good hands.  I had moved away from the town I was in and lost touch with these docs, and then my general practitioner just kept refilling my Luvox for all those years.  So, I recommend a specialist for anyone that is considering seeking treatment for OCD, anxiety, or anything like that, NOT just a general practitioner.  Like I said, these drugs are very powerful, and in my opinion, a specialist is needed.

It's said that regular sleep and exercise is great for both body and mind.  I have always exercised regularly (3-4 times a week), yet the FD still occurred.  I'm sure I'm reaping much benefit from the exercise anyway :)

Regarding your experience with the Lexapro.  I wanted to tell you that I also experienced palpitations with the desipramine.  Also, insomnia and something strange; I would be trying to go to sleep and all of a sudden experience chills.  I even checked my temp, but was not running a fever.  I also forgot to tell you that before the desipramine, he had me on Librax.  I HATED Librax!  It also caused insomnia, ANXIETY (which, hello, isn't that part of the problem???), but even worse, it bloated my lower belly pretty significantly.  I looked 4 months pregnant!  I took Librax for one week, then trashed it after I saw what it was doing to me.  

Isn't Lexapro similar to Luvox?  I had no bad side effects from Luvox (except for sleepiness at higher doses and loss of libido).  

I fear I'm also losing weight too, but i do exercise (run and lift weights).  I have always had a high metabolism also.  I'm 41 years old, so I would think that my metabolism should be slowing down.  

Have you had an upper endoscopy?  Since nothing seems to be helping you, and the weight loss, I would recommend you really push for one.  It may put your mind at east too, if you're concerned with your symptoms being anything more serious.  I certainly was.  Because of OCD (I assume), I feared I had cancer or an ulcer.   I always assume the worse.

I apologize about the length of my response.  There are so many variables with FD.  




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Avatar universal
Have you ever been tested for MALS?
Helpful - 0
Avatar universal
I have also been recently diagnosed with FD. I have had extremely intermittant (and not too severe) symptoms for the past 8 years. I have tried several times in the past to get a diagnosis of some kind. My husband and I thought we should get to the bottom of it before we tried for a baby in case it got worse (I, like the original poster cannot concentrate when I am having an episode - usually mainly hunger pain and burning at my sternum). Scope found "irritation" of the lining of my stomach fundus. The only advise my gastro gave me was "cut back on spicy foods".

I have looked up various diets for dyspepsia and have found disappointing conflicting advice, so I have started trying things out (cutting back a lot). No alcohol, coffee, tea, pop, juice, spices or strong flavourings (all condiments), tomato products, citrus, vinegar, chocolate, red meat. Low fat (low or non fat dairy, no fired foods), and I am trying to cut back on raw veggies and cooked dried beans, but I need to eat something! I am mostly eating brown rice, tofu, lentils, skinless chicken, pork and steamed veggies for lunches and dinners and cereal with almond milk or whole grain toast for breakfast. It is hard eating out. I tried a chicken quesadilla at a sports bar last night (the only other thing on the menu I could eat had a lot of raw veggies) - I asked for no tomato, sour cream or salsa, and low on the cheese. It was really cheesy and greasy. I only ate half but it bothered me later. Now I am not sure if I am making my body had a reaction by worrying about it, as I cannot recall having a problem with cheese before!

Anyway, I am tring to view eating as what it is - a necessary proccess to nourish my body. I used to be able to eat whatever I wanted, but I guess my stomach has had enough. Unfortunately society has turned eating into a social and artistic activity. The hardest part is that my husband is a really good cook, and likes to use all kinds of yummy flavours and spices! And I LOVE Thai and Indian food. :( I am having some relief with my altered diet, so I will keep at it and see how it goes. If anyone has more dietary advise, please pass it along!
Helpful - 0
Avatar universal
I know  I'm coming a little late but I just wanted to let you know that I think Lexapro is worth continuing with. I was put on it about 8 months ago for anxiety and mild depression. I started with 1/2 of a 10mg tablet (5mg a day), then after about a week graduated to 10mg. Then, after about a month, my GP decided to put me on the higher dose, 20mg, so I did the same thing: 15mg for about a week, then graduating to 20mg. You've got to take it really slowly or it can cause nausea. I'm really really glad that I'm on Lexapro.
Helpful - 0
Avatar universal
Same stuff with me.. Found nothing so far but pretty tired and depressed all the time and getting worried because I am now underweight.. All my doctor has me on is a weak dose of anti acids which hasn't helped a bit or even discussed all this stuff with me
But so glad people are going through the same thing and discussing it! Makes me feel a little bit more normal hahaha and omg my doctor told me to drink coffee instead of tea... Lucky I didn't I just stick to water now and Bye bye Alcohol
Helpful - 0
Avatar universal
Hi Matt,

Luckily my email still gets notifications about comments on this post. To make a long story short, I am feeling a lot better compared to when I originally made this post, but I'm not where I want to be. I rarely drink alcohol now and when I do, I can easily tell when things are going to turn sour for me the next day. Coffee is also a big nono. I think it may be the caffeine because energy shots leave me feeling terrible as well. My appetite still isn't great and I haven't put much weight back on, but I feel a lot better than I used to and I got off of all medications. If I  would find any benefit it would get would go away over time (like my body got used to it) and when I stopped, it was like going through withdrawal  and everything sucked. I pushed through though and over time felt better, but I had to take it very easy. It took me a long time before I even let myself take a sip of beer again.
Hope you start feeling normal again asap.
Helpful - 0
Avatar universal
I am experiencing the exact same problem! About six months ago I had been drinking heavily then one day I was fasting, exercised heavily, didn't eat and drank on an empty stomach. This led to excruciating pain. My appetite immediately disappeared and I started having problems with nausea and belching. No doctor could find any problems at all after many tests and medications. They all thought the alcohol connection was impossible, but I just think it's an impossible coincidence. I'm relieved to hear of someone else suffering the same problem. Have had the same panics and dark thoughts. But I just think that this can't be permanent. I know this is an old post, but are you feeling any better?
Helpful - 0
Avatar universal
You may wish to have your doctor try you on a low dose of Mirtazapine (Remeron). It will help with nausea and motility.  In addition, it stimulates your appetite so you can gain some weight back.  

I was diagnosed with FD and now also have Reactive Hypoglycemia following gallbladder removal.  Many days I am so miserable I wish I'd died on the operating table, so I empathize with your situation.  It took them months to find the hypoglycemia during which time I was pretty much written off as a nutcase because (according to the surgeon) I was "a perfect textbook extraction".  Yeah, thanks so much.

There is a lot of good information on the Internet...stick to credible medical sites...be your own advocate...even the best doctor can't keep up with all the research out there...don't be afraid to ask questions or seek a second or even third opinion.

Good luck & God bless.
Helpful - 0
Avatar universal
i recently have been diagnosed with fd and know your frustration.  i am currently under a gastro's care who has the heart of a teacher and really wants me to be comfortable.  my pain is as if my bra is tooo tight, upper epigastric burning and gnawing back pain between my shoulder blades.  i have always thought of myself as someone with "irritable bowel" but my doctor says fd is a motility problem and put me on a lifetime daily dose of miralax and metacmucil--mixed together per directions in 10 oz of water.  ALSO, he has given me a prescription for domperidome 10 mg po before meals daily (a motility drug out of canada).  as for diet---he said contrary to popular belief never eat a raw veggie--cook them and eat whatever, avoid a raw apple like the plague--cooked is ok.  never, ever have a carbonated beverage again that this is the number one reason for fd and lastly--stay away from coffee, reg or decaf, popcorn, and caffeine (ie chocolate).  i have done these things and been pretty much symptom free for 10 days now.  
by the way, i have had 2 negative egd's, ct scan of the abd with contrast, lap choly with ioc--and was convinced i somehow still had a stone in the pancreatic duct.  my md said that if i had another acute flareup while doing the things he suggested to let him know and he would perform and ERCP--however, so far so good.  i have had "tummy troubles" since i was a child and thought this is just how i'm made--however, i am beginning to see we are what we eat and i now eat much healthier, drink lots of water and poop 3 x's a day and feel much better.  hope you find what works for you.
Helpful - 0
Avatar universal
Thank you so much for responding! I was starting to think my thread would just go unnoticed and no one would ever see it!

I'm surprised your doc put you on desipramine before any of the other tricyclics. Apparently, it's one of the more potent and dangerous ones.  I was started on amitriptyline first (the one that worked but gave me pounding heart) and then switched to nortriptyline (the one that gave me 20 min palpitation session).  I was on the nortriptyline long enough to have the same bowel trouble as you did, and then some.  I wouldn't pass a stool for days, and when I would, they were (embarrassingly) very large and PAINFUL.  I bled every time.  I'm wondering if the problem might've been solved by taking a bulk-forming laxative like Metamucil everyday.  I never got to try this out fully while I was on it.  Maybe this is something to look into if you have the same problem.

The ginger root idea is interesting.  Besides the initial burning, has it always worked to bring relief 10 minutes later?  Is your stomach discomfort localized?  I noticed the tender spot appears to be where my esophagus meets my stomach.   Also, there's some slight tenderness in places in my intestines but not nearly as significant.  It's mostly this one spot!

It's interesting that your symptoms started within a year after stopping the Luvox.  Do you still get OCD symptoms?  Perhaps both of our situations resulted from chronic anxiety over something.  I noticed mine started within a month of my 21st birthday, something I was looking forward to (but unfortunately never got to enjoy for obvious reasons).  I was also in the summer interim before my first professional year of pharmacy school, so perhaps that was also subconsciously on my mind (along with a billion other things).

As for the Lexapro, I'm still sketchy about starting it.  I'm wondering if a steady sleep pattern and eating habits will help along with an exercise routine.  I'm now done school for the summer and have time to try out things (although I still need to get back to work).  The Lexapro I've just been deathly afraid of taking again since no one else I know who's taken it has reacted how I did (I'm so lucky!).  I've heard that some people don't regain their appetites back for 8 weeks, something I'm not sure I can afford.  I really NEED to gain weight. I'm still slowly losing weight (about a pound a month) and I can't seem to put anything back on (I'm already blessed/cursed with a fast metabolism). So the Lexapro will have to wait.

Please be sure to keep in contact with me about any updates or insights you might have. Feel free to send me a message anytime!  
Helpful - 0
Avatar universal
I have been diagnosed with Functional Dyspepsia.  I understand your frustration very well.  I had an endoscopy and biopsy - no ulcer, not nothing.  Doc said I had a "boring stomach"  lol  I had ultra sounds on my liver, pancreas, and gallbladder.  All was clear.  The doc put me on desipermine (they may not be spelled correctly), but the entire 6 days I was on it, I NEVER had a bowel movement!  I stopped taking it and the next day, things were normal.  WHY should I trade one issue for another?  I think it takes weeks for that med to take affect, but I will not tolerate not having a bowel movement for 6 days!!!

Let me add, I was on Luvox for 10 years for OCD.  Came off of it and within the year I started with the stomach symptoms that led to the functional dyspepsia diagnosis.  I fear my body is revolting against me for coming off of Luvox.  ???  Something to think about.

So, here I am still having these symptoms of FD and I am beyond frustrated.  I heard Lexapro was a possible treatment.  I swore I'd never take an SRRI again, but things are looking like I may have to.  After all, I started having FD AFTER I came off one SRRI (Luvox)!

I too am tired of feeling like crap (when the attacks come on, and the attacks can last anywhere from 2 days to weeks).  I'm only 41 and healthy otherwise.  I just want to feel good again.  YES, FD can make you depressed.  It does me.  

I get some relief by eating fresh ginger root.  I chop up about 1/2 teaspoon and put it on a big tablespoon.  I then cover it with honey.  I put it all in my mouth and chew really well to crunch up the ginger.  It burns until you get used to it, but for me, it brings relief in about 10 minutes after swallowing it.  

Let me know if you continue with the Lexapro.  I know this drug can take a couple months to take affect.  I'm going to request it when I see my doc again in June.  

You're not alone!
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