Functional dyspepsia (FD) is a condition where a child has frequent or ongoing upper abdominal discomfort — such as pain, nausea, or fullness — without any disease, inflammation, or blockage in the stomach or intestines.
FD is a type of functional gastrointestinal (GI) disorder and is common in both children and adults. Functional GI disorders occur when the GI tract and brain are not communicating or functioning normally. Changes in movement, sensation, and the signals between the brain and digestive system can cause GI symptoms, even when there is no visible disease, inflammation, or blockage.
What Causes Functional Dyspepsia?
The exact cause is not fully understood. Factors may include:
- Changes in how the stomach functions, such as problems with stomach emptying or stretching
- Increased sensitivity of stomach nerves to normal digestion
- Brain-gut interaction changes — the nerves and signals between the stomach and brain are more reactive
- Psychological stress or anxiety which can worsen symptoms
Subtypes of Functional Dyspepsia
- Epigastric Pain Syndrome (EPS) This type causes pain or burning in the upper abdomen (epigastrium) that is not exclusively related to meals. The discomfort is persistent or recurrent, may occur while fasting, and is not explained by reflux or other structural disease.
- Postprandial Distress Syndrome (PDS): This type causes symptoms after eating a meal such as:
- Early Satiety: feeling very full quickly after starting a meal
- Postprandial fullness: feeling overly full after a normal-sized meal
Symptoms that are triggered by eating often lead to reduced food intake and can overlap with bloating or nausea.
What are the Signs and Symptoms?
Children with functional dyspepsia often report:
- Persistent or recurrent upper abdominal pain or discomfort
- Nausea (with or without vomiting)
- Feeling full quickly after beginning to eat (early satiety)
- Feeling overly full after a normal-sized meal (postprandial fullness)
- Bloating or upper belly pressure
Symptoms are not typically relieved by a bowel movement and are not explained by constipation, diarrhea, or another disease.
How is Functional Dyspepsia Diagnosed?
A pediatric gastroenterologist diagnoses FD by:
- Reviewing a detailed history of symptoms
- Performing a physical exam
- Ruling out alarm signs or other medical conditions
Testing is not always necessary. A healthcare provider will decide whether tests are needed to look for other causes of symptoms.
What are the Treatment Options?
Treatment focuses on reducing symptoms and improving daily life. Options include:
- Education & reassurance: Understanding that symptoms are real but not dangerous often reduces worry.
- Dietary adjustments: Smaller, more frequent meals; avoiding high-fat or spicy foods; limiting caffeine or carbonated drinks.
- Medications:
- Acid reducers (PPIs, H2 blockers) if heartburn-like symptoms are present
- Prokinetics (to help stomach emptying)
- Medications to calm stomach nerve sensitivity
- Psychological therapies:
- Cognitive behavioral therapy (CBT) (A psychological treatment that focuses on changing unhelpful thinking patterns and behaviors to improve emotional regulation and coping skills.
- Guided Imagery (A mind-body technique that is a type of calming therapy. It uses each of the five senses and descriptive language to create mental images that promote relaxation and stress reduction.
- Lifestyle changes: good sleep, stress management, and staying active.
What is the Long-Term Outlook?
Functional dyspepsia is not dangerous and does not cause long-term damage to the stomach.
- Many children improve with reassurance, dietary changes, and coping strategies.
- Some experience symptoms that come and go for months or years.
- With support, most children are able to maintain normal growth, school attendance, and quality of life.
If symptoms are persistent, worsening, or interfering with eating, growth, school, or daily activities, talk with your child’s healthcare provider.
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Adapted from IFFGD Publication: Dyspepsia in Children by Mohamad Abi Nassif, Neha Santucci MD; Pediatric Gastroenterology, Cincinnati Children’s Hospital; Department of Pediatrics, University of Cincinnati College of Medicine Edited By: Jose M Garza MD, Medical director, Neurogastroenterology and Motility, Children’s Healthcare of Atlanta. Partner at Gi Care for Kids, Atlanta, GA