IntroductionThe term “dyspepsia” comes from the Greek words “dys’ and ‘peptin”, which maen “ill digestion” or indigestion, although this set of symptoms in the adult clinic has little to do with the digestion or absorption process, and refers more to ailments related to the upper section of the gastrointestinal tract.AimAssessment of the frequency of functional dyspepsia diagnosis, the characteristics of the group and an attempt to identify the accompanying symptoms, assessment of histological lesions and an attempt to answer question about the efficiency of anti-secretory and eradication therapy.Material and methodsThe study involved patients reporting for gastrofiberscopic examination due to dyspeptic ailments. A total of 230 patients were examined, including 140 women and 90 men, above 18 years of age. They underwent endoscopic examination, and a selected group with functional dyspepsia (FD), analysed using the ‘Gast’ questionnaire, underwent eradication therapy or proton pump inhibitors. Statistical analysis involved χ2 and Fischer’s test.ResultsThe study involved 230 individuals with dyspeptic disorders. The largest age group was 46–60 years. These patients reported due to their ailments mostly in autumn and winter. The differentiated group with FD included 53 patients (23% of the clinical population). 69.8% of the FD group was infected with Helicobacter pylori (with 81.2% of the whole population, respectively). Individuals with FD reported improvement more often after being administered drugs to decrease gastric secretion, more often declared post-elementary education and suffered from non-gastric ailments yet still described their state of health as good. No positive therapeutic effect of eradication was noticed during the 6-month observation.ConclusionsDue to the very high ratio of subjects with functional dyspepsia, also observed in the study sample, and the influence of civilization progress, we should expect increasing frequency of occurrence of this problem.

The study focuses on evaluation of the Default Mode Network (DMN) activity in functional magnetic resonance imaging (fMRI) in resting state in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), Crohn's disease and colitis ulcerosa (IBD) in comparison to healthy volunteers. We assume that etiology of both functional and nonspecific inflammatory bowel diseases is correlated with disrupted structure of axonal connections. We would like to identify the network of neuronal connections responsible for presentation of symptoms in these diseases. 56 patients (functional dyspepsia, 18; Crohn's disease and colitis ulcerosa, 18; irritable bowel syndrome, 20) and 18 healthy volunteers underwent examination in MRI of the brain with assessment of brain morphology and central nervous system activity in functional imaging in resting state performed in 3T scanner. Compared to healthy controls' DMN in patients with nonspecific digestive tract diseases comprised additional areas in superior frontal gyrus of left hemisphere, in left cingulum and in the left supplementary motor area. Discovered differences in the DMNs can be interpreted as altered processing of homeostatic stimuli. Our study group involved patients suffering from both functional and nonspecific inflammatory bowel diseases. Nevertheless a spectrum of changes in the study group (superior frontal gyrus of the left hemisphere, in the left cingulum and in the left supplementary motor area) we were able to find common features, differentiating the whole study group from the healthy controls.

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Functional brain imaging (positron emission tomography – PET, functional magnetic resonance imaging – fMRI), allowing in vivo analysis of the brain-digestive tract interaction and the neurological mechanisms underlying visceral hypersensitivity, significantly advanced research and helped in the understanding of the interrelations in this field. Differences in this parameter can result from alterations in task-related cognitive states or from resting state processes. Nowadays, advanced imaging techniques such as fMRI are more frequently used and are acknowledged among both clinicians and radiologists in the diagnostic algorithm of digestive tract diseases. Functional dyspepsia is a condition in which neuroimaging allows for analysis of dysfunctions within the brain-gut axis (BGA) engaged in processing of visceral discomfort and pain. The results of studies in patient groups with irritable bowel syndrome prove that psychosocial factors significantly affect the mechanisms regulating visceral sensitivity within the brain. The BGA includes neuronal pathways (autonomic nervous system), neuroendocrine (hypothalamo-pituitary-adrenal axis), and neuroimmunological ones. Psychological processes affect the functioning of the digestive system and can cause dyspeptic symptoms. A patient’s mental condition associated with stress can affect processes taking place in the central nervous system and trigger somatic reactions in the digestive tract through the autonomic visceral system.

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