Dyspepsia is a digestive disorder that causes discomfort in the upper abdomen due to gastric acid or stomach disease. In Indonesia, the prevalence of dyspepsia reaches 40-50%, and in 2020, it was estimated that the incidence of dyspepsia increased from 10 million people to 28 million people.

The discomfort in the upper left abdomen or the epigastric area can be accompanied by symptoms such as nausea, vomiting, early satiety, feeling full after eating, bloating, and regurgitation. Complaints like bloating may occur but are not always associated with dyspepsia. Dyspepsia can be caused by organic factors as well as psychological stress. However, it can also be caused by underlying diseases.

There are five major causes of dyspepsia that can be identified: Gastroesophageal reflux (with or without inflammation in the esophagus), certain medications, functional dyspepsia, peptic ulcer disease, and malignancy. Other less common causes include hepatobiliary diseases, intestinal motility disorders, chronic inflammation such as gastritis, Crohn's disease, sarcoidosis, irritable bowel syndrome (IBS), metabolic disorders (hypercalcemia), hernia, and abdominal wall pain.

Gastroesophageal Reflux Disease (GERD), commonly known as GERD, is a condition caused by the reflux of stomach contents into the esophagus, leading to symptoms or medical complications. The prevalence of GERD in Indonesia is 27%. Typically, the diagnosis of GERD is suspected in patients with classic symptoms of "heartburn" or burning sensation in the chest or esophagus. GERD is strongly influenced by factors such as stress and a healthy diet.

Dyspepsia and GERD can be diagnosed through history-taking, physical examination, and additional tests. From the history, complaints such as digestive discomfort, epigastric pain, bloating, regurgitation, and nausea/vomiting can be obtained. These symptoms can be triggered by poor eating habits, such as eating late, eating in a hurry, irregular eating schedules, or consuming irritating foods like spicy, acidic, or caffeinated foods, as well as stress factors. An important aspect of the physical examination is to differentiate between Dyspepsia and GERD from acute Dyspepsia syndrome. Additional examinations may include endoscopy to assess the severity of damage and the extent of ulceration or corrosive effects. Other tests that can be performed include barium studies and fecal examinations to determine the cause of dyspepsia.

Dyspepsia and GERD require comprehensive management. It is important to address dyspepsia and GERD because their symptoms significantly affect a person's quality of life. Individuals may struggle to eat due to discomfort in their digestive organs. Additionally, a decreased appetite can worsen dyspepsia and GERD, potentially affecting a person's future health. Management options include medication therapy and lifestyle changes. Lifestyle changes that can be implemented include:

• Adopting a healthy eating pattern a. Eating before feeling overly hungry and stopping before feeling too full b. Eating small, frequent meals c. Avoiding lying down after eating, with a 2-hour gap d. Avoiding large meal portions e. Avoiding high-fat intake f. Avoiding irritating foods such as spicy and acidic foods
• Avoiding caffeine
• Quitting smoking
• Losing weight if overweight

References: Albertus, Audric. 2022. Red Flag Dyspepsia. Alomedika. Retrieved from: https://www.alomedika.com/red-flag-dispepsia. Accessed on January 27, 2023. Harmon, R.C., Peura, D.A. 2010. Evaluation and Management of Dyspepsia. Therapeutic Advances in Gastroenterology (3): 2. Occifa, G.A. 2022. GERD. Alomedika. Retrieved from: https://www.alomedika.com/penyakit/gastroentero-hepatologi/gerd. Accessed on January 27, 2023.

Author: Dr. Sendyka Rinduwastuty (Medical Consultant at PRAMITA Clinical Laboratory Branch Jl. Gajah Mada No. 88 Tegal)