Functional dyspepsia

At a glance

  • Functional dyspepsia usually causes a feeling of fullness and pain in the upper abdomen (belly).
  • It is not a dangerous condition, but it can be distressing.
  • It often comes and goes in phases of more and less severe symptoms.
  • Various things can help to better cope with the symptoms.
  • Functional dyspepsia can also occur in children and teenagers.


Photo of a mother with young daughter

Having stomach pain over long periods of time and often feeling unwell after eating can be very distressing, especially if it's not clear what's causing these symptoms. That is often the case with functional dyspepsia, because it can take a long time to get a .

Functional dyspepsia (also called non-ulcer dyspepsia) causes symptoms in the upper abdomen for months at a time, with no known physical cause. “Functional” means that the stomach and the first part of the small intestine (the duodenum) appear to be healthy but aren't working as they should. Sometimes people also have other illnesses that add to the functional dyspepsia symptoms or make them worse, like reflux or irritable bowel syndrome (IBS).

It is not known what causes functional dyspepsia. Factors that might play a role include reduced stomach movement (motility), a chronic bacterial , or previous inflammations in the digestive tract. Depression and anxiety can also make this type of recurring indigestion more likely. A mix of physical and mental factors are often involved.

Good to know

Functional dyspepsia isn’t dangerous. It doesn't affect your life expectancy.


Functional dyspepsia can cause a number of different symptoms. The two most typical kinds are:

  • Pain or a burning feeling in the upper abdomen (belly), often unrelated to meals (epigastric pain syndrome)
  • Feeling full early on while eating, or feeling full after eating (postprandial distress syndrome)

Other symptoms that may be directly related to functional dyspepsia include:

  • Bloating and cramping in the upper abdomen
  • Frequent burping
  • Nausea and feeling unwell
  • Vomiting (less common)

The symptoms may be almost constant or come in phases.

Some symptoms, such as insomnia, aren't in the digestive tract. Generally speaking, functional dyspepsia often has a greater effect on quality of life in the following people: women and older people, and those with anxiety disorders and depression.

Children and teenagers can also have functional dyspepsia. Their main symptoms are pain in the upper or lower abdomen.

Causes and risk factors

There is a lack of research on the causes of functional dyspepsia. Various factors are believed to play a role.

Things like pressure, stretching or chemical substances in food don't normally cause receptors and nerves in the stomach to trigger pain. But the way we feel pain is influenced by complex physical and psychological processes that are all interconnected. For instance, if an or irritates the mucous membrane lining the stomach, normal stomach activities might still feel painful after the has gone away.

Other causes may include:

  • A chronic with called Helicobacter pylori.
  • A healthy stomach stretches and relaxes after eating. Some people’s stomachs don't do this. As a result, the contents of their stomach don't spread out enough, which can easily cause a permanent feeling of being full or even nausea.
  • It might take longer than usual for the stomach contents to be passed on to the small intestine.
  • Experts suspect that other factors can cause stomach problems too. These include mental stress, tension, anxiety disorders and . Researchers are also looking into the role of things like processes in the small intestine and genetic predispositions.
  • The symptoms might be caused or affected by changes in the gut microbiome (the mix of living in the bowel) too.

Researchers are also looking into various causes of recurring indigestion in children and teenagers. Children often get belly ache when they're feeling anxious, worried, out of their depth, or have distressing experiences. In turn, their belly ache can affect children mentally and they might start doing fewer activities. A distressing family situation can increase the risk of longer-lasting functional stomach problems in children. Children who have a family member with chronic pain (of any kind) are more likely to develop these problems. The risk may also be higher if the symptoms already develop at pre-school age or if they occur together with anxiety or .


Around 20-30 % of adults in Germany have long-term stomach trouble. In over half of those who go to the doctor because of it, no physical causes can be found. That means that about 10-15 % of people living in Germany have functional dyspepsia (recurring indigestion for no clear reason).

The true percentage is probably higher, though, because it can be difficult to tell it apart from other stomach problems.

Stomach pain and other symptoms that are signs of functional dyspepsia are about as common in children and teenagers as they are in adults. About 10-20 % of children have the typical long-lasting or recurring symptoms.


Functional dyspepsia symptoms can last for months or years. In half of those affected, the symptoms disappear without treatment after several years. The condition may return and repeatedly lead to symptoms. Some people constantly have stomach pain or other symptoms of functional dyspepsia.


Almost half of the long-term stomach symptoms are triggered or made worse by other physical causes or medications. Because of this, it is only considered to be functional dyspepsia if other potential causes of the symptoms have been checked and ruled out. These include

Sometimes gastritis or gallstones are diagnosed but the symptoms aren't completely typical. Then the person may have functional dyspepsia on top of the other diagnosed condition.

Doctors diagnose functional dyspepsia based on a description of the symptoms together with physical examinations and other tests. These may include blood and stool tests, an ultrasound scan of the abdomen, or a gastroscopy. Gastroscopy can be done as an outpatient procedure. If children have stomach problems over a period of weeks, you should talk to your pediatrician and discuss the next steps together.


The good news is that functional dyspepsia isn’t dangerous. The aim of treatment is to relieve the often distressing symptoms, or at least help you cope better with them.

Some people with functional dyspepsia say that certain foods make their symptoms worse, so they change their diet. Other people find that eating smaller, low-fat meals spread across the day can help. But research has not shown that changing your diet generally leads to an improvement.

Other things that can help include eating in a pleasant environment, chewing your food well, and taking your time when eating. Some people also find that breathing techniques and have a positive effect. Relaxation and stress management techniques like autogenic training and progressive muscle relaxation can be helpful too. Exercise and sports stimulate your digestion.

Essential oils and extracts from various plants (like peppermint and caraway oil) can relieve cramping and might stimulate the digestive tract too. Medications that reduce acid production in the stomach, like proton pump inhibitors and H2-receptor antagonists, can also help. But they have only been approved for the treatment of other digestive problems and diseases (off-label use). Studies have found that these medications can relieve the symptoms of functional dyspepsia. They are recommended as a treatment for this condition.

If someone has a Helicobacter pylori in the lining of their stomach, that is often treated first. It is also important to treat other illnesses such as or psychological problems such as .

If children have symptoms over a period of weeks, it can be a good idea to talk to your pediatrician and discuss the next steps: How can the symptoms be dealt with better? Where can you find psychological support? Are other medical examinations a good idea and, if so, when? These are some of the questions you can discuss.

Everyday life

Functional dyspepsia can affect your overall wellbeing and everyday life. The symptoms often make it hard to enjoy eating and drinking.

Some people don't want to go to the doctor because they're worried about unpleasant outcomes. Some ignore their symptoms or find their own explanations for them. Others don't feel like their symptoms are being taken seriously. But talking to your doctor and having medical examinations can both help to relieve symptoms and to find a suitable treatment.

Many people with unexplained symptoms are worried that they may have cancer. But stomach problems are only rarely caused by cancer. Warning signs like blood in your stool or losing weight for no known reason should be looked into, though.

A lot of people try to fix the problem themselves. Some withdraw from social life or call in sick a lot. Others change their diet and use expensive special products, buy over-the-counter medication from the pharmacy, or try to find relief with natural medicine treatments like and osteopathy. But trying out all sorts of treatments can cause more stress and have side effects. If you want to try doing things for yourself, it is best to talk to your doctor about which treatments are suitable – and which treatments are not. They will also be able to tell you which treatments are covered by statutory health insurers (in Germany).

People often learn to cope better with the symptoms over time. New possibilities can open up if you stop putting all of your energy into fighting the symptoms. Rethinking what is really important in your everyday life and observing your own limits might help.

And last but not least, it’s important not to stop doing things that you enjoy. This also applies to social activities and staying in touch with friends and family.

Braun J, Müller-Wieland D. Basislehrbuch Innere Medizin. München: Urban und Fischer; 2018.

De Bruijn CM, Rexwinkel R, Gordon M et al. Antidepressants for functional abdominal pain disorders in children and adolescents. Cochrane Database Syst Rev 2021; (2): CD008013.

Deutsches Kollegium für Psychosomatische Medizin (DKPM), Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM). Funktionelle Körperbeschwerden (S3-Leitlinie). AWMF-Registernr.: 051-001. 2018.

Eusebi LH, Black CJ, Howden CW et al. Effectiveness of management strategies for uninvestigated dyspepsia: systematic review and network meta-analysis. BMJ 2019; 367: l6483.

Guo Y, Wei W, Chen JD. Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review. World J Gastroenterol 2020; 26(19): 2440-2457.

Madisch A, Andresen V, Enck P et al. The Diagnosis and Treatment of Functional Dyspepsia. Dtsch Arztebl Int 2018; 115(13): 222-232.

Mao X, Guo S, Ni W et al. Electroacupuncture for the treatment of functional dyspepsia: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99(45): e23014.

National Institute for Health and Care Excellence (NICE). Dyspepsia and gastro-oesophageal reflux disease: investigation and management of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease, or both. 2014.

Pschyrembel Online. Funktionelle Dyspepsie. 2018.

Robert Koch-Institut (RKI), Statistisches Bundesamt (Destatis). Gastritis, Magen- und Zwölffingerdarmgeschwüre. (Gesundheitsberichterstattung des Bundes; Heft 55). 2013.

Stanghellini V, Chan FK, Hasler WL et al. Gastroduodenal Disorders. Gastroenterology 2016; 150(6): 1380-1392.

Turco R, Salvatore S, Miele E et al. Does a low FODMAPs diet reduce symptoms of functional abdominal pain disorders? A systematic review in adult and paediatric population, on behalf of Italian Society of Pediatrics. Ital J Pediatr 2018; 44(1): 53.

Wauters L, Dickman R, Drug V et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia. United European Gastroenterol J 2021; 9(3): 307-331.

Wegh CA, Benninga MA, Tabbers MM. Effectiveness of Probiotics in Children With Functional Abdominal Pain Disorders and Functional Constipation: A Systematic Review. J Clin Gastroenterol 2018; 52 Suppl 1: S10-S26.

Zeevenhooven J, Timp ML, Singendonk MMJ et al. Definitions of Pediatric Functional Abdominal Pain Disorders and Outcome Measures: A Systematic Review. J Pediatr 2019; 212: 52-59.e16.

Zhang J, Liu Y, Huang X et al. Efficacy Comparison of Different Acupuncture Treatments for Functional Dyspepsia: A Systematic Review with Network Meta-Analysis. Evid Based Complement Alternat Med 2020: 3872919.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas - either via our form or by We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Über diese Seite

Created on November 28, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.