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Dyspepsia - Symptoms
Last reviewed: 04.07.2025
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Depending on the prevalence of putrefactive or fermentative processes in the intestines in the clinical picture, putrefactive and fermentative forms of alimentary dyspepsia are conventionally distinguished.
Putrefactive dyspepsia occurs mainly due to protein digestion disorders, fermentative dyspepsia - carbohydrates, and the nature of the intestinal microflora is significant. Putrefactive dyspepsia is manifested by moderate abdominal distension, the passage of a small amount of gases with a typical foul (putrefactive) odor, diarrhea. The stool is dark in color, also with a putrefactive odor. As a result of the formation in the intestine and absorption of putrefactive products, signs of general intoxication occur: weakness, headache, decreased appetite, mood, work capacity, neurocirculatory dystonia with angiospasms. Coprological examination reveals a sharply alkaline reaction of feces due to the formation of ammonia, pronounced creatorrhea, with muscle fibers predominating with preserved transverse striation. Indican is sometimes detected in the urine.
Fermentative dyspepsia is characterized by pronounced flatulence, a feeling of heaviness, rumbling, and overflow in the abdomen; the passage of a large amount of gas with virtually no odor; paroxysmal, intestinal colic-type abdominal pain that decreases or disappears after the passage of gas, taking carbolene, carminative tea, walking, or being in a knee-elbow position with a raised pelvis. The pathognomonic sign is frequent, liquid, foamy stool with a sour odor. The color of the feces is light yellow, undigested remains of eaten food (fruits, vegetables, etc.) are found in them, the reaction of the feces is sharply acidic. Microscopic examination of feces reveals many starch grains both extra- and intracellularly, a significant amount of fiber, crystals of organic acids, and representatives of iodophilic flora.
In addition to putrefactive and fermentative dyspepsia, there is also fatty dyspepsia, characterized by profuse diarrhea, polyfecalia, and the appearance of light, “fatty” feces of a neutral or alkaline reaction.
A coprological examination reveals quite a lot of droplets of neutral fat, especially crystals of fatty acids and their insoluble salts - soaps (mainly the intestinal form of steatorrhea).
In clinical practice, a mixed type of alimentary dyspepsia is often encountered due to the involvement of other parts of the digestive tract in the pathological process along with the intestines.
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