I have functional dyspepsia. I think of it as the "IBS" of the upper GI tract...neither is fun.

The worst of my symptoms are distention and bloating, upper GI pain, but mine is more cramping and heaviness after and sometimes during eating, early satiety (get full quickly) and appetite loss. I have some lower abdominal pain too, but the FD pain is more limiting for me.

I'm very sensitive to medications, and my GI doctor knows this, so we didn't immediately go that route. She did mention they often prescribe low doses of neuromodulators (aka antidepressants) for GI conditions because FD and IBS are considered to be disorders of brain-gut communication.

I took FDGard, which is an over-the-counter blend of caraway oil and peppermint oil. It's enteric coated so that it makes it intact to the place where it needs to break down to sooth the pain. I found it very effective for pain and cramping if taken 30 minutes before eating, but sometimes the peppermint oil aggravates people with reflux or the "cooling" sensation can be disconcerting... I prefer that to the pain though. It's really expensive though and there's not really a good generic substitute because these are enteric-coated. It probably has the most immediate effect for me. It can also be taken after eating, but I find it doesn't work as well when I take it that way.

I've also used Iberogast, which is an herbal blend (both FDGard and Iberogast have been clinically tested) that you put in a liquid and drink. There's more flexibility than FDGard because you can take it right when you eat or symptomatically. Iberogast is a first line treatment for IBS and FD in Europe and Canada, for some weird reason it's not in the US. My dietician told me about it. You can order it online or I order it from a site called Northern Vitality. I usually use it for pain after eating. It feels not as strong to me as FDGard.

My GI also referred me to see a GI psychologist (I'm seen at an academic medical center), but the rationale as is when you calm the brain and nervous system, because of the mind-gut connection, it can also calm GI symptoms. Even when you feel actively calm, the central nervous system can still be riled up. I have other chronic pain conditions, so this is usually the case. It can sound minimizing or "woo woo," but we worked on different breathing techniques, which for me is effective for taking the edge off pain. Most GI psychologists also practice gut-directed hypnotherapy, which feels more like a guided meditation to me. I didn't really get to try it because my sessions got interrupted by pandemic lockdowns, but you can find hypnotherapy recordings online or in the app Insight Timer. There's a paid app called Nerva; it's technically for IBS, but the app is still applicable for FD symptoms.

Last, I recently started experimenting with enzymes (think like Beano and Lactaid)... For some people, our body is more sensitive to the normal sensations that happen when food breaks down in the stomach and gut and that causes the pain. The enzymes for beans and lactose intolerance are more well-known, but a type of carbohydrate called fructans (sorry if you already know all this, but I didn't when I got diagnosed) in one of the most common sensitives--it's found in garlic, onion, wheat. Those are clear triggers for me, so my dietician recommended this new product called Fodzyme, which is one of the few products on the market that has enzymes to help with fructans. It's sooo expensive though! All gut medications are so expensive for some reason.

There are diet interventions and people will swear by eliminating gluten or sugar, or whatever (but more power to those people if it makes them feel better), but my dietician specializes in gut health and she said there's really not much research and more and more the research is showing that restrictive diets can lead to development of disordered thoughts around eating. It may be part of the reason why there's a higher incidence of eating disorders in people with functional GI conditions than in the general public. That happened to me, and food restriction really stressed me out, when I had never been susceptible or concerned about what I ate before, so for that reason I've done a lot of work with my dietician on expanding what I'm able to eat while also considering my symptoms. But if it's something you're interested in looking into, there are a lot of conversations probably here and in other places about the best diets for it.