Functional dyspepsia means the stomach looks normal on camera but is sensitive, empties slowly or does not relax well with food.

Diet and lifestyle

• Regular aerobic exercise, such as brisk walking most days Proven
• Five to six small meals instead of three large ones May help
• Reduce fat and fried food; fat slows stomach emptying and increases fullness May help
• Stop anti-inflammatory painkillers (ibuprofen, diclofenac) unless your doctor advises otherwise, and do not stop aspirin prescribed for your heart without advice Proven
• Drink water between meals rather than large volumes with food May help

Common herbal products

• Peppermint and caraway oil in enteric-coated capsules reduced pain and fullness in several trials.
• STW5 (Iberogast) drops, a herbal combination including chamomile and peppermint (avoid in liver disease or pregnancy), helped in several trials.
• Anise seed powder (3 g after each meal, three times daily) outperformed placebo in a small trial.
• Ginger may speed stomach emptying and ease nausea.
• Black seed (Nigella sativa) with honey showed benefit in a small study. Honey in large amounts is not suitable for people with diabetes.
• Mastic gum improved symptoms in a small trial.
• Manuka honey kills H. pylori in the laboratory only and does not replace its treatment.
• Kefir taken with H. pylori treatment improved results and reduced side effects in one trial.

Try one product at a time for 4 weeks and stop it if there is no benefit. Avoid peppermint products if you have significant heartburn. Do not use herbs in pregnancy without advice.