 Dispepsia is just a fancy word for an upset stomach, feelings of fullness, a discomfort, nausea, bloating, belching, affecting up to one in five individuals. In my last video, I talked about the risks associated with proton pump inhibitor drugs like Nexium, as well as folk remedies like baking soda. So all in all, studies have emphasized the unmet need for medications to treat patients with dyspepsia, but why not try food? One study put Amalaki to the test, which is just another name for Amla. They call it an iovatic drug, but it's just a fruit of powdered Indian gooseberries. One teaspoon of dried Indian gooseberry powder three times a day versus an ounce of some gel and acid every three hours. And both work just as well. Significant decreases in peak acid output and a cutting of dyspepsia symptoms scores in half. If I conclude that Amla is therefore better, I mean it's about a hundred times cheaper, about a penny a week instead of a dollar a week, and more convenient than downing an acid six times a day. Though Amla may be a safe, simple, natural remedy, such an approach is still very much in the pharmaceutical model of treating the symptoms rather than the underlying cause. I mean, dyspepsia is not caused by a gooseberry deficiency. What is it caused by? Well, about one in seven people describing a range of gastrointestinal symptoms feel better cutting out gluten. But for the other 86% of people, the most well-characterized trigger is high-fat meals. If you give people a fatty soup, just broth with added fat, it takes three times longer to empty from your stomach compared to the broth alone, like an hour and a half versus just a half hour. Now the emptying grate didn't necessarily correlate with how people felt, but regardless, the fatty broth increased the severity and frequency of dyspepsia over the regular broth. What happens in dyspepsia is people become hypersensitive to the stretching of the stomach when you eat, but it also matters what you eat. The human stomach can normally accommodate about a quart of food, a thousand milliliters, four cups. But if you stick a balloon into people's stomachs attached to a hose, people with dyspepsia will start feeling discomfort about here, only about one and a half cups, when the stomach is less than half full. But that's when you're dripping fat into their gut. But if you're instead dripping sugar into their gut while you're blowing up the balloon, it can get up to here, before causing discomfort in dyspeptics. About 70% more, and the same with fullness and nausea. Increase the pressure on the stomach with fat in there, and fullness and nausea shoot up with fake fat in your stomach. Instead, the same pressures resulted in significantly less feelings of fullness and nausea. These studies show that during the distention of the stomach, as the stomach fills up, dietary fats are a major trigger of dyspeptic symptoms, such as nausea, pain, bloating, fullness, and they modulate symptoms in a dose-related fashion, meaning more fat, the worse people felt. These were some pretty elegant experiments, but also a bit artificial. I mean, we don't typically eat with balloons in our stomach, so how about an experiment using actual food? They compared yogurt's high in sugar, low in fat, versus high in fat, low in sugar. Including the low-fat yogurt, there wasn't much of a difference in the nausea, pain, and bloating scores between those with dyspepsia and healthy subjects, but give them the same amount of high-fat yogurt and dyspepsia symptoms shot up almost immediately. So one of our major findings was that the induction of gastrointestinal symptoms after the test meals were nutrient-specific. The consumption of a high-fat test meal was associated with a substantially greater increase in nausea and pain when compared to a high-carbohydrate meal among those with dyspepsia. With the symptoms scores increasing immediately after eating. This would suggest that sufferers not only reduced the amount of food they eat, which is the typical advice, but also tried to keep the fat content down, a message echoed by a recent review of all such studies put together. Current studies show that fatty foods are associated with occurrence of dyspeptic symptoms, and reduction of fat intake may help alleviate symptoms.