A Story About Functional Dyspepsia and Damjeok Disease Symptoms

Your stomach hurts, but tests show nothing is wrong? You experience recurring heartburn, bloating, a feeling of pressure in your chest, and even intermittent headaches, dizziness, insomnia, or feelings of depression. When you go to the hospital for tests, your gastroscopy is clear, there's no H. pylori, and your stomach acid levels are normal. Yet, your body feels uncomfortable every day. “Mealtime is stressful.” “I constantly feel indigestion, but there's no diagnosis.” Such experiences are often labeled as Functional Dyspepsia. However, for patients, the term 'functional' often signifies not the possibility of treatment, but the despair of having no language to explain their suffering.

Functional Dyspepsia – A Disease with a Name, but Lacking Explanatory Power

Functional dyspepsia has no clear anatomical or pathological lesions. Therefore, it is diagnosed based on international standards known as the Rome Criteria. According to Rome IV criteria, functional dyspepsia is defined by the following symptom groups:

• Postprandial fullness
• Early satiety
• Epigastric pain
• Epigastric burning

When one or more of these symptoms recur for at least three months, and there are no organic abnormalities, the term 'functional' is attached. However, while the disease has a name, treatment remains uncertain. Acid suppressants, gastroprokinetic agents, SSRIs, low-dose tricyclic antidepressants (TCAs)… Theoretically, they are supposed to help, but in actual clinical practice, patients' remarks like “It's the same even after taking them” are all too familiar. Why is this? Because this condition is not merely a problem with a single digestive organ, but a breakdown of the entire body's neurophysiological rhythm.

Patients Say, “Something Feels Off”

Medicine prefers clear symptoms. Like, “My stomach hurts,” “I have heartburn,” “I'm vomiting.” However, functional dyspepsia patients don't describe it this way. “My stomach constantly feels off, I'm drained of energy, and I feel a tightness from my epigastrium upwards.” “Some days my mind feels foggy, and on others, my mood sinks for no reason.” “I feel like I'm not digesting even while sleeping.” These are not single symptoms, but multiple symptoms that arise when the body's rhythm is disturbed. This is a classic manifestation of the Gut-Brain Axis, where the gastrointestinal tract, central nervous system, and autonomic nervous system are interconnected.

The Meaning of ‘Doctor-Centric Conceptual Compartmentalization’

The diagnosis of 'functional' is a physician's language for classifying diseases. This aligns with the assertion by French philosopher Georges Canguilhem that “normality should emerge from the meaning of life, not from statistics.” In other words, telling a patient 'it's not a disease' can be perceived as a dismissal of their suffering. The criteria of normal/abnormal held by physicians are too rigid to encompass the patient's suffering, and this compartmentalization ultimately led to the term 'functional'. Suffering that is real but unproven – ultimately, it's not a disease name but a signal that the structure of sensations and life itself has collapsed.

Damjeokbyeong (Accumulated Phlegm Syndrome) – Not a Disease Name, But a Patient's Narrative

Thus, some patients find greater solace in the term 'Damjeok' than 'functional'. Literally translated, 'Damjeok' means 'a disease of accumulated phlegm (痰).' However, in modern Korean traditional medicine, it is more broadly understood as a complex signal of autonomic nervous system dysfunction + weakened gastrointestinal function + systemic imbalance. The 'Damjeok' that patients describe is not merely a mass in the stomach, but a state where nerves are hypersensitive, the autonomic nervous system is unstable, the stomach is chronically weak, and emotions are also disrupted. This is expressed through Korean traditional medicine concepts such as Spleen-Stomach Qi Deficiency and Coldness (비위허한), Liver Qi Stagnation (간기울결), and Phlegm-Damp Stagnation (담울내결), and in Western medicine, it can be explained as sympathetic dominance, reduced vagal tone, and HPA axis dysfunction.

A Disease of Flow, To Be Addressed Through Flow

Human digestion is an evolutionarily unique process. Since we began cooking with fire, we have evolved to pre-digest energy externally and reduce the burden on our internal organs. However, modern lifestyles run counter to this flow. Fast eating, static postures, prolonged sitting, high stress, shallow breathing, insufficient sleep, low heart rate variability… All of these factors affect the stomach and eventually lead to a breakdown of the overall rhythm, manifesting as functional gastrointestinal disorders or Damjeok. The reason it cannot be treated with medication alone is clear. This is because it is a disease of flow, not structure.

This 'flow' is the 'rhythm of life,' encompassing Qi, blood, respiration, emotions, movement, and digestion. Functional dyspepsia is not simply a disease caused by excessive stomach acid. Therefore, linear drug prescriptions like acid suppressants or prokinetics have limited efficacy. Even with medication, improvement is often temporary or partial, and most patients repeatedly say, “My body remains sensitive even after taking medication,” or “When one symptom gets better, another part hurts.” The reason is clear.

This condition is not a malfunction of 'one part of the machine,' like a digestive organ, but rather a comprehensive manifestation resulting from a disrupted rhythm of life itself, encompassing the body's entire autonomic nervous system, sensory circuits, emotional amplitude, sleep, posture, breathing, eating speed, and even interpersonal relationships. For example, the vagus nerve regulates gastric motility while also being connected to heart rate, emotional regulation, and immune responses. Furthermore, the movement of the diaphragm not only regulates the stomach's position and tension but also shifts the balance between the sympathetic and parasympathetic nervous systems depending on the depth of breath. However, modern eating environments almost exclusively disrupt this rhythm. People hastily swallow food while sitting, press down on their digestive organs with shallow breaths, distract themselves with smartphones or screens, and immediately after eating, sit for long hours working or driving. Such daily routines largely disregard the physiological cooperation required for digestion, repeatedly increasing the burden on individual organs. Ultimately, functional dyspepsia should be understood not as organ failure, but as a failure of life's coordination.

Therefore, true treatment should not be mere 'antacid consumption' but rather the restoration of the body's rhythm, stabilization of the autonomic nervous system, and recovery of visceral movement and coordination. What's important here is a perspective that addresses the flow – or connectivity – between organs, rather than the organs themselves. In Korean traditional medicine, this is explained through concepts such as 'Qi flow,' 'Disharmony between Liver and Spleen (간비불화),' and 'Phlegm-Damp Stagnation (담울내결).' In modern physiology, terms like 'autonomic dysregulation,' 'vagal tone recovery,' and 'visceral motility' are used. Though the expressions differ, the core idea is the same. It's about restoring the overall flow, not just fixing a single cause. This flow is precisely the 'body's metabolic rhythm' that we have overlooked, and it is a crucial perspective for properly understanding functional dyspepsia and Damjeokbyeong.

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