The management of functional dyspepsia in clinical practice: what lessons can be learnt from recent literature?

Abstract

Functional dyspepsia is a prevalent functional gastrointestinal disorder that can significantly erode the quality of life of sufferers and places a major cost burden on healthcare services. In this article, we review the recent literature, selecting the information we consider relevant since it has changed our clinical management of patients with functional dyspepsia.

Keywords: functional dyspepsia; gastroenterology; gastrointestinal disorder.

Figure 1.. Practical management algorithm in functional dyspepsia.

EPS, epigastric pain syndrome; FD, functional dyspepsia; FODMAP, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; GERD, gastro-oesophageal reflux disease; GI, gastrointestinal; IBS, irritable bowel syndrome; PDS, postprandial distress syndrome; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant.

Figure 2.. Abnormal gastric motility and function could be implicated in the pathophysiology of symptoms in functional dyspepsia, especially in patients with postprandial distress syndrome.

Heightened visceral sensitivity has an important role in epigastric pain syndrome but is also present in many individuals with postprandial distress. In clinical practice, with the exception of detection of abnormal gastric emptying by scintigraphy, it is currently not possible to identify the specific causes of disease.