J Korean Med Assoc.  2016 Apr;59(4):311-318. 10.5124/jkma.2016.59.4.311.

Diagnosis and treatment of functional dyspepsia

Affiliations
  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 2Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea. kchuh2020@hanmail.net

Abstract

Functional dyspepsia is defined as the presence of the symptoms that originate from the gastroduodenal area, without evidence of any organic, systemic, or metabolic disease that could explain these symptoms. The pathophysiology of functional dyspepsia includes chronic duodenal inflammation, Helicobacter pylori, excessive gastric acid secretion, dietary factors, and psychosocial, genetic, and environmental factors. However, gastric dysmotility and visceral hypersensitivity are thought to play a major role in the pathogenesis of functional dyspepsia, and other factors may affect gastric motility and visceral hypersensitivity. In the diagnosis of functional dyspepsia, upper gastrointestinal endoscopy is important to rule out organic diseases; an H. pylori test-and-treat strategy is currently not recommended for the initial diagnostic step in Korea where both H. pylori prevalence and gastric incidence are very high. Anti-secretory drugs (proton pump inhibitors and histamine 2 receptor antagonists) and prokinetics can be used as a first-line treatment depending on the patient's symptoms (postprandial distress syndrome vs. epigastric pain syndrome). If initial treatment is not effective, tricyclic antidepressants and/or anxiolytics (fundic relaxants) could be used in selected patients.

Keyword

Functional dyspepsia; Helicobacter pylori; Diagnosis; Therapeutics

MeSH Terms

Anti-Anxiety Agents
Antidepressive Agents, Tricyclic
Diagnosis*
Dyspepsia*
Endoscopy, Gastrointestinal
Gastric Acid
Helicobacter pylori
Histamine
Humans
Hypersensitivity
Incidence
Inflammation
Korea
Metabolic Diseases
Prevalence
Anti-Anxiety Agents
Antidepressive Agents, Tricyclic
Histamine
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