Functional dyspepsia: past, present, and future

Abstract

Functional dyspepsia (FD) is a highly prevalent gastrointestinal disorder characterized by symptoms originating from the gastroduodenal region in the absence of underlying organic disease that readily explains the symptoms. The Rome II consensus, which defined FD as the presence of unexplained pain or discomfort in the epigastrium, had a number of drawbacks, including an unjustified focus on pain, inclusion of a large number of nonspecific symptoms, and an unclear position on overlap with gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). The Rome III consensus redefined FD as the presence of epigastric pain or burning, postprandial fullness or early satiation in the absence of underlying organic disease. Frequent overlap with GERD and IBS is acknowledged but does not exclude a diagnosis of FD. A subgroup classification into postprandial distress syndrome and epigastric pain syndrome was proposed. Ongoing studies will clarify the impact of this subdivision on clinical management and treatment outcomes.

Cigarette Smoking and its Association with Overlapping Gastroesophageal Reflux Disease, Functional Dyspepsia, or Irritable Bowel Syndrome

“…Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and irritable bowel syndrome (IBS) are common gastrointestinal (GI) diseases in adults (1)(2)(3). GERD is caused by an abnormal reflux of gastric contents into the esophagus and is characterized by bothersome symptoms such as heartburn and acid regurgitation (4).…”

Comparison of Gastric Wall Thicknesses with Hydrogastric Sonography in Functional Dyspepsia Patients

“…1,3,16 The symptom comp lex inc lu des epi gas tric pa in, post pran di alfull ness,blo a ting,earlysa ti ety,na use a,vo mi ting,andepi gas tricdis com fort,andthese symptoms are of ten re la ted to in ges ti on of a me al. [3][4][5]9,17 Be ca u se,symptompat ternsvarygreatlyamongdyspep ticpa ti ents,func ti o naldyspepsi a can be di vi ded in to sub gro ups with dis tinct de mog rap hicfe a tu resandfuncti o naldis tur ban ces ac cor dingtothepre do mi nantsymptomtype.…”

“…1,3,16 The symptom comp lex inc lu des epi gas tric pa in, post pran di alfull ness,blo a ting,earlysa ti ety,na use a,vo mi ting,andepi gas tricdis com fort,andthese symptoms are of ten re la ted to in ges ti on of a me al. [3][4][5]9,17 Be ca u se,symptompat ternsvarygreatlyamongdyspep ticpa ti ents,func ti o naldyspepsi a can be di vi ded in to sub gro ups with dis tinct de mog rap hicfe a tu resandfuncti o naldis tur ban ces ac cor dingtothepre do mi nantsymptomtype. 18 Re centstu di esha vein di ca tedare la ti ons hipbetwe en spe ci fic symptoms and the pre sen ce of pat hoph ysi o lo gi cal mec ha nisms in func ti o nal dyspep si awit ho utastruc tu ralexp la na ti on.The pre sen ceofim pa i redpro ces singofame al,ab normal up per gas tro in tes ti nal mo ti lity and vis ce ral per cep ti onisas so ci a tedwithpost pran di aldis tress, na u se a,blo a tingandearlysa ti etyindyspep ticpati ents.…”

“…19 Thepre sen ceofhyper sen si ti vitytogas tric dis ten si onandtogas tricacid,withorwit ho utinf lam ma ti onofthemu co saisas so ci a tedwithsymptomsofepi gas tricpa in,bur ning,earlysa ti ety,and we ightloss. 3,20 Asub setofdyspep ticpa ti entshas de la yedgas tricemp tyingofso lidsorli qu ids.De layedgas tricemp tyingofso lidswascons tantlyasso ci a ted with post pran di al full ness and with vo mi ting.De la yedemp tyingforli qu idswasal so as so ci a tedwithpost pran di alfull nessandwithseve reearlysa ti ety. 21,22 Eventho ughourre sultscan not match to any of pat hoph ysi o lo gi cal mec hanismsmen ti o nedabo ve,thisisthefirststudyprovi ded evidence for struc tu ral chan ges in the sto machwallinfunc ti o naldyspep si apa ti ents.…”

“…[1][2][3][4][5] Theexis ten ceof dif fe rentfunc ti o naldyspep si asub gro upshaslong be enpos tu la tedbe ca u sedyspep ticsymptomsare in tu i ti velysug ges ti veofdif fe rentun derl yingpatho ge ne ticmec ha nisms. [6][7][8][9] Twoma inhypot he ti cal sub gro upswe reiden ti fi edinal mostallofthereports:"ul cer-li ke "and"dy smo ti lity-li ke "dyspep sia,thefor merbe ingcha rac te ri zedbyse ve ralas pects ofpa inandthelat terbysymptomssug ges ti veof im pa i redgas tro du o de nalmo ti lity.…”