The Association between Functional Dyspepsia and Metabolic Syndrome—The State of the Art

Abstract

Functional dyspepsia is a common functional disorder of the gastrointestinal tract that is responsible for many primary care visits. No organic changes have been found to explain its symptoms. We hypothesize that modern lifestyles and environmental factors, especially psychological stress, play a crucial role in the high prevalence of functional dyspepsia and metabolic syndrome. While gastrointestinal tract diseases are rarely linked to metabolic disorders, chronic stress, obesity-related metabolic syndrome, chronic inflammation, intestinal dysbiosis, and functional dyspepsia have significant pathophysiological associations. Functional dyspepsia, often associated with anxiety and chronic psychological stress, can activate the neuroendocrine stress axis and immune system, leading to unhealthy habits that contribute to obesity. Additionally, intestinal dysbiosis, which is commonly present in functional dyspepsia, can exacerbate systemic inflammation and obesity, further promoting metabolic syndrome-related disorders. It is worth noting that the reverse is also true: obesity-related metabolic syndrome can worsen functional dyspepsia and its associated symptoms by triggering systemic inflammation and intestinal dysbiosis, as well as negative emotions (depression) through the brain–gut axis. To understand the pathophysiology and deliver an effective treatment strategy for these two difficult-to-cure disorders, which are challenging for both caregivers and patients, a psychosocial paradigm is essential.

A bibliometric analysis of interstitial cells of Cajal research

“…Currently, treatment options for FD include dietary modifications, probiotics, antibiotics, acid suppressants, neuromodulators, prokinetics, and others, but none of these methods are consistently effective. Recent research has found that alterations in gut flora may play an important role in the pathogenesis of FD, especially changes in duodenal microbiome may be caused or contributed to by immune and neuronal dysregulation ( 71 , 75 , 76 ). Restoring microbial homeostasis with probiotics has been shown to be effective in FD ( 77 , 78 ).…”

Putting Functional Gastrointestinal Disorders within the Spectrum of Inflammatory Disorders Can Improve Classification and Diagnostics of These Disorders

“…The third line of evidence refers to studies that, considered together, promote the idea that patients with FGIDs may receive inflammatory signals from two different sources—gut mucosal inflammation and systemic inflammation [ 68 ]. To quantify the contribution of these two sources of inflammation would be important because variations in the composition of markers of systemic vs. gut mucosae-associated inflammation may have the potential to create a new, more diverse classification of FGIDs, which, in turn, could lead to etiologically-driven treatment ( Figure 3 ).…”

“…Another way is through the effects of the gut microbiota and mucosal immune system in modulating the activity of the gut–brain axis by releasing a variety of neuroactive metabolites [ 67 ]. We provided detailed information on this in our recently published paper [ 68 ].…”