Causes and Treatment of Functional Dyspepsia

Overview

Journal Curr Gastroenterol Rep

Specialty Gastroenterology

Date 2001 Nov 7

PMID 11696288

Citations 8

Authors

J Tack

R Bisschops

B Demarchi

Affiliations

Soon will be listed here.

Abstract

Functional dyspepsia is a clinical syndrome defined by upper abdominal symptoms without identifiable cause by conventional diagnostic means. Recent studies have established that functional dyspepsia is a heterogeneous disorder in which different pathophysiologic disturbances underlie different symptom profiles. Delayed gastric emptying is associated with postprandial fullness, nausea, and vomiting; impaired accommodation is associated with early satiety and weight loss; and hypersensitivity to gastric distention is associated with epigastric pain, belching, and weight loss. The pathogenesis of functional dyspepsia is unknown but may be postinfectious in a subgroup of patients. The role of psychological disturbances and of duodenal hypersensitivity requires further study. Treatment of the underlying pathophysiologic abnormality seems logical, but options for pharmacotherapy are limited to acid suppression, prokinetic drugs, and antidepressants. Psychotherapy can be considered for refractory patients. Several novel drug therapies are under evaluation.

Citing Articles

Treatment of Functional GI Disorders With Psychotropic Medicines: A Review of Evidence With a Practical Approach.

Thiwan S, Drossman D Gastroenterol Hepatol (N Y). 2017; 2(9):678-688.

PMID: 28316538 PMC: 5350580.

Dietary fat intake and functional dyspepsia.

Khodarahmi M, Azadbakht L Adv Biomed Res. 2016; 5:76.

PMID: 27195249 PMC: 4863403. DOI: 10.4103/2277-9175.180988.

Effect of DA-9701 on Gastric Motor Function Assessed by Magnetic Resonance Imaging in Healthy Volunteers: A Randomized, Double-Blind, Placebo-Controlled Trial.

Min Y, Min B, Kim S, Choi D, Rhee P PLoS One. 2015; 10(9):e0138927.

PMID: 26402448 PMC: 4581730. DOI: 10.1371/journal.pone.0138927.

Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study.

Nasr I, Rao S, Attaluri A, Hashmi S, Summers R Indian J Gastroenterol. 2009; 28(4):136-42.

PMID: 19937173 PMC: 3883142. DOI: 10.1007/s12664-009-0048-6.

Serotonin pharmacology in the gastrointestinal tract: a review.

Beattie D, Smith J Naunyn Schmiedebergs Arch Pharmacol. 2008; 377(3):181-203.

PMID: 18398601 DOI: 10.1007/s00210-008-0276-9.

References

Gwee K, GRAHAM J, McKendrick M, Collins S, Marshall J, Walters S . Psychometric scores and persistence of irritable bowel after infectious diarrhoea. Lancet. 1996; 347(8995):150-3. DOI: 10.1016/s0140-6736(96)90341-4. View

Danesh J, Lawrence M, Murphy M, Roberts S, Collins R . Systematic review of the epidemiological evidence on Helicobacter pylori infection and nonulcer or uninvestigated dyspepsia. Arch Intern Med. 2000; 160(8):1192-8. DOI: 10.1001/archinte.160.8.1192. View

Feinle C, Meier O, Otto B, Damato M, Fried M . Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia. Gut. 2001; 48(3):347-55. PMC: 1760121. DOI: 10.1136/gut.48.3.347. View

Troncon L, Bennett R, Ahluwalia N, Thompson D . Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients. Gut. 1994; 35(3):327-32. PMC: 1374584. DOI: 10.1136/gut.35.3.327. View

Wilhelmsen I, Haug T, Ursin H, Berstad A . Discriminant analysis of factors distinguishing patients with functional dyspepsia from patients with duodenal ulcer. Significance of somatization. Dig Dis Sci. 1995; 40(5):1105-11. DOI: 10.1007/BF02064207. View

Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J . Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001; 121(3):526-35. DOI: 10.1053/gast.2001.27180. View

Coffin B, Bouhassira D, Chollet R, Fraitag B, De Meynard C, Geneve J . Effect of the kappa agonist fedotozine on perception of gastric distension in healthy humans. Aliment Pharmacol Ther. 1996; 10(6):919-25. DOI: 10.1046/j.1365-2036.1996.109280000.x. View

Nyren O, Adami H, Gustavsson S, Loof L . Excess sick-listing in nonulcer dyspepsia. J Clin Gastroenterol. 1986; 8(3 Pt 2):339-45. DOI: 10.1097/00004836-198606002-00004. View

Tanum L, Malt U . A new pharmacologic treatment of functional gastrointestinal disorder. A double-blind placebo-controlled study with mianserin. Scand J Gastroenterol. 1996; 31(4):318-25. DOI: 10.3109/00365529609006404. View

10.

Piessevaux H, Tack J, Wilmer A, Coulie B, Geubel A, Janssens J . Perception of changes in wall tension of the proximal stomach in humans. Gut. 2001; 49(2):203-8. PMC: 1728394. DOI: 10.1136/gut.49.2.203. View

11.

Talley N, VAN Zanten S, Saez L, Dukes G, Perschy T, Heath M . A dose-ranging, placebo-controlled, randomized trial of alosetron in patients with functional dyspepsia. Aliment Pharmacol Ther. 2001; 15(4):525-37. DOI: 10.1046/j.1365-2036.2001.00941.x. View

12.

Mertz H, Fullerton S, Naliboff B, Mayer E . Symptoms and visceral perception in severe functional and organic dyspepsia. Gut. 1998; 42(6):814-22. PMC: 1727129. DOI: 10.1136/gut.42.6.814. View

13.

Tack J, Peeters T . What comes after macrolides and other motilin stimulants?. Gut. 2001; 49(3):317-8. PMC: 1728448. DOI: 10.1136/gut.49.3.317. View

14.

Bityutskiy L, Soykan I, McCallum R . Viral gastroparesis: a subgroup of idiopathic gastroparesis--clinical characteristics and long-term outcomes. Am J Gastroenterol. 1997; 92(9):1501-4. View

15.

Thumshirn M, Camilleri M, Choi M, Zinsmeister A . Modulation of gastric sensory and motor functions by nitrergic and alpha2-adrenergic agents in humans. Gastroenterology. 1999; 116(3):573-85. DOI: 10.1016/s0016-5085(99)70179-4. View

16.

Zerbib F, Bruley des Varannes S, Oriola R, McDonald J, Isal J, Galmiche J . Alosetron does not affect the visceral perception of gastric distension in healthy subjects. Aliment Pharmacol Ther. 1994; 8(4):403-7. DOI: 10.1111/j.1365-2036.1994.tb00307.x. View

17.

Chaudhary N, TRUELOVE S . The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962; 31:307-22. View

18.

Feinle C, Grundy D, Read N . Effects of duodenal nutrients on sensory and motor responses of the human stomach to distension. Am J Physiol. 1997; 273(3 Pt 1):G721-6. DOI: 10.1152/ajpgi.1997.273.3.G721. View

19.

Camilleri M, Hasler W, Parkman H, Quigley E, Soffer E . Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology. 1998; 115(3):747-62. DOI: 10.1016/s0016-5085(98)70155-6. View

20.

Moayyedi P, Soo S, Deeks J, Delaney B, Harris A, Innes M . Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2001; (1):CD002096. DOI: 10.1002/14651858.CD002096. View