Functional dyspepsia
Functional dyspepsia (FD is a common gastrointestinal disorder defined by symptoms emanating from the gastroduodenal region in the absence of an underlying organic disease that may easily explain the symptoms. Characteristic symptoms include epigastric burning, epigastric pain, postprandial fullness, and early satiety. FD was formerly known as non-ulcer dyspepsia, as opposed to "organic dyspepsia" with underlying conditions of gastritis, peptic ulcer disease, or cancer.
| Functional dyspepsia | |
|---|---|
| Other names | Non-ulcer dyspepsia |
| Stomach pain is a common symptom of functional dyspepsia. | |
| Symptoms | Early satiety, heartburn, nausea, postprandial fullness, vomiting, and/or epigastric pain. |
| Complications | Symptoms of anxiety, depression, and somatization. |
| Types | Postprandial distress syndrome and epigastric pain syndrome. |
| Diagnostic method | Rome IV criteria. |
| Differential diagnosis | Gastroesophageal reflux disease, gastroparesis, and irritable bowel syndrome. |
| Treatment | Symptom control. |
| Medication | Proton pump inhibitors, H2 receptor antagonists, antidepressants, and prokinetic agents. |
| Prognosis | 15% to 20% of patients have persistent symptoms during extended follow-up. |
| Frequency | 5-11% worldwide. |
The exact cause of functional dyspepsia is unknown however there has been many theories regarding the mechanisms. Risk factors for developing functional dyspepsia include female sex, smoking, non-steroidal anti-inflammatory medication use, and H pylori infection. Gastrointestinal infections can trigger the onset of functional dyspepsia.
Theories behind the pathophysiology of functional dyspepsia include gastroduodenal motility, gastroduodenal sensitivity, intestinal microbiota, immune dysfunction, gut-brain axis dysfunction, abnormalities of gastric electrical rhythm, and autonomic nervous system/central nervous system dysregulation.
Functional dyspepsia is diagnosed based off clinical criteria and symptoms. Depending on the symptoms present patients may need blood work, imaging, or endoscopies to confirm the diagnosis of functional dyspepsia. Functional dyspepsia is further classified into two subtypes, postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).
Functional dyspepsia can be managed with medications such as prokinetic agents, fundus-relaxing drugs, centrally acting neuromodulators, and proton pump inhibitors. Up to 15-20% of patients with functional dyspepsia experience persistent symptoms.
Functional dyspepsia is more common in women than men. In Western nations the prevalence is believed to be 10-40% and 5-30% in Asian nations.