Functional dyspepsia

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.[1]
Complications	Symptoms of anxiety, depression, and somatization.[2]
Types	Postprandial distress syndrome and epigastric pain syndrome.[1]
Diagnostic method	Rome IV criteria.[1]
Differential diagnosis	Gastroesophageal reflux disease, gastroparesis, and irritable bowel syndrome.[1]
Treatment	Symptom control.[2]
Medication	Proton pump inhibitors, H2 receptor antagonists, antidepressants, and prokinetic agents.[2]
Prognosis	15% to 20% of patients have persistent symptoms during extended follow-up.[2]
Frequency	5-11% worldwide.[1]

Functional dyspepsia (FD) is a common gastrointestinal disorder defined by symptoms arising from the gastroduodenal region in the absence of an underlying organic disease that could easily explain the symptoms.^[3] 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.

The exact cause of functional dyspepsia is unknown however there has been many hypotheses regarding the mechanisms. 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. 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.

Functional dyspepsia is diagnosed based on clinical criteria and symptoms. Depending on the symptoms present people suspected of having FD 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.