Functional dyspepsia

Holtmann, Gerald and Talley, Nicholas J. (2015) Functional dyspepsia. Current Opinion in Gastroenterology, 31 6: 492-498. doi:10.1097/MOG.0000000000000219


Author Holtmann, Gerald
Talley, Nicholas J.
Title Functional dyspepsia
Journal name Current Opinion in Gastroenterology   Check publisher's open access policy
ISSN 1531-7056
0267-1379
Publication date 2015-11-01
Year available 2015
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/MOG.0000000000000219
Open Access Status Not Open Access
Volume 31
Issue 6
Start page 492
End page 498
Total pages 7
Place of publication London, United Kingdom
Publisher Lippincott Williams and Wilkins
Collection year 2016
Language eng
Formatted abstract
Purpose of review
Structural causes are absent in more than 50% of patients with symptoms referred to the gastroduodenal region when routine diagnostic tests are applied. New knowledge holds the prospect that targeted therapy may more optimally manage subsets of these patients with functional dyspepsia.

Recent findings
An understanding of gut-to-brain and brain-to-gut pathways in functional dyspepsia is expanding. Minimal mucosal inflammation with eosinophils (and in some cases mast cells) characterized by ultrastructural changes in the duodenum appears to be present in a substantial subgroup of functional dyspepsia patients as identified now by investigators globally. Although antibiotic therapy targeting Helicobacter pylori appears to be effective in a small proportion of functional dyspepsia patients, eradication therapy may be more effective in functional dyspepsia patients with microscopic duodenal inflammation, a potentially important finding needing to be confirmed. This may suggest that the effects of antibiotics for functional dyspepsia are not simply mediated by the eradication of gastric H. pylori, but have other antibacterial effects (e.g., on the duodenal microbiome). Abnormal visceral sensory function plays a key role not only in the manifestations of functional dyspepsia but also in peptic ulcer disease.

Summary 
The pathophysiologic concepts underlying functional dyspepsia and related treatment approaches are shifting from a focus on H. pylori, acid suppression or modulation of motility toward new models. New evidence suggests that minimal duodenal inflammation plays a role in symptom generation in at least a proportion of patients with otherwise unexplained symptoms. This is a paradigm shift and ultimately may change the treatment of many patients with functional gastrointestinal disorders.
Keyword Abdominal pain eosinophils
Helicobacter pylori
Mast cells
Visceral hypersensitivity
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Faculty of Health and Behavioural Sciences -- Publications
Faculty of Medicine
Official 2016 Collection
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 1 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 20 Oct 2015, 02:47:44 EST by System User on behalf of Scholarly Communication and Digitisation Service