- Title
- Functional dyspepsia: advances in diagnosis and therapy
- Creator
- Talley, Nicholas J.
- Relation
- Gut and Liver Vol. 11, Issue 3, p. 349-357
- Publisher Link
- http://dx.doi.org/10.5009/gnl16055
- Publisher
- Gut and Liver Editorial Office
- Resource Type
- journal article
- Date
- 2017
- Description
- Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. Epidemiologically, there are two clinically distinct FD syndromes (although these often overlap clinically): postprandial distress syndrome (PDS; comprising early satiety or meal-related fullness) and epigastric pain syndrome. Symptoms of gastroesophageal reflux disease overlap with FD more than expected by chance; a subset has pathological acid reflux. The pretest probability of FD in a patient who presents with classical FD symptoms and no alarm features is high, approximately 0.7. Coexistent heartburn should not lead to the exclusion of FD as a diagnosis. One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. Small bowel homing T cells, signaling intestinal inflammation, and increased cytokines have been detected in the circulation, and elevated tumor necrosis factor-á levels have been significantly correlated with increased anxiety. Postinfectious gastroenteritis is a risk factor for FD. Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD-Helicobacter pylori eradication. Treatment of duodenal eosinophilia is under investigation.
- Subject
- functional dyspepsia; epidemiology; Epidemiological; meal-related fullness
- Identifier
- http://hdl.handle.net/1959.13/1351497
- Identifier
- uon:30721
- Identifier
- ISSN:1976-2283
- Rights
- This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Language
- eng
- Full Text
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