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Functional dyspepsia is impaired digestion for which there is no evidence of an organic disease that could explain the symptoms. Abdominal pain, bloating and quickly feeling full when eating are some of the symptoms of functional dyspepsia.
Although GERD and functional dyspepsia are generally thought of as completely distinct disorders with unique symptoms and treatments, they are, in many ways, more similar than different and can overlap in the same individual. This Review, which focuses on the overlap of GERD with functional dyspepsia, describes similarities and differences with regards to the epidemiology, pathophysiology, diagnosis and treatment of these two disorders.
Functional dyspepsia treatment remains unsatisfactory for too many patients. Here, the authors provide an overview of current management strategies, covering both lifestyle modifications for patients with mild or intermittent symptoms and drug therapy for patients with severe symptoms or non-responders.
Symptom-based diagnostic criteria have been criticized for being overly complex and performing modestly in differentiating organic from functional gastrointestinal diseases. The new Rome IV criteria now supersede Rome III. In general, these minor amendments are unlikely to lead to substantial improvement in accuracy and use in routine clinical care. Is a different approach required in future?
A global consensus report on Helicobacter pylori gastritis has been
developed. Topics discussed include whether dyspepsia caused by H. pylori
infection is separate from functional dyspepsia or not, the evaluation method for H.
pylori-induced gastritis, eradication therapy for H. pylori gastritis to
prevent gastric carcinogenesis and management after H. pylori
Functional dyspepsia has been defined in various ways, but the diagnostic yield of these definitions has not been well validated. Ford et al. have now reported the diagnostic yield of the Rome III criteria, which was not superior to previous definitions. The study also indicates the difficulty of excluding organic diseases using these criteria.
Functional gastrointestinal disorders (FGIDs) have traditionally been diagnosed on the basis of characteristic symptom patterns in the absence of organic disease that explains the symptoms. Evidence is now emerging that structural abnormalities in the brain might have a role in the pathophysiology of FGIDs.