Functional dyspepsia articles from across Nature Portfolio

Functional dyspepsia (FD) is a common chronic gastrointestinal disorder. Here, in a randomized, parallel-group, positive-drug, and placebo-controlled clinical trial, the authors show that supplementation with the probiotic Bifidobacterium animalis subsp. lactis BL-99 (BL-99) improves FD clinical response rate and promotes accumulation of SCFA-producing microbiota.

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 eradication.

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.