Functional dyspepsia is one of the most common functional gastrointestinal disorders worldwide. Although the condition does not affect life expectancy, it can have a marked influence on quality of life, and is associated with a high economic burden; an estimated US$1 billion per year is spent on the management of functional dyspepsia in the USA alone. This comprehensive Focus issue from Nature Reviews Gastroenterology & Hepatology contains seven Reviews that have been specially commissioned to cover key themes in functional dyspepsia. Experts from around the world provide up-to-date overviews of the most important topics in the field, including the influence of dietary, lifestyle and psychosocial factors, relevance of Helicobacter pylori infection, overlap with GERD, changes in gastrointestinal tract structure and function, symptom pattern and validity of the Rome III criteria, as well as current and emerging treatment options.
EDITORIAL
Functional dyspepsia: Glimmers of hope for functional dyspepsia
Isobel Leake
doi:10.1038/nrgastro.2013.25
Nature Reviews Gastroenterology & Hepatology 10, 125 (2013)
REVIEWS
Functional dyspepsia—symptoms, definitions and validity of the Rome III criteria
Jan Tack & Nicholas J. Talley
doi:10.1038/nrgastro.2013.14
Nature Reviews Gastroenterology & Hepatology 10, 134-141 (2013)
The Rome III consensus has divided functional dyspepsia into two subgroups; postprandial distress syndrome, characterized by postprandial fullness and early satiation, and epigastric pain syndrome, characterized by epigastric pain or burning. This Review describes the symptoms of functional dyspepsia and discusses the evidence to support the two subgroups.
Changes in gastrointestinal tract function and structure in functional dyspepsia
Hanne Vanheel & Ricard Farré
doi:10.1038/nrgastro.2012.255
Nature Reviews Gastroenterology & Hepatology 10, 142-149 (2013)
Functional dyspepsia is thought to be a heterogeneous disorder, with a wide variety of pathophysiological mechanisms underlying the varied symptoms observed in patients. Here, Vanheel and Farré provide an overview of the pathogenesis of functional dyspepsia, adding insight on the diverse functional and structural changes in the gastrointestinal tract in this condition.
Dietary and lifestyle factors in functional dyspepsia
Christine Feinle-Bisset & Fernando Azpiroz
doi:10.1038/nrgastro.2012.246
Nature Reviews Gastroenterology & Hepatology 10, 150-157 (2013)
Dietary factors are increasingly recognized to have an important role in triggering symptoms in a large proportion of patients with functional dyspepsia. This Review outlines the role of diet and specific foods and/or food components in symptom induction, summarizes potential mechanisms, and highlights the role that dietary interventions might have in treating functional dyspepsia.
The role of psychosocial factors and psychiatric disorders in functional dyspepsia
Lukas Van Oudenhove & Qasim Aziz
doi:10.1038/nrgastro.2013.10
Nature Reviews Gastroenterology & Hepatology 10, 158-167 (2013)
In this Review, Van Oudenhove and Aziz provide an overview of epidemiological studies that demonstrate an association between functional dyspepsia and psychological traits, states or psychiatric disorders. They also describe pathophysiological evidence on how psychosocial factors and psychiatric disorders might exert their role in functional dyspepsia.
Helicobacter pylori infection in functional dyspepsia
Hidekazu Suzuki & Paul Moayyedi
doi:10.1038/nrgastro.2013.9
Nature Reviews Gastroenterology & Hepatology 10, 168-174 (2013)
Helicobacter pylori infection is one likely cause of functional dyspepsia. Here, the authors discuss the clinical evidence in relation to H. pylori eradication in patients with functional dyspepsia if they test positive for this bacterium.
Overlap of functional dyspepsia and GERD—diagnostic and treatment implications
Eamonn M. M. Quigley & Brian E. Lacy
doi:10.1038/nrgastro.2012.253
Nature Reviews Gastroenterology & Hepatology 10, 175-186 (2013)
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.
Current management strategies and emerging treatments for functional dyspepsia
Michael Camilleri & Vincenzo Stanghellini
doi:10.1038/nrgastro.2013.11
Nature Reviews Gastroenterology & Hepatology 10, 187-194 (2013)
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.
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