Functional Dyspepsia: Pathogenesis, Diagnosis, and Treatment

Functional dyspepsia (FD) is a functional gastroduodenal disorder presenting with dyspeptic symptoms such as postprandial fullness, early satiety, epigastric burning, or epigastric pain in the absence of organic disease. The factors supposed to be related with symptom generation are delayed gastric emptying, impaired accommodation of the proximal stomach, abnormal gastric acid secretions, visceral hypersensitivity, and psychological factors. If H. pylori is positive, eradication treatment is recommended. The evidence-based clinical practice guideline for FD recently developed by The Japanese Society of Gastroenterology (JSGE) proposed a two-step pharmacological treatment. The first-line treatment includes prokinetic agents or acid suppression therapy. If initial treatment fails, anxiolytics, antidepressants, or traditional Japanese herbal medicine can be employed.