Korean J Gastroenterol.  2019 Feb;73(2):77-83. 10.4166/kjg.2019.73.2.77.

Functional Dyspepsia

• Oh JH
• Kwon JG

• KMID: 2438706
• DOI: http://doi.org/10.4166/kjg.2019.73.2.77

Abstract

Dyspepsia is a common problem, and when dyspeptic symptoms develop within a short period of time, organic diseases such as gastroesophageal reflux disease, peptic ulcer diseases, pancreatoduodenal diseases, and gastrointestinal cancers should be suspected. Furthermore, functional dyspepsia (FD) should be considered if chronic or recurrent symptoms persist after eliminating underlying disease. FD is classified as epigastric pain syndrome (EPS) or postprandial distress syndrome (PDS), but these two conditions may overlap. Patients with the EPS subtype can be treated with proton pump inhibitors (PPIs), whereas patients with the PDS subtype may be managed primarily with prokinetics, and patients with EPS and PDS can be co-administered PPIs and prokinetics. Helicobacter pylori eradication therapy can be administered on a test-and-treat basis when PPIs and prokinetics are ineffective or to younger patients with chronic dyspepsia, and tricyclic antidepressants can be used as a secondary treatment because they are effective in patients with the EPS subtype. In addition, because the pathophysiology of FD is diverse, dietary education and stress management are required in addition to medical therapy, and should substantially aid treatment and long-term management. Here, we introduce and summarize recently published guidelines for the treatment of FD.

Keyword

Dyspepsia; Guideline; Helicobacter pylori; Proton pump inhibitors

MeSH Terms

Antidepressive Agents, Tricyclic
Dyspepsia*
Education
Gastroesophageal Reflux
Gastrointestinal Neoplasms
Helicobacter pylori
Humans
Peptic Ulcer
Proton Pump Inhibitors
Antidepressive Agents, Tricyclic
Proton Pump Inhibitors

Figure

• 

  Fig. 1. Treatment algorithm for dyspepsia. EGD, esophagogastroduodenoscopy; PPI, proton pump inhibitor; HP, Helicobacter pylori; FD, functional dyspepsia; PDS, postprandial distress syndrome; EPS, epigastric pain syndrome; TCA, tricyclic antidepressant; GI, gastrointestinal.

Reference

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