Korean J Gastroenterol.  2022 Mar;79(3):91-98. 10.4166/kjg.2022.027.

Duodenal Microbiome and Its Clinical Implications in Functional Dyspepsia

• Kim SH

• KMID: 2527476
• DOI: http://doi.org/10.4166/kjg.2022.027

Abstract

Functional dyspepsia is one of the most common functional gastrointestinal disorders with chronic bothersome epigastric pain or postprandial fullness without a definite organic cause. Despite its high clinical burden, the treatment modalities for modulating impaired motor dysfunction and visceral hypersensitivity have been unsatisfactory. Recently, studies demonstrating low-grade inflammation and dysbiosis of the duodenal mucosa as potential triggers of the disease have attracted attention. Observations, such as an increase in the proportion of oral commensal bacteria in the duodenal mucosa, such as Streptococcus species, highlight the importance of bacterial ecology in developing symptoms of functional dyspepsia. In the near future, anti-inflammatory drugs and probiotics that modulate the host-microbiome interaction are expected to emerge to treat functional dyspepsia.

Keyword

Functional dyspepsia; Dysbiosis; Low grade inflammation; Eosinophils; Probiotics

Figure

• 

  Fig. 1 Changes in the duodenal microenvironment and pathophysiology of functional dyspepsia symptoms. Diverse endoluminal triggers from altered food and/or dysbiosis may lead to both local and systemic immune activation with impaired signaling of duodeno-gastric reflex mechanisms by neuronal changes in afferent nerves of the duodenum. TEER, trans-epithelial electrical resistance; CCR2, C-C chemokine receptor 2; IL, interleukin; TNF-α, tumor necrosis factor-α.

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