Functional Dyspepsia

Jung Hwan Oh; Joong Goo Kwon

doi:10.4166/kjg.2019.73.2.77

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Oh and Kwon: Functional Dyspepsia

Review Article

Korean J Gastroenterol 2019;73(2):77-83.

Published online: 4 October 2019

DOI: https://doi.org/10.4166/kjg.2019.73.2.77

Functional Dyspepsia

Jung Hwan Oh, Joong Goo Kwon¹

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

¹Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea

Correspondence to: Joong Goo Kwon, Department of Internal Medicine, Daegu Catholic University School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea. Tel: +82-53-650-4215, Fax: +82-53-621-4487, E-mail: kwonjg@cu.ac.kr, ORCID: https://orcid.org/0000-0003-3392-785X

Received 28 December 2018 Revised 28 January 2019 Accepted 7 February 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Dyspepsia, Guideline, Helicobacter pylori, Proton pump inhibitors

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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.

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ORCID iDs: Joong Goo Kwon
https://orcid.org/0000-0003-3392-785X
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