The treatment of functional dyspepsia: present and future

Expert Rev Gastroenterol Hepatol. 2023 Jan;17(1):9-20. doi: 10.1080/17474124.2023.2162877. Epub 2023 Jan 1.

Abstract

Introduction: Functional dyspepsia (FD) is a prevalent, but frequently overlooked and/or under diagnosed disorder of gut-brain interaction (DGBI). Functional dyspepsia frequently co-exists with other DGBIs, and persistent symptoms have a significant impact on patients' quality of life. A variety of therapies (e.g. diet, probiotics, antibiotics, acid suppressants, neuromodulators, prokinetics) are employed to treat the multiple symptoms of FD, although none are uniformly effective.

Areas covered: This review covers currently available therapies for the treatment of FD in addition to novel and emerging therapies that may change the treatment paradigm in the near future. PubMed, Embase and the Cochrane data bank were searched from 1990 to October 2022 for relevant articles.

Expert opinion: Dietary intervention, eradication of H. pylori, and/or a trial of acid suppression are reasonable initial treatment options for patients with FD. Neuromodulators and fundic accommodation agents are underemployed and should be used more routinely by healthcare providers, especially for patients with moderate-severe symptoms. Alternative therapies, such as cognitive behavioral therapy and hypnotherapy, are gaining recognition as safe and effective treatments for FD and can be used alone or in combination with medications. Virtual reality has the potential to significantly improve global FD symptoms.

Keywords: Abdominal pain; dyspepsia; functional dyspepsia; neuromodulators; virtual reality.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Dyspepsia* / diagnosis
  • Dyspepsia* / drug therapy
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / drug therapy
  • Humans
  • Quality of Life
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents