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Evidence-based clinical practice guidelines for functional dyspepsia.

Hiroto Miwa1, Motoyasu Kusano, Tomiyasu Arisawa

  • 1Guidelines Committee for creating and evaluating the "Evidence-based clinical practice guidelines for functional dyspepsia", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13 Ginza, Chuo, Tokyo, 104-0061, Japan, miwahgi@hyo-med.ac.jp.

Journal of Gastroenterology
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Summary

Japanese doctors now have a clinical practice guideline for functional dyspepsia (FD), a common gastrointestinal disorder. The guideline offers a two-step treatment approach and emphasizes H. pylori eradication.

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Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Growing interest in functional gastrointestinal disorders, including functional dyspepsia (FD), in Japan.
  • Increased focus on quality of life and advancements in understanding gastrointestinal disease pathophysiology.
  • Japan's pioneering step in listing FD for national insurance billing, despite poor recognition and lack of standard treatment.

Purpose of the Study:

  • To summarize the Japanese Society of Gastroenterology's (JSGE) evidence-based clinical practice guideline for FD.
  • To provide a focused overview of the treatment strategies outlined in the guideline.
  • To establish a standard approach for managing FD in Japan.

Main Methods:

  • Development of a comprehensive, evidence-based clinical practice guideline by the JSGE.
  • The guideline covers FD concept, epidemiology, pathophysiology, diagnosis, treatment, and prognosis.
  • This article specifically highlights the treatment recommendations within the guideline.

Main Results:

  • The guideline recommends initial patient education on FD's benign nature and doctor-patient relationship building.
  • Pharmacological treatment involves a two-step approach: initial (acid inhibitors or prokinetics) and second-line (anxiolytics, antidepressants, traditional medicine).
  • H. pylori eradication is strongly recommended separately, and refractory cases require further investigation or specialist referral.

Conclusions:

  • The JSGE guideline provides a structured approach to managing functional dyspepsia in Japan.
  • Effective FD management involves patient education, lifestyle advice, and a stepwise pharmacological treatment plan.
  • H. pylori eradication is a key component, with clear pathways for refractory cases and specialist consultation.