Functional Dyspepsia: Advances in Diagnosis and Therapy

Area of Science:

• Gastroenterology
• Internal Medicine

Background:

• Functional dyspepsia (FD) is a prevalent gastrointestinal disorder characterized by recurrent upper abdominal symptoms.
• FD encompasses postprandial distress syndrome (PDS) and epigastric pain syndrome, often overlapping with gastroesophageal reflux disease.
• A high pretest probability of FD exists in patients with classical symptoms and no alarm features.

Purpose of the Study:

• To review the epidemiology, pathophysiology, and therapeutic options for functional dyspepsia.
• To highlight key findings such as duodenal eosinophilia and intestinal inflammation in FD.
• To discuss the role of *Helicobacter pylori* eradication and emerging treatments.

Main Methods:

• Literature review of epidemiological studies, clinical observations, and research on FD pathophysiology.
• Analysis of findings related to duodenal eosinophilia, circulating inflammatory markers, and cytokines.
• Evaluation of current and investigational therapeutic strategies for FD.

Main Results:

• FD presents as PDS or epigastric pain syndrome, with significant overlap with GERD.
• Increased duodenal eosinophilia is a consistent finding, particularly in PDS.
• Circulating inflammatory markers, including tumor necrosis factor-α, are elevated and correlate with anxiety; postinfectious gastroenteritis is a risk factor.

Conclusions:

• *Helicobacter pylori* eradication is the only therapy known to alter the natural history of FD.
• Treatment targeting duodenal eosinophilia and inflammation is under investigation.
• FD remains under-recognized, necessitating further research into its pathophysiology and effective management.