Functional dyspepsia: New insights into the pathophysiology

Area of Science:

• Gastroenterology
• Neurogastroenterology
• Visceral Pain Research

Background:

• The exact causes of functional dyspepsia (FD) are not fully understood.
• Emerging evidence suggests visceral hypersensitivity, characterized by reduced sensory thresholds in the stomach and small intestine, is a primary factor in FD pathogenesis.
• Other potential contributors include motor abnormalities and psychological influences, but their roles require further clarification.

Purpose of the Study:

• To explore the current understanding of functional dyspepsia pathogenesis.
• To highlight the role of gastroduodenal visceral hypersensitivity.
• To discuss other contributing factors and their controversial roles.

Main Methods:

• Review of existing literature on functional dyspepsia.
• Analysis of evidence supporting visceral hypersensitivity as a primary mechanism.
• Evaluation of data on motor abnormalities, psychological factors, H. pylori, and gastric acid.

Main Results:

• Gastroduodenal visceral hypersensitivity is increasingly recognized as a predominant factor in functional dyspepsia.
• Subgroups of patients exhibit motor abnormalities like delayed gastric emptying and small intestinal dysmotility, potentially secondary phenomena.
• The influence of psychological factors, Helicobacter pylori gastritis, and gastric acid sensitivity remains debated.

Conclusions:

• Visceral hypersensitivity is a central mechanism in functional dyspepsia.
• Motor dysfunctions and psychological factors may contribute but are often secondary.
• Further research is needed to clarify the roles of H. pylori and gastric acid in FD.