[Rational treatment of patients with functional dyspepsia]

Area of Science:

• Gastroenterology
• Pharmacology

Context:

• Functional dyspepsia (FD) is a prevalent gastrointestinal disorder.
• FD pathogenesis involves motor dysfunction, visceral hypersensitivity, and autonomic nervous system imbalances.
• Current management often involves empirical and polypharmacy approaches due to a lack of specific therapies.

Purpose:

• To review the current therapeutic landscape for functional dyspepsia.
• To highlight the role of pharmacotherapy, including prokinetics, in managing FD symptoms.
• To discuss the limitations of existing treatments and the place of emerging options.

Summary:

• Pharmacological management for FD includes proton pump inhibitors, herbal remedies, and H. pylori eradication.
• Prokinetic agents are crucial for motor dysfunction, but safety concerns limit agents like cisapride, domperidone, and metoclopramide.
• Itopride is the primary prokinetic available for clinical use, while tricyclic antidepressants and psychotherapy are options for refractory FD.

Impact:

• Provides an overview of current FD treatment strategies for clinicians.
• Emphasizes the importance of rational drug selection in FD management.
• Informs clinical practice regarding the appropriate use of prokinetics and alternative therapies for functional dyspepsia.