Functional dyspepsia assessment - current diagnostic methods and new promising techniques.

Area of Science:

• Gastroenterology
• Neurogastroenterology
• Digestive Physiology

Background:

• Functional Dyspepsia (FD) is a prevalent disorder of gut-brain interaction (DGBI) affecting up to 20% of the population.
• Characterized by chronic upper gastrointestinal symptoms without an identifiable organic cause, FD significantly impairs quality of life and burdens healthcare systems.
• Current diagnostic approaches often rely on symptom-based criteria (Rome IV) and limited utility upper endoscopy, highlighting a need for objective functional assessments.

Purpose of the Study:

• To review and summarize current and emerging diagnostic methods for Functional Dyspepsia (FD).
• To explore objective assessments of gastric motility, accommodation, and sensory function in FD.
• To discuss the potential of advanced techniques for improving FD diagnosis and management.

Main Methods:

• A comprehensive PubMed literature search was conducted using keywords: Functional Dyspepsia, Gastric Motility Assessment, ROME IV, and Gastric Emptying (GE).
• Relevant studies were manually reviewed, focusing on diagnostic modalities for FD and gastric function.
• The review encompasses various techniques including drink tests, ultrasonography, MRI, scintigraphy, breath tests, electrogastrography (HR-EGG), EndoFLIP, fMRI, and PET scans.

Main Results:

• Several objective diagnostic methods exist for evaluating gastric accommodation, hypersensitivity, and delayed gastric emptying in FD.
• Techniques like drinking-ultrasonography, MRI, gastric emptying scintigraphy, 13C-breath tests, HR-EGG, and EndoFLIP provide objective measures of gastric motor and sensory functions.
• Advanced neuroimaging (fMRI, PET) offers insights into brain-gut interactions relevant to FD pathophysiology.

Conclusions:

• Advanced diagnostic methodologies offer objective insights into FD pathophysiology, moving beyond symptom-based diagnosis.
• These techniques enhance the understanding and management of FD by providing objective measures of gastric function.
• Standardization and integration of these advanced diagnostic tools into clinical practice are crucial for optimizing patient care and developing individualized treatment strategies for FD.