Functional dyspepsia: where do we stand?

Despite its high prevalence, our understanding of the pathophysiology and therapy of functional or nonulcer dyspepsia is very limited. Because of differences in definition, diagnostic work-up and patient or population characteristics, interpretation of published studies on functional dyspepsia is difficult. Recently developed new proposals, such as the role of Helicobacter pylori in the pathogenesis and the clinical relevance of dividing dyspeptic patients into subgroups based on clusters of symptoms, have appeared to be less promising than originally thought. No new therapies have been developed that have been shown to be superior to H2-receptor antagonists. New approaches have to be taken to unravel the pathogenesis and to determine the optimal therapy of functional dyspepsia.