Functional dyspepsia: mechanisms of symptom generation and appropriate management of patients.
With the exception of predominant heartburn, the management of upper abdominal symptoms not caused by an organic disorder remains a challenge. Systematic reviews of large trials show that suppressing acid secretion and eradicating Helicobacter pylori, prokinetics, and antidepressants have inconsistent effects on the treatment of functional dyspepsia. This inconsistent therapeutic efficacy has been attributed to the heterogeneity of patients, and the contribution of multiple mechanisms to development of symptoms. To achieve greater therapeutic efficacy, it may be necessary to target the therapeutic approach to a specific pathophysiology, such as impaired gastric emptying.
Camilleri
Michael
M
Clinical Enteric Neuroscience Translational and Epidemiological Research Group, Mayo Clinic College of Medicine, Charlton 8-110, 200 First Street, SW, Rochester, MN 55905, USA. camilleri.michael@mayo.edu
D001521:Behavior Therapy / Q000379:methods*; D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D018589:Gastroparesis / Q000150:complications / Q000503:physiopathology; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D011379:Prognosis; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*
D005765:Gastrointestinal Agents; D017366:Serotonin Receptor Agonists