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Digestive Diseases (Basel, Switzerland) 2017The correct diagnosis of functional gastrointestinal disorders (FGIDs) is quite a challenge. The overlaps between syndromes can complicate the interpretation of clinical... (Review)
Review
BACKGROUND
The correct diagnosis of functional gastrointestinal disorders (FGIDs) is quite a challenge. The overlaps between syndromes can complicate the interpretation of clinical data.
SUMMARY
The incidence of functional digestive disorders and irritable bowel syndrome are still underestimated with the currently applied diagnostic tools, and the management of the seemingly elusive disease is not satisfactory. For this reason, the "Rome" criteria were created to provide a better understanding and classification of FGIDs. Key Messages: Rome diagnostic criteria and recommendations should be used in the design and performance of clinical studies in the field of functional dyspepsia and irritable bowel syndrome.
Topics: Diagnosis, Differential; Dyspepsia; Humans; Incidence; Irritable Bowel Syndrome
PubMed: 29421792
DOI: 10.1159/000485408 -
Digestive Diseases (Basel, Switzerland) 2022Dyspepsia is a very frequent condition, affecting up to 50% of general population. Primary care is the logical setting for starting a management. In treating dyspeptic... (Review)
Review
BACKGROUND
Dyspepsia is a very frequent condition, affecting up to 50% of general population. Primary care is the logical setting for starting a management. In treating dyspeptic patients, it is a crucial point to distinguish between functional problems, common diseases such as reflux esophagitis or peptic ulcer, and life-threatening diseases such as upper gastrointestinal (GI) cancer. In Europe, there are different approaches to this problem. We describe the management of dyspepsia, with a particular focus on relationship between dyspepsia and gastric cancer.
SUMMARY
Initial treatment of dyspepsia includes empirical treatment, noninvasive testing for Helicobacter pylori, and upper GI tract endoscopy. Treatment choice is based on different variables, including alarm signs, patient preference, and possibility to perform a gastroscopy. General practitioners are not allowed in all European nations to order a gastroscopy. This may have some reflection on quality of cure.
KEY MESSAGE
In European countries, there are heterogeneities in terms of gastric cancer incidence, mortality, and quality of cure. Awareness of them is a first step in identifying possible solutions.
Topics: Dyspepsia; Endoscopy, Gastrointestinal; Helicobacter Infections; Helicobacter pylori; Humans; Primary Health Care; Prospective Studies; Stomach Neoplasms
PubMed: 33971660
DOI: 10.1159/000517112 -
Revista de Gastroenterologia de Mexico Aug 2012
Topics: Dyspepsia; Humans
PubMed: 22939479
DOI: 10.1016/j.rgmx.2012.07.018 -
Journal of Nippon Medical School =... Mar 2020Functional dyspepsia (FD) is a common disease that can markedly impair quality of life. In the 2016 Rome IV criteria, a diagnosis of FD requires the presence of... (Comparative Study)
Comparative Study Review
Functional dyspepsia (FD) is a common disease that can markedly impair quality of life. In the 2016 Rome IV criteria, a diagnosis of FD requires the presence of bothersome FD symptoms. In 2009, a new diagnosis, early chronic pancreatitis (ECP), was proposed as a means to facilitate early treatment of chronic pancreatitis and prevent progression to chronic pancreatitis. Although chronic pancreatitis was reported to be a cause of dyspepsia, data on the relation between ECP and FD patients are limited. We therefore investigated differences between ECP patients and FD patients in the percentages of those with severe epigastric pain, early satiety, and postprandial abdominal fullness. Several studies reported an association between the cause of chronic pancreatitis and endosonographic features. In addition, endosonography was useful for distinguishing ECP patients from FD patients with pancreatic enzyme abnormalities. Thus, we compared endosonographic characteristics in these patient groups. Future studies should attempt to determine why selected FD patients with pancreatic enzyme abnormalities develop ECP.
Topics: Dyspepsia; Endosonography; Glucagon-Like Peptide 1; Humans; Pancreatitis, Chronic
PubMed: 31434841
DOI: 10.1272/jnms.JNMS.2020_87-101 -
Neurogastroenterology and Motility Feb 2010Despite the relatively high prevalence of gastroparesis and functional dyspepsia, the aetiology and pathophysiology of these disorders remain incompletely understood.... (Review)
Review
BACKGROUND
Despite the relatively high prevalence of gastroparesis and functional dyspepsia, the aetiology and pathophysiology of these disorders remain incompletely understood. Similarly, the diagnostic and treatment options for these two disorders are relatively limited despite recent advances in our understanding of both disorders.
PURPOSE
This manuscript reviews the advances in the understanding of the epidemiology, pathophysiology, diagnosis, and treatment of gastroparesis and functional dyspepsia as discussed at a recent conference sponsored by the American Gastroenterological Association (AGA) and the American Neurogastroenterology and Motility Society (ANMS). Particular focus is placed on discussing unmet needs and areas for future research.
Topics: Diagnosis, Differential; Dyspepsia; Gastrointestinal Motility; Gastroparesis; Humans
PubMed: 20003077
DOI: 10.1111/j.1365-2982.2009.01434.x -
Gut and Liver May 2017Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning.... (Review)
Review
Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. Epidemiologically, there are two clinically distinct FD syndromes (although these often overlap clinically): postprandial distress syndrome (PDS; comprising early satiety or meal-related fullness) and epigastric pain syndrome. Symptoms of gastroesophageal reflux disease overlap with FD more than expected by chance; a subset has pathological acid reflux. The pretest probability of FD in a patient who presents with classical FD symptoms and no alarm features is high, approximately 0.7. Coexistent heartburn should not lead to the exclusion of FD as a diagnosis. One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. Small bowel homing T cells, signaling intestinal inflammation, and increased cytokines have been detected in the circulation, and elevated tumor necrosis factor-α levels have been significantly correlated with increased anxiety. Postinfectious gastroenteritis is a risk factor for FD. Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD- eradication. Treatment of duodenal eosinophilia is under investigation.
Topics: Diagnosis, Differential; Duodenal Diseases; Dyspepsia; Eosinophilia; Gastroesophageal Reflux; Heartburn; Helicobacter Infections; Helicobacter pylori; Humans; Postprandial Period; Symptom Assessment
PubMed: 28452210
DOI: 10.5009/gnl16055 -
Journal of Gastrointestinal and Liver... Mar 2024Functional dyspepsia (FD), a widespread and debilitating digestive disease, is thought to originate from disrupted gut-brain communication. The cause of FD is not... (Review)
Review
Functional dyspepsia (FD), a widespread and debilitating digestive disease, is thought to originate from disrupted gut-brain communication. The cause of FD is not completely understood, but recent evidence suggests it could be due to multiple factors and can vary among different patient groups. Factors like gut motility changes, increased sensitivity to pain in the gut, ongoing low-level inflammation, and increased gut permeability have all been linked to the development of FD. Additionally, changes in the gut microbiome have been suggested to play a significant role in the disease. The gut microbiota in the duodenum could either be a cause or a result of the immune and nervous system issues seen in FD, but the ways in which the gut flora in the small intestine affects gut function, digestive metabolites and symptoms are not yet clear, more studies being needed in order to completely assess the relationship between gastrointestinal microbiota and development and progression of FD. This review summarizes the available research on the relationship between FD and the microbiota and examines the various treatments, including probiotics, that have been shown to relieve symptoms. Finally, suggestions for improving diagnosis and treatment for those with FD are presented.
Topics: Humans; Dyspepsia; Inflammation; Duodenum; Intestine, Small; Gastrointestinal Microbiome
PubMed: 38386888
DOI: 10.15403/jgld-5024 -
Journal of Clinical Gastroenterology 2005Functional dyspepsia is a highly prevalent symptom complex and a heterogenous disorder. Recent studies showed potential associations between specific pathophysiologic... (Review)
Review
Functional dyspepsia is a highly prevalent symptom complex and a heterogenous disorder. Recent studies showed potential associations between specific pathophysiologic disturbances and dyspeptic symptoms. Delayed gastric emptying reported in about 30% of patients with functional dyspepsia is associated with the symptoms of postprandial fullness, nausea, and vomiting. Impaired gastric accommodation present in 40% of functional dyspepsia patients is found to be associated with early satiety. Hypersensitivity to gastric distension is observed in 37% of functional dyspepsia patients and associated with the symptoms of postprandial pain, belching, and weight loss. Psychosocial factors and altered response to duodenal lipids or acid have also been identified as pathophysiologic mechanisms. Therapeutic options are still limited but targeted therapy directed at the underlying pathophysiology seems desirable. Thus, efforts to further elucidate underlying pathophysiologic mechanisms and identify the appropriate patient population using some type of pathophysiologic testing will be required.
Topics: Dyspepsia; Enteric Nervous System; Gastrointestinal Agents; Gastrointestinal Motility; Humans; Psychotherapy; Treatment Outcome
PubMed: 15798487
DOI: 10.1097/01.mcg.0000156109.97999.d1 -
Journal of Psychosomatic Research Aug 2024To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia. (Meta-Analysis)
Meta-Analysis Comparative Study
Comparing the prevalence and association between anxiety, depression and gastrointestinal symptoms in gastroparesis versus functional dyspepsia: A systematic review and meta-analysis.
OBJECTIVE
To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia.
METHODS
Twenty adult studies were identified through systematic searches of three databases (PubMed, CINAHL and PsycINFO) in September 2023. Meta-analysis was performed to estimate the pooled prevalence rates of anxiety and depression across gastroparesis and functional dyspepsia, and to determine whether the associations of anxiety/depression and gastrointestinal (GI) symptoms differ in gastroparesis versus functional dyspepsia.
RESULTS
The overall pooled prevalence rate for anxiety was similar (χ(1) = 2.45, p = .12) in gastroparesis (49%) and functional dyspepsia (29%). The overall pooled prevalence rate for depression in gastroparesis (39%), and functional dyspepsia (32%) was also similar (χ(1) = 0.81, p = .37). No significant relationship between anxiety and GI symptoms (r = 0.11) or depression and GI symptoms (r = 0.16) was found in gastroparesis, whilst significant, though weak, positive relationships between anxiety and GI symptoms (r = 0.30) and depression and GI symptoms (r = 0.32) were found in functional dyspepsia. The association between GI symptoms and anxiety, but not depression, across gastroparesis and functional dyspepsia was found to be significant (χ(1) = 5.22, p = .02).
CONCLUSION
Contributing to ongoing debate as to whether gastroparesis and functional dyspepsia are interchangeable syndromes, this review found that anxiety and depression prevalence was similar in both conditions. Psychological assessment and the utilisation of effective and holistic care in both conditions is therefore warranted.
Topics: Humans; Gastroparesis; Dyspepsia; Prevalence; Depression; Anxiety; Gastrointestinal Diseases
PubMed: 38896986
DOI: 10.1016/j.jpsychores.2024.111834 -
Journal of Pediatric Gastroenterology... Dec 2016As defined by Rome III, there are 4 abdominal pain-related functional gastrointestinal disorders in children: irritable bowel syndrome, functional dyspepsia (FD),... (Review)
Review
As defined by Rome III, there are 4 abdominal pain-related functional gastrointestinal disorders in children: irritable bowel syndrome, functional dyspepsia (FD), abdominal migraine, and functional abdominal pain. Dyspepsia is a constellation of symptoms referable to the gastroduodenal region of the upper gastrointestinal tract. FD refers to dyspeptic symptoms that cannot currently be explained by an organic cause, and affects 25% to 40% of the adult population over a lifetime. In children, this condition results in increased specialist consultations, with reported prevalence between 3% and 27%. The Rome III criteria for pediatric FD include the presence or persistence of recurrent pain or discomfort centered in the upper abdomen, without evidence of organic disease or change in frequency of stools. Symptoms must be chronic, occurring at least weekly and over a period of at least 6 months. The goal of this article is to provide a narrative review of diagnosis and management of the FD in the pediatric population. A comprehensive search of published literature using the PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) database was carried out to identify all articles published in English from 1998 to November 2015, using 3 key terms; "FD," "functional gastrointestinal disorders," and "children."
Topics: Abdominal Pain; Child; Diagnosis, Differential; Dyspepsia; Gastroesophageal Reflux; Humans; Irritable Bowel Syndrome; Stress, Psychological
PubMed: 27437927
DOI: 10.1097/MPG.0000000000001344