PMID- 22591037
OWN - NLM
STAT- MEDLINE
DCOM- 20121011
LR  - 20240406
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Print)
IS  - 0269-2813 (Linking)
VI  - 36
IP  - 1
DP  - 2012 Jul
TI  - Review article: current treatment options and management of functional dyspepsia.
PG  - 3-15
LID - 10.1111/j.1365-2036.2012.05128.x [doi]
AB  - BACKGROUND: Functional dyspepsia (FD), a common functional gastrointestinal 
      disorder, is defined by the Rome III criteria as symptoms of epigastric pain or 
      discomfort (prevalence in FD of 89-90%), postprandial fullness (75-88%), and 
      early satiety (50-82%) within the last 3 months with symptom onset at least 6 
      months earlier. Patients cannot have any evidence of structural disease to 
      explain symptoms and predominant symptoms of gastroesophageal reflux are 
      exclusionary. Symptoms of FD are non-specific and the pathophysiology is diverse, 
      which explains in part why a universally effective treatment for FD remains 
      elusive. AIM: To present current management options for the treatment of FD 
      (therapeutic gain/response rate noted when available). RESULTS: The utility of 
      Helicobacter pylori eradication for the treatment of FD is modest (6-14% 
      therapeutic gain), while the therapeutic efficacy of proton pump inhibitors (PPI) 
      (7-10% therapeutic gain), histamine-type-2-receptor antagonists (8-35% 
      therapeutic gain), prokinetic agents (18-45%), tricyclic antidepressants (TCA) 
      (response rates of 64-70%), serotonin reuptake inhibitors (no better than 
      placebo) is limited and hampered by inadequate data. This review discusses 
      dietary interventions and analyses studies involving complementary and 
      alternative medications, and psychological therapies. CONCLUSIONS: A reasonable 
      treatment approach based on current evidence is to initiate therapy with a daily 
      PPI in H. pylori-negative FD patients. If symptoms persist, a therapeutic trial 
      with a tricyclic antidepressant may be initiated. If symptoms continue, the 
      clinician can possibly initiate therapy with an anti-nociceptive agent, a 
      prokinetic agent, or some form of complementary and alternative medications, 
      although evidence from prospective studies to support this approach is limited.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - Lacy, B E
AU  - Lacy BE
AD  - Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. brian.lacy@hitchcock.org
FAU - Talley, N J
AU  - Talley NJ
FAU - Locke, G R 3rd
AU  - Locke GR 3rd
FAU - Bouras, E P
AU  - Bouras EP
FAU - DiBaise, J K
AU  - DiBaise JK
FAU - El-Serag, H B
AU  - El-Serag HB
FAU - Abraham, B P
AU  - Abraham BP
FAU - Howden, C W
AU  - Howden CW
FAU - Moayyedi, P
AU  - Moayyedi P
FAU - Prather, C
AU  - Prather C
LA  - eng
GR  - P30 DK056338/DK/NIDDK NIH HHS/United States
GR  - U01 DK065713/DK/NIDDK NIH HHS/United States
GR  - U01DK065713/DK/NIDDK NIH HHS/United States
GR  - P30 DK56338/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Review
DEP - 20120516
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Analgesics)
RN  - 0 (Antidepressive Agents, Tricyclic)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Analgesics/*therapeutic use
MH  - Antidepressive Agents, Tricyclic/*therapeutic use
MH  - Complementary Therapies
MH  - Dietary Supplements
MH  - Dyspepsia/*drug therapy/microbiology
MH  - Gastrointestinal Agents/*therapeutic use
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/isolation & purification
MH  - Histamine H2 Antagonists/*therapeutic use
MH  - Humans
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Psychotherapy
MH  - Treatment Outcome
PMC - PMC3970847
MID - NIHMS564451
EDAT- 2012/05/18 06:00
MHDA- 2012/10/12 06:00
PMCR- 2014/03/31
CRDT- 2012/05/18 06:00
PHST- 2012/02/07 00:00 [received]
PHST- 2012/02/26 00:00 [revised]
PHST- 2012/04/18 00:00 [revised]
PHST- 2012/04/21 00:00 [accepted]
PHST- 2012/05/18 06:00 [entrez]
PHST- 2012/05/18 06:00 [pubmed]
PHST- 2012/10/12 06:00 [medline]
PHST- 2014/03/31 00:00 [pmc-release]
AID - 10.1111/j.1365-2036.2012.05128.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2012 Jul;36(1):3-15. doi: 
      10.1111/j.1365-2036.2012.05128.x. Epub 2012 May 16.