DOI QR코드

DOI QR Code

Functional dyspepsia: new insights into pathogenesis and therapy

  • Talley, Nicholas J. (Department of Gastroenterology, John Hunter Hospital, The University of Newcastle Australia Faculty of Health and Medicine)
  • 투고 : 2016.02.14
  • 심사 : 2016.03.05
  • 발행 : 2016.05.01

초록

One in 10 people suffer from functional dyspepsia (FD), a clinical syndrome comprising chronic bothersome early satiety, or postprandial fullness, or epigastric pain or burning. Postprandial distress syndrome (PDS, comprising early satiety and/or postprandial fullness) and epigastric pain syndrome (EPS) are increasingly accepted as valid clinical entities, based on new insights into the pathophysiology and the results of clinical trials. Diagnosis is based on the clinical history, and exclusion of peptic ulcer and cancer by endoscopy. Evidence is accumulating FD and gastroesophageal ref lux disease are part of the same disease spectrum in a major subset. The causes of FD remain to be established, but accumulating data suggest infections and possibly food may play an important role in subsets. FD does not equate with no pathology; duodenal eosinophilia is now an accepted association, and Helicobacter pylori infection is considered to be causally linked to dyspepsia although only a minority will respond to eradication. In those with EPS, acid suppression therapy is a first line therapy; consider a $H_2$ blocker even if proton pump inhibitor fails. In PDS, a prokinetic is preferred. Second line therapy includes administration of a tricyclic antidepressant in low doses, or mirtazapine, but not a selective serotonin reuptake inhibitor.

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참고문헌

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  3. System Pharmacology-Based Strategy to Decode the Synergistic Mechanism of Zhi-zhu Wan for Functional Dyspepsia vol.9, pp.None, 2018, https://doi.org/10.3389/fphar.2018.00841
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  5. Effect of “Pistacia atlantica” Resin (Baneh) on Functional Dyspepsia: A Double-Blind, Randomized Clinical Study vol.20, pp.7, 2016, https://doi.org/10.5812/ircmj.63822
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  7. Effect of miRNA-19a on gastrointestinal motility in rats with functional dyspepsia vol.15, pp.6, 2016, https://doi.org/10.3892/etm.2018.6009
  8. Electroacupuncture via chronically implanted electrodes improves gastric dysmotility mediated by autonomic‐cholinergic mechanisms in a rodent model of functional dyspepsia vol.30, pp.10, 2018, https://doi.org/10.1111/nmo.13381
  9. Evaluation of the Safety and Efficacy of a Multienzyme Complex in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study vol.21, pp.11, 2016, https://doi.org/10.1089/jmf.2017.4172
  10. Efficacy of Jianpi Liqi therapy for functional dyspepsia : A meta-analysis of randomized, positive medicine-controlled trials vol.98, pp.33, 2019, https://doi.org/10.1097/md.0000000000016607
  11. Efficacy of serotonin receptor agonists in the treatment of functional dyspepsia: a meta-analysis vol.15, pp.1, 2016, https://doi.org/10.5114/aoms.2017.69234
  12. Expression of tryptophan hydroxylase in gastric mucosa in symptomatic and asymptomatic Helicobacter pylori infection vol.15, pp.2, 2016, https://doi.org/10.5114/aoms.2018.76928
  13. Efficacy of Weikang Pian in Patients with Functional Dyspepsia: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial vol.2019, pp.None, 2016, https://doi.org/10.1155/2019/4827046
  14. Thailand Dyspepsia Guidelines: 2018 vol.25, pp.1, 2016, https://doi.org/10.5056/jnm18081
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  18. Duodenal low‐grade inflammation and expression of tight junction proteins in functional dyspepsia vol.31, pp.10, 2016, https://doi.org/10.1111/nmo.13576
  19. The Effects of Low-Dose and High-Dose Decoctions of Fructus aurantii in a Rat Model of Functional Dyspepsia vol.26, pp.None, 2020, https://doi.org/10.12659/msm.919815
  20. Association of duodenal eosinophilia with Helicobacter pylori-negative functional dyspepsia vol.21, pp.1, 2020, https://doi.org/10.1016/j.ajg.2020.03.001
  21. Comparison of CD4+ and CD8+ T- lymphocyte in Helicobacter pylori-negative functional dyspepsia vol.11, pp.2, 2020, https://doi.org/10.22088/cjim.11.2.150
  22. Effects of electroacupuncture on stress-induced gastric dysrhythmia and mechanisms involving autonomic and central nervous systems in functional dyspepsia vol.319, pp.1, 2016, https://doi.org/10.1152/ajpregu.00256.2019
  23. Prevalence and severity of dyspepsia in Saudi Arabia: A survey-based study vol.28, pp.9, 2016, https://doi.org/10.1016/j.jsps.2020.07.006
  24. Disorders of the brain-gut interaction and eating disorders vol.27, pp.24, 2016, https://doi.org/10.3748/wjg.v27.i24.3668
  25. The Usefulness of Symptom-based Subtypes of Functional Dyspepsia for Predicting Underlying Pathophysiologic Mechanisms and Choosing Appropriate Therapeutic Agents vol.27, pp.3, 2016, https://doi.org/10.5056/jnm21042
  26. Role of Bile Reflux in Functional Dyspepsia: Areas That Need Further Research vol.27, pp.3, 2016, https://doi.org/10.5056/jnm21112
  27. Functional dyspepsia: A critical appraisal of the European consensus from a global perspective vol.33, pp.9, 2016, https://doi.org/10.1111/nmo.14216
  28. 족삼리와 상완, 중완, 하완혈의 침 자극으로 기능성 소화불량증 환자의 위 평활근 전기적 활성 장애를 정상화시켰던 증례 2례 vol.42, pp.4, 2016, https://doi.org/10.22246/jikm.2021.42.4.707
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  30. Extracts of Poria cocos improve functional dyspepsia via regulating brain-gut peptides, immunity and repairing of gastrointestinal mucosa vol.95, pp.None, 2022, https://doi.org/10.1016/j.phymed.2021.153875