Functional dyspepsia: literature review

Emilija Šabatina1, Mindaugas Stonis1

1 Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Functional dyspepsia is a common functional gastrointestinal disease. Functional dyspepsia is characterized by postprandial fullness, early satiation, epigastric pain, and/or epigastric burning, bloating, belching, nausea and vomiting. Functional dyspepsia is not usually a life-threatening disease, but the symptoms significantly worsen the quality of life for patients and decrease their ability to work. According to the latest Rome IV criteria, functional dyspepsia is divided into two main subtypes according to the predominant symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). However, diagnosis is clinical and requires exclusion of structural gastrointestinal disease, evaluation of “alarm“ symptoms. Differential diagnosis is associated with drug-induced dyspepsia (nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX – 2 inhibitors) and irritable bowel syndrome (IBS). Prevalence of dyspepsia ranges from 20 % to 40 %, and dyspepsia accounts for 3 % to 5 % of primary care visits. Gastrointestinal infection caused by Helicobacter pylori, Escherichia coli, Campylobacter jejuni, Salmonella, recent use of antibiotics, use of non-steroidal anti-inflammatory drugs (NSAIDs), obesity, smoking and psychosocial dysfunction are risk factors for functional dyspepsia. Functional dyspepsia involves many pathogenic factors, such as gastric motility disorders, visceral hypersensitivity, Helicobacter pylori infection, altered intestinal microbiota, eosinophilic duodenitis and psychological factors. When functional dyspepsia is diagnosed, it is recommended to explain to the patient that the symptoms are not related to the oncological process, also recommend relaxation exercises, try to identify possible psychosocial causes (anxiety, depression, stress). Diet has little effect on the onset of symptoms, but it should be recommended to abandon products that the patient does not tolerate. Because there is no etiological cure, treatments are focused on relieving symptoms and improving quality of life.

Keywords: functional dyspepsia, dyspepsia, Rome IV diagnostic criteria, postprandial distress syndrome, epigastric pain syndrome.