Functional Dyspepsia, 2016

Nicholas J. Talley; Marjorie M. Walker; Gerald Holtmann


Curr Opin Gastroenterol. 2016;32(6):467-473. 

In This Article


Functional dyspepsia has been unexplained, but recent advances have provided new insights and opened up the potential for new treatment options. Data continue to accumulate that duodenal inflammation, most notably with eosinophils and perhaps mast cells, is key to explaining a major subset with functional dyspepsia. HpD is now considered a distinct syndrome from functional dyspepsia, although we suggest it would be preferable to conceptualize H. pylori as one of the causes of functional dyspepsia. Following a bout of gastroenteritis, there is a risk of functional dyspepsia or an overlap syndrome developing, presumably in those genetically predisposed. Food plays a key role in inducing functional dyspepsia symptoms. In patients who fail to respond to standard gut-directed options, centrally acting drugs may be helpful, with the best data supporting a low-dose tricyclic or possibly mirtazapine.