An update on current pharmacotherapy options for dyspepsia

University of Miami, Division of Gastroenterology , 1120 NW 14th Street, Miami, FL 33136 , USA +1 305 243 2515
Expert Opinion on Pharmacotherapy (Impact Factor: 3.09). 06/2013; 14(13). DOI: 10.1517/14656566.2013.809063
Source: PubMed

ABSTRACT Introduction: Functional dyspepsia (FD) is a highly prevalent and challenging disorder which impacts patients' quality of life and poses a considerable socioeconomic burden. Given the vagueness of the definition of FD based on the current Rome III criteria's expert opinion, the diagnosis of FD continues to be one of exclusion. Despite efforts to better define what constitutes FD, validity of such diagnostic criteria remains controversial given the lack of a distinct pathophysiologic mechanism. Areas covered: New insights into the pathophysiology of FD have expanded our treatment options for the syndrome. This review will discuss the current pharmacologic treatments of FD with particular focus on the more robust randomized controlled trials to date. Expert opinion: Recently, the understanding of the pathophysiology of FD has evolved with novel hypothesis such as sensorimotor abnormalities of the stomach or duodenum, genetic polypmorphisms, psychological comorbidities, food sensitivities and allergies, and immune dysregulation found to be possibly responsible for its pathogenesis. Despite the expanding knowledge about the likely multifactorial pathophysiology of FD, its treatment remains a challenge.

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    • "Functional dyspepsia is diagnosed using the Rome III criteria (Tack et al 2006). However, due to the vague description of the disease diagnosis is based on exclusion (Moshiree et al 2013). Our understanding of the relationship between abnormal gastric motility and functional dyspepsia is far from complete (Miwa et al 2011), and the need for long-term monitoring of gastric motility in association with functional dyspepsia is obvious because its symptoms and associated factors are poorly understood (Kindt et al 2010). "
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    ABSTRACT: Function dyspepsia (FD) may cause patients to suffer from anxiety and depression, and psychosocial disorders would have a significant effect on FD symptoms. To examine the prevalence of anxiety and depression among function dyspepsia (FD) patients and to identify social factors of anxiety-depression among FD patients. Patients with FD, who fulfilled the Rome III criteria, were enrolled. All patients were administered a validated Chinese version of the self-rating scale (SDS) and self-rating anxiety scale (SAS), and investigated regarding the patients' social factors. A total of 907 patients were enrolled, including 516 (56.89%) FD patients within anxiety-depression status; SDS mean scores were 51.57 ±8.22; SAS mean scores were 51.04 ±7.53; 52.28% were male and 64.25% were female (χ(2) = 262.54, p < 0.01); 56.16% were aged 18-29 years, 54.15% were aged 30-39 years, 54.77% were aged 40-49 years, 62.02% were aged 50-59 years, 69.23% were aged above 60 years (χ(2) = 18.14, p < 0.01); 67.44% were the retirees; 63.31% were manual workers; 55.10% were soldiers; 43.57% were mental workers; 38.89% were students (χ(2) = 716.53, p < 0.01); 64.20% had junior high school degree or below; 57.36% had high school degrees; 42.03% had college degrees; 44.44% had master's or above degrees (χ(2) = 27.21, p < 0.05); 38.10% were in good health condition; 61.90% were in poor health condition (χ(2) = 7.94, p < 0.01); 20.31% had correlative family history; and 79.69% had no correlative family history (χ(2) = 2.23, p > 0.05). The FD patients have higher rates of anxiety and depression. Gender, age, occupation, education level, and health condition have a significant effect on anxiety and depression status. Female gender, advanced age, high-stress occupation, lower education level, and poor health condition all are risk factors. Family history has no relationship with anxiety and depression among FD patients.
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