5-Minute Clinical Consult

Dyspepsia, Functional

Dyspepsia, Functional is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • A condition defined as the presence of bothersome postprandial fullness, early satiety, or epigastric pain/burning in the absence of causative structural disease (to include upper endoscopy) for the preceding 3 months with initial symptom onset at least 6 months prior to diagnosis (Rome III criteria)
  • Rome III criteria divide patients into two subtypes:
    • Postprandial distress syndrome
    • Epigastric pain syndrome
  • System(s) affected: GI
  • Synonym(s): idiopathic dyspepsia, nonulcer dyspepsia, nonorganic dyspepsia, postprandial distress syndrome, and epigastric pain syndrome

Epidemiology

Incidence
  • Unknown
  • Accounts for 70% of patients with dyspepsia
  • Accounts for ~5% of primary care visits

Prevalence
  • 15–30% prevalence in developed countries (3–10% when strict Rome III criteria are used)
  • Predominant age: adults, but can be seen in children
  • Predominant gender: female > male

Etiology and Pathophysiology

Unknown, but proposed mechanisms or associations include gastric motility disorders, visceral hypersensitivity to pain, Helicobacter pylori infection, alteration in upper GI microbiome, medications, anxiety, and depression

Genetics
Possible link to G-protein β-3 subunit 825 CC genotype and serotonin transport genes

Pediatric Considerations
Be alert for family system dysfunction.

Pregnancy Considerations
Pregnancy may exacerbate symptoms.

Geriatric Considerations
Patients older than age 55 years with new-onset dyspepsia should have an upper endoscopy.

Risk Factors

  • Other functional disorders
  • Anxiety/depression psychosocial factors: divorce, unemployment
  • Smoking

General Prevention

Avoid foods and habits known to exacerbate symptoms.

Commonly Associated Conditions

Other functional bowel disorders

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