5-Minute Clinical Consult

Dyspepsia, Functional

Dyspepsia, Functional was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.

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Basics

Description

  • A condition characterized by the presence of chronic intermittent symptoms without mucosal lesions or other structural abnormalities of the GI tract (1)[A] for at least 3 months:
    • Symptoms include:
      • Epigastric pain
      • Postprandial fullness
      • Early satiety
      • Epigastric burning
  • Analogous to irritable bowel syndrome (IBS) of the upper GI tract
  • System(s) affected: GI
  • Synonym(s): Nonulcer dyspepsia; Moynihan dyspepsia; Pseudoulcer dyspepsia; Phantom ulcer; Nonorganic dyspepsia; Nervous dyspepsia

Epidemiology


Incidence
  • 1–3%/year incidence of dyspepsia
  • Accounts for 70% of patients with dyspepsia
  • Accounts for ~5% of primary care visits
Prevalence
  • 15–30% prevalence in developed countries
  • Predominant age: Adults, but can be seen in children
  • Predominant gender: Females > Males

Risk Factors

  • Other functional disorders
  • Anxiety
  • Depression

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

General Prevention

Avoid foods and habits known to exacerbate symptoms (see “Diet”).

Pathophysiology

  • Not well understood
  • Motility disorder
  • Impaired gastric accommodation to food
  • Visceral hypersensitivity
  • Inflammation after Helicobacter pylori infection
  • Psychosocial factors

Etiology

  • Often unknown; may be of several different etiologies
  • Evanescent ulcers (20–30% go on to develop ulcers)
  • Gastric motility disorder (delayed/accelerated)
  • Visceral hypersensitivity to gastric distention, lipids, and acids (2)[B]
  • Impaired gastric accommodation (2)[B]
  • Association with H. pylori infection
  • Adverse drug effects (NSAIDs, bisphosphonate, corticosteroids)
  • Carbohydrate malabsorption
  • Food intolerance
  • Psychosocial factors

Commonly Associated Conditions

Other functional bowel disorders

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