Functional dyspepsia

• Dyspepsia refers to symptoms originating in the upper GI

tract; is used to describe upper abdominal pain or
discomfort often exacerbated with eating, early satiety,
postprandial abdominal bloating or distention, and nausea
• Rome III criteria for functional dyspepsia including the
following requirements (these features be fulfilled for the
previous 3 months with symptom onset at least 6 months
before diagnosis):
– The presence of one or more of the following: bothersome
postprandial fullness, early satiation, epigastric pain, epigastric
burning.
– No evidence of structural disease (including at upper
endoscopy) that is likely to explain the symptoms.
 Etiology
• Delayed gastric emptying and antral hypomotility:
antral hypomotility or small intestine dysmotility
→ delayed gastric emptying
• Regional gastric dysfunction (impaired fundic
accommodation and antral distention): poor
receptive relaxation or accommodation of the
proximal stomach → rapid transit from the
proximal stomach to antrum
• Gastric myoelectric abnormalities: measured by
ECG to measure bradygastria or tachygastria
• Visceral hypersensitivity
 Treatment
• Promotility agent:
– Domperidone is a peripherally acting dopamine
antagonist that is known to promote gastric
emptying and antropyloric motility
– Cisapride stimulates gastrointestinal motility
through its action as a partial 5HT4 agonist
• Antidepressant
• Cognitive psychotherapy