Asian consensus report on functional dyspepsia

Hiroto Miwa, Uday C Ghoshal, Sutep Gonlachanvit, Kok-Ann Gwee, Tiing-Leong Ang, Full-Young Chang, Kwong Ming Fock, Michio Hongo, Xiaohua Hou, Udom Kachintorn, Meiyun Ke, Kwok-Hung Lai, Kwang Jae Lee, Ching-Liang Lu, Sanjiv Mahadeva, Soichiro Miura, Hyojin Park, Poong-Lyul Rhee, Kentaro Sugano, Ratha-Korn Vilaichone, Benjamin Cy Wong, Young-Tae Bak, Hiroto Miwa, Uday C Ghoshal, Sutep Gonlachanvit, Kok-Ann Gwee, Tiing-Leong Ang, Full-Young Chang, Kwong Ming Fock, Michio Hongo, Xiaohua Hou, Udom Kachintorn, Meiyun Ke, Kwok-Hung Lai, Kwang Jae Lee, Ching-Liang Lu, Sanjiv Mahadeva, Soichiro Miura, Hyojin Park, Poong-Lyul Rhee, Kentaro Sugano, Ratha-Korn Vilaichone, Benjamin Cy Wong, Young-Tae Bak

Abstract

Background/aims: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia.

Methods: Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group.

Results: Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added.

Conclusions: This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.

Keywords: Asia; Diagnosis; Epidemiology; Functional dyspepsia; Management; Pathophysiology.

Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Diagnostic algorithm for functional dyspepsia in Asian primary care settings. aDyspepsia refers to a symptom or set of symptoms that are considered to originate from the gastroduodenal region. The dyspeptic symptoms are epigastric pain, epigastric burning, postprandial fullness, early satiation and other symptoms including bloating in the upper abdomen, nausea, vomiting and belching. Chronic dyspeptic symptoms can be continuous, intermittent or recurrent. More than two thirds of the consensus members agreed that symptom duration of 3 months or longer might be enough. bThe alarm features are unintended weight loss, progressive dysphagia, recurrent or persistent vomiting, evidence of gastrointestinal bleeding, anemia, fever, family history of gastric cancer, new onset dyspepsia in the subjects over 40 years of age in population with high prevalence of upper gastrointestinal malignancy and over 45 and 50 years in populations with intermediate and low prevalence, respectively. cThe appropriate choice from the three options depends on patient's symptom profiles, patient's wish, local risk of Helicobacter pylori infection and gastric cancer as well as local health care or re-imbursement system. H. pylori, Helicobacter pylori.
Figure 2
Figure 2
Management algorithm for functional dyspepsia in Asian primary care settings. aWhere socio-economic conditions allow, Helicobacter pylori test and eradication should be part of the management strategy for all patients presenting with dyspepsia in Asia. bSpecific food ingredients may provoke dyspeptic symptoms. Dietary modification can be considered in functional dyspepsia but data are lacking. cWhere there is any available herbal medication previously validated, it may be tried. H. pylori, Helicobacter pylori.

References

    1. Colin-Jones D, Bloom B, Bodemar G, et al. Management of dyspepsia: report of a working party. Lancet. 1988;331:576–579.
    1. Murphy MK, Black NA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2:i–iv. 1–88.
    1. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.
    1. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–1479.
    1. Tuteja AK, Talley NJ, Joos SK, Tolman KG, Hickam DH. Abdominal bloating in employed adults: prevalence, risk factors, and association with other bowel disorders. Am J Gastroenterol. 2008;103:1241–1248.
    1. Jiang X, Locke GR, 3rd, Choung RS, Zinsmeister AR, Schleck CD, Talley NJ. Prevalence and risk factors for abdominal bloating and visible distention: a population-based study. Gut. 2008;57:756–763.
    1. Manabe N, Haruma K, Hata J, et al. Clinical characteristics of Japanese dyspeptic patients: is the Rome III classification applicable? Scand J Gastroenterol. 2010;45:567–572.
    1. Wang A, Liao X, Xiong L, et al. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC Gastroenterol. 2008;8:43.
    1. Suzuki H, Gotoda T, Sasako M, Saito D. Detection of early gastric cancer: misunderstanding the role of mass screening. Gastric Cancer. 2006;9:315–319.
    1. Ryu E, Kim K, Cho MS, Kwon IG, Kim HS, Fu MR. Symptom clusters and quality of life in Korean patients with hepatocellular carcinoma. Cancer Nurs. 2010;33:3–10.
    1. Karahocagil MK, Akdeniz H, Sunnetcioglu M, et al. A familial outbreak of fascioliasis in Eastern Anatolia: a report with review of literature. Acta Trop. 2011;118:177–183.
    1. Grazioli B, Matera G, Laratta C, et al. Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia: a prospective study. World J Gastroenterol. 2006;12:1941–1944.
    1. Upatham ES, Viyanant V, Kurathong S, et al. Relationship between prevalence and intensity of Opisthorchis viverrini infection, and clinical symptoms and signs in a rural community in north-east Thailand. Bull World Health Organ. 1984;62:451–461.
    1. Khuroo NS, Khuroo MS. Gastric ascariasis presenting as unique dyspeptic symptoms in an endemic area. Am J Gastroenterol. 2010;105:1675–1677.
    1. Chen WX, Zhang WF, Li B, et al. Clinical manifestations of patients with chronic pancreatitis. Hepatobiliary Pancreat Dis Int. 2006;5:133–137.
    1. Gunsar F, Yilmaz S, Bor S, et al. Effect of hypo- and hyperthyroidism on gastric myoelectrical activity. Dig Dis Sci. 2003;48:706–712.
    1. Van Vlem B, Schoonjans R, Vanholder R, Vandamme W, De Vos M, Lameire N. Dyspepsia and gastric emptying in chronic renal failure patients. Clin Nephrol. 2001;56:302–307.
    1. Ashizawa N, Hashimoto T, Miyake T, Shizuku T, Imaoka T, Kinoshita Y. Efficacy of camostat mesilate compared with famotidine for treatment of functional dyspepsia: is camostat mesilate effective? J Gastroenterol Hepatol. 2006;21:767–771.
    1. Gonlachanvit S, Mahachai V, Chaiwatanarat T, Kullavanijaya P. Lack of effect of Helicobacter pylori on symptom improvement with a prokinetic medication, cisapride, in patients with non-ulcer dyspepsia. J Med Assoc Thai. 2005;88:660–667.
    1. Vakil N, Moayyedi P, Fennerty MB, Talley NJ. Limited value of alarm features in the diagnosis of upper gastrointestinal malignancy: systematic review and meta-analysis. Gastroenterology. 2006;131:390–401.
    1. Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25:479–486.
    1. Parkman HP, Jones MP. Tests of gastric neuromuscular function. Gastroenterology. 2009;136:1526–1543.
    1. Ghoshal UC, Singh R, Chang FY, Hou X, Wong BCY, Kachintorn U. Epidemiology of uninvestigated and functional dyspepsia in Asia: facts and fiction. J Neurogastroenterol Motil. 2011;17:235–244.
    1. Li XB, Liu WZ, Ge ZZ, et al. Analysis of clinical characteristics of dyspeptic symptoms in Shanghai patients. Chin J Dig Dis. 2005;6:62–67.
    1. Kwan AC, Bao TN, Chakkaphak S, et al. Validation of Rome II criteria for functional gastrointestinal disorders by factor analysis of symptoms in Asian patient sample. J Gastroenterol Hepatol. 2003;18:796–802.
    1. Kim JS, Lee KJ, Kim JH, Hahm KB, Cho SW. Functional gastrointestinal disorders in patients referred to specialist gastroenterologists in a tertiary hospital. Korean J Neurogastroenterol Motil. 2004;10:111–117.
    1. Mahadeva S, Chia YC, Vinothini A, Mohazmi M, Goh KL. Cost-effectiveness of and satisfaction with a Helicobacter pylori "test and treat" strategy compared with prompt endoscopy in young Asians with dyspepsia. Gut. 2008;57:1214–1220.
    1. Wai CT, Yeoh KG, Ho KY, Kang JY, Lim SG. Diagnostic yield of upper endoscopy in Asian patients presenting with dyspepsia. Gastrointest Endosc. 2002;56:548–551.
    1. Kawamura A, Adachi K, Takashima T, et al. Prevalence of functional dyspepsia and its relationship with Helicobacter pylori infection in a Japanese population. J Gastroenterol Hepatol. 2001;16:384–388.
    1. Nakamura R, Saikawa Y, Takahashi T, et al. Retrospective analysis of prognostic outcome of gastric cancer in young patients. Int J Clin Oncol. 2011;16:328–334.
    1. Ghoshal UC, Tiwari S, Dhingra S, et al. Frequency of Helicobacter pylori and CagA antibody in patients with gastric neoplasms and controls: the Indian enigma. Dig Dis Sci. 2008;53:1215–1222.
    1. Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001;20:103–106.
    1. Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008;27:22–28.
    1. Okumura T, Tanno S, Ohhira M, Tanno S. Prevalence of functional dyspepsia in an outpatient clinic with primary care physicians in Japan. J Gastroenterol. 2010;45:187–194.
    1. Hu WH, Wong WM, Lam CL, et al. Anxiety but not depression determines health care-seeking behaviour in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther. 2002;16:2081–2088.
    1. Hori K, Matsumoto T, Miwa H. Analysis of the gastrointestinal symptoms of uninvestigated dyspepsia and irritable bowel syndrome. Gut Liver. 2009;3:192–196.
    1. Kitapçioğlu G, Mandiracioğlu A, Caymaz Bor C, Bor S. Overlap of symptoms of dyspepsia and gastroesophageal reflux in the community. Turk J Gastroenterol. 2007;18:14–19.
    1. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196–201.
    1. Sperber AD. The challenge of cross-cultural, multi-national research: potential benefits in the functional gastrointestinal disorders. Neurogastroenterol Motil. 2009;21:351–360.
    1. Lu CL, Lang HC, Chang FY, et al. Prevalence and health/social impacts of functional dyspepsia in Taiwan: a study based on the Rome criteria questionnaire survey assisted by endoscopic exclusion among a physical check-up population. Scand J Gastroenterol. 2005;40:402–411.
    1. Moayyedi P, Mason J. Clinical and economic consequences of dyspepsia in the community. Gut. 2002;50(suppl 4):iv10–iv12.
    1. Jeong JJ, Choi MG, Cho YS, et al. Chronic gastrointestinal symptoms and quality of life in the Korean population. World J Gastroenterol. 2008;14:6388–6394.
    1. Hu WH, Lam KF, Wong YH, et al. The Hong Kong index of dyspepsia: a validated symptom severity questionnaire for patients with dyspepsia. J Gastroenterol Hepatol. 2002;17:545–551.
    1. Mahadeva S, Yadav H, Rampal S, Goh KL. Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life. Am J Gastroenterol. 2010;105:904–912.
    1. Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL. Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia. Aliment Pharmacol Ther. 2010;31:1141–1151.
    1. Mahadeva S, Wee HL, Goh KL, Thumboo J. The EQ-5D (Euroqol) is a valid generic instrument for measuring quality of life in patients with dyspepsia. BMC Gastroenterol. 2009;9:20.
    1. Pan XP, Li YY, Sha WH, Yang FY. Psychological factors in functional dyspepsia and its treatment. Chin J Dig Dis. 2000;1:17–20.
    1. Mahadeva S, Goh KL. Anxiety, depression and quality of life differences between functional and organic dyspepsia. J Gastroenterol Hepatol. 2011;26(suppl 3):49–52.
    1. Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol. 2009;24:1601–1607.
    1. Lee KJ, Kindt S, Tack J. Pathophysiology of functional dyspepsia. Best Pract Res Clin Gastroenterol. 2004;18:707–716.
    1. Miwa H, Watari J, Fukui H, et al. Current understanding of pathogenesis of functional dyspepsia. J Gastroenterol Hepatol. 2011;26(suppl 3):53–60.
    1. Mimidis K, Tack J. Pathogenesis of dyspepsia. Dig Dis. 2008;26:194–202.
    1. Kato M, Nishida U, Nishida M, et al. Pathophysiological classification of functional dyspepsia using a novel drinking-ultrasonography test. Digestion. 2010;82:162–166.
    1. Tack J. Prokinetics and fundic relaxants in upper functional GI disorders. Curr Opin Pharmacol. 2008;8:690–696.
    1. Perri F, Clemente R, Festa V, et al. Patterns of symptoms in functional dyspepsia: role of Helicobacter pylori infection and delayed gastric emptying. Am J Gastroenterol. 1998;93:2082–2088.
    1. Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol. 2003;98:783–788.
    1. Rahim MK, Durr-e-Sabih, Mateen A, Najam-Uddin, Yousaf M. Studies of gastric emptying time in patients with non-ulcer dyspepsia. Nucl Med Commun. 2007;28:852–858.
    1. Aoki S, Haruma K, Kusunoki H, et al. Evaluation of gastric emptying measured with the 13C-octanoic acid breath test in patients with functional dyspepsia: comparison with ultrasonography. Scand J Gastroenterol. 2002;37:662–666.
    1. Duan LP, Zheng ZT, Li YN. A study of gastric emptying in non-ulcer dyspepsia using a new ultrasonographic method. Scand J Gastroenterol. 1993;28:355–360.
    1. Shindo T, Futagami S, Hiratsuka T, et al. Comparison of gastric emptying and plasma ghrelin levels in patients with functional dyspepsia and non-erosive reflux disease. Digestion. 2009;79:65–72.
    1. Takamori K, Mizuta Y, Takeshima F, et al. Relation among plasma ghrelin level, gastric emptying, and psychologic condition in patients with functional dyspepsia. J Clin Gastroenterol. 2007;41:477–483.
    1. Chang CS, Chen GH, Kao CH, Wang SJ, Peng SN, Huang CK. The effect of Helicobacter pylori infection on gastric emptying of digestible and indigestible solids in patients with nonulcer dyspepsia. Am J Gastroenterol. 1996;91:474–479.
    1. Waldron B, Cullen PT, Kumar R, et al. Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study. Gut. 1991;32:246–251.
    1. Quartero AO, de Wit NJ, Lodder AC, Numans ME, Smout AJ, Hoes AW. Disturbed solid-phase gastric emptying in functional dyspepsia: a meta-analysis. Dig Dis Sci. 1998;43:2028–2033.
    1. Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology. 2004;127:1239–1255.
    1. Talley NJ, Verlinden M, Jones M. Can symptoms discriminate among those with delayed or normal gastric emptying in dysmotility-like dyspepsia? Am J Gastroenterol. 2001;96:1422–1428.
    1. Wegener M, Börsch G, Schaffstein J, Reuter C, Leverkus F. Frequency of idiopathic gastric stasis and intestinal transit disorders in essential dyspepsia. J Clin Gastroenterol. 1989;11:163–168.
    1. Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J. Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology. 1998;115:1346–1352.
    1. Piessevaux H, Tack J, Walrand S, Pauwels S, Geubel A. Intragastric distribution of a standardized meal in health and functional dyspepsia: correlation with specific symptoms. Neurogastroenterol Motil. 2003;15:447–455.
    1. Hou XH, Li Q, Zhu L, Xie X, Chen JD. Correlation of gastric liquid emptying with various thresholds of sensation in healthy controls and patients with functional dyspepsia. Dig Dis Sci. 2004;49:188–195.
    1. Rhee PL, Kim YH, Son HJ, et al. The etiologic role of gastric hypersensitivity in functional dyspepsia in Korea. J Clin Gastroenterol. 1999;29:332–335.
    1. Mertz H, Fullerton S, Naliboff B, Mayer EA. Symptoms and visceral perception in severe functional and organic dyspepsia. Gut. 1998;42:814–822.
    1. Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001;121:526–535.
    1. Vandenberghe J, Vos R, Persoons P, Demyttenaere K, Janssens J, Tack J. Dyspeptic patients with visceral hypersensitivity: sensitisation of pain specific or multimodal pathways? Gut. 2005;54:914–919.
    1. Lee KJ, Tack J. Duodenal implications in the pathophysiology of functional dyspepsia. J Neurogastroenterol Motil. 2010;16:251–257.
    1. Son HJ, Rhee PL, Kim JJ, Koh KC, Paik SW, Rhee JC. Hypersensitivity to acid in ulcer-like functional dyspepsia. Korean J Intern Med. 1997;12:188–192.
    1. Hammer J, Fuhrer M, Pipal L, Matiasek J. Hypersensitivity for capsaicin in patients with functional dyspepsia. Neurogastroenterol Motil. 2008;20:125–133.
    1. Li Y, Nie Y, Sha W, Su H. The link between psychosocial factors and functional dyspepsia: an epidemiological study. Chin Med J. 2002;115:1082–1084.
    1. Chen TS, Luo JC, Chang FY. Psychosocial-spiritual factors in patients with functional dyspepsia: a comparative study with normal individuals having the same endoscopic features. Eur J Gastroenterol Hepatol. 2010;22:75–80.
    1. Kang SG, Kim HJ, Lee SY, Cha MJ, Hwang HH. A study of anger, alexithymia, and depression in the functional dyspepsia. J Korean Acad Fam Med. 2002;23:881–889.
    1. Mujakovic S, de Wit NJ, van Marrewijk CJ, et al. Psychopathology is associated with dyspeptic symptom severity in primary care patients with a new episode of dyspepsia. Aliment Pharmacol Ther. 2009;29:580–588.
    1. Hsu YC, Liou JM, Liao SC, et al. Psychopathology and personality trait in subgroups of functional dyspepsia based on Rome III criteria. Am J Gastroenterol. 2009;104:2534–2542.
    1. Hojo M, Miwa H, Yokoyama T, et al. Treatment of functional dyspepsia with antianxiety or antidepressive agents: systematic review. J Gastroenterol. 2005;40:1036–1042.
    1. Lee S, Park M, Choi S, Nah Y, Abbey SE, Rodin G. Stress, coping, and depression in non-ulcer dyspepsia patients. J Psychosom Res. 2000;49:93–99.
    1. Moon JI, Go EH, Kim SY, Hwang IH. Comparison of stressful life events among peptic ulcer, not ulcer dyspepsia and control groups. J Korean Acad Fam Med. 1999;20:804–811.
    1. Hui WM, Shiu LP, Lam SK. The perception of life events and daily stress in nonulcer dyspepsia. Am J Gastroenterol. 1991;86:292–296.
    1. Chen TS, Lee YC, Chang FY, Wu HC, Lee SD. Psychosocial distress is associated with abnormal gastric myoelectrical activity in patients with functional dyspepsia. Scand J Gastroenterol. 2006;41:791–796.
    1. Cheng C, Hui WM, Lam SK. Coping style of individuals with functional dyspepsia. Psychosom Med. 1999;61:789–795.
    1. Cheng C, Yang FC, Jun S, Hutton JM. Flexible coping psychotherapy for functional dyspeptic patients: a randomized, controlled trial. Psychosom Med. 2007;69:81–88.
    1. Ahn MK, Lee SY, Kim YJ. The relationship between functional dyspepsia and family function. J Korean Acad Fam Med. 1999;20:917–924.
    1. Ochi M, Tominaga K, Iketani T, et al. Perfectionism underlying psychological background correlated with the symptoms of functional dyspepsia. J Gastroenterol. 2008;43:699–704.
    1. Talley NJ, Meineche-Schmidt V, Paré P, et al. Efficacy of omeprazole in functional dyspepsia: double-blind, randomized, placebo-controlled trials (the Bond and Opera studies) Aliment Pharmacol Ther. 1998;12:1055–1065.
    1. Moayyedi P, Soo S, Deeks J, Delaney B, Innes M, Forman D. Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2006;(4):CD001960.
    1. Seno H, Nakase H, Chiba T. Usefulness of famotidine in functional dyspepsia patient treatment: comparison among prokinetic, acid suppression and antianxiety therapies. Aliment Pharmacol Ther. 2005;21(suppl 2):32–36.
    1. Wong WM, Wong BC, Hung WK, et al. Double blind, randomised, placebo controlled study of four weeks of lansoprazole for the treatment of functional dyspepsia in Chinese patients. Gut. 2002;51:502–506.
    1. Leung WK, Wu JC, Chan FK, et al. Initial treatment with lansoprazole in young dyspeptic patients with negative urea breath test result: a randomized controlled trial with 12-month follow-up. Am J Gastroenterol. 2007;102:1483–1488.
    1. Tack J, Caenepeel P, Arts J, Lee KJ, Sifrim D, Janssens J. Prevalence of acid reflux in functional dyspepsia and its association with symptom profile. Gut. 2005;54:1370–1376.
    1. Samsom M, Verhagen MA, vanBerge Henegouwen GP, Smout AJ. Abnormal clearance of exogenous acid and increased acid sensitivity of the proximal duodenum in dyspeptic patients. Gastroenterology. 1999;116:515–520.
    1. Lee KJ, Demarchi B, Demedts I, Sifrim D, Raeymaekers P, Tack J. A pilot study on duodenal acid exposure and its relationship to symptoms in functional dyspepsia with prominent nausea. Am J Gastroenterol. 2004;99:1765–1773.
    1. Misra SP, Broor SL. Is gastric acid responsible for the pain in patients with essential dyspepsia? J Clin Gastroenterol. 1990;12:624–627.
    1. Lambert JR. The role of Helicobacter pylori in nonulcer dyspepsia. A debate - for. Gastroenterol Clin North Am. 1993;22:141–151.
    1. Jaakkimainen RL, Boyle E, Tudiver F. Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ. 1999;319:1040–1044.
    1. el-Omar E, Penman I, Ardill JE, McColl KE. A substantial proportion of non-ulcer dyspepsia patients have the same abnormality of acid secretion as duodenal ulcer patients. Gut. 1995;36:534–538.
    1. Sarnelli G, Cuomo R, Janssens J, Tack J. Symptom patterns and pathophysiological mechanisms in dyspeptic patients with and without Helicobacter pylori. Dig Dis Sci. 2003;48:2229–2236.
    1. Moayyedi P, Soo S, Deeks J, et al. Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. BMJ. 2000;321:659–664.
    1. Laine L, Schoenfeld P, Fennerty MB. Therapy for Helicobacter pylori in patients with nonulcer dyspepsia. A meta-analysis of randomized, controlled trials. Ann Intern Med. 2001;134:361–369.
    1. Miwa H, Hirai S, Nagahara A, et al. Cure of Helicobacter pylori infection does not improve symptoms in non-ulcer dyspepsia patients-a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2000;14:317–324.
    1. Wong WM, Xiao SD, Hu PJ, et al. Standard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese. Aliment Pharmacol Ther. 2005;21:73–81.
    1. Moayyedi P, Soo S, Deeks J, et al. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2006;(2):CD002096.
    1. Jin X, Li YM. Systematic review and meta-analysis from Chinese literature: the association between Helicobacter pylori eradication and improvement of functional dyspepsia. Helicobacter. 2007;12:541–546.
    1. Mearin F, Perez-Oliveras M, Perello A, et al. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology. 2005;129:98–104.
    1. Li X, Chen H, Lu H, et al. The study on the role of inflammatory cells and mediators in post-infectious functional dyspepsia. Scand J Gastroenterol. 2010;45:573–581.
    1. Kindt S, Tertychnyy A, de Hertogh G, Geboes K, Tack J. Intestinal immune activation in presumed post-infectious functional dyspepsia. Neurogastroenterol Motil. 2009;21:832–e56.
    1. Tack J, Demedts I, Dehondt G, et al. Clinical and pathophysiological characteristics of acute-onset functional dyspepsia. Gastroenterology. 2002;122:1738–1747.
    1. Camilleri CE, Carlson PJ, Camilleri M, et al. A study of candidate genotypes associated with dyspepsia in a U.S. community. Am J Gastroenterol. 2006;101:581–592.
    1. Holtmann G, Siffert W, Haag S, et al. G-protein beta 3 subunit 825 CC genotype is associated with unexplained (functional) dyspepsia. Gastroenterology. 2004;126:971–979.
    1. Tahara T, Arisawa T, Shibata T, et al. Homozygous 825T allele of the GNB3 protein influences the susceptibility of Japanese to dyspepsia. Dig Dis Sci. 2008;53:642–646.
    1. van Lelyveld N, Linde JT, Schipper M, Samsom M. Candidate genotypes associated with functional dyspepsia. Neurogastroenterol Motil. 2008;20:767–773.
    1. Oshima T, Nakajima S, Yokoyama T, et al. The G-protein beta3 subunit 825 TT genotype is associated with epigastric pain syndrome-like dyspepsia. BMC Med Genet. 2010;11:13.
    1. Arisawa T, Tahara T, Shibata T, et al. Genetic polymorphisms of molecules associated with inflammation and immune response in Japanese subjects with functional dyspepsia. Int J Mol Med. 2007;20:717–723.
    1. Tahara T, Arisawa T, Shibata T, Nakamura M, Wang F, Hirata I. COMT geneval158met polymorphism in patients with dyspeptic symptoms. Hepatogastroenterology. 2008;55:979–982.
    1. Tahara T, Arisawa T, Shibata T, et al. 779 TC of CCK-1 intron 1 is associated with postprandial syndrome (PDS) in Japanese male subjects. Hepatogastroenterology. 2009;56:1245–1248.
    1. Arisawa T, Tahara T, Shibata T, et al. Genetic polymorphisms of cyclooxygenase-1 (COX-1) are associated with functional dyspepsia in Japanese women. J Womens Health (Larchmt) 2008;17:1039–1043.
    1. Tahara T, Shibata T, Wang F, et al. A genetic variant of the p22PHOX component of NADPH oxidase C242T is associated with reduced risk of functional dyspepsia in Helicobacter pylori-infected Japanese individuals. Eur J Gastroenterol Hepatol. 2009;21:1363–1368.
    1. Tahara T, Shibata T, Nakamura M, et al. Homozygous TRPV1 315C influences the susceptibility to functional dyspepsia. J Clin Gastroenterol. 2010;44:e1–e7.
    1. Watt AH, Lewis DJ, Horne JJ, Smith PM. Reproduction of epigastric pain of duodenal ulceration by adenosine. Br Med J (Clin Res Ed) 1987;294:10–12.
    1. Rao SS, Mudipalli RS, Mujica V, Utech CL, Zhao X, Conklin JL. An open-label trial of theophylline for functional chest pain. Dig Dis Sci. 2002;47:2763–2768.
    1. Barbera R, Feinle C, Read NW. Nutrient-specific modulation of gastric mechanosensitivity in patients with functional dyspepsia. Dig Dis Sci. 1995;40:1636–1641.
    1. Pilichiewicz AN, Feltrin KL, Horowitz M, et al. Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY. Am J Gastroenterol. 2008;103:2613–2623.
    1. Feinle-Bisset C, Horowitz M. Dietary factors in functional dyspepsia. Neurogastroenterol Motil. 2006;18:608–618.
    1. Lee KJ, Kim JH, Cho SW. Dietary influence on electro-gastrography and association of alterations in gastric myoelectrical activity with symptoms in patients with functional dyspepsia. J Gastroenterol Hepatol. 2006;21:59–64.
    1. Chua AS, Bekkering M, Rovati LC, Keeling PW. Clinical efficacy and prokinetic effect of the CCK-A antagonist loxiglumide in nonulcer dyspepsia. Ann N Y Acad Sci. 1994;713:451–453.
    1. Carvalho RV, Lorena SL, Almeida JR, Mesquita MA. Food intolerance, diet composition, and eating patterns in functional dyspepsia patients. Dig Dis Sci. 2010;55:60–65.
    1. Gonlachanvit S. Are rice and spicy diet good for functional gastrointestinal disorders? J Neurogastroenterol Motil. 2010;16:131–138.
    1. Hu ML, Wu KL, Chiu YC, Chiu KW, Changchien CS. Effect of ginger on patients with functional dyspepsia. J Gastroenterol Hepatol. 2009;24(suppl 1):A31.
    1. Feinle-Bisset C, Vozzo R, Horowitz M, Talley NJ. Diet, food intake, and disturbed physiology in the pathogenesis of symptoms in functional dyspepsia. Am J Gastroenterol. 2004;99:170–181.
    1. Gwee KA, Bak YT, Ghoshal UC, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1189–1205.
    1. Harvey RF, Mauad EC, Brown AM. Prognosis in the irritable bowel syndrome: a 5-year prospective study. Lancet. 1987;1:963–965.
    1. Owens DM, Nelson DK, Talley NJ. The irritable bowel syndrome: long-term prognosis and the physician-patient interaction. Ann Intern Med. 1995;122:107–112.
    1. Haag S, Senf W, Tagay S, et al. Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy? Aliment Pharmacol Ther. 2007;25:973–986.
    1. Zhang G, Li Y. Psychological intervention on improvement of depression emotion in patients with functional dyspepsia. Chin J Clin Rehabil. 2006;10:160–161.
    1. Sheu BS, Lin CY, Lin XZ, Shiesh SC, Yang HB, Chen CY. Long-term outcome of triple therapy in Helicobacter pylori-related nonulcer dyspepsia: a prospective controlled assessment. Am J Gastroenterol. 1996;91:441–447.
    1. Dhali GK, Garg PK, Sharma MP. Role of anti-Helicobacter pylori treatment in H. pylori-positive and cytoprotective drugs in H. pylori-negative, non-ulcer dyspepsia: results of a randomized, double-blind, controlled trial in Asian Indians. J Gastroenterol Hepatol. 1999;14:523–528.
    1. Hsu PI, Lai KH, Tseng HH, et al. Eradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like functional dyspepsia. Aliment Pharmacol Ther. 2001;15:195–201.
    1. Ang TL, Fock KM, Teo EK, et al. Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study. J Gastroenterol. 2006;41:647–653.
    1. Gwee KA, Teng L, Wong RK, Ho KY, Sutedja DS, Yeoh KG. The response of Asian patients with functional dyspepsia to eradication of Helicobacter pylori infection. Eur J Gastroenterol Hepatol. 2009;21:417–424.
    1. Fock KM, Katelaris P, Sugano K, et al. Second Asia-Pacific consensus guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol. 2009;24:1587–1600.
    1. Correa P, Fontham ET, Bravo JC, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. J Natl Cancer Inst. 2000;92:1881–1888.
    1. Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6:639–642.
    1. Mera R, Fontham ET, Bravo LE, et al. Long term follow up of patients treated for Helicobacter pylori infection. Gut. 2005;54:1536–1540.
    1. You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006;98:974–983.
    1. Leung WK, Lin SR, Ching JY, et al. Factors predicting progression of gastric intestinal metaplasia: results of a randomised trial on Helicobacter pylori eradication. Gut. 2004;53:1244–1249.
    1. Zhou L, Sung JJ, Lin S, et al. A five-year follow-up study on the pathological changes of gastric mucosa after H. pylori eradication. Chin Med J (Engl) 2003;116:11–14.
    1. Fuccio L, Zagari RM, Eusebi LH, et al. Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer. Ann Intern Med. 2009;151:121–128.
    1. Zhou L. Ten-year follow-up study on the incidence of gastric cancer and the pathological changes of gastric mucosa after H. pylori eradication in China. Gastroenterology. 2008;134:A233.
    1. Saito D, Boku N, Fujioka T, Fukuda Y. Impact of H. pylori eradication on gastric cancer prevention: endosopic results of the Japanese Intervention Trial (JITHP-Study). A randmized multi-center trial. Gastroenterology. 2005;128:A4.
    1. Wong BC, Lam SK, Wong WM, et al. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA. 2004;291:187–194.
    1. Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol. 2006;12:2661–2666.
    1. Spechler SJ. Epidemiology and natural history of gastro-oesophageal reflux disease. Digestion. 1992;51(suppl 1):24–29.
    1. Locke GR, 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ., 3rd Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;112:1448–1456.
    1. Quigley EM. Functional dyspepsia (FD) and non-erosive reflux disease (NERD): overlapping or discrete entities? Best Pract Res Clin Gastroenterol. 2004;18:695–706.
    1. Small PK, Loudon MA, Waldron B, Smith D, Campbell FC. Importance of reflux symptoms in functional dyspepsia. Gut. 1995;36:189–192.
    1. Bolling-Sternevald E, Lauritsen K, Aalykke C, et al. Effect of profound acid suppression in functional dyspepsia: a double-blind, randomized, placebo-controlled trial. Scand J Gastroenterol. 2002;37:1395–1402.
    1. Blum AL, Arnold R, Stolte M, Fischer M, Koelz HR The Frosch Study Group. Short course acid suppressive treatment for patients with functional dyspepsia: results depend on Helicobacter pylori status. Gut. 2000;47:473–480.
    1. Gerson LB, Triadafilopoulos G. A prospective study of oesophageal 24-h ambulatory pH monitoring in patients with functional dyspepsia. Dig Liver Dis. 2005;37:87–91.
    1. Peura DA, Kovacs TO, Metz DC, Siepman N, Pilmer BL, Talley NJ. Lansoprazole in the treatment of functional dyspepsia: two double-blind, randomized, placebo-controlled trials. Am J Med. 2004;116:740–748.
    1. Hengels K. Therapeutic efficacy of 15 mg lansoprazole mane in 269 patients suffering from non-ulcer dyspepsia (NUD): a multicentre, randomized, double-blind study. Gut. 1998;43:A89.
    1. Talley NJ, Lauritsen K. The potential role of acid suppression in functional dyspepsia: the BOND, OPERA, PILOT, and ENCORE studies. Gut. 2002;50(suppl 4):iv36–iv41.
    1. Wang WH, Huang JQ, Zheng GF, et al. Effects of proton-pump inhibitors on functional dyspepsia: a meta-analysis of randomized placebo-controlled trials. Clin Gastroenterol Hepatol. 2007;5:178–185.
    1. Gwee KA, Hwang JE, Ho KY, Yeoh KG, Lum CF, Ang PK. In-practice predictors of response to proton pump inhibitor therapy in primary care patients with dyspepsia in an Asian population. J Clin Gastroenterol. 2008;42:134–138.
    1. Reimer C, Søndergaard B, Hilsted L, Bytzer P. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology. 2009;137:80–87. 87.e1.
    1. Niklasson A, Lindström L, Simrén M, Lindberg G, Björnsson E. Dyspeptic symptom development after discontinuationof a proton pump inhibitor: a double-blind placebo-controlled trial. Am J Gastroenterol. 2010;105:1531–1537.
    1. Lombardo L, Foti M, Ruggia O, Chiecchio A. Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy. Clin Gastroenterol Hepatol. 2010;8:504–508.
    1. Hiyama T, Yoshihara M, Matsuo K, et al. Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia. J Gastroenterol Hepatol. 2007;22:304–310.
    1. Tack J, Masclee A, Heading R, et al. A dose-ranging, placebo-controlled, pilot trial of Acotiamide in patients with functional dyspepsia. Neurogastroenterol Motil. 2009;21:272–280.
    1. Matsueda K, Hongo M, Tack J, Aoki H, Saito Y, Kato H. Clinical trial: dose-dependent therapeutic efficacy of acotiamide hydrochloride (Z-338) in patients with functional dyspepsia - 100 mg t.i.d. is an optimal dosage. Neurogastroenterol Motil. 2010;22:618–e173.
    1. Qin F, Huang X, Ren P. Chinese herbal medicine modified xiaoyao san for functional dyspepsia: meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2009;24:1320–1325.
    1. Tatsuta M, Iishi H. Effect of treatment with liu-jun-zi-tang (TJ-43) on gastric emptying and gastrointestinal symptoms in dyspeptic patients. Aliment Pharmacol Ther. 1993;7:459–462.
    1. Kusunoki H, Haruma K, Hata J, et al. Efficacy of rikkunshito, a traditional Japanese medicine (Kampo), in treating functional dyspepsia. Intern Med. 2010;49:2195–2202.
    1. Soo S, Forman D, Delaney BC, Moayyedi P. A systematic review of psychological therapies for nonulcer dyspepsia. Am J Gastroenterol. 2004;99:1817–1822.
    1. Mertz H, Fass R, Kodner A, Yan-Go F, Fullerton S, Mayer EA. Effect of amitriptyline on symptoms, sleep, and visceral perception in patients with functional dyspepsia. Am J Gastroenterol. 1998;93:160–165.
    1. Dinan TG, Mahmud N, Rathore O, et al. A double-blind placebo-controlled study of buspirone-stimulated prolactin release in non-ulcer dyspepsia - are central serotoninergic responses enhanced? Aliment Pharmacol Ther. 2001;15:1613–1618.
    1. Chua A, Keating J, Hamilton D, Keeling PW, Dinan TG. Central serotonin receptors and delayed gastric emptying in non-ulcer dyspepsia. BMJ. 1992;305:280–282.
    1. Dinan TG, Yatham LN, Barry S, Chua A, Keeling PW. Serotonin supersensitivity: the pathophysiologic basis of non-ulcer dyspepsia? A preliminary report of buspirone/prolactin responses. Scand J Gastroenterol. 1990;25:541–544.
    1. Miwa H, Nagahara A, Tominaga K, et al. Efficacy of the 5-HT1A agonist tandospirone citrate inimproving symptoms of patients with functional dyspepsia: a randomized controlled trial. Am J Gastroenterol. 2009;104:2779–2787.
    1. van Kerkhoven LA, Laheij RJ, Aparicio N, et al. Effect of the anti-depressant venlafaxine in functional dyspepsia: a randomized, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2008;6:746–752.
    1. Wu CY, Chou LT, Chen HP, Chang CS, Wong PG, Chen GH. Effect of fluoxetine on symptoms and gastric dysrhythmia in patients with functional dyspepsia. Hepatogastroenterology. 2003;50:278–283.
    1. Tanum L, Malt UF. Personality traits predict treatment outcome with an antidepressant in patients with functional gastrointestinal disorder. Scand J Gastroenterol. 2000;35:935–941.
    1. Kang JY, Tay HH, Guan R. Chronic upper abdominal pain: site and radiation in various structural and functional disorders and the effect of various foods. Gut. 1992;33:743–748.
    1. Pilichiewicz AN, Horowitz M, Holtmann GJ, Talley NJ, Feinle-Bisset C. Relationship between symptoms and dietary patterns in patients with functional dyspepsia. Clin Gastroenterol Hepatol. 2009;7:317–322.
    1. Feinle-Bisset C, Meier B, Fried M, Beglinger C. Role of cognitive factors in symptom induction following high and low fat meals in patients with functional dyspepsia. Gut. 2003;52:1414–1418.
    1. Feinle C, Meier O, Otto B, D'Amato M, Fried M. Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia. Gut. 2001;48:347–355.
    1. Feinle C, Fried M. Duodenal sensitivity to lipids and gastric motility: contribution to functional dyspepsia. Praxis (Bern 1994) 1998;87:1817–1820.
    1. Tsai SC, Hsieh JF, Ho YJ, Kao CH. Effects of butter and soybean oils on solid-phase gastric emptying in patients with functional dyspepsia. Abdom Imaging. 2000;25:35–37.
    1. Barbera R, Feinle C, Read NW. Abnormal sensitivity to duodenal lipid infusion in patients with functional dyspepsia. Eur J Gastroenterol Hepatol. 1995;7:1051–1057.
    1. Mullan A, Kavanagh P, O'Mahony P, Joy T, Gleeson F, Gibney MJ. Food and nutrient intakes and eating patterns in functional and organic dyspepsia. Eur J Clin Nutr. 1994;48:97–105.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe