Materiały źródłowe

• #1 Functional dyspepsia | Altru Health System

  https://www.altru.org/health-library/conditions/functional-dyspepsia

  Functional dyspepsia is a term used to describe a lingering upset stomach that has no obvious cause. […] No one knows what causes functional dyspepsia. Medical professionals consider it a functional disorder. That means it can’t be explained by a medical condition, so routine testing may not show any problems or causes. As a result, the diagnosis is based on symptoms.

• #1 Functional Dyspepsia: A Review of the Symptoms, Evaluation, and Treatment Options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8132673/

  The etiology of dyspepsia has been poorly defined; however, numerous pathophysiologic mechanisms, most of which are directed at gastroduodenal pathways, have been proposed to explain the disorder. Many mechanisms are currently being investigated as potential causes of functional dyspepsia symptoms. Given the number of potentially unidentified etiologies for dyspepsia symptoms and the association of the word functional with a lack of an organic cause for symptoms, we cautiously use the term functional dyspepsia to describe dyspepsia symptoms without an identified organic etiology. […] Gastric neuromuscular dysfunction, including delayed gastric emptying, impaired gastric fundus relaxation with blunting of postprandial accommodation, and altered gastric mechanosensitivity, has been of particular interest in this area. Up to 70% of patients with functional dyspepsia have abnormal antroduodenal manometry results, and approximately 40% have impaired gastric accommodation.

• #1 Functional Dyspepsia: Advances in Diagnosis and Therapy

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16055

  Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. […] One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. […] Postinfectious gastroenteritis is a risk factor for FD. […] Only one therapy is known to change the natural history of FD: Helicobacter pylori eradication. […] Familial aggregation of abdominal pain has been reported in FD implying either genes or early life factors must be important in the pathogenesis. […] New evidence suggests anxiety often precedes the onset of FD. […] Gastric emptying is slow in 25% of patients with FD, but symptoms fail to correlate with delayed gastric emptying in this syndrome.

• #1 GiKids – Functional Dyspepsia (Non-Ulcer Dyspepsia, Indigestion)

  https://gikids.org/digestive-topics/functional-dyspepsia/

  Functional dyspepsia (FD) can be caused by many factors, including changes in the gastrointestinal tract, genetics, environmental influences, and psychological temperament. […] After a meal, the stomach normally expands to allow more space for the food. After food is digested, it then normally passes out of the stomach and into the intestines. In patients with FD, the stomach may not expand properly, or passage of digested food out of the stomach is slowed. This causes a feeling of fullness. […] Patients with FD may have visceral hypersensitivity, which means that nerves in the gastrointestinal tract are overactive and highly sensitive. This causes increased pain even during normal stomach function (for example, food stretching the stomach as it passes through). […] FD can develop in children after they have a bacterial infection of the gastrointestinal tract. Some patients have undetectable inflammation in the stomach or small intestine, which may affect function of these organs.

• #1 Functional dyspepsia – Wikipedia

  https://en.wikipedia.org/wiki/Functional_dyspepsia

  Acute gastroenteritis can lead to the development of post-infection functional dyspepsia. According to a meta-analysis of 19 papers, exposed people had nearly three times the chance of developing functional dyspepsia over the course of more than six months following an infection compared to non-exposed people. […] The causes of dyspeptic symptoms have been attributed to a number of pathophysiologic processes. These include gastroduodenal motility, gastroduodenal sensitivity, intestinal microbiota, immune dysfunction, gut-brain axis dysfunction, abnormalities of gastric electrical rhythm, and autonomic nervous system/central nervous system dysregulation.

• #1 Functional Dyspepsia: A Review of the Symptoms, Evaluation, and Treatment Options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8132673/

  There is preliminary evidence concerning the presence of increased postprandial duodenal acid exposure in functional dyspepsia patients with prominent nausea symptoms. In addition, duodenal motility and bolus clearance impairment have been induced by instilling acid into the duodenum, raising concern that duodenal acid driven pathology may contribute to dyspepsia symptoms in a subset of patients. […] There is growing evidence regarding the role of duodenal inflammation and duodenal eosinophilia in functional dyspepsia. Duodenal inflammation, and in particular duodenal eosinophilia, has been seen in up to 40% of patients with functional dyspepsia. […] The phenomenon of postinfectious irritable bowel syndrome due to bowel inflammation has been expanded to include postinfectious dyspepsia as a potential cause of functional dyspepsia. […] Psychological distress has been associated with dyspepsia, with research showing both that distress and anxiety can precede symptoms and that symptoms can induce distress and anxiety. Thus, a bidirectional gut-brain pathway mechanism has been proposed.

• #1 Functional dyspepsia – Wikipedia

  https://en.wikipedia.org/wiki/Functional_dyspepsia

  Functional dyspepsia has a wide range of complex etiologies. Gastric motor function abnormalities have long been linked to functional dyspepsia. However, a study revealed that there was no relationship between symptoms and stomach physiological abnormalities. The symptoms are significantly influenced by meal consumption, and genetic factors may also play a part. […] Several epidemiological studies have demonstrated a moderate correlation between dyspepsia in the general population and female sex, smoking, non-steroidal anti-inflammatory medication use, and H pylori infection. In one long-term investigation, a high body mass index was an independent predictor of the emergence of functional dyspepsia. […] Since the brain and gut communicate through the hypothalamic-pituitary-adrenal axis and the enteric nerve system, psychological comorbidity plays a significant influence in the development of functional dyspepsia. Anxious participants had an eight-fold increased risk of developing functional dyspepsia compared to those without anxiety in a population-based survey conducted in Sweden.

• #1 Functional Dyspepsia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

  Common contributing factors in functional dyspepsia include hypersensitivity and gut motility disorders. […] There’s no single cause of functional dyspepsia, but several factors may contribute. Many people who have it have these conditions. […] While there’s no single cause of functional dyspepsia, several factors might be involved. These include: […] Visceral hypersensitivity. If your nervous system is extra sensitive, you might be more likely to have a physical response to stress. […] Motility disorders affect how your GI tract moves food along through the digestive process. […] Gut dysbiosis. Dysbiosis in your gut microbiome an imbalance of microbes in your gut may cause symptoms of functional dyspepsia in various ways. […] Eosinophilic duodenitis. Some people with functional dyspepsia have an excess of white blood cells (called eosinophils) in the top of the small intestine (duodenum). This can cause chronic inflammation (duodenitis).

• #1 Patient education: Upset stomach (functional dyspepsia) in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/upset-stomach-functional-dyspepsia-in-adults-beyond-the-basics

  Functional dyspepsia is the medical term for a condition that causes an upset stomach or pain or discomfort in the upper belly, near the ribs. Functional dyspepsia often comes back over time. Doctors are not able to find a cause for functional dyspepsia in most people. […] It is usually not clear what causes functional dyspepsia. However, researchers have focused on several factors that may be involved. […] Motor or nerve problems — The process of digesting food involves a series of events involving the nerves and muscles of the digestive tract. Problems in this system can cause the stomach to empty more slowly than normal, causing nausea and vomiting, feeling full quickly when eating, or bloating. However, not everyone whose stomach empties slowly has functional dyspepsia. […] Pain sensitivity — The stomach normally stretches as we eat to hold more food. However, some people are sensitive to this stretching and feel pain. It is not clear why this happens.

• #1 Functional Dyspepsia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554563/

  Although the exact mechanism is poorly understood, the pathophysiology of functional dyspepsia is complex, involving several different mechanisms thought to contribute to each subtype. Traditionally, disturbances in gastric physiologic factors, including both macroscopic and microscopic mechanisms, have been attributed to functional dyspepsia. […] Macroscopic physiological mechanisms include: Gastroesophageal reflux disease (GERD). Delayed gastric emptying, rapid gastric emptying, gastric dysrhythmias, and antral hypomotility. Visceral hypersensitivity alterations in the nervous system, including a lower threshold for pain in the presence of normal gastric compliance, abnormal processing of afferent input in the spinal cord or brain, and dysfunction of mechanoreceptors. […] Microscopic physiologic mechanisms include: Impaired barrier function due to altered sensitivity to duodenal acid or lipids that impair mucosal integrity. Gastroduodenal inflammation characterized by altered lymphocytes, including „gut-homing” lymphocytes, increased eosinophils, and mast cells. Altered gut microbiome and H pylori infection. […] Psychological factors such as anxiety and depression can lead to increased activation of the amygdala and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, indicating central processing of visceral stimuli from the gastrointestinal tract.

• #1 Functional Dyspepsia: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0115/p84.html

  Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. […] The causes of functional dyspepsia are multifactorial. […] Helicobacter pylori infection and acid secretion may play a role because H. pylori eradication and acid suppression improve symptoms of dyspepsia. […] Abnormal gastric or duodenal motility and impaired gastric myoelectrical activity are present in 70% to 80% of patients with functional dyspepsia accompanied by postprandial pain or discomfort. […] Other studies implicate immune activation, with increased T cells, eosinophilia, and mast cells found in the bowel wall of patients with functional dyspepsia and irritable bowel syndrome. […] There is also an association with mental health disorders, because rates of anxiety and depression are higher for patients with functional dyspepsia than for patients with dyspepsia from an organic cause or for healthy individuals. […] There is overlap in functional dyspepsia with gastroesophageal reflux disease and irritable bowel syndrome, with some studies estimating that 50% of patients with functional dyspepsia have gastroesophageal reflux disease and 35% have irritable bowel syndrome.

• #1 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  H pylori infection can retrospectively be presumed to be the cause of functional dyspepsia if the symptoms resolve after the organism is eradicated. However, eradicating H pylori does not guarantee that dyspepsia will go away: in various studies, between seven and 15 patients needed to undergo H pylori eradication for one case of functional dyspepsia to be resolved.9,10 […] Numerous studies have found a strong link between gut microbiome dysbiosis and functional dyspepsia, as the biological barrier and immune functions of the intestinal mucosa are disrupted. […] Eosinophilia in the duodenum and a correlation with early satiety have been observed in patients with functional dyspepsia. Changes in permeability and inflammation in the duodenal mucosal lining have been associated with stress, food allergies, smoking, infection and acid exposure.1

• #1 Functional Dyspepsia (Non-ulcer Dyspepsia)

  https://patient.info/digestive-health/dyspepsia-indigestion/non-ulcer-dyspepsia-functional-dyspepsia

  Infection with a germ (bacterium) called H. pylori may cause some cases. […] You are more likely to suffer from functional dyspepsia if you have a family history of it (if close relatives are also affected). There is likely to be a genetic cause in some people. […] A side-effect of some medicines can cause dyspepsia: The most common culprits are anti-inflammatory medicines such as ibuprofen and aspirin. […] If you are infected with H. pylori, the first treatment usually tried is to clear the H. pylori infection. However, infection with H. pylori is probably a coincidence rather than a cause in most cases of functional dyspepsia.

• #1 Functional Dyspepsia – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/functional-dyspepsia/

  Functional dyspepsia, the most common cause of dyspepsia symptoms, is ultimately diagnosed in 8 out of 10 cases of indigestion. […] There is no known single cause of functional dyspepsia. […] The gut and brain are linked, and they constantly communicate with one another through our nerves. […] A disorder of the gut-brain interaction is the term used to describe an illness where tests do not reveal a medical known cause for the symptoms. […] There are several different causes that can contribute to symptoms. […] These include alterations to the variety of bacteria that normally live in the digestive system because of a gut infection. […] Other factors include stress, lifestyle factors and the emotional response to symptoms. […] High levels of anxiety or stress can make symptoms worse and are an important consideration. […] Functional dyspepsia has no known cause, and more research into underlying causes and variables that worsen symptoms may lead to future breakthroughs in treatment options.

• #1 Functional Dyspepsia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

  Additional risk factors for functional dyspepsia include: Psychological factors like anxiety and mood disorders or a history of trauma or abuse. […] A family history of nervous disorders or other functional GI disorders, like IBS. […] Food sensitivities (such as FODMAPs) or intolerances (such as lactose intolerance). […] Having a lot of allergic conditions or atopy.

• #1 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  A relationship between psychiatric disease, anxiety, depression and functional dyspepsia has been confirmed, and a relationship between functional dyspepsia and neuroticism is often acknowledged.1 Troubles managing life affairs and experiencing emotional and physical abuse as an adult may contribute to functional dyspepsia.

• #1 Functional Dyspepsia (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/functional-dyspepsia.html

  Functional dyspepsia (dis-PEP-see-uh) is a kind of upset stomach or indigestion that doesnt have a definite cause. Its thought to happen because of a mix of things. […] Theres still a lot to understand about functional dyspepsia, but it could be due to things like: nerve signals from the brain or belly that make someone more sensitive to pain, food moving too slowly from the stomach to the rest of the digestive system, food sensitivity (digestive symptoms after having certain foods or drinks, like belly pain after drinking milk), a past infection, emotional stress, a family history of functional dyspepsia. […] Mental health problems like anxiety dont cause functional dyspepsia, but they can make symptoms worse.

• #1 Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20026

  Functional dyspepsia (FD) is among the most common gastrointestinal disorders affecting quality of life (QoL). […] However, little is known about sex or gender differences among patients with FD. […] In spite of limited studies, consistent points are that FD occurs more often in women than in men and there are several symptom differences between men and women with FD. […] Similarly, the pathophysiology of FD likely to vary depending on gender. […] Due to the sex-gender differences in physiological and psychological factors, treatment strategies should differ between women and men with FD. […] A systematic review by the Rome Working Team summarized the available prevalence data for dyspepsia in men and women but reported that the prevalence is heterogeneous. […] A meta-analysis by Ford et al for UD also showed a slightly higher prevalence in women than in men (25.3% vs 21.9%) with significant interstudy heterogeneity.

• #1 Functional Dyspepsia: Definition, Causes, Symptoms, Diagnosis, More

  https://www.healthline.com/health/functional-dyspepsia

  Functional dyspepsia (FD) is a chronic digestive condition that includes feelings of prolonged indigestion without a clear structural cause. […] Many nonstructural factors can cause FD, including: bacterial infection, diet, some medications, impaired gut barrier function, gastroesophageal reflux (GERD). […] There is no single cause of FD. Many factors can result in FD symptoms, either alone or in combination. […] Some of the causes of functional dyspepsia may include: intestinal microbiome changes, infection, the bacterium H. pylori, gastroesophageal reflux (GERD), exposure to allergens, more acid secretion than usual, inflammation in the small bowel, ability of the stomach to mobilize and accommodate food, diet and lifestyle habits, stress, anxiety, or depression, side effects of medications like nonsteroidal anti-inflammatory drugs (NSAIDs).

• #1 Functional Dyspepsia Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/functional-dyspepsia/causes-and-diagnoses

  Functional dyspepsia has, by definition, no known cause. […] Regular dyspepsia, or indigestion, has numerous causes, which may be related to functional dyspepsia. These causes include: Diet: overeating or eating fatty or spicy foods, Gastritis (infectious, inflammatory, bile-acid), Gastroparesis (slow emptying of the stomach), Helicobacter pylori infection, Peptic (stomach) ulcer, Pancreatitis, Lactose intolerance (inability to digest milk and dairy products), Celiac disease, Gallstones, biliary colic (gallbladder pain) or cholecystitis (gallbladder inflammation), Side effect of medication (Aspirin, NSAIDs, Iron), Reaction to alcohol, caffeine or carbonated beverages, Stomach cancer, Intestinal blockage, Small intestinal bacterial overgrowth (SIBO). […] To arrive at a diagnosis of functional, your physician must eliminate these conditions as the cause of your chronic indigestion.

• #1 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  Functional dyspepsia is defined as persistent symptoms of postprandial bloating, early satiety or pain in the center of the upper abdomen, without findings on upper endoscopy such as peptic ulcer disease to explain these symptoms. […] The global prevalence of functional dyspepsia ranges between 10% and 30%.3 Risk factors include female sex, high socioeconomic status, older age, living in a rural location, using nonsteroidal inflammatory drugs and being married. Smoking is weakly associated with functional dyspepsia, whereas coffee and alcohol consumption have no known association with it.1,3 […] The pathophysiology of functional dyspepsia, like that of all disorders of gut-brain interaction, is poorly understood. However, there are clear associations with visceral hypersensitivity, disruptions of normal gastro duodenal motility, or both. Potential mechanisms include the following:

• #1 Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20026

  Various complex mechanisms have been proposed for the pathogenesis of FD, including altered gastric motility, visceral hypersensitivity, brain-gut interactions, low-grade mucosal inflammation, H. pylori infection, and genetic or social and psychological factors, but the etiology and optimal treatment of FD remain unclear. […] The underlying pathogenesis for the gender difference in FD has not been investigated in detail. […] Female sex hormones might affect visceral pain and gastric motility, supporting female sex as a risk factor of FD. […] Studies using a beverage test at administer nutrient or water drinks at a constant rate up to the level of discomfort found that women have a lower tolerance than men. […] A recent systematic review evaluating the effect of gender differences on drug therapy found that women generally have a shorter gastric emptying time, lower gastric pH, lower lean body mass, a higher plasma volume, BMI, body fat, a decreased hepatic clearance, different cytochrome P450 enzyme activity, and different drug metabolic rates than men. […] In conclusion, our review regarding sex- and gender difference of FD has several limitations. […] In spite of limited studies consistent points are FD occurs more often in women than in men and there are several symptom differences between men and women with FD.

• #1 The Diagnosis and Treatment of Functional Dyspepsia (30.03.2018)

  https://www.aerzteblatt.de/int/archive/article/197088/The-diagnosis-and-treatment-of-functional-dyspepsia

  Functional dyspepsia (FD) is one of the more common functional disorders, with a prevalence of 10-20%. It affects the gastrointestinal tract. […] The etiology of the disorder is heterogeneous and multifactorial. Contributory causes include motility disturbances, visceral hypersensitivity, elevated mucosal permeability, and disturbances of the autonomic and enteric nervous system. […] The causes of functional dyspepsia are heterogeneous and multifactorial. In recent decades numerous systematic pathophysiological studies comparing functional dyspepsia patients with healthy volunteers have shown that functional dyspepsia is an organic disorder, even though the pathophysiologically relevant factors discussed in the further course of this article currently cannot be detected by routine clinical work-up.

• #2 Functional Dyspepsia: A Review of the Symptoms, Evaluation, and Treatment Options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8132673/

  The etiology of dyspepsia has been poorly defined; however, numerous pathophysiologic mechanisms, most of which are directed at gastroduodenal pathways, have been proposed to explain the disorder. Many mechanisms are currently being investigated as potential causes of functional dyspepsia symptoms. Given the number of potentially unidentified etiologies for dyspepsia symptoms and the association of the word functional with a lack of an organic cause for symptoms, we cautiously use the term functional dyspepsia to describe dyspepsia symptoms without an identified organic etiology. […] Gastric neuromuscular dysfunction, including delayed gastric emptying, impaired gastric fundus relaxation with blunting of postprandial accommodation, and altered gastric mechanosensitivity, has been of particular interest in this area. Up to 70% of patients with functional dyspepsia have abnormal antroduodenal manometry results, and approximately 40% have impaired gastric accommodation.

• #2 Functional Dyspepsia: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0115/p84.html

  Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. […] The causes of functional dyspepsia are multifactorial. […] Helicobacter pylori infection and acid secretion may play a role because H. pylori eradication and acid suppression improve symptoms of dyspepsia. […] Abnormal gastric or duodenal motility and impaired gastric myoelectrical activity are present in 70% to 80% of patients with functional dyspepsia accompanied by postprandial pain or discomfort. […] Other studies implicate immune activation, with increased T cells, eosinophilia, and mast cells found in the bowel wall of patients with functional dyspepsia and irritable bowel syndrome. […] There is also an association with mental health disorders, because rates of anxiety and depression are higher for patients with functional dyspepsia than for patients with dyspepsia from an organic cause or for healthy individuals. […] There is overlap in functional dyspepsia with gastroesophageal reflux disease and irritable bowel syndrome, with some studies estimating that 50% of patients with functional dyspepsia have gastroesophageal reflux disease and 35% have irritable bowel syndrome.

• #2 Patient education: Upset stomach (functional dyspepsia) in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/upset-stomach-functional-dyspepsia-in-adults-beyond-the-basics

  Functional dyspepsia is the medical term for a condition that causes an upset stomach or pain or discomfort in the upper belly, near the ribs. Functional dyspepsia often comes back over time. Doctors are not able to find a cause for functional dyspepsia in most people. […] It is usually not clear what causes functional dyspepsia. However, researchers have focused on several factors that may be involved. […] Motor or nerve problems — The process of digesting food involves a series of events involving the nerves and muscles of the digestive tract. Problems in this system can cause the stomach to empty more slowly than normal, causing nausea and vomiting, feeling full quickly when eating, or bloating. However, not everyone whose stomach empties slowly has functional dyspepsia. […] Pain sensitivity — The stomach normally stretches as we eat to hold more food. However, some people are sensitive to this stretching and feel pain. It is not clear why this happens.

• #2 Functional Dyspepsia: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/functional-gastrointestinal-disorders/functional-dyspepsia

  Functional dyspepsia is a condition with symptoms of stomach pain, burning, fullness, bloating, or inability to eat a typical meal. With functional dyspepsia, no evidence of structural disease is seen on tests. […] The cause of functional dyspepsia is unclear. Still, there are risk factors and symptoms that you should be aware of. […] Individuals whose nervous systems react more strongly to stress and anxiety may have visceral hypersensitivity. In people with visceral hypersensitivity, nerves in the digestive tract may have increased sensitivity, making natural expansion and contraction of the digestive tract uncomfortable. […] Stomach muscles are supposed to relax and expand to accommodate food passed into the small intestine. But in some individuals, this mechanism is impaired, leading to a consistent feeling of being full. The signals telling the stomach to empty food into the small intestine could also be damaged. […] Helicobacter pylori (H pylori) is a bacteria that infects the stomach. H pylori may cause chronic inflammation and erode the mucous lining in the stomach. Some people with functional dyspepsia improve after being treated for H. pylori.

• #2 Dyspepsia – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/dyspepsia

  There are several common causes of dyspepsia (see table Some Causes of Dyspepsia). […] Many patients have findings on testing (eg, duodenitis, motility disturbance, Helicobacter pylori gastritis, lactose deficiency, cholelithiasis) that correlate poorly with symptoms (ie, correction of the condition does not alleviate dyspepsia). […] Nonulcer dyspepsia (functional dyspepsia) is defined as dyspeptic symptoms in a patient who has no abnormalities on physical examination and upper gastrointestinal (GI) endoscopy and/or other evaluation (eg, laboratory tests, imaging). […] There is no clear evidence that matching the medication class to the specific symptoms (eg, reflux vs dysmotility) makes a difference. Misoprostol and anticholinergics are not effective in functional dyspepsia.

• #2 Functional Dyspepsia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554563/

  Although the exact mechanism is poorly understood, the pathophysiology of functional dyspepsia is complex, involving several different mechanisms thought to contribute to each subtype. Traditionally, disturbances in gastric physiologic factors, including both macroscopic and microscopic mechanisms, have been attributed to functional dyspepsia. […] Macroscopic physiological mechanisms include: Gastroesophageal reflux disease (GERD). Delayed gastric emptying, rapid gastric emptying, gastric dysrhythmias, and antral hypomotility. Visceral hypersensitivity alterations in the nervous system, including a lower threshold for pain in the presence of normal gastric compliance, abnormal processing of afferent input in the spinal cord or brain, and dysfunction of mechanoreceptors. […] Microscopic physiologic mechanisms include: Impaired barrier function due to altered sensitivity to duodenal acid or lipids that impair mucosal integrity. Gastroduodenal inflammation characterized by altered lymphocytes, including „gut-homing” lymphocytes, increased eosinophils, and mast cells. Altered gut microbiome and H pylori infection. […] Psychological factors such as anxiety and depression can lead to increased activation of the amygdala and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, indicating central processing of visceral stimuli from the gastrointestinal tract.

• #2 Functional Dyspepsia: Advances in Diagnosis and Therapy

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16055

  Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. […] One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. […] Postinfectious gastroenteritis is a risk factor for FD. […] Only one therapy is known to change the natural history of FD: Helicobacter pylori eradication. […] Familial aggregation of abdominal pain has been reported in FD implying either genes or early life factors must be important in the pathogenesis. […] New evidence suggests anxiety often precedes the onset of FD. […] Gastric emptying is slow in 25% of patients with FD, but symptoms fail to correlate with delayed gastric emptying in this syndrome.

• #2 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  H pylori infection can retrospectively be presumed to be the cause of functional dyspepsia if the symptoms resolve after the organism is eradicated. However, eradicating H pylori does not guarantee that dyspepsia will go away: in various studies, between seven and 15 patients needed to undergo H pylori eradication for one case of functional dyspepsia to be resolved.9,10 […] Numerous studies have found a strong link between gut microbiome dysbiosis and functional dyspepsia, as the biological barrier and immune functions of the intestinal mucosa are disrupted. […] Eosinophilia in the duodenum and a correlation with early satiety have been observed in patients with functional dyspepsia. Changes in permeability and inflammation in the duodenal mucosal lining have been associated with stress, food allergies, smoking, infection and acid exposure.1

• #2 The Diagnosis and Treatment of Functional Dyspepsia (30.03.2018)

  https://www.aerzteblatt.de/int/archive/article/197088/The-diagnosis-and-treatment-of-functional-dyspepsia

  Functional dyspepsia (FD) is one of the more common functional disorders, with a prevalence of 10-20%. It affects the gastrointestinal tract. […] The etiology of the disorder is heterogeneous and multifactorial. Contributory causes include motility disturbances, visceral hypersensitivity, elevated mucosal permeability, and disturbances of the autonomic and enteric nervous system. […] The causes of functional dyspepsia are heterogeneous and multifactorial. In recent decades numerous systematic pathophysiological studies comparing functional dyspepsia patients with healthy volunteers have shown that functional dyspepsia is an organic disorder, even though the pathophysiologically relevant factors discussed in the further course of this article currently cannot be detected by routine clinical work-up.

• #2 Patient education: Upset stomach (functional dyspepsia) in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/upset-stomach-functional-dyspepsia-in-adults-beyond-the-basics

  Infection — Helicobacter pylori (H. pylori) is a bacterial infection of the stomach that can lead to inflammation (gastritis) or ulcers. There may be a relationship between infection with H. pylori and functional dyspepsia. However, not all people with H. pylori have functional dyspepsia. […] Functional dyspepsia occasionally begins with acute gastroenteritis, usually due to a bacterial or viral infection. Dyspepsia can persist long after the infection subsides, perhaps caused by a change in the bacteria that normally live in the gastrointestinal tract. […] Duodenal inflammation — Minor inflammation of the mucosal lining of the duodenum, the first part of the small intestine, and changes in the normal microorganisms in this area could play a role in the development of functional dyspepsia. […] Psychological and social factors — People with functional dyspepsia often have mood problems, like anxiety or depression. Treating the underlying depression or anxiety can improve symptoms of abdominal pain.

• #2 Functional dyspepsia – Wikipedia

  https://en.wikipedia.org/wiki/Functional_dyspepsia

  Functional dyspepsia has a wide range of complex etiologies. Gastric motor function abnormalities have long been linked to functional dyspepsia. However, a study revealed that there was no relationship between symptoms and stomach physiological abnormalities. The symptoms are significantly influenced by meal consumption, and genetic factors may also play a part. […] Several epidemiological studies have demonstrated a moderate correlation between dyspepsia in the general population and female sex, smoking, non-steroidal anti-inflammatory medication use, and H pylori infection. In one long-term investigation, a high body mass index was an independent predictor of the emergence of functional dyspepsia. […] Since the brain and gut communicate through the hypothalamic-pituitary-adrenal axis and the enteric nerve system, psychological comorbidity plays a significant influence in the development of functional dyspepsia. Anxious participants had an eight-fold increased risk of developing functional dyspepsia compared to those without anxiety in a population-based survey conducted in Sweden.

• #2 Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20026

  Several studies suggested that female sex, a low body mass index (BMI), old age, Helicobacter pylori infection, smoking, use of aspirin or NSAIDs, and low education level are risk factors for FD. […] An abuse history is more common in women with FD and early childhood is a critical period for the development of certain brain circuits that control stress and nociception. […] Some epidemiological studies have reported a male preponderance of reflux-like and ulcer-like dyspepsia and a female preponderance of dysmotility-like dyspepsia. […] The mechanism by which FD coexists with other FGIDs is not yet fully known, but it may be due to similar common pathophysiological factors such as visceral hypersensitivity, altered GI motility, dysfunction of the brain and gut interaction, and psychological comorbidities.

• #2 Functional Dyspepsia (Non-ulcer Dyspepsia)

  https://patient.info/digestive-health/dyspepsia-indigestion/non-ulcer-dyspepsia-functional-dyspepsia

  Infection with a germ (bacterium) called H. pylori may cause some cases. […] You are more likely to suffer from functional dyspepsia if you have a family history of it (if close relatives are also affected). There is likely to be a genetic cause in some people. […] A side-effect of some medicines can cause dyspepsia: The most common culprits are anti-inflammatory medicines such as ibuprofen and aspirin. […] If you are infected with H. pylori, the first treatment usually tried is to clear the H. pylori infection. However, infection with H. pylori is probably a coincidence rather than a cause in most cases of functional dyspepsia.

• #2 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  Functional dyspepsia is defined as persistent symptoms of postprandial bloating, early satiety or pain in the center of the upper abdomen, without findings on upper endoscopy such as peptic ulcer disease to explain these symptoms. […] The global prevalence of functional dyspepsia ranges between 10% and 30%.3 Risk factors include female sex, high socioeconomic status, older age, living in a rural location, using nonsteroidal inflammatory drugs and being married. Smoking is weakly associated with functional dyspepsia, whereas coffee and alcohol consumption have no known association with it.1,3 […] The pathophysiology of functional dyspepsia, like that of all disorders of gut-brain interaction, is poorly understood. However, there are clear associations with visceral hypersensitivity, disruptions of normal gastro duodenal motility, or both. Potential mechanisms include the following:

• #2 Functional Dyspepsia Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/functional-dyspepsia/causes-and-diagnoses

  Functional dyspepsia has, by definition, no known cause. […] Regular dyspepsia, or indigestion, has numerous causes, which may be related to functional dyspepsia. These causes include: Diet: overeating or eating fatty or spicy foods, Gastritis (infectious, inflammatory, bile-acid), Gastroparesis (slow emptying of the stomach), Helicobacter pylori infection, Peptic (stomach) ulcer, Pancreatitis, Lactose intolerance (inability to digest milk and dairy products), Celiac disease, Gallstones, biliary colic (gallbladder pain) or cholecystitis (gallbladder inflammation), Side effect of medication (Aspirin, NSAIDs, Iron), Reaction to alcohol, caffeine or carbonated beverages, Stomach cancer, Intestinal blockage, Small intestinal bacterial overgrowth (SIBO). […] To arrive at a diagnosis of functional, your physician must eliminate these conditions as the cause of your chronic indigestion.

• #2 Understanding Functional Dyspepsia

  https://lakecountyin.gov/departments/health/Nursing-Clinic/Diseases-and-Conditions/Gastrointestinal/understanding-functional-dyspepsia

  Functional dyspepsia does not have a single identifiable cause but is believed to result from a combination of factors. […] Common causes and risk factors include: […] Gastrointestinal Motility Disorders: Delayed Gastric Emptying: Slower than normal emptying of the stomach contents can lead to discomfort and bloating. […] Psychological Factors: Stress and Anxiety: Psychological stress and anxiety can exacerbate symptoms of dyspepsia or contribute to the development of the condition. […] Dietary Factors: Food Sensitivities: Certain foods, such as fatty, spicy, or acidic foods, may trigger symptoms. […] Helicobacter pylori Infection: Bacterial Infection: Infection with Helicobacter pylori, a bacterium that can cause inflammation in the stomach lining, is associated with dyspeptic symptoms. […] Medications: Use of Certain Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and other medications can contribute to gastrointestinal symptoms.

• #2 Functional Dyspepsia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

  Additional risk factors for functional dyspepsia include: Psychological factors like anxiety and mood disorders or a history of trauma or abuse. […] A family history of nervous disorders or other functional GI disorders, like IBS. […] Food sensitivities (such as FODMAPs) or intolerances (such as lactose intolerance). […] Having a lot of allergic conditions or atopy.

• #2 Functional dyspepsia: causes, symptoms and treatment

  https://siliciumg5.com/blog/en/functional-dyspepsia-causes-symptoms-and-integrative-treatment/

  Functional dyspepsia is a common digestive disorder that causes recurring pain or discomfort in the upper abdomen. Although the exact cause is unknown, it is often related to abnormalities in the functioning of the digestive system. […] Many factors can cause indigestion or functional dyspepsia: Eating certain foods: for example, foods that are very spicy and fatty, or foods that have a lot of acid or fibre. Dining too late. Drinking alcohol. Too much caffeine. Some medicines. Smoking. Not getting enough sleep. […] There are also certain pathologies and gastrointestinal problems that can cause dyspepsia: Irritable bowel syndrome (IBS). Reflux, gastro-oesophageal reflux (GOR) or gastro-oesophageal reflux disease (GORD). Helicobacter pylori bacterial infection. Ulcer. Gastroparesis. Stomach cancer. Gastritis. […] Many studies have reported that the symptoms of dyspepsia are exacerbated by the ingestion of certain foods such as: Onions. Peppers. Fried and fatty foods. Alcohol. Citrus fruit. Wheat. Gluten. Spicy foods. Food chemicals (precooked food containing preservatives).

• #2 Functional Dyspepsia (Non-ulcer Dyspepsia)

  https://patient.info/digestive-health/dyspepsia-indigestion/non-ulcer-dyspepsia-functional-dyspepsia

  Functional dyspepsia (non-ulcer dyspepsia) causes pain and sometimes other symptoms in your upper tummy (abdomen). The cause is often not clear. Medication to reduce stomach acid helps in some cases. Infection with Helicobacter pylori (H. pylori) may cause a small number of cases. Clearing this infection, if present, helps in some people. […] The symptoms seem to come from the upper gut but the cause is not known. If you have tests, nothing abnormal is found inside your gut. The lining inside your gut looks normal and is not inflamed. The amount of acid in the stomach is normal. […] The following are some theories as to possible causes: Sensation in the stomach or the first part of the small intestine (the duodenum) may be altered in some way – an 'irritable stomach’. About one in three people with non-ulcer dyspepsia also have irritable bowel syndrome and have additional symptoms of lower tummy (abdominal) pains, erratic bowel movements, etc. The cause of irritable bowel syndrome is not known.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/functionaldyspepsia/comments/182gs5a/functional_dyspepsia_101/

  Functional dyspepsia (FD) is one of the more common chronic upper gastrointestinal disorders without a known structural or organic cause. […] Modern medical research indicates that FD is a complex disorder that could involve multiple causes, including abnormal gastrointestinal motility, visceral hypersensitivity, altered gut-brain interactions, psychological factors, food allergies or intolerances, and immune system dysfunction. […] Visceral hypersensitivity plays a significant role in conditions like functional dyspepsia or irritable bowel syndrome (IBS). […] Many researchers view these disorders as lying on the same spectrum (e.g., Jane is 20% GP; 80% FD). […] An undiagnosed food allergy can produce an inflammatory response in the gut. […] Some FD patients have higher white blood cell counts, suggesting the gut immune system is activated.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/functionaldyspepsia/comments/182gs5a/functional_dyspepsia_101/

  The ecosystem of microbes within the gut plays a crucial role in digestion. […] Pathogens such as SIBO and H. pylori can lead to FD. […] There’s a high overlap between functional dyspepsia and IBS, with many individuals experiencing symptoms of both conditions. […] Gastroparesis (GP) is a condition that affects the ability of muscular contractions to effectively propel food through your digestive tract. […] Functional dyspepsia and GERD can coexist or have overlapping symptoms such as upper abdominal discomfort and heartburn. […] Some studies suggest a potential association between NAFLD and functional dyspepsia, although the exact nature of the relationship is still being explored. […] MCAS is correlated to having SIBO as well.

• #2 Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20026

  Various complex mechanisms have been proposed for the pathogenesis of FD, including altered gastric motility, visceral hypersensitivity, brain-gut interactions, low-grade mucosal inflammation, H. pylori infection, and genetic or social and psychological factors, but the etiology and optimal treatment of FD remain unclear. […] The underlying pathogenesis for the gender difference in FD has not been investigated in detail. […] Female sex hormones might affect visceral pain and gastric motility, supporting female sex as a risk factor of FD. […] Studies using a beverage test at administer nutrient or water drinks at a constant rate up to the level of discomfort found that women have a lower tolerance than men. […] A recent systematic review evaluating the effect of gender differences on drug therapy found that women generally have a shorter gastric emptying time, lower gastric pH, lower lean body mass, a higher plasma volume, BMI, body fat, a decreased hepatic clearance, different cytochrome P450 enzyme activity, and different drug metabolic rates than men. […] In conclusion, our review regarding sex- and gender difference of FD has several limitations. […] In spite of limited studies consistent points are FD occurs more often in women than in men and there are several symptom differences between men and women with FD.

• #2 Functional Dyspepsia: Causes, Treatments and New Directions

  https://chicagohealthonline.com/functional-dyspepsia/

  Functional dyspepsia remains a significant challenge for patients and physicians alike. Some may take comfort that functional dyspepsia is not a dangerous condition in terms of putting patients at increased risk of death. […] Yet hope does exist for those suffering with the condition, both from the judicious use of existing, evidence-based treatments and the potential emergence of novel treatments in the future.

• #3 Functional dyspepsia – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/functional-dyspepsia.html

  Functional dyspepsia is characterised by troublesome early satiety, fullness, or epigastric pain or burning. […] The pathophysiology of functional dyspepsia is not completely understood. It is thought to be associated with upper gastrointestinal inflammation and motility disturbances, which may be triggered by an infectious or allergenic agent, or a change in the intestinal microbiome. […] Functional dyspepsia has been considered an idiopathic disorder but this view is changing. In some cases, functional dyspepsia develops after acute infectious gastroenteritis, suggesting acute intestinal inflammation may play a role. […] Helicobacter pylori is a recognised cause of functional dyspepsia. […] Gastric and duodenal motility disturbances have been observed in functional dyspepsia. […] People with postprandial distress have unique duodenal pathology, namely increased duodenal eosinophils that may degranulate. […] Recently a unifying disease model has been proposed for functional dyspepsia. […] The microbiome is disturbed in functional dyspepsia.

• #3 Functional Dyspepsia (Part I)

  https://consultqd.clevelandclinic.org/functional-dyspepsia-how-to-manage-the-burn-and-the-bloat-part-i

  A relationship between psychiatric disease, anxiety, depression and functional dyspepsia has been confirmed, and a relationship between functional dyspepsia and neuroticism is often acknowledged.1 Troubles managing life affairs and experiencing emotional and physical abuse as an adult may contribute to functional dyspepsia.

• #3 Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20026

  Several studies suggested that female sex, a low body mass index (BMI), old age, Helicobacter pylori infection, smoking, use of aspirin or NSAIDs, and low education level are risk factors for FD. […] An abuse history is more common in women with FD and early childhood is a critical period for the development of certain brain circuits that control stress and nociception. […] Some epidemiological studies have reported a male preponderance of reflux-like and ulcer-like dyspepsia and a female preponderance of dysmotility-like dyspepsia. […] The mechanism by which FD coexists with other FGIDs is not yet fully known, but it may be due to similar common pathophysiological factors such as visceral hypersensitivity, altered GI motility, dysfunction of the brain and gut interaction, and psychological comorbidities.

• #3 Functional dyspepsia: causes, symptoms and treatment

  https://siliciumg5.com/blog/en/functional-dyspepsia-causes-symptoms-and-integrative-treatment/

  Functional dyspepsia is a common digestive disorder that causes recurring pain or discomfort in the upper abdomen. Although the exact cause is unknown, it is often related to abnormalities in the functioning of the digestive system. […] Many factors can cause indigestion or functional dyspepsia: Eating certain foods: for example, foods that are very spicy and fatty, or foods that have a lot of acid or fibre. Dining too late. Drinking alcohol. Too much caffeine. Some medicines. Smoking. Not getting enough sleep. […] There are also certain pathologies and gastrointestinal problems that can cause dyspepsia: Irritable bowel syndrome (IBS). Reflux, gastro-oesophageal reflux (GOR) or gastro-oesophageal reflux disease (GORD). Helicobacter pylori bacterial infection. Ulcer. Gastroparesis. Stomach cancer. Gastritis. […] Many studies have reported that the symptoms of dyspepsia are exacerbated by the ingestion of certain foods such as: Onions. Peppers. Fried and fatty foods. Alcohol. Citrus fruit. Wheat. Gluten. Spicy foods. Food chemicals (precooked food containing preservatives).

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