Materiały źródłowe

• #1 Diagnosis and Treatment of Functional Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0201/ot1.html

  Functional dyspepsia is a diagnosis of exclusion. […] Treatment of functional dyspepsia is nonpharmacologic and pharmacologic. Nonpharmacologic approaches include dietary modification, such as limiting dietary fat, avoiding meals too late in the day, and eating smaller meals. Patients should avoid specific foods if they correlate with symptoms. […] Pharmacologic treatments may be beneficial. There may be a small positive impact on symptoms with H. pylori eradication (number needed to treat = 14), but this should be initiated only with proven infection. […] Antidepressants were shown to be of benefit in one systematic review. Selective serotonin reuptake inhibitors have not been studied, but tricyclics are thought to have beneficial impact on symptoms through their anticholinergic effect.

• #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. […] For patients younger than 60 years, a test and treat strategy for Helicobacter pylori is recommended before acid suppression therapy. […] All patients should be advised to limit foods associated with increased symptoms of dyspepsia; a diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) is suggested. […] A systematic review of 15 observational studies and one randomized controlled trial found that foods high in fat, wheat, FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), and naturally occurring food chemicals, such as caffeine, were associated with symptoms of functional dyspepsia.

• #1 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). 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 of functional dyspepsia can be affected by psychological factors. Psychological treatments such as cognitive-behavioural therapy (CBT), gut-directed hypnotherapy and psychodynamic psychotherapy may be helpful. These treatments are not always available on the NHS. […] The National Institute for Health and Care Excellence (NICE) recommends the following lifestyle changes: Eat smaller meals and eat your evening meal 3-4 hours before going to bed. Lose weight, if you are obese. If you are a smoker, consider giving up. Don’t drink too much alcohol.

• #1 Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatments

  https://www.webmd.com/heartburn-gerd/indigestion-overview

  Indigestion Prevention […] The best way to prevent indigestion is to avoid the foods and situations that seem to cause it. Keeping a food diary may help you identify foods that cause your indigestion. […] Lifestyle changes can help ease mild indigestion. Try these to see if they help you: […] – Eat small meals more often throughout the day. […] – Chew your food slowly and thoroughly before swallowing. […] – Try not to chew with your mouth open, talk while you chew, or eat too fast. This makes you swallow too much air, which can make your symptoms worse. […] – Avoid drinks and foods that can trigger indigestion, such as caffeine, alcohol, citrus fruits, tomatoes, spicy foods, and fried or fatty foods. […] – Don’t lie down right after eating. Wait at least 3 hours after your last meal of the day before going to bed.

• #1 Managing functional dyspepsia | Medicina Universitaria

  https://www.elsevier.es/en-revista-medicina-universitaria-304-articulo-managing-functional-dyspepsia-X1665579614675951

  Functional dyspepsia is a highly prevalent disease worldwide. Its symptoms are manifested as pain (burning or not) in the upper abdomen and early satiety, postprandial fullness, bloating, nausea and belching. For its study and treatment, it is divided into 2 syndromes: epigastric pain, which is meal unrelated, and postprandial distress, which as the name suggests, are meal related symptoms. These 2 syndromes frequently overlap. […] Within the therapeutic approach of functional dyspepsia, there are important pharmacological and non-pharmacological measures, including: […] Non-pharmacological measures […] a. Diet […] We suggest avoiding foods such as: soft drinks, coffee, tea, chocolate, mint, peppermint, garlic, onion, tomato, pepper, gum, spices and citrus, as well as excessive amounts of fruit and vegetables, especially when symptoms suggest problems with gastric emptying.

• #1 Symptoms of functional dyspepsia | Ada

  https://ada.com/conditions/functional-dyspepsia/

  Functional dyspepsia cannot be fully cured, but its symptoms can be successfully managed through lifestyle changes, medication, or a combination of the two. […] Lifestyle changes may include: reducing, managing or removing any causes of ongoing stress and anxiety, avoiding food and drinks which make the symptoms worse (caffeinated drinks or fatty food, for example), eating small, frequent meals as opposed to fewer, larger meals, losing weight if overweight, cutting down or giving up alcohol and tobacco. […] Most people manage their symptoms well with lifestyle changes and medications. Treating Helicobacter pylori (if present in the stomach) may significantly reduce the symptoms.

• #1 Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatments

  https://www.webmd.com/heartburn-gerd/indigestion-overview

  – Sleep with your head elevated (at least 6 inches) above your feet and use pillows to prop yourself up. This will help allow digestive juices to flow into the intestines rather than to the esophagus. […] – If stress is a trigger for your indigestion, learn new methods for managing stress, such as relaxation and biofeedback techniques. […] – If you smoke, quit. Smoking can irritate the lining of the stomach. […] – Get to and stay at a healthy weight. Extra weight puts pressure on your stomach and lower esophagus. Exercising regularly not only helps you get to a healthy weight, but it can also help you digest your food better. […] If you don’t feel better after trying these changes, talk to your doctor. They may prescribe medicines for you or suggest a good OTC medicine to help ease your symptoms.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  There is no clear scientific proof that changing your diet can relieve symptoms. But experts recommend the options listed above, and they are easy to try out at no risk. Keeping a diary of what you eat and drink can help to find out what your stomach reacts to. […] It can sometimes be helpful to reduce your stress levels and respect your own limits. Various relaxation and stress management techniques can help here. Examples include autogenic training and progressive muscle relaxation. […] Being physically active in daily life can also improve your wellbeing and digestion for instance, taking the stairs instead of the elevator whenever possible, or walking or cycling instead of driving. Functional dyspepsia is less common in people who integrate exercise and sport into their daily life.

• #1 Managing functional dyspepsia | Medicina Universitaria

  https://www.elsevier.es/en-revista-medicina-universitaria-304-articulo-managing-functional-dyspepsia-X1665579614675951

  c. Avoid alcohol, tobacco and non-steroidal anti-inflammatory drug (nsaIDs) […] These are unarguably dyspepsia generators and are associated with peptic ulcers. We suggest avoiding them due to their GI toxicity. […] d. Psychoeducation and psychotherapy […] Prevalence of depression and especially of anxiety is high in patients with dyspepsia. It is important to detect such diseases and treat them, since these may increase the perception of symptoms. […] We strongly recommend the use of tools like the in hospital anxiety and Depression scale survey (validated in Mexico) as well as the Rome psychosocial alarm survey for anxiety and depression detection in patients with dyspepsia. […] Management guidelines are different based on prokinetic availability; always consider H. pylori eradication as a first choice. They suggest subdividing the patient into 2 groups (epigastric pain or postprandial distress); however, it is very frequent that the patient suffers both (up to 50%). Therefore my recommendation is to consider the fact that symptoms are the key to establishing a treatment plan, because they can explain whether the patient is hypersensitive and requires a tricyclic, if the patient has gastric relaxation or emptying issues where a prokinetic would be ideal, or if acid is casual and an anti-secretor would be the best option. Even though we must consider that the best option is probably the combination of 2 or more medications based on the symptoms.

• #1 Functional Dyspepsia | American Hospital Dubai

  https://www.ahdubai.com/blogs/functional-dyspepsia

  Some lifestyle changes can help control the occurrence of functional dyspepsia, such as: […] Eat smaller, more frequent meals as an empty stomach can make you feel sick. Try eating a small snack, like a cracker or a piece of fruit. Never skip meals but eat smaller meals more frequently. Avoid trigger foods like fatty and spicy foods, carbonated beverages, caffeine, and alcohol. Chew the food slowly and thoroughly. Reduce stress in your daily life with stress-reduction techniques or relaxation therapy, and do things that you enjoy, like hobbies or sports.

• #1 Functional Dyspepsia: Advances in Diagnosis and Therapy

  https://www.gutnliver.org/journal/view.html?volume=11&number=3&spage=349

  Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. […] Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD—Helicobacter pylori eradication. […] A firm diagnosis followed by explanation and reassurance are key elements of the therapeutic equation and may help maximize the placebo response if therapy is prescribed. […] Only one therapy is known to change the natural history of FD and that is H. pylori eradication therapy.

• #1 Functional Dyspepsia: Evaluation and Management | AAFP

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

  A test and treat strategy for H. pylori for all patients younger than 60 years is a safe and effective option before treatment with acid suppression. […] The mainstay of acid suppression includes two classes of medications: PPIs and histamine H2 receptor antagonists. […] A systematic review of psychotropic medications compared with placebo for the treatment of functional dyspepsia included three trials of tricyclic antidepressants (TCAs) and found a reduction in dyspepsia symptoms. […] The ACG does not recommend the routine use of complementary and alternative medicines for the treatment of functional dyspepsia but states that these alternatives can be considered for patients who are motivated.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  If you have functional dyspepsia symptoms and you also have a Helicobacter pylori infection, treatment with antibiotics can kill the bacteria. That can relieve the symptoms, or even completely get rid of them in about 10 out of 100 affected people. […] Some medications reduce the production of stomach acid. The most commonly used ones are called proton pump inhibitors (PPIs). They include the active ingredients pantoprazole and omeprazole. These medications have not been approved for the treatment of functional dyspepsia, so they can only be used off-label. […] If medications like PPIs do not help, treatment with tricyclic antidepressants (TCAs) may be an option. […] Probiotic foods and dietary supplements contain certain microorganisms like lactic acid bacteria. The idea is that they will settle in the digestive tract and help with digestion.

• #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. […] Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD—Helicobacter pylori eradication. […] A firm diagnosis followed by explanation and reassurance are key elements of the therapeutic equation and may help maximize the placebo response if therapy is prescribed. […] Only one therapy is known to change the natural history of FD and that is H. pylori eradication therapy. […] Simple dietary advice may help some patients although randomized controlled trials are lacking. In particular, eating small meals that are low fat is a reasonable starting point. […] Medical therapy remains largely symptom driven although in patients with H. pylori infection there is the hope of symptom cure in a small minority with eradication therapy.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  If you take medications for other conditions, it can be a good idea to check whether they have an influence. Some things, like iron supplements and medication for rheumatoid arthritis, can cause functional dyspepsia symptoms or make them worse. […] It can help to write down which medications you take and then talk to your doctor about whether the stomach problems might be side effects of the medications. Your doctor can then check whether you could take your medication differently, take a break or completely stop taking it, or take a different kind. […] Many people try herbal products to relieve their symptoms. Known as phytotherapy products, these are available without a prescription. Essential oils and extracts of various plants can relieve cramping and prevent inflammation, and might also be able to increase movement in the digestive tract.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  A summary of scientific studies suggests that a combination of peppermint and caraway oil can relieve symptoms of functional dyspepsia. These products aren’t generally recommended for the treatment of functional dyspepsia. But they are considered to be well tolerated. […] Antacids containing mineral salts are often used to reduce feelings of fullness, heartburn and reflux. They are designed to protect the lining of the stomach by neutralizing excess stomach acid and binding to bile acid. There is hardly any research into whether these kinds of over-the-counter antacids can help reduce the symptoms of functional dyspepsia. If you have kidney disease or a metabolic disorder, it is important to talk to your doctor before taking any of them. […] In some people with functional dyspepsia, the lining of the stomach is infected with bacteria called Helicobacter pylori.

• #1

  https://www.annalskemu.org/journal/index.php/annals/article/view/2322

  Functional dyspepsia (FD) is a set of relapsing or chronic dyspeptic symptoms in the absence of structural organic lesions. […] Objective: This study was designed to evaluate the effectiveness of carica papaya extract (CP) in preventing functional dyspepsia in human volunteers. […] Results: In this trial, 200 patients fully participated in this study (age 36.319.711 years, range 18-55, 60% female). Compared with placebo, Carica papaya extract (CP group) showed a clinically significant improvement. […] Conclusions: CP extract was significantly effective gastro-protective as compared with placebo.

• #1

  https://bpac.org.nz/bpj/2011/february/dyspepsia.aspx

  Functional dyspepsia is managed the same as undifferentiated dyspepsia. […] A PPI is considered first line treatment for functional dyspepsia, with or without symptoms of hyperacidity. Management follows the same approach as for undifferentiated dyspepsia. […] Dyspepsia without heartburn that has not been investigated (undifferentiated dyspepsia), first rule out the possibility of serious disease, based on the presence of red flags. Review lifestyle factors and use of medicines that may be exacerbating symptoms. Patients can then be managed by either empiric treatment (usually with a PPI) or testing for H. pylori. […] For most people, empiric treatment is appropriate. A suggested approach is as follows: An antacid (or alginate) can be used for immediate relief of symptoms. Prescribe a full dose PPI, e.g. omeprazole 20 mg, for one month. If there is no response to the PPI, test and treat for H. pylori. If there is no response to a PPI or H. pylori treatment, trial an H2-antagonist or a prokinetic (e.g. domperidone, metoclopramide) for one month. Referral can be considered at this point. If there is no response to the above steps refer for further investigation with endoscopy. If symptoms recur, restart treatment with a PPI at the lowest effective dose and advise intermittent or as required treatment. Review maintenance treatment annually. […] Functional dyspepsia in patients, that have not responded to a PPI or prokinetic and are H. pylori negative (or have had the infection eradicated), is often challenging to treat.

• #1 Proton pump inhibitors for functional dyspepsia | Cochrane

  https://www.cochrane.org/CD011194/UPPERGI_proton-pump-inhibitors-functional-dyspepsia

  There is evidence that PPIs are effective for the treatment of FD, independent of the dose and duration of treatment compared with placebo. PPIs may be slightly more effective than prokinetics for the treatment of FD; however, the evidence is scarce. […] Acid suppressive therapy, including proton pump inhibitors (PPIs), has been proposed as a therapeutic option in FD, but its efficacy remains controversial. […] Therefore, decisions on whether to initiate or continue PPI therapy should be made based on an appropriate clinical indication. […] To determine the efficacy of proton pump inhibitors in the improvement of global symptoms of dyspepsia and quality of life compared to placebo, H2 receptor antagonists or prokinetics, in people with functional dyspepsia.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  Prokinetics are thought to increase movement in the digestive tract and make sure that stomach contents are passed on to the bowel more quickly. This is meant to reduce nausea, reflux and feelings of fullness in the upper abdomen. […] Apart from medication, there are various other treatments that can be offered in certain situations to treat functional dyspepsia. They include acupuncture and psychotherapy. […] Psychotherapy helps in some people, especially if they also have psychological symptoms such as stress, anxiety or depression.

• #1

  https://journals.lww.com/md-journal/fulltext/2019/10110/benefit_of_small_dose_antidepressants_for.45.aspx

  This retrospective cohort study indicated that small dose antidepressant therapy, especially citalopram and fluoxetine, is an effective and well tolerated treatment option for refractory FD. […] This study provided real-world insights for future randomized trials in the application of antidepressants for FD. […] The findings from this retrospective review showed the benefit of antidepressants in treating refractory FD patients who were unresolved by traditional therapies. […] Antidepressants achieved a high response rate in patients with FD; citalopram had a trend toward to be superior to sulpiride and mirtazapine in overall analysis, whereas regimens that contained fluoxetine had significant increased remission rate compared to any other antidepressant regimens in PDS subgroup analysis; small dosages of antidepressants were employed and few adverse effects occurred during improvement; and older patients seemed to have a better outcome.

• #1 Understanding Functional Dyspepsia

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

  While functional dyspepsia may not always be preventable, managing risk factors and adopting healthy habits can help reduce the likelihood of symptoms: […] 1. Healthy Lifestyle Choices: Maintaining a balanced diet, regular exercise, and effective stress management. 2. Avoiding Known Triggers: Identifying and avoiding foods, beverages, or medications that trigger symptoms. 3. Regular Medical Check-Ups: Seeking medical advice if experiencing persistent or severe digestive symptoms.

• #1 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  Functional dyspepsia isnt dangerous, but it can be distressing and take a long time. There are various ways to relieve the symptoms and make it easier to cope with them in daily life. You can do a lot yourself, even if there’s a lack of good research on the available products and approaches. […] There is no cure-all for functional dyspepsia, but there are some helpful treatments that can relieve the symptoms. Depending on what the main symptoms are for example, pain or a feeling of fullness various approaches can help. The first treatment steps are usually the same: changes in diet, more exercise, and individually selected medication. […] Many people say their symptoms are affected by certain foods or eating habits. Studies show that functional dyspepsia symptoms are sometimes linked to wheat products, fatty foods and caffeine. A lot of people find that it helps to take their time when eating, eat in a pleasant and relaxed environment, chew slowly and thoroughly, eat smaller, more frequent meals rather than a few larger ones, avoid fatty or spicy foods, and keep an eye on whether hot drinks, alcohol, or coffee make the symptoms worse and, if so, avoid or reduce the number of these drinks.

• #2 Functional Dyspepsia: Advances in Diagnosis and Therapy

  https://www.gutnliver.org/journal/view.html?volume=11&number=3&spage=349

  Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. […] Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD—Helicobacter pylori eradication. […] A firm diagnosis followed by explanation and reassurance are key elements of the therapeutic equation and may help maximize the placebo response if therapy is prescribed. […] Only one therapy is known to change the natural history of FD and that is H. pylori eradication therapy.

• #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. […] For patients younger than 60 years, a test and treat strategy for Helicobacter pylori is recommended before acid suppression therapy. […] All patients should be advised to limit foods associated with increased symptoms of dyspepsia; a diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) is suggested. […] A systematic review of 15 observational studies and one randomized controlled trial found that foods high in fat, wheat, FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), and naturally occurring food chemicals, such as caffeine, were associated with symptoms of functional dyspepsia.

• #2 Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatments

  https://www.webmd.com/heartburn-gerd/indigestion-overview

  Indigestion Prevention […] The best way to prevent indigestion is to avoid the foods and situations that seem to cause it. Keeping a food diary may help you identify foods that cause your indigestion. […] Lifestyle changes can help ease mild indigestion. Try these to see if they help you: […] – Eat small meals more often throughout the day. […] – Chew your food slowly and thoroughly before swallowing. […] – Try not to chew with your mouth open, talk while you chew, or eat too fast. This makes you swallow too much air, which can make your symptoms worse. […] – Avoid drinks and foods that can trigger indigestion, such as caffeine, alcohol, citrus fruits, tomatoes, spicy foods, and fried or fatty foods. […] – Don’t lie down right after eating. Wait at least 3 hours after your last meal of the day before going to bed.

• #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. […] Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD—Helicobacter pylori eradication. […] A firm diagnosis followed by explanation and reassurance are key elements of the therapeutic equation and may help maximize the placebo response if therapy is prescribed. […] Only one therapy is known to change the natural history of FD and that is H. pylori eradication therapy. […] Simple dietary advice may help some patients although randomized controlled trials are lacking. In particular, eating small meals that are low fat is a reasonable starting point. […] Medical therapy remains largely symptom driven although in patients with H. pylori infection there is the hope of symptom cure in a small minority with eradication therapy.

• #2 Functional Dyspepsia | American Hospital Dubai

  https://www.ahdubai.com/blogs/functional-dyspepsia

  Some lifestyle changes can help control the occurrence of functional dyspepsia, such as: […] Eat smaller, more frequent meals as an empty stomach can make you feel sick. Try eating a small snack, like a cracker or a piece of fruit. Never skip meals but eat smaller meals more frequently. Avoid trigger foods like fatty and spicy foods, carbonated beverages, caffeine, and alcohol. Chew the food slowly and thoroughly. Reduce stress in your daily life with stress-reduction techniques or relaxation therapy, and do things that you enjoy, like hobbies or sports.

• #2 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  There is no clear scientific proof that changing your diet can relieve symptoms. But experts recommend the options listed above, and they are easy to try out at no risk. Keeping a diary of what you eat and drink can help to find out what your stomach reacts to. […] It can sometimes be helpful to reduce your stress levels and respect your own limits. Various relaxation and stress management techniques can help here. Examples include autogenic training and progressive muscle relaxation. […] Being physically active in daily life can also improve your wellbeing and digestion for instance, taking the stairs instead of the elevator whenever possible, or walking or cycling instead of driving. Functional dyspepsia is less common in people who integrate exercise and sport into their daily life.

• #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). 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 of functional dyspepsia can be affected by psychological factors. Psychological treatments such as cognitive-behavioural therapy (CBT), gut-directed hypnotherapy and psychodynamic psychotherapy may be helpful. These treatments are not always available on the NHS. […] The National Institute for Health and Care Excellence (NICE) recommends the following lifestyle changes: Eat smaller meals and eat your evening meal 3-4 hours before going to bed. Lose weight, if you are obese. If you are a smoker, consider giving up. Don’t drink too much alcohol.

• #2 Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatments

  https://www.webmd.com/heartburn-gerd/indigestion-overview

  – Sleep with your head elevated (at least 6 inches) above your feet and use pillows to prop yourself up. This will help allow digestive juices to flow into the intestines rather than to the esophagus. […] – If stress is a trigger for your indigestion, learn new methods for managing stress, such as relaxation and biofeedback techniques. […] – If you smoke, quit. Smoking can irritate the lining of the stomach. […] – Get to and stay at a healthy weight. Extra weight puts pressure on your stomach and lower esophagus. Exercising regularly not only helps you get to a healthy weight, but it can also help you digest your food better. […] If you don’t feel better after trying these changes, talk to your doctor. They may prescribe medicines for you or suggest a good OTC medicine to help ease your symptoms.

• #2 Symptoms of functional dyspepsia | Ada

  https://ada.com/conditions/functional-dyspepsia/

  Functional dyspepsia cannot be fully cured, but its symptoms can be successfully managed through lifestyle changes, medication, or a combination of the two. […] Lifestyle changes may include: reducing, managing or removing any causes of ongoing stress and anxiety, avoiding food and drinks which make the symptoms worse (caffeinated drinks or fatty food, for example), eating small, frequent meals as opposed to fewer, larger meals, losing weight if overweight, cutting down or giving up alcohol and tobacco. […] Most people manage their symptoms well with lifestyle changes and medications. Treating Helicobacter pylori (if present in the stomach) may significantly reduce the symptoms.

• #2 Diagnosing Functional Dyspepsia | The Oregon Clinic

  https://www.oregonclinic.com/newsroom/diagnosing-functional-dyspepsia/

  Current recommendations for those without alarm symptoms (see Table 1) include testing and treatment for H. pylori. […] If H. pylori eradication is not effective, treatment can then be guided based on the functional dyspepsia subtype. […] Reassurance that there is no associated increased mortality as well as treatment of underlying stress are important adjuncts to pharmacologic therapy.

• #2 Diagnosis and Treatment of Functional Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0201/ot1.html

  Functional dyspepsia is a diagnosis of exclusion. […] Treatment of functional dyspepsia is nonpharmacologic and pharmacologic. Nonpharmacologic approaches include dietary modification, such as limiting dietary fat, avoiding meals too late in the day, and eating smaller meals. Patients should avoid specific foods if they correlate with symptoms. […] Pharmacologic treatments may be beneficial. There may be a small positive impact on symptoms with H. pylori eradication (number needed to treat = 14), but this should be initiated only with proven infection. […] Antidepressants were shown to be of benefit in one systematic review. Selective serotonin reuptake inhibitors have not been studied, but tricyclics are thought to have beneficial impact on symptoms through their anticholinergic effect.

• #2 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  If you have functional dyspepsia symptoms and you also have a Helicobacter pylori infection, treatment with antibiotics can kill the bacteria. That can relieve the symptoms, or even completely get rid of them in about 10 out of 100 affected people. […] Some medications reduce the production of stomach acid. The most commonly used ones are called proton pump inhibitors (PPIs). They include the active ingredients pantoprazole and omeprazole. These medications have not been approved for the treatment of functional dyspepsia, so they can only be used off-label. […] If medications like PPIs do not help, treatment with tricyclic antidepressants (TCAs) may be an option. […] Probiotic foods and dietary supplements contain certain microorganisms like lactic acid bacteria. The idea is that they will settle in the digestive tract and help with digestion.

• #2 Prevention of Functional Dyspepsia with Carica Papaya Extract

  https://researcherslinks.com/current-issues/Prevention-of-Functional-Dyspepsia-with-Carica/25/1/1648/html

  Prevention of Functional Dyspepsia with Carica Papaya Extract […] Objective: This study was designed to evaluate the effectiveness of carica papaya extract (CP) in preventing functional dyspepsia in human volunteers. […] Results: Compared with placebo, Carica papaya extract (CP group) showed a clinically significant improvement. The GIS significantly decreased in CP group during the first 2 weeks, compared to the placebo (p 0.05). After 6 weeks, 95.7% on CP treatment and 3.1% on placebo were completely relieved of FD symptoms (p 0.001). […] Conclusions: CP extract was significantly effective gastro-protective as compared with placebo. […] No study was conducted so far revealing the efficacy of carica papaya extract used in very little quantity producing instant effect and without any side effect in humans. As we are aware that eating habits in our societies are not up to the mark so there is dire need to develop a solution for instant relief and prevention of functional dyspepsia on a long-term basis.

• #2 Functional Dyspepsia: Evaluation and Management | AAFP

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

  A test and treat strategy for H. pylori for all patients younger than 60 years is a safe and effective option before treatment with acid suppression. […] The mainstay of acid suppression includes two classes of medications: PPIs and histamine H2 receptor antagonists. […] A systematic review of psychotropic medications compared with placebo for the treatment of functional dyspepsia included three trials of tricyclic antidepressants (TCAs) and found a reduction in dyspepsia symptoms. […] The ACG does not recommend the routine use of complementary and alternative medicines for the treatment of functional dyspepsia but states that these alternatives can be considered for patients who are motivated.

• #2

  https://bpac.org.nz/bpj/2011/february/dyspepsia.aspx

  Functional dyspepsia is managed the same as undifferentiated dyspepsia. […] A PPI is considered first line treatment for functional dyspepsia, with or without symptoms of hyperacidity. Management follows the same approach as for undifferentiated dyspepsia. […] Dyspepsia without heartburn that has not been investigated (undifferentiated dyspepsia), first rule out the possibility of serious disease, based on the presence of red flags. Review lifestyle factors and use of medicines that may be exacerbating symptoms. Patients can then be managed by either empiric treatment (usually with a PPI) or testing for H. pylori. […] For most people, empiric treatment is appropriate. A suggested approach is as follows: An antacid (or alginate) can be used for immediate relief of symptoms. Prescribe a full dose PPI, e.g. omeprazole 20 mg, for one month. If there is no response to the PPI, test and treat for H. pylori. If there is no response to a PPI or H. pylori treatment, trial an H2-antagonist or a prokinetic (e.g. domperidone, metoclopramide) for one month. Referral can be considered at this point. If there is no response to the above steps refer for further investigation with endoscopy. If symptoms recur, restart treatment with a PPI at the lowest effective dose and advise intermittent or as required treatment. Review maintenance treatment annually. […] Functional dyspepsia in patients, that have not responded to a PPI or prokinetic and are H. pylori negative (or have had the infection eradicated), is often challenging to treat.

• #2

  https://journals.lww.com/md-journal/fulltext/2019/10110/benefit_of_small_dose_antidepressants_for.45.aspx

  This study indicated that antidepressants may be more effective than traditional therapies. […] Furthermore, employment of low dosages obviously minimized the side effects that are likely to interfere with compliance and efficacy measures. […] In summary, this retrospective cohort study indicates that small-dose antidepressant therapy is an effective and well tolerated treatment option to improve symptom in refractory FD, resulting in great patient satisfaction and minimal adverse effects.

• #2 Functional dyspepsia: What can help? | informedhealth.org

  https://www.informedhealth.org/functional-dyspepsia-what-can-help.html

  Functional dyspepsia isnt dangerous, but it can be distressing and take a long time. There are various ways to relieve the symptoms and make it easier to cope with them in daily life. You can do a lot yourself, even if there’s a lack of good research on the available products and approaches. […] There is no cure-all for functional dyspepsia, but there are some helpful treatments that can relieve the symptoms. Depending on what the main symptoms are for example, pain or a feeling of fullness various approaches can help. The first treatment steps are usually the same: changes in diet, more exercise, and individually selected medication. […] Many people say their symptoms are affected by certain foods or eating habits. Studies show that functional dyspepsia symptoms are sometimes linked to wheat products, fatty foods and caffeine. A lot of people find that it helps to take their time when eating, eat in a pleasant and relaxed environment, chew slowly and thoroughly, eat smaller, more frequent meals rather than a few larger ones, avoid fatty or spicy foods, and keep an eye on whether hot drinks, alcohol, or coffee make the symptoms worse and, if so, avoid or reduce the number of these drinks.

• #3 Symptoms of functional dyspepsia | Ada

  https://ada.com/conditions/functional-dyspepsia/

  Functional dyspepsia cannot be fully cured, but its symptoms can be successfully managed through lifestyle changes, medication, or a combination of the two. […] Lifestyle changes may include: reducing, managing or removing any causes of ongoing stress and anxiety, avoiding food and drinks which make the symptoms worse (caffeinated drinks or fatty food, for example), eating small, frequent meals as opposed to fewer, larger meals, losing weight if overweight, cutting down or giving up alcohol and tobacco. […] Most people manage their symptoms well with lifestyle changes and medications. Treating Helicobacter pylori (if present in the stomach) may significantly reduce the symptoms.

• #3 Understanding Functional Dyspepsia

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

  While functional dyspepsia may not always be preventable, managing risk factors and adopting healthy habits can help reduce the likelihood of symptoms: […] 1. Healthy Lifestyle Choices: Maintaining a balanced diet, regular exercise, and effective stress management. 2. Avoiding Known Triggers: Identifying and avoiding foods, beverages, or medications that trigger symptoms. 3. Regular Medical Check-Ups: Seeking medical advice if experiencing persistent or severe digestive symptoms.

• #3 Indigestion (Dyspepsia): Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/dyspepsia-indigestion

  The most important factors in preventing indigestion are: […] Maintaining a healthy weight. […] Not smoking – or stopping smoking. […] Drinking alcohol within recommended limits. […] Eating a balanced diet. […] Eating small regular meals instead of large meals. […] Avoiding eating too late at night before going to bed. […] Avoiding foods that trigger the indigestion – in some people, they find that certain foods such as onions, garlic, tomatoes or spicy foods will trigger a bout of indigestion. Those people should avoid those triggers.

• #3 Prevention of Functional Dyspepsia with Carica Papaya Extract

  https://researcherslinks.com/current-issues/Prevention-of-Functional-Dyspepsia-with-Carica/25/1/1648/html

  We evaluated and compared the effects CP extract with placebo and found that in this six-week trial significant improvement was observed in CP extract group as compared with placebo. […] In summary, it was evident that CP extract was much more effective in relieving the symptoms of FD as compared with placebo. However, follow up studies might be required to establish the usefulness of CP extract. The exact mechanism, efficacy and optimal duration of treatment with CP extract in different communities for improving FD symptoms might be established. […] During this trial there was no change recorded in vital parameters and no adverse effects reported. As a matter of fact adverse effects were practically nil in CP group as compared with placebo group. This might be a good addition in the library of remedies for FD and characterized by natural, instant relief, easy to use, micro dosage, without taste or smell, very economical, and without side effects even after prolonged use.

• #3

  https://bpac.org.nz/bpj/2011/february/dyspepsia.aspx

  Functional dyspepsia is managed the same as undifferentiated dyspepsia. […] A PPI is considered first line treatment for functional dyspepsia, with or without symptoms of hyperacidity. Management follows the same approach as for undifferentiated dyspepsia. […] Dyspepsia without heartburn that has not been investigated (undifferentiated dyspepsia), first rule out the possibility of serious disease, based on the presence of red flags. Review lifestyle factors and use of medicines that may be exacerbating symptoms. Patients can then be managed by either empiric treatment (usually with a PPI) or testing for H. pylori. […] For most people, empiric treatment is appropriate. A suggested approach is as follows: An antacid (or alginate) can be used for immediate relief of symptoms. Prescribe a full dose PPI, e.g. omeprazole 20 mg, for one month. If there is no response to the PPI, test and treat for H. pylori. If there is no response to a PPI or H. pylori treatment, trial an H2-antagonist or a prokinetic (e.g. domperidone, metoclopramide) for one month. Referral can be considered at this point. If there is no response to the above steps refer for further investigation with endoscopy. If symptoms recur, restart treatment with a PPI at the lowest effective dose and advise intermittent or as required treatment. Review maintenance treatment annually. […] Functional dyspepsia in patients, that have not responded to a PPI or prokinetic and are H. pylori negative (or have had the infection eradicated), is often challenging to treat.

• #3 Diagnosis and Treatment of Functional Dyspepsia | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0201/ot1.html

  Functional dyspepsia is a diagnosis of exclusion. […] Treatment of functional dyspepsia is nonpharmacologic and pharmacologic. Nonpharmacologic approaches include dietary modification, such as limiting dietary fat, avoiding meals too late in the day, and eating smaller meals. Patients should avoid specific foods if they correlate with symptoms. […] Pharmacologic treatments may be beneficial. There may be a small positive impact on symptoms with H. pylori eradication (number needed to treat = 14), but this should be initiated only with proven infection. […] Antidepressants were shown to be of benefit in one systematic review. Selective serotonin reuptake inhibitors have not been studied, but tricyclics are thought to have beneficial impact on symptoms through their anticholinergic effect.

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