Updates in functional dyspepsia and bloating.
Journal
Current opinion in gastroenterology
ISSN: 1531-7056
Titre abrégé: Curr Opin Gastroenterol
Pays: United States
ID NLM: 8506887
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
entrez:
11
10
2022
pubmed:
12
10
2022
medline:
14
10
2022
Statut:
ppublish
Résumé
Functional dyspepsia and bloating are common gastrointestinal conditions that frequently lead to gastroenterology referral. Both disorders have a significant negative impact on patients' quality of life and the healthcare system. The purpose of this review is to highlight important new findings in the cause, pathophysiology and treatment of these two disorders. Confocal laser endomicroscopy identified changes in epithelial barrier structure and function, providing important insights into the development of functional dyspepsia symptoms when combined with new observations of localized duodenal inflammation. Changes in the gut microbiome may be responsible for functional dyspepsia symptoms in some patients and may respond to gut-selective antibiotics. New data from the NIH-sponsored Gastroparesis Consortium confirmed that functional dyspepsia and gastroparesis are not distinct disorders but rather exist on a spectrum. Virtual reality may be a new therapeutic option for the treatment of functional dyspepsia. A novel questionnaire was developed and validated to assess symptoms, prevalence and impact in patients with bloating and distension. A meta-analysis identified medications to treat symptoms of bloating in patients with irritable bowel syndrome and constipation. Advances in our understanding of the pathophysiology of functional dyspepsia and bloating are leading to important changes in medical therapies.
Identifiants
pubmed: 36219129
doi: 10.1097/MOG.0000000000000882
pii: 00001574-202211000-00015
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
613-619Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Références
Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015; 64:1049–1057.
Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology 2020; 160:99–114.
Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology 2016; 150:1380–1392.
Talley NJ, Ford AC. Functional dyspepsia. N Engl J Med 2015; 373:1853–1863.
Ford AC, Mahadeva S, Carbone MF, et al. Functional dyspepsia. Lancet 2020; 396:1689–1702.
Komori K, Ihara E, Minoda Y, et al. The altered mucosal barrier function in the duodenum plays a role in the pathogenesis of functional dyspepsia. Dig Dis Sci 2019; 64:3228–3239.
Vanheel H, Vicario M, Vanuystel T, et al. Impaired duodenal mucosal integrity and low-grade inflammation in functional dyspepsia. Gut 2014; 63:262–271.
Nojkov B, Zhou SY, Dolan RD, et al. Evidence of duodenal epithelial barrier impairment and increased pyroptosis in patients with functional dyspepsia on confocal laser endomicroscopy and “ex vivo” mucosa analysis. Am J Gastroenterol 2020; 115:1891–1901.
Talley NJ, Walker MM, Aro P, et al. Nonulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case-control study. Clin Gastrenterol Hepatol 2007; 5:1175–1183.
Du L, Chen B, Kim JJ, et al. Micro-inflammation in functional dyspepsia: a systematic review and meta-analyses. Neurogastroenterol Motil 2018; 30:e13304.
Wauters L, Ceulemans M, Frings D, et al. Proton pump inhibitors reduce duodenal eosinophilia, mast cells, and permeability in patients with functional dyspepsia. Gastroenterology 2021; 160:1521–1531.
Moayyedi P, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol 2017; 112:998–1013.
Moayyedi P, Eikelboom JW, Bosch J, et al. Safety of proton pump inhibitors based on a large, multiyear, randomized trial of patients receiving rivaroxaban or aspirin. Gastroenterology 2019; 157:682–691.
Tsuda A, Suda W, Morita H, et al. Influence of proton pump inhibitors on the luminal microbiota in the gastrointestinal tract. Clin Trans Gastroenterol 2015; 6:e89.
Igarashi M, Nakae H, Matsuoka T, et al. Alterations in the gastric microbiota and its restoration by probiotics in patients with functional dyspepsia. BMJ Open Gastroenterol 2017; 4:e000144.
Gurusamy SR, Shah A, Talley NJ, et al. Small intestinal bacterial overgrowth in functional dyspepsia: a systematic review and meta-analysis. Am J Gastroenterol 2021; 116:935–942.
Tan VPY, Liu KSH, Lam FYF, et al. Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia. Aliment Pharmacol Ther 2017; 45:767–776.
Ohtsu T, Takagi A, Uemura N, et al. The ameliorating effect of Lactobacillus gasseri OLL2716 on functional dyspepsia in Helicobacter pylori-uninfected individuals: a randomized, controlled study. Digestion 2017; 96:92–102.
Lacy BE, Crowell MD, Cangemi D, et al. Diagnostic evaluation of gastric motor and sensory disorders. Am J Gastroenterol 2021; 116:2345–2356.
Lacy BE. Functional dyspepsia and gastroparesis: one disease or two? Am J Gastroenterol 2012; 107:1615–1620.
Cangemi DJ, Lacy BE. Functional dyspepsia and gastroparesis: different diseases or different ends of the spectrum? Curr Opin Gastroenterol 2020; 36:509–517.
Pasricha PJ, Grover M, Yates KP, et al. NIDDK/NIH GpCRC consortium. Functional dyspepsia and gastroparesis in tertiary care are interchangeable syndromes with common clinical and pathological features. Gastroenterology 2021; 160:2006–2017.
Calvert EL, Houghton LA, Cooper P, et al. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology 2002; 123:1778–1785.
Orive M, Barrio I, Orive VM, et al. A randomized controlled trial of a 10 week group psychotherapeutic treatment added to standard medical treatment in patients with functional dyspepsia. J Psychosomat Res 2015; 78:563–568.
Cangemi DJ, Montenegro M, Spiegel B, Lacy BE. Virtual reality improves symptoms of functional dyspepsia: preliminary analysis of a prospective study. Am J Gastroenterol 2021; 116:S232.
Pittayanon R, Yuan Y, Bollegala NP, et al. Prokinetics for functional dyspepsia: a systematic review and meta-analysis of randomized control trials. Am J Gastroenterol 2019; 114:233–243.
Ford AC, Moayyedi P, Black CJ, et al. Systematic review and network meta-analysis: efficacy of drugs for functional dyspepsia. Aliment Pharmacol Therapeutic 2021; 53:8–21.
Sandler RS, Stewart WF, Liberman JN, et al. Abdominal pain, bloating and diarrhea in the United States: prevalence and impact. Dig Dis Sci 2000; 45:1166–1171.
Drossman DA, Morris CB, Schneck S, et al. International survey of patients with IBS: symptom features and their severity, health status, treatments, and risk taking to achieve clinical benefit. J Clin Gastroenterol 2009; 43:541–550.
Lacy BE, Cangemi D, Vazquez-Roque M. Management of chronic abdominal distension and bloating. Clin Gastroenterol Hepatol 2021; 19:210–231.
Lacy BE, Cangemi DJ, Wise J, Crowell MD. Development and validation of a novel scoring system for bloating and distension: the Mayo bloating questionnaire. Neurogastroenterol Motil 2022; 24:e14330.
Uribarri J, Oh MS, Carroll HJ. D-lactic acidosis. A review of clinical presentation, biochemical features and pathophysiologic mechanisms. Medicine 1998; 77:73–82.
Ross AJ, Medow MS, Rowe PC, Stewart JM. What is brain fog? An evaluation of the symptom in postural tachycardia syndrome. Clin Auton Res 2013; 23:305–311.
Rao SC, Rehman A, Yu S, Martinez de Andino N. Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis. Clin Trans Gastroenterol 2018; 9:162.
Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology 2016; 150:1393–1407.
Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: management of irritable bowel syndrome. Am J Gastroenterol 2021; 116:17–44.
Nelson AD, Black CJ, Houghton LA, et al. Systematic review and network meta-analysis: efficacy of licensed drugs for abdominal bloating in irritable bowel syndrome with constipation. Aliment Pharmacol Ther 2021; 54:98–108.
van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 2013; 368:407–415.
Xu D, Chen VL, Steiner CA, et al. Efficacy of fecal microbiota transplantation in irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol 2019; 114:1043–1050.
Holvoet T, Joossens M, Vazquez-Castellanos JF, et al. Fecal microbiota transplantation reduces symptoms in some patients with irritable bowel syndrome with predominant abdominal bloating: short- and long-term results from a placebo-controlled randomized trial. Gastroenterology 2021; 160:145–157.