Current opinion: functional dyspepsia.
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 Nov 2024
01 Nov 2024
Historique:
medline:
3
10
2024
pubmed:
3
10
2024
entrez:
3
10
2024
Statut:
ppublish
Résumé
Functional dyspepsia is a common gastrointestinal disease that is under-recognized and under-diagnosed. It is a complex disorder of gut-brain interaction with no FDA-approved treatment options. The purpose of this review is to highlight updates in the proposed pathophysiology and present new data regarding potential therapies for functional dyspepsia. Alterations in the intestinal microbiome and integrity of the intestinal membrane may play a crucial role in the pathogenesis of functional dyspepsia. The low FODMAP diet, in addition to modulating the microbiome with antibiotics and probiotics, are targets for large future studies. Novel methods of delivery of gut-brain therapies have shown promising results, especially virtual reality. The pathophysiology and management of functional dyspepsia is complex and there is still much unknown; however, continued research is identifying new targets for treatment. New and more targeted treatment options provide clinicians a variety of tools to offer patients with functional dyspepsia.
Identifiants
pubmed: 39360697
doi: 10.1097/MOG.0000000000001045
pii: 00001574-202411000-00007
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
470-476Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation global study. Gastroenterology 2021; 160:99–114.
Arnaout AY, Alhejazi TJ, Nerabani Y, et al. PRIBS Study Team. The prevalence and risk factors of functional dyspepsia among adults in low and middle income countries: an international cross-sectional study. Medicine 2023; 102:40.
Stanghellini V, Chan FKL, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology 2016; 150:1380–1392.
Ford AC, Mahadeva S, Carbone MF, et al. Functional dyspepsia. Lancet 2020; 396:1689–1702.
Cangemi D, Stephens L, Lacy BE. Diagnosis of gastroparesis is common: a retrospective review of patients referred to a tertiary gastroenterology practice. Clin Gastroenterol Hepatol 2023; 21:2670–2672.
Leite GGS, Weitsman S, Parodi G, et al. Mapping the segmental microbiome in the human small bowel in comparison with stool: a REIMAGINE study. Dig Dis Sci 2020; 65:2595–2604.
Spichak S, Bastiaanssen TFS, Berding K, et al. Mining microbiobes for mental health: determining the role of microbial metabolic pathways in human brain health and disease. Neurosci Biobehav Rev 2021; 125:698–761.
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; 16:935–942.
Zhong L, Shanahan ER, Raj A, et al. Dyspepsia and the microbiome: time to focus on the small intestine. Gut 2017; 1:1168–1169.
Fukui A, Takagi T, Naito Y, et al. Higher levels of streptococcus in upper gastrointestinal mucosa associated with symptoms in patients with functional dyspepsia. Digestion 2020; 101:38–45.
Cervantes J, Michael M, Hong BY, et al. Investigation of oral, gastric, and duodenal microbiota in patients with upper gastrointestinal symptoms. J Invest Med 2021; 69:870–877.
Wauters L, Tito RY, Ceulmans M, et al. Duodenal dysbiosis and relation to the efficacy of proton pump inhibitors and functional dyspepsia. Int J Mol Sci 2021; 22:13609.
Wauters L, Burns G, Ceulemans M, et al. Duodenal inflammation: an emerging target for functional dyspepsia? Expert Opin Ther Targ 2020; 24:511–523.
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, Ford AC. Functional dyspepsia. N Engl J Med 2015; 373:1853–1863.
Pryor J, Burns GL, Duncanson K, et al. Functional dyspepsia and food: immune overlap with food sensitivity disorders. Curr Gastroenterol Rep 2020; 22:51.
Saito YA, Locke GR, Weaver AL, et al. Diet and functional gastrointestinal disorders: a population-based case-control study. Am J Gastroenterol 2005; 100:2743–2748.
Duncanson KR, Talley NJ, Walker MM, et al. Food and functional dyspepsia: a systematic review. J Hum Nutr Diet 2018; 31:390–407.
Popa SL, Dumitrascu DI, Pop C, et al. Exclusion diets in functional dyspepsia. Nutrients 2022; 14:2057.
Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: management of irritable bowel syndrome. Am J Gastroenterol 2021; 116:17–44.
Goyal O, Nohria S, Batta S, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet versus traditional dietary advice for functional dyspepsia: a randomized controlled trial. J Gastroenterol Hepatol 2021; 37:301–309.
Wauters L, Talley NJ, Walker MM, et al. Novel concepts in the pathophysiology and treatment of functional dyspepsia. Gut 2020; 69:591–600.
Zhang Q, Li G, Zhao W, et al. Efficacy of Bifidobacterium animalis subsp. lactis BL-99 in the treatment of functional dyspepsia: a randomized placebo-controlled clinical trial. Nat Commun 2024; 15:227.
Patch C, Pearce AJ, Cheng M, et al. Bacillus subtilis (BG01-4TM) improves self-reported symptoms for constipation, indigestion, and dyspepsia: a phase 1/2A randomized controlled trial. Nutrients 2023; 15:4490.
Majeed M, Nagabhushanam K, Paulose S, et al. The effects of Bacillus coagulans MTCC 5856 on functional gas and bloating in adults: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore) 2023; 102:e33109.
Lacy BE, Chase RC, Cangemi DJ. The treatment of functional dyspepsia: present and future. Expert Rev Gastroenterol Hepatol 2023; 17:9–20.
Shah A, Gurusamy SR, Hansen T, et al. Concomitant Irritable Bowel Syndrome Does Not Influence the Response to Antimicrobial Therapy in Patients with Functional Dyspepsia. Dig Dis Sci 2022; 67:2299–2309.
Tan VP, Liu KS, Lam FY, et al. Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia. Aliment Pharmacol Ther 2017; 45:767–776.
Qi Q, Wang N, Liu H, et al. Prokinetics for the treatment of functional dyspepsia: an updated systematic review and network meta-analysis. BMC Gastroenterol 2023; 23:370.
Carbone F, De Buysscher R, Van den Houte K, et al. Relationship between gastric emptying rate and simultaneously assessed symptoms in functional dyspepsia. Clin Gastroenterol Hepatol 2022; 20:e429–e437.
Carbone F, Vandenberghe A, Holvoet L, et al. A double-blind randomized, multicenter, placebo-controlled study of itopride in functional dyspepsia postprandial distress syndrome. Neurogastroenterol Motil 2022; 34:e14337.
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.
Kindt S, Tack J. Impaired gastric accommodation and its role in dyspepsia. Gut 2006; 55:1685–1691.
Tack J, Ly HG, Carbone F, et al. Efficacy of mirtazapine in patients with functional dyspepsia and weight loss. Clin Gastroenterol Hepatol 2016; 14:385.e4–392.e4.
Jamshidfar N, Hamdieh M, Eslami P, et al. Comparison of the potency of nortriptyline and mirtazapine on gastrointestinal symptoms, the level of anxiety and depression in patients with functional dyspepsia. Gastroenterol Hepatol Bed Bench 2023; 16:468–477.
Chen X, Chen X, Chen B, et al. Electroacupuncture enhances gastric accommodation via the autonomic and cytokine mechanisms in functional dyspepsia. Dig Dis Sci 2023; 68:98–105.
Rupp SK, Stengel A. Bi-directionality of the microbiota-gut-brain axis in patients with functional dyspepsia: relevance of psychotherapy and probiotics. Front Neurosci 2022; 16:844564.
Law M, Pickering I, Bartlett E, et al. Cognitive behavioural therapy-based interventions for gastroduodenal disorders of gut-brain interaction: A systematic review. J Psychosom Res 2023; 175:111516.
Cangemi D, Montenegro M, Spiegel BMR, et al. Virtual reality improves symptoms of functional dyspepsia: results of a randomized, double-blind, sham-controlled, pilot study. Am J Gastroenterol 2024; 119:210–213.
Lacy BE, Cangemi DJ, Spiegel BR. Virtual reality: a new treatment paradigm for disorders of gut-brain interaction. Gastroenterol Hepatol 2023; 19:86–94.
Kinsinger SW, Joyce C, Venu M, et al. Pilot study of a self-administered hypnosis intervention for functional dyspepsia. Dig Dis Sci 2022; 67:3017–3025.