Journal
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume 26, Issue -, Pages 32-34Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1440-1746.2011.06647.x
Keywords
functional dyspepsia; non-drug therapy; non-responder; pharmacological therapy; practical approach
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Background and aim: Functional dyspepsia (FD) represents one of the important GI disorders confronting clinicians worldwide including Thailand. FD is a clinical syndrome with various underlying pathophysiologies, and their treatment remains a major challenge. This article aims at the approach of FD and its management. Method: For current situation, optimal therapy includes non-drug therapy namely reassurance by ruling out relevant differential diagnoses, general advice with regard to the underlying causes, dietary measures, lifestyle modification, and good doctor-patient relationship. Removing precipitating causes, such as medications, food or psychological factors/stress contributing to symptoms, is mandatory. A wide variety of drug treatments have been used to manage FD including antisecretory agents, prokinetics and H.pylori eradication. Results: It is understandable that there is no ideal drug available. The overall gain over placebo ranges from less than 5% for H.pylori eradication to 15%-20% for antisecretory agents and prokinetics. Conclusion: Drug therapy includes acid inhibitory agents, prokinetics and H.pylori eradication are still the mainstay and should be adjusted accordingly on a case-by-case basis. In the future, it would be logical to develop multi-target therapies that simultaneously address various underlying mechanisms.
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