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FD – Functional Dyspepsia: Causes and Treatment
FD (Functional Dyspepsia) is a chronic stomach disorder causing symptoms like bloating, nausea, and upper abdominal pain without an identifiable organic cause.
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FD (Functional Dyspepsia) is a chronic stomach disorder causing symptoms like bloating, nausea, and upper abdominal pain without an identifiable organic cause.
What is FD (Functional Dyspepsia)?
FD stands for Functional Dyspepsia – a common functional gastrointestinal disorder in which patients experience recurring upper abdominal discomfort without any identifiable organic cause such as a peptic ulcer or inflammation. It is estimated to affect 10–30% of the global population and significantly impacts quality of life.
Causes
The exact causes of Functional Dyspepsia are not yet fully understood. Key contributing factors include:
- Impaired gastric motility: Delayed gastric emptying can cause bloating and nausea.
- Visceral hypersensitivity: Heightened sensitivity of the stomach nerves to normal stimuli.
- Helicobacter pylori infection: A bacterial infection detected in a subset of patients.
- Psychosocial factors: Stress, anxiety, and depression can trigger or worsen symptoms.
- Disrupted gut-brain axis: Altered communication between the gut and the brain plays a significant role.
Symptoms
Symptoms of Functional Dyspepsia vary and are classified into two main patterns:
Postprandial Distress Syndrome (PDS)
- Persistent fullness after eating
- Early satiation during meals
- Nausea and occasional vomiting
Epigastric Pain Syndrome (EPS)
- Pain or burning in the upper abdomen
- Symptoms not necessarily related to meals
Diagnosis
Functional Dyspepsia is diagnosed based on the Rome IV criteria, requiring symptoms present for at least three months with onset at least six months prior. Organic causes must be ruled out through:
- Upper endoscopy (esophagogastroduodenoscopy, EGD)
- Abdominal ultrasound
- Laboratory tests (e.g., Helicobacter pylori testing)
- Gastric emptying scintigraphy if indicated
Treatment
Because Functional Dyspepsia lacks a clear organic cause, treatment is individualized and symptom-focused:
General Measures
- Dietary adjustments: smaller, easily digestible meals and avoidance of trigger foods
- Stress reduction and relaxation techniques
- Regular physical activity
Pharmacological Therapy
- Prokinetics (e.g., metoclopramide): promote gastric emptying
- Proton pump inhibitors (PPIs): reduce gastric acid production
- H2 blockers: an alternative for acid reduction
- Helicobacter pylori eradication: recommended when infection is confirmed
- Low-dose antidepressants: used in refractory cases with a psychosomatic component
Psychotherapeutic Approaches
Cognitive behavioral therapy and psychosomatic support can be beneficial in persistent cases where psychosocial factors are involved.
References
- Stanghellini V. et al. – Gastroduodenal Disorders. Gastroenterology 2016; 150(6): 1380–1392. (Rome IV Criteria)
- World Gastroenterology Organisation (WGO) – Practice Guideline: Dyspepsia (2018). Available at: https://www.worldgastroenterology.org
- Moayyedi P. et al. – The Efficacy of Proton Pump Inhibitors in Nonulcer Dyspepsia. Gastroenterology 2004; 127(5): 1329–1337.
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