Functional dyspepsia and overlapping disorders of gut-brain interaction

Disorders of the gut-brain interaction (DGBI) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms without a structural or biochemical alteration causing them. Different disorders affect various regions of the digestive tract and can frequently occur in the same patient. The overlap of symptoms and evidence of common pathophysiological characteristics suggest that the various DGBI could be different presentations of the same disease. DGBI have a high prevalence in the population, and one-third of them present symptom overlap. Functional dyspepsia, which is highly prevalent, overlaps with gastroesophageal reflux disease, irritable bowel syndrome and chronic constipation. The overlap of these conditions leads to greater symptom severity, and there is a direct association between the number of functional disorders and increased somatization, poorer quality of life, and higher healthcare resource utilization. In patients with functional dyspepsia, a detailed medical history should be conducted to identify other possible DGBI indicating overlap. Additionally, it is important to assess the presence of psychological comorbidity, such as anxiety, depression, and somatization, as addressing them will always be relevant in the treatment of these patients. There is no systematic practice guideline for diagnostic studies in patients with overlap. The presence of multiple symptoms does not necessarily warrant additional studies. The overlap of DGBI represents a greater challenge in establishing a treatment plan.