Functional dyspepsia and mental health: a bidirectional relationship

Functional dyspepsia is one of the most prevalent disorders of gut-brain interaction, characterized by persistent upper gastrointestinal symptoms in the absence of structural abnormalities. There is robust evidence supporting the high comorbidity between functional dyspepsia and mental health disorders such as anxiety, depression, and somatization. These conditions directly influence symptom perception and chronicity through shared pathophysiological mechanisms, including visceral hypersensitivity, hypothalamic-pituitary-adrenal axis dysregulation, neuroinflammation, and altered brain connectivity. Chronic stress and central sensitization are major contributors to symptom amplification. Psychological therapies —including cognitive behavioral therapy, gut-directed hypnotherapy, and mindfulness-based approaches— have shown sustained efficacy in improving both digestive and emotional symptoms. Additionally, modulation of the gut-brain axis with psychobiotics is an emerging strategy supported by preclinical research and early clinical trials. This article reviews the common pathophysiology, clinical interactions, and the most effective therapeutic tools from a biopsychosocial and integrative approach, promoting patient-centered care based on the most current scientific evidence.