Pharmacological treatment of functional dyspepsia: from A to Z

Functional dyspepsia (FD) is a condition characterized by recurrent upper gastrointestinal symptoms with no obvious organic cause. It frequently overlaps with other disorders of brain-gut interaction and affects the quality of life of those who suffer from it. It is a multifactorial and complex disease with multiple therapeutic targets. Several drugs can help to control symptoms and improve quality of life in this disorder, but adequate knowledge is required to optimize their use. The objective of this article is to present an updated review of the pharmacological treatment of FD. A PubMed search was conducted from January 2016 to May 2025, and all relevant publications were included, giving preference to consensus statements, guidelines, systematic reviews, and meta-analyses. It was supplemented with relevant articles from the archives of Revista de Gastroenterología de México in the same period. We present a critical review of the pharmacological treatment of FD, with an emphasis on locally acting medications, antisecretory and acid-lowering therapies, prokinetics, neuromodulators, antibiotics, probiotics, and phytopharmaceuticals. We conclude that FD is one of the most common digestive disorders, and believe that this critical and updated review of its pharmacological treatment for this disorder is applicable in daily practice.