Functional dyspepsia: an evolving multidimensional enigma
The second issue of Clínicas de Gastroenterología de México is entirely dedicated to a disorder as prevalent as it is complex: functional dyspepsia (FD). This issue offers a comprehensive review of its multiple dimensions, from pathophysiology to therapeutic management, consolidating an integrative and contemporary vision that redefines our understanding of this syndrome. It begins with […]
Functional dyspepsia, definition and epidemiology
Definition and diagnostic criteria In May 2016, the Rome Foundation (an international group of experts) published a supplement in the journal Gastroenterology dedicated to functional gastrointestinal disorders, which from that moment were redefined as disorders of gut-brain interaction. That supplement presented the latest update of the Rome criteria: the Rome IV criteria, which included eight […]
Pathophysiology of dyspepsia: an integrative view
Introduction: pathophysiological differences between functional dyspepsia subtypes The pathophysiology of functional dyspepsia (FD) is considered multifactorial, resulting in a heterogeneous disorder in which different underlying pathophysiological mechanisms are associated with different symptom profiles. The pathophysiology of FD (Fig. 1) includes gastric abnormalities, such as delayed gastric emptying, impaired fundic accommodation, hypersensitivity to gastric distension, and […]
Functional dyspepsia: a practical approach to diagnosis
Introduction The term “dyspepsia” derives from the Greek words δυς- (dys-) and πέψη (pepse), which translate as “difficult digestion”1. When referring to dyspepsia, it generally denotes pain of gastroduodenal origin that has certain characteristics, which are detailed throughout the chapter. The prevalence of dyspepsia varies according to country and the criteria used for its diagnosis; […]
The role of Helicobacter pylori in functional dyspepsia
Relationship between Helicobacter pylori infection and functional dyspepsia: current evidence Helicobacter pylori is a bacterium recognized as a Group 1 carcinogen. Infection by this microorganism is associated with common gastrointestinal diseases, such as chronic gastritis, acid-peptic disease, functional dyspepsia, and, more importantly, although less frequently, gastric cancer. It is a flagellated, Gram-negative bacillus with a […]
Dyspepsia or gastroparesis: different disorders or part of the same spectrum?
Introduction Functional dyspepsia (FD) and gastroparesis (Gp) represent a challenge for the gastroenterologist, as both are characterized by upper gastrointestinal symptoms such as epigastric pain, early satiety, and nausea; with the difference that FD is diagnosed by clinical criteria (after performing an upper gastrointestinal endoscopy), whereas Gp requires an objective measurement of gastric emptying (GE) […]
Functional dyspepsia and overlapping disorders of gut-brain interaction
Introduction Disorders of gut-brain interaction (DGBI), formerly known as functional gastrointestinal disorders, are highly prevalent in the general population. They are characterized by chronic gastrointestinal symptoms without an evident organic cause and reflect an alteration in bidirectional brain-gut communication1. Definition of functional dyspepsia The Rome IV Consensus defines functional dyspepsia (FD) as the presence of […]
Pharmacological treatment of functional dyspepsia: from A to Z
Introduction Dyspepsia is a symptom complex that presents with a wide variety of recurrent symptoms originating in the gastroduodenal area, caused by different pathophysiological mechanisms that may coexist in the same patient1. This translates clinically into heterogeneous groups of subjects who frequently present with other overlapping disorders of gut-brain interaction, thus requiring differentiated treatments. In […]
Dietary management and lifestyle changes in functional dyspepsia
Introduction Dietary modification and lifestyle changes play a fundamental role in the management of functional dyspepsia (FD) symptoms and may therefore be considered a first-line therapeutic option1. Several studies have indicated that certain foods are frequently recognized by patients as triggers of functional dyspepsia symptoms. Among the most commonly reported are dairy products, alcohol, coffee, […]
Functional dyspepsia and mental health: a bidirectional relationship
Introduction Functional dyspepsia (FD) is one of the most common disorders of gut-brain interaction, characterized by persistent symptoms such as postprandial fullness, early satiety, epigastric pain, and burning, in the absence of demonstrable structural lesions. Beyond its high prevalence, FD represents a clinical challenge due to its chronic course, its negative impact on quality of […]